“…The regional ethical review board of Gothenburg, Sweden, approved the study (Dnr 284‐18), which adheres to the Declaration of Helsinki (24). The four principles of autonomy, beneficence, justice and nonmaleficence were adhered to in every step of the research process.…”
Section: Ethical Approvalmentioning
confidence: 99%
“…Semi-structured interviews were performed with openended questions such as 'Tell me what it's like to be in (17,23). Toys and images can lead to less unease in the research situation and reduce the power imbalance that may exist between researcher and participant (24). Therefore, some toys and craft materials were used during the interviews.…”
Background
Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children's fear and pain. More knowledge, from children’s own perspectives, is needed about how they deal with their experiences.
Aim
To explore child‐identified strategies that children use to manage fear and pain during needle‐related medical procedures in hospital.
Methods
Interviews with children, age 4–12 years, with experience of hospital care were analysed qualitatively using content analysis.
Results
Children have self‐identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed.
Conclusions
Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child's needs and ability to use their strategies due to lack of knowledge of the child’s chosen strategies.
“…The regional ethical review board of Gothenburg, Sweden, approved the study (Dnr 284‐18), which adheres to the Declaration of Helsinki (24). The four principles of autonomy, beneficence, justice and nonmaleficence were adhered to in every step of the research process.…”
Section: Ethical Approvalmentioning
confidence: 99%
“…Semi-structured interviews were performed with openended questions such as 'Tell me what it's like to be in (17,23). Toys and images can lead to less unease in the research situation and reduce the power imbalance that may exist between researcher and participant (24). Therefore, some toys and craft materials were used during the interviews.…”
Background
Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children's fear and pain. More knowledge, from children’s own perspectives, is needed about how they deal with their experiences.
Aim
To explore child‐identified strategies that children use to manage fear and pain during needle‐related medical procedures in hospital.
Methods
Interviews with children, age 4–12 years, with experience of hospital care were analysed qualitatively using content analysis.
Results
Children have self‐identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed.
Conclusions
Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child's needs and ability to use their strategies due to lack of knowledge of the child’s chosen strategies.
“…[9][10][11]20,21,24,30,33,35,[41][42][43]46,50,51,56,61,94,96,101,105,106,112,115,116,118,120,122,126,136 from the same spot every time. 21 10,11,20,21,23,24,39,41-43,47,49,52,58-61,97,105,115,116,119,120, 122,124,129,136,139,140 .…”
Effective communication is challenging in childhood cancer, where decisions carry unpredictable and life-threatening implications. We aimed to describe patients' experiences of communicating with clinicians during treatment of childhood cancer. A systematic review of qualitative studies to April 2019 was performed. Eligible studies included patients diagnosed with cancer at age ≤ 18 years and reported their perspectives of communicating with clinicians during treatment of childhood cancer. Data were extracted from primary studies for thematic synthesis. From 101 articles across 25 countries involving 1870 participants who were diagnosed with cancer between ages 3 to 18 years, we identified 6 themes: 1) rendered invisible and powerless (displaced and undermined by adult authority; betrayed and distrustful; feeling neglected; helpless and intimidated; disempowered by lack of information); 2) fear and worry for the future (paralyzed by devastating news; uncertainty, anticipation, and dread; broaching intimate and private topics); 3) burdened with responsibility (pressured and unprepared; balancing external expectations; protecting hope); 4) therapeutic patient-provider relationships (emotional support and encouragement; validated personhood and companionship); 5) safety in trust (truthfulness and transparency; prepared by awareness and understanding; reassured by reliable expertise; depending on adults for protection and difficult decisions; security in expressing opinions and needs); and 6) empowerment and assertive agency (right to individual knowledge and choice; control over own life; partnership and respect; enhancing capacity for self-management). During treatment of childhood cancer, patients gain a sense of respect, safety, and control when they feel clinicians address their information and developmental needs. However, communication that is perceived to be parent-centered can be disempowering. Promoting child agency and partnership may improve care and outcomes for children with cancer. Cancer 2020;126:701-716.
“…A 2019 study by Cardarelli et al asked students to take photographs which visualized contributors and consequences of respiratory disease in Appalachian communities [ 11 ]. Specifically, regarding cancer, photovoice projects have also been conducted to assess the experiences of young siblings of children diagnosed with cancer, as well as the perceptions of young cancer patients themselves [ 11 , 13 , 14 , 15 ]. Photovoice has also been used to engage youth in rural communities regarding increased obesity rates [ 16 ].…”
Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members—especially young people—can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, subthemes, and subtopics. The six themes that emerged were risk factors and exposures, marketing, awareness and support, health care, experiences, and metaphorical representations. Many of the submitted photographs aligned with cultural, environmental and/or situational factors prevalent in Appalachian Kentucky. Of the submitted photographs, 54 were displayed as an installment in two Kentucky art galleries. Viewer comments at the exhibitions demonstrated that young community members can educate and motivate change in those around them. Ultimately, this project demonstrates that young community members can recognize cancer-related issues around them and connect personal experiences back to the larger Appalachian Kentucky cancer disparity while also having an impact on other community members.
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