TY - JOUR
T1 - The influence of contextual factors on children's communication of pain during pediatric Haematopoietic Stem Cell Transplantation
T2 - A qualitative case study
AU - Plummer, Karin
AU - McCarthy, Maria
AU - Newall, Fiona
AU - Manias, Elizabeth
N1 - Funding Information:
The authors declare that Dr. Karin Plummer received PhD funding support of this study by The Australian Nurses Memorial Centre, The Australian Federation of Graduate Women's and The Windermere Foundation.The authors would like to gratefully acknowledge the PhD funding support of this study by The Australian Nurses Memorial Centre, The Australian Federation of Graduate Women's and The Windermere Foundation. The Pain in Child Health training consortium and Australian and New Zealand Children's Oncology Group are also recognized for their assistance with this study.
Funding Information:
The authors would like to gratefully acknowledge the PhD funding support of this study by The Australian Nurses Memorial Centre , The Australian Federation of Graduate Women's and The Windermere Foundation . The Pain in Child Health training consortium and Australian and New Zealand Children's Oncology Group are also recognized for their assistance with this study.
Funding Information:
The authors declare that Dr. Karin Plummer received PhD funding support of this study by The Australian Nurses Memorial Centre , The Australian Federation of Graduate Women's and The Windermere Foundation .
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Purpose: The aim of this study was to describe how contextual factors related to the clinical setting of a pediatric HSCT unit influenced children's communication of pain to their health-care providers and parents during hospitalization. Design and methods: A qualitative case study design was conducted in two-phases in a tertiary level pediatric HSCT unit. The Social Communication Model of Pain provided the conceptual framework for the study. In phase one participants were parents and phase two participants were health-care providers and children in a pediatric HSCT unit. Parents participated in semi-structured interviews at 30- and 90-days post-transplantation regarding their child's communication of pain. Naturalistic observations of children receiving clinical care were conducted and health-care providers participated in semi-structured interviews. Results: Children extensively denied pain to their parents and health-care providers. When children did communicate pain, they were motivated by a need to seek interventions for their pain. Children's willingness to communicate pain was influenced by the physiological impact of HSCT therapy, their previous experiences of pain, their relationship with parents and health-care providers and parents and an environment of fear and uncertainty. Conclusions: There is a pressing need for child-centric approaches to support children to communicate their pain experiences to overcome the limitations imposed by the complexity of their medical treatment and the clinical environment in which they receive healthcare. Practice implications: In the context of HSCT therapy children may not communicate pain until pain is severe, and no longer bearable, or outright deny the presence of pain.
AB - Purpose: The aim of this study was to describe how contextual factors related to the clinical setting of a pediatric HSCT unit influenced children's communication of pain to their health-care providers and parents during hospitalization. Design and methods: A qualitative case study design was conducted in two-phases in a tertiary level pediatric HSCT unit. The Social Communication Model of Pain provided the conceptual framework for the study. In phase one participants were parents and phase two participants were health-care providers and children in a pediatric HSCT unit. Parents participated in semi-structured interviews at 30- and 90-days post-transplantation regarding their child's communication of pain. Naturalistic observations of children receiving clinical care were conducted and health-care providers participated in semi-structured interviews. Results: Children extensively denied pain to their parents and health-care providers. When children did communicate pain, they were motivated by a need to seek interventions for their pain. Children's willingness to communicate pain was influenced by the physiological impact of HSCT therapy, their previous experiences of pain, their relationship with parents and health-care providers and parents and an environment of fear and uncertainty. Conclusions: There is a pressing need for child-centric approaches to support children to communicate their pain experiences to overcome the limitations imposed by the complexity of their medical treatment and the clinical environment in which they receive healthcare. Practice implications: In the context of HSCT therapy children may not communicate pain until pain is severe, and no longer bearable, or outright deny the presence of pain.
KW - Child
KW - Communication
KW - Haematopoietic stem cell transplant
KW - Health-care provider
KW - Nurses
KW - Pain
KW - Parent
KW - Qualitative
UR - http://www.scopus.com/inward/record.url?scp=85123350744&partnerID=8YFLogxK
U2 - 10.1016/j.pedn.2021.12.009
DO - 10.1016/j.pedn.2021.12.009
M3 - Article
C2 - 35086748
AN - SCOPUS:85123350744
SN - 0882-5963
VL - 64
SP - e119-e129
JO - Journal of Pediatric Nursing
JF - Journal of Pediatric Nursing
ER -