Caring in Pediatric Emergency Nursing

Article excerpt

An environment committed to providing family-centered care to children must be aware of the nurse caring behaviors important to parents of children. This descriptive study assessed the psychometrics of a revised version of the Caring Behaviors Assessment (CBA) and examined nurse caring behaviors identified as important to the parents of pediatric patients in a pediatric emergency department. Jean Watson's theory of human caring provided the study's theoretical underpinnings. The instrument psychometrics was determined through an index of content validity (CVI) and internal consistency reliability. The instrument was determined to be valid (CVI = 3.75) and reliable (Cronbach's alpha = .971). The revised instrument was completed by a stratified, systematic random sample of 300 parents of pediatric emergency patients. Participants rated the importance of each item for making the child feel cared for by nurses. Individual survey item means were computed. Items with the highest means represented the most important nurse caring behaviors. Leading nurse caring behaviors centered on carative factors of "human needs assistance" and "sensitivity to self and others." Nearly all nurse caring behaviors were important to the parents of pediatric patients, although some behaviors were not priority. It is important for nurses to provide family-centered care in a way that demonstrates nurse caring.

Keywords: theory of human caring; caring; pediatrics; emergency nursing; caring behaviors assessment

Emergency nurses are responsible for providing family-centered care in pediatric settings. The priorities of patient care are likely to be dependent on the findings identified during the nursing assessment and the treatment plan requested by emergency physicians and midlevel providers. The priorities of patient care may not reflect the wants and needs of the family unit, possibly leaving the family with a perception that nurses are uncaring. For example, Weman and Fagerberg (2006) reported that nurses preferred patients and families to choose patient care options from a list presented by the nurses. Nurses did not like patients or family members to identify care options that were not among those presented. This accentuates a potential disconnect between nurses and nurse caring.

The purpose of this study was to examine nurse caring behaviors identified as important to the parents of pediatric patients in a pediatric emergency department. This study will answer the following research questions: (a) What is the validity and reliability of the Caring Behaviors Assessment (CBA) instrument when adapted for use with parents of pediatric emergency patients? and (b) What nurse caring behaviors are most important to the parents of pediatric emergency patients?

An environment committed to providing family-centered care to children must be aware of the nurse caring behaviors important to the parents of children. An appropriate instrument must be identified that can be used to measure the priority nurse caring behaviors that parents desire for their children when receiving nursing care. The CBA (Cronin & Harrison, 1988) was developed to measure patient perceptions of nurse caring behaviors. The CBA was intended for use with adult patients; therefore, the CBA was adapted for use in this study. Validity and reliability testing need to be done before the revised instrument could be used to identify priority nurse caring behaviors in the pediatric emergency population.

The significance of this study in relation to human health and nursing is that identification of priority nurse caring behaviors may be used to develop and implement systems that will increase the demonstration of such nurse caring behaviors in the pediatric emergency setting. Nurses that routinely demonstrate the priority nurse caring behaviors may be perceived as more caring and, in turn, more readily foster a positive nurse-patient-family relationship. This study provided additional clarification to the priority of caring behaviors in the pediatric emergency setting by determining if a variance existed based on patient acuity level. …