Challenges perceived by pediatric intensive care unit nurses in caring for maltreated children and adolescents: A qualitative phenomenological study

Po-Lin Huang; Ching-Hsuan Lin; Wei-Chieh Tseng; Bih-Shya Gau

doi:10.1016/j.iccn.2024.103887

Challenges perceived by pediatric intensive care unit nurses in caring for maltreated children and adolescents: A qualitative phenomenological study

Intensive Crit Care Nurs. 2024 Nov 25:87:103887. doi: 10.1016/j.iccn.2024.103887. Online ahead of print.

Authors

Po-Lin Huang¹, Ching-Hsuan Lin², Wei-Chieh Tseng³, Bih-Shya Gau⁴

Affiliations

¹ Department of Nursing, National Taiwan University Hospital and Medical College, National Taiwan University, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100226, Taiwan, PR China.
² Department of Social Work, College of Social Science, National Taiwan University, No.1, Section 4, Roosevelt Rd, Daan Dist., Taipei City 106319, Taiwan, PR China.
³ Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100226, Taiwan, PR China.
⁴ Department of Nursing, National Taiwan University Hospital and Medical College, National Taiwan University, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100226, Taiwan, PR China; School of Nursing, College of Medicine, National Taiwan University, No. 1 Jen Ai road section 1, Taipei City 10051, Taiwan, PR China; Second Degree of Bachelor of Science in Nursing, College of Medicine, National Taiwan University, No. 1 Jen Ai road section 1, Taipei City 10051, Taiwan, PR China. Electronic address: bsgau@ntu.edu.tw.

PMID: 39591736
DOI: 10.1016/j.iccn.2024.103887

Abstract

Objectives: This study explores the challenges and experiences faced by paediatric intensive care unit (PICU) nurses while caring for maltreated paediatric patients.

Research methodology/design: A qualitative study was conducted using face-to-face semi-structured interviews from February to May 2022. The data were transcribed verbatim and a simple thematic analysis was used.

Setting: Twenty PICU nurses from National Taiwan University Children's Hospital were recruited through purposive and snowball sampling.

Findings: Ten sub-themes were identified and synthesised into three primary themes: 'unstable nurse-patient relationships', highlighting the tensions and communication challenges between nurses, and the families of maltreated children and adolescents; 'insufficient pertinent competencies in handling child maltreatment', pointing to nurses' lack of sensitivity, experience, and requisite skills for addressing child maltreatment; and 'challenges in multidisciplinary team collaboration', which underscores nurses' feelings of being overwhelmed and apprehensions regarding the continuity of care as various professional teams are involved.

Conclusion: PICU nurses face considerable stress while caring for maltreated children and adolescents. This can be attributed to unstable nurse-patient relationships, insufficient care-related competencies of nurses, and the complexities introduced by multidisciplinary team interventions. Therefore, priority actions include continuous in-service education, sharing pertinent professional experiences, enhancing nurses' sensitivity toward maltreatment, establishing standard operating procedures, and developing comprehensive case management systems and multidisciplinary expertise tailored to the needs of PICU nurses.

Implications for clinical practice: Understanding the stressors and challenges encountered by PICU nurses in caring for maltreated children and adolescents can guide the design and implementation of interventions by current hospital decision-making bodies or child protection medical centres to enhance the clinical working environment. These interventions can aim to bolster the competencies of nurses and promote joint efforts in delivering superior medical care.

Keywords: Challenges; Child maltreatment; Paediatric intensive care unit nurse; Phenomenology; Qualitative study.