The Practical Application and Evaluation of a Care Model for Informing and Reassuring Children Who Are to Undergo Medical Examinations and/or Procedures (Part 2)

The purpose of this study was to determine methods of relating to children and practical nursing techniques that best bring out the potential ability of children about to undergo a medical procedure (for example, venipuncture, or IV cannulation), using an original care model for providing pediatric patients with an appropriate explanation suited to their comprehension level. For six months, we enlisted the cooperation of seven pediatric wards in five hospitals in the Kanto and Kansai areas in applying the care model on a trial basis and evaluating its effect. The effectiveness of the care model was evaluated in monthly meetings held with nursing staff participating in the study (nurses who executed our Care Model). From nursing discussions of 82 cases in such meetings, four categories were extracted. This study presents second category that has eight subcategories. First, factors related to effectiveness of the care model formed five subcategories. Children performed best when: provided with an explanation; able to select treatment circumstances by themselves; explanations took the form of continuous predictions while procedures were performed, and every aspect of the procedure was timed optimally, using a distraction technique. Second, considerations not included in the care model formed three subcategories: negotiations with children; cooperation of the mother and family, and children were influenced by their first impressions of and relationships with health care providers. We found that nurses executed procedures while accumulating experience and could best bring out the potential of children while protecting patient dignity.