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  • 1.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    How do we best analyze the meaning of the child’s experience and not just the content?2011Conference paper (Other academic)
  • 2.
    Darcy, Laura
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Humanising Care for Sick Children in Hospital: – are we ready to meet the demands of The Convention on Human Rights of the Child (CHRC)?2018Conference paper (Refereed)
    Abstract [en]

    Background

    Nursing Care of children is complex and nurses need specific knowledge in meeting children to ensure high quality care. Caring for children based on their age, developmental stage and maturity can be a challenge for nurses and sets demands on care. When the CRC becomes law in Sweden 2020 children’s rights will be strengthened and we can expect repercussions in the quality of care delivered to children in need

     

    Aim

    The aim of this study was to investigate the degree to which nurses in paediatric hospital services work in compliance with the CRC.

     

    Method

    Nurses in paediatric services in Western Sweden answered a survey on if their work situation allowed them to give care to children in accordance with the CRC. Survey responses (n=69) were analysed with descriptive analysis. Personal interviews were performed with paediatric nurses (n=9) and analysed with a qualitative content analysis.

     

    Results

    Nurses working in paediatric services are well aware of children’s rights in health care and strive to meet children’s needs. However, a stressed working situation with lack of time and/or an environment that is not child friendly means that their caring is not always optimal. Children are not participatory to the degree nurses would wish then to be and the CRC stipulates they should.

     

    Conclusions

    Nurses working with children show competence in and knowledge of children’s needs. However thay are limited by their working environments. Clear guidelines and working tools such as time for reflection are suggestions of measures that need to be taken to ensure compliance with the upcoming demands of the CRC.

  • 3.
    Darcy, Laura
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Meeting young children’s needs in hospital, from a human rights perspective - sustainable caring practices2019Conference paper (Refereed)
  • 4.
    Darcy, Laura
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Enskär, Karin
    CHILD, Jönköping University.
    The use of restraint with young children during painful medical procedures2016In: Nordic Conference in Nursing Research 2016: Methods and Networks for the future, 2016Conference paper (Other academic)
    Abstract [en]

    Children’s need for support is tied to their experiences of fear during times of trauma and uncertainty. Two recent studies gave insight to the experiences of young children (3-7 years of age) undergoing painful medical procedures. Children and parents described trauma related to the suddenly changed caring role parents’ play: from caring parent to health care assistant. Parents helped restrain children and took part in painful and unpleasant procedures and treatments. Nurses described the use of restraint as sometimes necessary due to logistical constraints but also as supportive to the child. Lack of access to parents as protectors was experienced as traumatic by the child. The child felt ashamed, humiliated and powerless, having lost the right to control his/her own body.

    The aim of this paper is to review the use of restraint with young children during painful medical procedures

    From the young child’s perspective, restraint is never supportive. Children require a sense of security to overcome fear. When the child seeks security in an adult, the adult’s response becomes extremely important. Children need to guide and be guided by adults, until they think: “I can manage this”. Adequate support enables a caring situation characterised by mutual trust. Parents ought to be involved to help alleviate fear, but strategies for collaboration and role definition for parents and health care professionals need to be reassessed.

  • 5.
    darcy, laura
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Galvin, Kathleen
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Humanising children's suffering during medical procedures2017In: European Conference in Nursing  and Nursing Research 2017, 2017, Vol. 16, p. 32-, article id suppl1Conference paper (Other academic)
    Abstract [en]

    Humanising children’s suffering during medical procedures

    Laura Darcy, Katarina Karlsson, Kate Galvin

    Background: The views of children have historically been seen as unimportant – they have been viewed as unintelligent and unable to tell of their experiences or participate in care, resulting in dehumanisation. Recent research has given young vulnerable children a voice and highlighted the importance of caring humanly for sick children (Darcy, 2015 & Karlsson, 2015). A conceptual framework consisting of eight dimensions of humanisation has been proposed by Todres, Galvin and Holloway (2009)which can highlight the need for young children to be cared for as human beings: Insiderness, Agency, Uniqueness, Togetherness, Meaning – making, Personal journey, Sense of Place and Embodiment. The aim of this study is to demonstrate the value of a humanising theoretical framework in paediatric care illustrated by examples of young children’s suffering when undergoing medical procedures.

    Materials and Methods: In two separate Swedish studies 20 children (3-7 years of age) with a variety of diagnosis were interviewed about their experiences of everyday life with cancer or their experiences of undergoing painful medical procedures. Parents and nurses views were welcomed as complimentary to child data. Interviews had been analysed qualitatively by either content analyses or by phenomenological and life world herme­neutic approaches. In the present study, a secondary inductive qualitative content analysis of the results has been made based on the proposed dimensions of humanisation/dehumanistion.

    Results: The eight dimensional framework Illustrated several forms of dehumanisation: Objectification –children’s opinions and experiences are seldom requested; Passivity – the use of restraint still happens and negatively affects the child; Homogenisation – children are viewed as their diagnosis; Isolation – children sense separation from parents, siblings and friends; Loss of meaning –appropriate information and preparation for the child is lacking; Loss of personal journey - everyday life functioning is affected making it difficult to see meaning; Dislocation – a sense of homelessness  is experienced at home, at the hospital and at preschool/school; Reductionist view – medical procedures becomes the professional focus of care, not the child.

    Conclusion: Dehumanisation occurs when humanising dimensions are obscured to a significant degree. Children’s own voices in care and research are required to correct the present power imbalance. Children require assistance in making sense of healthcare situations through play and preparation. Access to family and friends, being treated with dignity and encouragement to participate in care, will encourage humanising the dehumanisation illustrated in this study.

    References:

    Darcy, L. (2015). The everyday life of young children through their cancer trajectory. Jönköping: School of Health Sciences.

    Karlsson, K. (2015). ”I´m afraid, I want my mommy”: Younger children´s, parents’ and nurses´ lived experiences of needle procedures in health care. Jönköping: Jönköping University, School of Health and Welfare

    Todres, L., Galvin, K. T., & Holloway, I. (2009). The humanization of healthcare: A value framework for qualitative research. International Journal of Qualitative Studies on Health and Well-being, 4(2), 68-77.

  • 6.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    Hur barn upplever och hanterar procedurrelaterade åtgärder i vården2012Conference paper (Other academic)
  • 7.
    Karlsson, Katarina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Jönköping University.
    "Jag är rädd, jag vill till mamma": Yngre barns, föräldrars och sjuksköterskors levda erfarenheter av nålprocedurer ivården2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of the thesis is to create knowledge about what it means for younger children toundergo needle-related medical procedures (NRMPs), and what caring support in relation to this meansbased on nurses’, parents’, and younger children's perspectives.

    Methods: The first and second papers used descriptive phenomenological analysis to describe themeanings of supporting younger children during NRMPs from the perspective of nurses (Ι) and parents(ΙΙ). The third and fourth papers used lifeworld hermeneutic analysis to explain and understand theconsequences related to NRMPs (ΙΙΙ) and support (ΙV) during these procedures from younger children’sperspectives. Data has been collected by participant observations and lifeworld interviews documented byvideo-recorded observations, field notes, and audio-recorded interviews. In total 60 people participated,fourteen nurses, twenty-five parents, and twenty-one children.

    Main results: The results show that an important consequence for children of procedures with needles isexperiences of fear. The child's fear affects how the child is able to manage the procedure and the supportthe child gets from adults is crucial to whether the child's fear increases or decreases.

    The support consists of giving support or receiving support. Parents support the child by safeguarding andprotecting the child during the needle-related procedure; they “keep the child under the protection of theirwings,” sometimes very close and sometimes a little further out under the wingtips. Nurses support thechild by starting from individual child’s experiences and needs; they "balance on a tightrope" in anunpredictable situation. In the meeting between the child, the parents, and the nurses, the adults areguided by the child in what forms of support are provided. This continues until the needle-related medicalprocedure is completed and the child can walk proud and strong from the procedure with a feeling that "Ican handle this.”

    Conclusions: Children’s need for support during needle-related medical procedures is primarily tied tochildren’s experiences of fear. For the child to experience a caring support, adults need to understandchildren’s experiences of fear as well as children’s need for support and what form the support shouldtake. A caring support develops dialectically between children and adults in a circular movement. In such adialectic, the child guides the adult and vice versa. That children have the capability of guiding adultsduring needle-related medical procedures shows that they are active and participating. Here it becomesclear that there is no objective location of the phenomenon of support. Support can therefore only bestudied as a lived experience of those who need it.

  • 8. Karlsson, Katarina
    Shared decision-making in a multicultural society: supporting children with cancer with symptom management: Medical procedures2019Conference paper (Refereed)
  • 9. Karlsson, Katarina
    The Children's Action-Reaction Assessment Tool (CARAT) as an observational tool for assessing pain management: An initial validation study with children undergoing needle procedures.2019In: 51 st congress of the international society of paediatrics oncolgy (SIOP), Wiley, 2019, Vol. 66Conference paper (Refereed)
  • 10.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    The support nurses give children during needle-related medical procedures2013Conference paper (Refereed)
  • 11. Karlsson, Katarina
    Yngre barns upplevelser och behov av stöd vid nålprocedurer2018Conference paper (Other academic)
  • 12. Karlsson, Katarina
    Är hälso- och sjukvård för barn redo för att möta barnkonventionen som lag?2019Conference paper (Other academic)
  • 13.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enskär, Karin
    Jönköping University.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7 Years)2016In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 6, p. 667-677Article in journal (Refereed)
    Abstract [en]

    Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.

    AIM:

    This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.

    METHOD:

    The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs.

    RESULTS:

    The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.

    CONCLUSIONS:

    The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.

  • 14.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Enskär, Karin
    Rydström, Ingela
    University of Borås, School of Health Science.
    Parents' perspectives on supporting children during needle-related medical procedures2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child’s horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child’s advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as ‘‘balancing on a tightrope’’ in an unpredictable situation.

  • 15.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enskär, Karin
    CHILD, Jönköping University.
    The use of restraint when undergoing medical procedures is never supportive from the child’s perspective2016In: Nordic Society of pediatric oncology nurses 2016, 2016Conference paper (Other academic)
    Abstract [en]

    During times of trauma and uncertainty such as when undergoing medical procedures, children’s need for support is tied to their experiences of fear. Two recent Swedish PhD dissertations gave insight to the experiences of young children (3-7 years of age) with cancer.

    The aim of this paper was to review the use of restraint with young children with cancer during painful medical procedures, as described in several recent Swedish studies.

    Results showed that children felt ashamed, humiliated and powerless, having lost the right to control his/her own body. Nurses described the use of restraint as sometimes necessary due to logistical constraints but also as supportive to children. Parents helped restrain children and took part in painful and unpleasant procedures and treatments.  Lack of access to parents as protectors was experienced as traumatic by the child.

    Restraint is never supportive from the young child’s perspective. Children require a sense of security to overcome fear. When the child seeks security in an adult, the adult’s response becomes extremely important. Children need to guide and be guided by adults, until they think: “I can manage this”. Adequate support enables a caring situation characterised by mutual trust. Parents ought to be involved to help alleviate fear, but strategies for collaboration and role definition for parents and health care professionals need to be reassessed.

  • 16.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Galvin, Kathleen
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care–a discussion paper.2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. 

    Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. 

    Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. 

    Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings.

  • 17.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Enskär, K
    Nurses' perspectives on supporting children during needle-related medical procedures.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents' ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as "balancing on a tightrope" in an unpredictable situation.

  • 18.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    Englund, Lotta
    Enskär, Karin
    Children`s experience of needle procedures2012Conference paper (Other academic)
  • 19.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Englund, Lotta
    Enskär, Karin
    The art of data collection: children´s experience of needle procedures2012Conference paper (Refereed)
  • 20.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enskär, Karin
    Jönköping University.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Consequences of Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3–7 Years)2015In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 2, p. 109-118Article in journal (Refereed)
    Abstract [en]

    Background Needle-related medical procedures (NRMPs) are often frightening and cause children anxiety and pain. Only a few studies have examined the perspectives of younger children. More knowledge is needed about younger children's experiences in caring situations such as NRMPs. Aim The aim of this study was to explain and understand the consequences related to NRMPs from younger children's perspectives. Methods Participant observations and interviews with younger children who had experienced NRMPs were analysed using a lifeworld hermeneutic approach. Results Experiencing fear is central for younger children during an NRMP and interpretation of its consequences formed the basis for the following themes: seeking security, realizing the adult's power, struggling for control, feeling ashamed, and surrendering. A comprehensive understanding is presented wherein younger children's experiences of NRMPs vary across time and space related to weakening and strengthening their feelings of fear. Conclusions Awareness is needed that adults' power becomes more obvious for children during an NRMP. Children's surrender does not necessarily imply acceptance of the procedure. Providing children with opportunities to control elements of the procedure creates a foundation for active participation, and vice versa.

  • 21.
    Kleye, Ida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    "This is the way i want it": Children's strategies for dealing with fear and pain during hospital care2019In: / [ed] Ida Kleye, 2019Conference paper (Refereed)
    Abstract [en]

    Introduction

    The aim of this study was to describe children's self-identified strategies for dealing with fear and pain during hospital care and treatment

  • 22.
    Lindberg, Elisabeth
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Exploring existential phenomena as dimensions for sustainable caring – Examples from four lifeworld research projects2019Conference paper (Refereed)
  • 23.
    Nyström, Maria
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    Palmér, Lina
    University of Borås, School of Health Science.
    Creativity in Reflective Lifeworld Research: Empirical examples2013Conference paper (Refereed)
  • 24.
    Palmér, Lina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    The lifeworld story as an opportunity to understand existential dimensions of importance for caring practice — from the perspective of children, new mothers and older people2019Conference paper (Refereed)
    Abstract [en]

    With a common ground in the epistemology of lifeworld phenomenological and hermeneutical approaches, we explored the possibility of understanding existential phenomena in different stages of human life, such as children’s illness and experience of medical procedures, childbirth and breastfeeding and old age. Through various forms of lifeworld theory-based data collection methods, examples of how lifeworld stories can emerge are presented. There is humbleness and an understanding that there may be more to be understood than what may be directly apparent in the story of a patient. This gives rise to the fact that analyses may sometimes need to be further developed with the aid of philosophical examination and interpretation, which open up opportunities to understand what is unspoken and hidden in stories. Such examination and interpretation also make it possible to deepen what is said. The philosophy of existence can help researchers get hold of what does not appear immediately and what is hinted at but not stated directly, and uncover hidden meanings in stories. Such in-depth understanding may have significance for developing caring practice by potentially bridging the dualistic view of human beings as body and soul. Through a lifeworld theory-based research approach, caring that takes into account existential dimensions in people's lives in relation to caring can be developed and stimulated.

1 - 24 of 24
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