title: The relationship of child acuity, maternal responses, nurse attitudes and contextual factors in the bone marrow transplant unit.
abstract: OBJECTIVE
  This study was designed to examine the relationships between maternal perceptions of an acutely ill child, nurse caregivers and contextual factors in a pediatric critical care unit.
  
  
  METHODS
  Subjects were mothers of 20 children who had had their first bone marrow transplant and the primary nurse of each child. The study was conducted on a bone marrow transplant unit. Variables included the acuity of the child, maternal satisfaction with nursing care, maternal vigilance as measured by the time spent at the child's bedside, nurses' attitudes toward family involvement with care, nursing experience and bone marrow transplant unit variables (census, unit acuity and staffing deficit).
  
  
  RESULTS
  Positive associations were observed between the child's acuity and maternal satisfaction with nursing care, and between maternal vigilance and staffing deficit. There was an inverse relationship between maternal vigilance and length of nursing experience of the primary nurse and between positive attitudes of nurses toward family participation and years of nursing experience.
  
  
  CONCLUSIONS
  These results show the complex nature of parental perceptions and involvement in the hospitalized child's care. They suggest that maternal attitudes about caregiving are associated with the child's acuity and that maternal vigilance is related to nursing and environmental factors, principally critical care experience of the primary nurse.
authors.affiliation: University Hospital, University of Minnesota, Minneapolis.
authors.forename: P S
authors.initials: PS
authors.lastname: Tomlinson
authors.forename: M
authors.initials: M
authors.lastname: Kirschbaum
authors.forename: B
authors.initials: B
authors.lastname: Tomczyk
authors.forename: J
authors.initials: J
authors.lastname: Peterson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016026:Bone Marrow Transplantation / Q000451:nursing* / Q000523:psychology; D002648:Child; D002654:Child Care; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006272:Health Facility Environment; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration / Q000592:standards*; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009732:Nursing Care / Q000523:psychology / Q000592:standards; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010358:Patient Participation; D017060:Patient Satisfaction; D011368:Professional-Family Relations; D011787:Quality of Health Care; D012720:Severity of Illness Index; D013997:Time Factors