The Knowledge, Attitude, and Practice of Nurses in the Implementation of Atraumatic Care in Hospitalized Children in Indonesia
(1) STIKES Telogorejo Semarang
(*) Corresponding Author
Abstract
Background: Children's main stresses during hospitalization are separation from family, trauma, pain, and the hospital environment itself, which is unfamiliar to them. Atraumatic care is therapeutic care provided through interventions that eliminate or reduce the psychological and physical distress experienced by children and families. The elements impacting nurses' abilities to provide atraumatic care in hospitals are based on person-centered perceptions, knowledge, beliefs, intentions, and attitudes for the outcomes of rational behavior in children with acute illness. Pediatric nurses must provide care on a foundation of atraumatic care.
Aim: This study was to explore nurses' knowledge, attitudes, and practices regarding atraumatic care for hospitalized children.
Method: The setting of this study is K.R.M.T. Wongsonegoro Regional General Hospital. This study used a cross-sectional and descriptive correlation method, and it observed how nurses implemented atraumatic care. The study sample consisted of 117 nurses, with 70 of them (45 in two pediatric wards and 25 in the PICU) observing their clinical practice. A 25 items Nurses' Practice Scale for Atraumatic Care was used to observe the behaviors of 45 nurses in pediatric wards and 25 nurses in the PICU at work.
Results: The post hoc test revealed that nurses in the ER (13.022.71) had significantly greater knowledge in providing atraumatic care. Post hoc comparisons using the Tukey HSD comparison test revealed that nurses in the pediatric ward (99.959.02) had a significantly better attitude toward providing atraumatic care than nurses in the PICU (89.618) and ER (95.948.91). Nurses who were single showed significantly higher attitudes than nurses who were married (z = 1.80, p = 0.04). The Mann-Whitney Test showed that nurses who were working in the pediatric wards (z = -2.80, p = 0.021), female (z = -4.62, p<0.001), and married (z = -2.27, p = 0.02) had significantly practice scores in providing atraumatic care than those who were working in the PICU, male, and single. The Spearman Rank Correlation analysis revealed significant correlations (p-value<0.005) that the more the nurse's knowledge in providing atraumatic care to hospitalized children, the better attitude in providing atraumatic care to hospitalized children, and the more practice in providing atraumatic care.
Conclusion: As a result, in order to offer optimal care to hospitalized children, the hospital must provide atraumatic care training for nurses as well as standard operational processes that can assist nurses in implementing atraumatic care and minimizing the impact on hospitalized children.
Keywords
References
Karbandi S, Soltanifar A, Salari M, Asgharinekah SM, Izie E. Effect of music therapy and distraction cards on anxiety among hospitalized children with chronic Diseases. Evid Based Care. 2020.
Wong, D. (2016). Wong’s Essentials of Pediatric Nursing (Tenth Edition ed.). Elsevier.
Dinkes. (2019). Profil Jateng tahun 2019.
Lulgjuraj D, Maneval RE. Unaccompanied hospitalized children: an integrative review. J Pediatr Nurs. 2020.
Lerwick JL. Minimizing pediatric healthcare-induced anxiety and trauma. World J Clin Pediatr. (2016) 8 5:143–50. doi: 10.5409/wjcp.v5. i2.143
Fernandes SC, Arriaga P. The effects of clown intervention on worries and emotional responses in children undergoing surgery. J Health Psychol 2010.
Schlegelmilch M, Punja S, Jou H, Mackie AS, Conway J, Wilson B, et al. Observational Study of Pediatric Inpatient Pain, Nausea/Vomiting and Anxiety. Children (Basel). 2019 May 3;6(5):65. DOI: 10.3390%2Fchildren6050065
Gomes GL, Fernandes MD, Nóbrega MM. Hospitalization anxiety in children: conceptual analysis. Rev Bras Enferm. 2016 Sep-Oct;69(5):940-945. Portuguese, English. DOI: 10.1590/0034-7167-2015-0116
Favara-Scacco C, Smirne G, Schiliro G, Di Cataldo A. Art therapy as support for children with leukemia during painful procedures. Med and Ped Oncol. (2001) 36:474–80. doi: 10.1002/mpo.1112
Hart D, Bossert E. Self-reported fears of hospitalized school-aged children. J Ped Nurs. (1994) 9:83–90.
Stephens BK, Barkey ME, Hall HR. Techniques to comfort children during stressful procedures. Accid. Emerg. Nurs. (1999) 7:226–36. doi: 10.1016/S0965-2302(99)80055-1
KEMENKES. (2020). Profil Kesehatan Indonesia Tahun 2020.
Barkmann C, Siem A, Wessolowski N, Schulte-Markwort M. Clowning as a supportive measure in pediatrics—a survey of clowns, parents and nursing staf. BMC Pediatr. 2013.
Meiri N, Ankri A, Ziadan F, Nahmias I, Konopnicki M, Schnapp Z, et al. Assistance of medical clowns improves the physical examinations of children aged 2–6 years. Isr Med Assoc J. 2017.
Meiri N, Ankri A, Hamad-Saied M, Konopnicki M, Pillar G. The efect of medical clowning on reducing pain, crying, and anxiety in children aged 2–10 years old undergoing venous blood drawing—a randomized controlled study. Eur J Pediatr. 2016.
Mahato, P., Shrestha, R., Karn, B. K., Chaudhary, A. K., & Singh, R. (2022). Knowledge and Attitude of Nurses on Implementation of Atraumatic Care among Hospitalized Children in Eastern Nepal: A Cross-sectional Study. Journal of Nepal Paediatric Society, 42(3), 24-28. https://doi.org/10.3126/jnps.v42i3.46172
Kirkby RJ, Whelan TA. The effects of hospitalisation and medical procedures on children and their families. J Fam Stud. 1996 Apr 1;2(1):65-77. DOI: 10.5172/jfs.2.1.65
Bonn M. The effects of hospitalisation on children: a review. Curationis. 1994 Jun;17(2):20-4. DOI: 10.4102/curationis.v17i2.1384
Mediani, H. S. (2019). Knowledge attitude of nurses in the implementation of atraumatic care in Indonesia. https://doi.org/10.9790/1959- 0801075156
Huff, L., Hamlin, A., Wolski, D., McClure, T., Eliades, A. B., Weaver, L., & Shelestak, D. (2009). Atraumatic care: EMLA cream and application of heat to facilitate peripheral venous cannulation in children. Issues in Comprehensive Pediatric Nursing, 32(2), 65-76. https://doi.org/10.1080/01460860902737418
Paliadelis, P., Cruickshank, M., Wainohu, D., Winskill, R., & Stevens, H. (2005). Implementing family-centred care: an exploration of the beliefs and practices of paediatric nurses. The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation, 23(1). https://search.ebscohost.com/login.aspx?direct=t rue&db=mnh&AN=16496815&site=ehost-live
Barrere C, Durkin A. Finding the right words: the experience of new nurses after ELNEC education integration into a BSN curriculum. Medsurg Nurs. 2014 Jan-Feb;23(1):35-43, 53. PMID: 24707667.
Olausson S, Ekebergh M, Osterberg SA. Nurses’ lived experiences of intensive care unit bed spaces as a place of care: a phenomenological study. Nurs Crit Care. 2014 May;19(3):126-34. DOI: 10.1111/nicc.12082
Twamley, K., Craig, F., Kelly, P., Hollowell, D. R., Mendoza, P., & Bluebond-Langner, M. (2014). Underlying barriers to referral to paediatric palliative care services: knowledge and attitudes of health care professionals in a paediatric tertiary care centre in the United Kingdom. J Child Health Care, 18(1), 19-30. https://doi.org/10.1177/1367493512468363
Achora, S., & Labrague, L. J. (2019). An Integrative Review on Knowledge and Attitudes of Nurses Toward Palliative Care: Implications for Practice. J Hosp Palliat Nurs, 21(1), 29-37. https://doi.org/10.1097/NJH.0000000000000481
Rehn, M., Chew, M. S., Olkkola, K. T., Sverrison, K. Ö., Yli-Hankala, A., & Møller, M. H. (2019). Clinical practice guideline on atraumatic (pencil-point) vs conventional needles for lumbar puncture: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine. Acta anaesthesiologica Scandinavica, 63(4), 438-439. https://doi.org/10.1111/aas.13312
Biresaw, H., Asfaw, N., & Zewdu, F. (2020). Knowledge and attitude of nurses towards patient safety and its associated factors. International Journal of Africa Nursing Sciences, 13. https://doi.org/10.1016/j.ijans.2020.100229
Shilpashree, K. B., Chaithra, V., Bhat, A., & Krishnamurthy, A. (2021). Survival Rate and Cost-Effectiveness of Conventional and Atraumatic Restorative Treatment Restorations among Anganwadi Preschool Children in Bengaluru City: A Follow-up Study. Indian Journal of Community Medicine, 46(2), 226-231. https://doi.org/10.4103/ijcm.IJCM_226_20
Wang, Y., & Lo, L. (2006). Therapeutic play. Journal of Nursing, 53(3), 79-83. https://search.ebscohost.com/login.aspx?direct=t rue&db=ccm&AN=106202771&site=ehost-live
Crabel, J., Martha, K., Highfield, F., & Patmon, F. (2021). Evidence-based Practice Knowledge, Attitudes, Practices, and Barriers. 10.1097/01.NURSE.0000754000.05371.
Article Metrics
Abstract view : 48 timesDOI: https://doi.org/10.26714/seanr.6.3.2024.%25p
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 Nafisatun Nisa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Universitas Muhammadiyah Semarang
Kedungmundu Raya Street No. 18 Semarang, NRC Building Universitas Muhammadiyah Semarang
Phone: 02476740287
Fax: 02476740287
Email: [email protected]