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Information exchange in paediatric care
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
2009 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Även barnet har rätt att få veta! (Swedish)
Abstract [en]

Information exchange is an essential component for all involved in the paediatric care encounter. Despite this, most of the research about information exchange concerns adults and the significance of the child’s existence in the encounter have not been given sufficient attention. Therefore, the overall aims of this thesis were twofold. Firstly, the aim was to identify, describe and generate concepts in information exchange between minors, parents/guardians and health care professionals in paediatric care situations. Secondly, the intention was to formulate a theoretical construction, a theory, of the phenomenon of information exchange in paediatric care situations.

This thesis is based on four studies. In studies I, II and III grounded theory was used according to Glaser and data have been analyzed using the constant comparative analysis method. Data have been collected through observations and medical records (I, II and III) and also with additional follow-up interviews (III). In study IV, at first a qualitative content analysis of Løgstrup’s ethical demand was conducted and, second, a simultaneous concept analysis of the findings from studies I, II and III and the findings from the qualitative content analysis was carried out. There were a total of 67 participants in the three observational studies: 28 minors (I), 24 parents/guardians (II) and 15 health care professionals (III), who exchanged information in different paediatric care encounters.

The information exchange interaction process was resolved by the minors “balancing the circumstances” (I), the parents/guardians used “firm handling” (II) and the health care professionals were “sharing and contributing the responsibility” (III). The qualitative content analysis of Løgstrup’s ethical demand provided the mediation and the social norms. The simultaneous concept analysis finally gave the advanced outcome to intergrade, which means to merge gradually with another through a continuous series of intermediates. At the same time as we intergrade in paediatric care, we protect the totality of minors, recognize the dependency of the parents/guardians and the social interplay by the health care professionals, the information exchange is improved. This thesis emphasizes the importance of health care professionals’ communication skills and the need for education and practice in this topic, in order to improve the information exchange with minors and their parents/guardians from an ethical viewpoint. The theory intergrade explains how this could be applied and implemented.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2009. , 58 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1106
Keyword [en]
Ethical demand, Grounded theory, Information exchange, Paediatric care, Qualitative content analysis, Simultaneous concept analysis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-18007ISBN: 978-91-7393-681-1 (print)OAI: oai:DiVA.org:liu-18007DiVA: diva2:213972
Public defence
2009-05-15, Aulan, Länssjukhuset Ryhov, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved
List of papers
1. Information exchange in paediatric settings: an observational study
Open this publication in new window or tab >>Information exchange in paediatric settings: an observational study
2007 (English)In: Paediatric nursing, ISSN 0962-9513, Vol. 19, no 7, 40-43 p.Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this observational study was to identify, describe and generate concepts regarding the exchange of information between children/young people and healthcare professionals in paediatric outpatient settings.

METHOD: The grounded theory methodology was used. Field notes from observations and excerpts from medical records were analysed using constant comparative analysis. Twenty eight children and young people were observed in three separate paediatric outpatient units; 76 observations were conducted of interactions between children/young people, parents and staff (paediatric nurses, paediatric enrolled nurses and paediatricians).

FINDINGS: 'Balancing the circumstances' was identified as the core category during information exchange, based on six categories: taking part, trust, being in touch, mutuality, getting facts and family influence. The six categories relate to one another and balance the circumstances in the information exchange to varying degrees. These children and young people seemed to be trying to enhance their situation as much as possible by finding out as much as they were able to, sharing their own knowledge with the staff and participating in social interaction with them.

CONCLUSION: With this understanding of information exchange, nurses can enable and support children and young people to balance their circumstances and improve information exchanges, thereby promoting their partnership in care.

Keyword
Children: Hospitalised, Communication, Interpersonal relations
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18000 (URN)17926774 (PubMedID)
Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved
2. Firm handling the information exchange interaction by parents/guardians in paediatric care: An observational study
Open this publication in new window or tab >>Firm handling the information exchange interaction by parents/guardians in paediatric care: An observational study
(English)Manuscript (Other academic)
Abstract [en]

Background. Health care professionals need further background knowledge to encounter the parents/guardians from their perspective in their minors’ health care. The parents/guardians possibility to manage the situations is dependent on their receiving optimal information, which is why it is important to study how information is exchanged.

Objective. To identify, describe and conceptualize how parents/guardians resolved their main concern in information exchange with health care professionals in paediatric care situations involving their minors.

Methods. The grounded theory method was used and all data were analysed using constant comparative analysis. The observational study took place at three paediatric outpatient units at a university hospital and twenty four parents/guardians participated. Data sources were field notes from 37 observations of paediatric care situations and adherent excerpts from the minors’ medical records.

Results. Firm handling revealed as the way the parents/guardians resolved their main concerns when they were exchanging information in their minors’ paediatric care. Firm handling is built on five inter-related categories: representative advocating, collaborating, aim sharing, supportive resourcing and minor bypassing.

Conclusions. This knowledge renders possibilities to the health care professionals to design paediatric care that supports, facilitates, strengthens and improves the parents’/guardians’ firm handling. The key issue is to find ways to support parents/guardians and minors so they can participate in health care encounters according to their preferences. Firm handling give an opportunity to both reinforce parenthood in paediatric care and invite minors to participate.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18003 (URN)
Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved
3. Observations of health care professionals sharing and contributing responsibility in paediatric caring situations
Open this publication in new window or tab >>Observations of health care professionals sharing and contributing responsibility in paediatric caring situations
2009 (English)In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 15, no 3, 185-190 p.Article in journal (Refereed) Published
Abstract [en]

This study aimed to identify, describe and generate concepts regarding health care professionals’ information exchanges with minors and/or their parents/guardians in paediatric caring situations. The study took place at three paediatric outpatient units at a university hospital and there were 15 health care professionals involved. Using the grounded theory and the constant comparative analysis methods, the data collection and analysis was undertaken simultaneously, using participant observation, review of medical records and follow-up interviews. The main concern of the health care professionals that emerged as the core category was: sharing and contributing responsibility, interrelated with the six categories; interchanging of knowledge, relationship-creating chat, calculated confirming, encouraging, dichotomous talking and of situation related effects. This research has explored the elements of information exchange in caring situations and highlighted the interaction between the involved persons. These findings could be valuable to health care professionals in order to develop and improve their caring skills.

Keyword
Caring situation, grounded theory, health care professional, information exchange, observation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18005 (URN)10.1111/j.1440-172X.2009.01743.x (DOI)
Note
This is the Authors’ version of the following article: Eva Mårtenson, Astrid Fägerskiöld and Carina Berterö, Observations of health care professionals sharing and contributing responsibility in paediatric caring situations, 2009, International Journal of Nursing Practice, (15), 3, 185-190. which has been published in final form at: http://dx.doi.org/10.1111/j.1440-172X.2009.01743.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/ Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved
4. The Ethical Demand in Nursing A Scandinavian Perspective
Open this publication in new window or tab >>The Ethical Demand in Nursing A Scandinavian Perspective
2009 (English)In: Nursing Science Quarterly, ISSN 0894-3184, E-ISSN 1552-7409, Vol. 22, no 3, 281-288 p.Article in journal (Refereed) Published
Abstract [en]

In this column the authors discuss the ethics of information exchange in nursing practice with children. Five concepts identified in three Swedish grounded theory studies and a content analysis that used the theoretical framework of ethical demand were analyzed. A simultaneous concept analysis found five related concepts: being interconnected, acting according to accepted procedure, completeness, interdependence, and social intercourse. These concepts are synthesized in the concept of intergrade, which emphasizes the value of maintaining the integrity of all involved in information exchange.

Keyword
ethical demand; information exchange; nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20215 (URN)10.1177/0894318409338681 (DOI)
Note
Original Publication: Eva K Mårtensson, Astrid Fägerskiöld, Ingrid V Runeson and Carina Berterö, The Ethical Demand in Nursing A Scandinavian Perspective, 2009, NURSING SCIENCE QUARTERLY, (22), 3, 281-288. http://dx.doi.org/10.1177/0894318409338681 Copyright: SAGE Publications (UK and US) http://www.uk.sagepub.com/ Available from: 2009-09-02 Created: 2009-08-31 Last updated: 2013-09-12

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