title: Nurses' perspectives on supporting children during needle-related medical procedures.
abstract: Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents' ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as "balancing on a tightrope" in an unpredictable situation.
authors.affiliation: School of Health Sciences, University of Borås, Borås, Sweden; Department of Nursing Sciences, CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden; katarina.karlsson@hb.se.
authors.forename: Katarina
authors.initials: K
authors.lastname: Karlsson
authors.affiliation: School of Health Sciences, University of Borås, Borås, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Rydström
authors.affiliation: Department of Nursing Sciences, CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Enskär
authors.affiliation: School of Health Sciences, University of Borås, Borås, Sweden.
authors.forename: Ann-Charlotte Dalheim
authors.initials: AC
authors.lastname: Englund
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002651:Child Advocacy / Q000523:psychology*; D002675:Child, Preschool; D003142:Communication; D004645:Empathy / Q000502:physiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D009339:Needles; D009723:Nurse-Patient Relations; D010371:Pediatric Nursing / Q000379:methods*
keywords: Lived experience; caring science; phenomenology; reflective lifeworld research; younger children