How nurses use reassurance to support the management of acute and chronic pain in children and young people: An exploratory, interpretative qualitative study

Abstract

Reassurance in the context of pediatric pain is regarded to promote distress. Typically, spoken reassurance is reported as short, generic statements (“it's ok,” “don't worry”); little research has considered wider reassuring behaviors and actions undertaken by nurses. Most studies focus on unidirectional, dyadic relationships between reassurance and pain (parent‐to‐child, professional‐to‐child) failing to capture the inherent complexities. Adopting an exploratory, interpretative, and qualitative approach, this paper reports on findings from the qualitative interview component of a mixed‐methods study, concerning how nurses actively use reassurance when talking to children and their parents about pain. Eighteen nurses with experience of managing children's pain were recruited on completion of an international online survey (distributed by pain and children's nursing networks and via newsletter, email, and social media). All 18 nurses completed a semi‐structured interview concerning their experiences of managing children's pain working in the UK (n = 14), Canada (n = 3), and Australia (n = 1) in primary, secondary, and tertiary settings with nursing experience ranging from pre‐qualification to >20 years. Thematic analysis generated three themes which reflect the main ways in which nurses focus their reassurance within encounters with children and their parent(s): (a) on child and parent(s), (b) on the child, and (c) on the parent. Nurses generated reassurance using language, gesture, relationship building, individualizing approaches, education, and preparation. The study highlights the diversity of reassurance provided by nurses in relation to children's pain. Our study finds that when nurses reassure children about pain, they focus their reassurance in three distinct directions (child, parents, and children and parents in partnership); this has not been specifically acknowledged by previous research. We highlight the wide range of implicit and explicit reassurance actions undertaken by nurses and propose that reassurance that extends beyond limited vocalizations is part of a complex package of care that can support children's current and future pain experiences.

Barriers to nurses’ therapeutic communication practices in a district hospital in Ghana

“…The current study further revealed the impact of positive reassurance on nurse-patient relationships and the need to avoid giving false hopes. This finding is consistent with findings from another study that showed that nurses used language, gestures, education, and relationship-building to reassure patients [ 39 ]. Another study also revealed the need for nurses to remain calm when their patients are angry [ 40 ].…”

Parents’/caregivers’ fears and concerns about their child’s epilepsy: A scoping review

“…Such different, albeit overlapping, agendas can result in parents/caregivers not receiving answers to questions they may find difficult to frame and clinicians missing opportunities to provide information about issues they do not appreciate are of concern to parents/caregivers. As seen in other studies, clinicians may offer reassurance to parents that does not meet their needs and lacks meaning [ 79 ]. The review highlighted that many parents/caregivers may benefit from psychological support to help them manage fears and the impact of these fears (threat).…”

“…The discussion of the findings of the review within the three affect systems of the CFT model [ 57 , 58 ] has the potential to help HCPs/clinicians understand, acknowledge and actively address and validate the fears and concerns of parents/caregivers of children with epilepsy and could help frame clinical consultations to address parental/caregiving fears and concerns. The provision of appropriate information, knowledge, meaningful clinical reassurance [ 79 ] and peer support may contribute to parents experiencing a greater sense of security (soothe) about managing daily life and the challenges of caring for their child with epilepsy.…”

“Pain talk”: A triadic collaboration in which nurses promote opportunities for engaging children and their parents about managing children’s pain

“…This paper reports on analyses of nurses’ responses to pediatric pain vignettes and questions about their confidence which formed Phase 1 of a mixed‐methods study to explore nurses’ “pain talk” with regard to managing children's pain. Findings from Phase 2 (qualitative interviews with a smaller sample of nurses) focus on the role of reassurance in “pain talk” 16 …”

“…Findings from Phase 2 (qualitative interviews with a smaller sample of nurses) focus on the role of reassurance in “pain talk”. 16 …”