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  • 1.
    Mattsson, Janet Yvonne
    et al.
    Karolinska Institutet, Sweden.
    Arman, Maria
    Karolinska Institutet, Sweden.
    Castren, Maaret
    Karolinska Institutet, Sweden.
    Forsner, Maria
    Högskolan Dalarna, Omvårdnad.
    Meaning of caring in pediatric intensive care unit from the perspective of parents: A qualitative study2014In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 18, no 4, p. 336-345Article in journal (Refereed)
    Abstract [en]

    When children are critically ill, parents still strive to be present and participate in the care of their child. Pediatric intensive care differs from other realms of pediatric care as the nature of care is technically advanced and rather obstructing than encouraging parental involvement or closeness, either physically or emotionally, with the critically ill child. The aim of this study was to elucidate the meaning of caring in the pediatric intensive care unit from the perspective of parents. The design of this study followed Benner's interpretive phenomenological method. Eleven parents of seven children participated in observations and interviews. The following aspects of caring were illustrated in the themes arising from the findings: being a bridge to the child on the edge, building a sheltered atmosphere, meeting the child's needs, and adapting the environment for family life. The overall impression is that the phenomenon of caring is experienced exclusively when it is directed toward the exposed child. The conclusion drawn is that caring is present when providing expert physical care combined with fulfilling emotional needs and supporting continuing daily parental care for the child in an inviting environment.

  • 2.
    Mattsson, Janet Yvonne
    et al.
    Department of Clinical Science and Education, Karolinska Institute.
    Forsner, Maria
    Högskolan Dalarna, Omvårdnad.
    Arman, Maria
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute.
    Uncovering pain in critically ill non-verbal children: Nurses' clinical experiences in the paediatric intensive care unit2011In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, no 3, p. 187-198Article in journal (Refereed)
    Abstract [en]

    Critically ill paediatric patients are frequently exposed to pain that is required to be assessed and treated effectively. The most reliable resource for assessing pain is the child itself, but children in the paediatric intensive care unit (PICU) are commonly unable to communicate their needs, requiring professional caregivers to uncover and interpret pain. However, nurses and paediatricians do not have sufficient knowledge of how critical illness affects childrens' signs of pain. The aim of this study was to illuminate clinical experiences of pain in the PICU; describing nurses' perceptions of expressions of pain in non-verbal, critically ill 2-6 year old children. The participants were 17 experienced PICU nurses. Data were analysed according to the phenomenographic method and three qualitatively different main categories, gained from clinical experience, emerged: changes in the measurable parameters; perceived muscular tension; and, altered behaviour. Furthermore, contrasting the categories revealed two diverse perspectives to focus pain: measure-oriented and patient-oriented. Subtle expressions of pain were recognised when focus was patient-oriented. These findings support the necessity of actively looking for pain deriving from various perspectives and considering diverse caring needs when doing so. Acknowledging pain makes pain visible.

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