Pain and nurses' emotion work in a paediatric clinic: Treatment procedures and nurse-child alignments

Abstract

In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff–child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses’ emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses’ emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative
 ‘we’-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle
 procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.

“Pain talk”: A triadic collaboration in which nurses promote opportunities for engaging children and their parents about managing children’s pain

“…"Pain talk" involved comfort and reassurance that a good solution would be identified and that children would be able to have choice and control and be agentic, as seen in nurses' emotion work relating to pain in a pediatric oncology clinic. 31 Additionally, study findings showed that nurses embraced the concept of trauma-informed care by asking children about any previous negative pain and wider medical experiences, using this knowledge to inform their attempts to better assess and manage children's pain. 32 While our study findings reassuringly highlighted the incredible efforts that nurses reported they adopted to engage in effective "pain talk," it is important to consider how this "pain talk" and nurses' actions are perceived by others, namely children and their parents.…”

“…Our findings in relation to nurses using protective and restoring “pain talk” are congruent with the concept of psychologically informed health care and efforts to align with existing evidence for effective pain management that supports the need to empower and support children and promote feelings of safety and help children create good memories 9 of procedures or painful experiences. “Pain talk” involved comfort and reassurance that a good solution would be identified and that children would be able to have choice and control and be agentic, as seen in nurses' emotion work relating to pain in a pediatric oncology clinic 31 . Additionally, study findings showed that nurses embraced the concept of trauma‐informed care by asking children about any previous negative pain and wider medical experiences, using this knowledge to inform their attempts to better assess and manage children's pain 32 …”

The Faces Emotional Coping Scale as a self-reporting instrument for coping with needle-related procedures: An initial validation study with children treated for type 1 diabetes

“…Needle-related fear in children with type 1 diabetes is also associated with higher HbA1c levels and less frequent blood sugar monitoring (Cemeroglu et al, 2015). According to this, it is incumbent on paediatric nurses to reach those children who need extra support to cope with the distress of needle-related procedures when interacting with a skilled nurse (Rindstedt, 2013). Consequently, assessment tools and guidelines adapted for children are important contributors to individualized pain management (Ljusegren et al, 2012).…”

Negotiating Illness in Medical Interactions: Narrative Styles of two Children with Leukaemia

“…The children were invited to participate in the conversations with the staff, and they were not viewed as the marginal participants that have been discussed in previous research with children with cancer (Bluebond‐Langner, ; Clemente, ). Furthermore, the children were made to feel special (Rindstedt, , , ). The parents also take part in the conversations and offer support to their children.…”