Aims and objectives To explore parental involvement in the child's acute pain care and establish ways in which parental preferences for involvement in their child's care can be identified, facilitated and enhanced by nurses. Background Despite growing evidence supporting effective acute pain management in children and the availability of national and international practice guidelines, children still experience acute pain. Involving parents in their child's pain care has been identified as being a central tenet of pain management in children. Design and methods A qualitative study using an ethnographical approach with nonparticipant observation and follow‐up semi‐structured interviews was undertaken. Nurses (n = 14), parents (n = 41), grandparents (n = 2), other relative (n = 1) and children (n = 30) participated. The framework approach underpinned data analysis. Consolidated criteria for reporting qualitative research (COREQ) enabled comprehensive reporting of the study. Results Three concepts emerged from the data: “parents as advocates for their child,” “nurses promoting involvement and partnership” and “nurses unintentionally preventing involvement and partnership.” Variations in the way parents were involved in their child's pain care were identified. Despite family‐centred care being the dominant model of involving families in their child's care, evidence of this being implemented was limited. Parents attempted to advocate effective pain care for their child, whether or not they were supported by nurses. Conclusions Parental involvement in their child's acute pain care can improve the child's pain experience, reduce parental anxiety and increase parents’ satisfaction in care. Nurses aspired to involve parents in pain care, but did not always enact this in practice. Relevance for practice Children deserve optimum pain care, which includes parental involvement. Parental involvement underpinned by the principles of family‐centred care was poorly implemented. Parents attempted to be involved and advocate for their child's pain care whether or not they were supported by nurses. An alternative approach for supporting parents to advocate in their child's acute pain care is offered, the “Partnership in Pain Care Model.”

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Purpose and BackgroundIn the UK, family-centred care (FCC) is espoused as being firmly embedded within the approach to care delivery when working with children and families (Smith and Coleman, 2010). Whilst the Royal College of Nursing (2009) advocates family involvement in pain care, research suggests parents and children are not actively involved in care decisions. The study explored the extent to which parents/main carers are involved and partners in their child’s pain care and the factors that influence parental involvement. The “Family-Centred Care continuum” was the conceptual framework used to examine parental involvement.MethodsA qualitative ethnographical approach was adopted. Data were collected using non-participant observation and follow up interviews with a purposive sample of nurses, parents and children on the children’s wards of a district general hospital. Framework approach underpinned data analysis.ResultsPartnership between nurses and parents was not overtly evident in relation to pain care. Involvement appeared to be “unspoken”, with neither party (nurse or parent) being clear about the extent to which parents can be, or are involved in care. Few examples of explicit negotiation related to pain care were observed. However, parents attempted to be involved and act as advocates for their child, particularly when pain care was perceived as sub-optimal. Parents used a number of strategies to be advocates for their child whether supported by nurses or not, including; being determined to be involved by persistence; speaking up for their child; having or gaining knowledge about their child’s care and knowing their child. Nurse’s actions either promoted involvement and parent advocacy or hindered it. Providing information, planning care with parents, valuing parent contributions and supporting parent choices were facilitating factors. Hindering factors were identified as; making decisions without involving parents; lack of communication and variations in understanding of the principles and subsequent implementation of FCC.Conclusions and implicationsNurses require knowledge and confidence to implement collaboration with parents, by empowering parents and overtly negotiating roles. Further research is necessary to identify how nurses can support parents to be partners in care.

To explore the experiences of nurses undertaking safeguarding children work in a district general hospital.