Parents’ Participation in Atraumatic Care During Children Hospitalization: Systematic Review


  • Dera Alfiyanti Faculty of Nursing and Health Sciences, Muhammadiyah University, Semarang, Jawa Tengah 50273, Indonesia ; Faculty of Nursing, Airlangga University, Surabaya, East Java 60115, Indonesia
  • Yuni Sufyanti Arief Faculty of Nursing, Airlangga University, Surabaya, East Java 60115, Indonesia
  • Ilya Krisnana Faculty of Nursing, Airlangga University, Surabaya, East Java 60115, Indonesia
  • Mira Triharini Faculty of Nursing, Airlangga University, Surabaya, East Java 60115, Indonesia
  • Mariyam Faculty of Nursing and Health Sciences, Muhammadiyah University, Semarang, Jawa Tengah 50273, Indonesia ; Faculty of Nursing, Airlangga University, Surabaya, East Java 60115, Indonesia



Introduction: Atraumatic care for children undergoing hospitalization requires parental participation. Parental participation is an important aspect of atraumatic care for hospitalized children. Parental participation is expected to reduce child pain and anxiety. Aim: This study aimed to describe the participation of parents in atraumatic care while the child is hospitalized. Methods: The methodology used in this study was a systematic review, which began with topic selection and entails searching several databases, including Proquest, PubMed, ScienceDirect, Ebscohost, CINAHL, Scopus, and Google Scholar, by entering keywords "parents’ participation" AND "atraumatic care" AND "hospitalized children." Articles were reviewed from 2019 to 2023. Protocol and evaluation of the literature review using the PRISMA checklist. Results: All databases provided 263 articles published in the years 2019–2023. There were forty articles left after duplicates were removed and inclusion and exclusion criteria were applied. Ten articles were left for quality assessment after the full-text review, and all of them scored higher than seven parental participations in atraumatic care while the child is hospitalized based on the results of the review of the articles above, including emotional support, distraction techniques, comfort measures, communication and education, advocacy, collaboration with the healthcare team, participating in care routines, and providing post-procedure comfort. Conclusion: Parental participation in atraumatic care while the child is hospitalized includes emotional support, distraction techniques, comfort measures, communication and education, advocacy, collaboration with the healthcare team, participating in care routines, and providing post-procedure comfort. This literature review provides a viewpoint for thinking about how to enhance the way that parents are currently being prepared to participate in the traumatic care of their children during hospitalization. Further research is expected to be able to develop research on specific interventions related to each form of parental participation in childcare during hospitalization.


Parents’ Participation, Atraumatic Care, Children Hospitalization


Download data is not yet available.


Ashcraft, L. E., Asato, M., Houtrow, A. J., Kavalieratos, D., Miller, E., & Ray, K. N. (2019). Parent empowerment in pediatric healthcare settings: a systematic review of observational studies. The Patient-Patient-Centered Outcomes Research, 12, 199-212.

Bahnsawy, N. S., Mohammed, A. R., Ibrahim, H., & Younis, R. A. (2023). Risk Factors Associated with Wound Infections in Burned Children. The Malaysian Journal of Nursing (MJN), 14(4), 100-109.

Bajpai, A., Ilayaraja, B. S., Muninarayanappa, N. V., & Nageshwar, V. (2017). Assessment of Anxiety among Hospitalized Children. Indian Journal of Public Health Research & Development, 8(2).

Barros, I., Lourenço, M., Nunes, E., & Charepe, Z. (2021). Nursing interventions promoting child/youth/family adaptation to hospitalization: A scoping review. Enfermeria Global, 20(1), 577-595.

Burns, K. E., Misak, C., Herridge, M., Meade, M. O., & Oczkowski, S. (2018). Patient and family engagement in the ICU. Untapped opportunities and underrecognized challenges. American Journal of Respiratory and Critical Care Medicine, 198(3), 310-319.

Çamur, Z., & Sarıkaya Karabudak, S. (2021). The effect of parental participation in the care of hospitalized children on parent satisfaction and parent and child anxiety: Randomized controlled trial. International Journal of Nursing Practice, 27(5), e12910.

Cardona, C. V., Rajah, C., Mzoneli, Y. N., Friedrichsdorf, S. J., Campbell, F., Cairns, C., & Rodseth, R. N. (2019). An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital. Pain Reports, 4(6).

Claridge, A. M., & J Powell, O. (2023). Children’s experiences of stress and coping during hospitalization: A mixed-methods examination. Journal of Child Health Care, 27(4), 531-546.

Considine, J., Shaban, R. Z., Fry, M., & Curtis, K. (2017). Evidence based emergency nursing: designing a research question and searching the literature. International Emergency Nursing, 32, 78-82.

Das, M. K., Arora, N. K., Chellani, H. K., Debata, P. K., Meena, K. R., Rasaily, R., ... & Kumari, M. (2021). Perceptions of the parents of deceased children and of healthcare providers about end-of-life communication and breaking bad news at a tertiary care public hospital in India: a qualitative exploratory study. PloS One, 16(3), e0248661.

Delvecchio, E., Salcuni, S., Lis, A., Germani, A., & Di Riso, D. (2019). Hospitalized children: anxiety, coping strategies, and pretend play. Frontiers in Public Health, 7, 250.

Ebrahem, G. G. S., Ahmed, G. E. N., Hammad, A., & Eid, R. (2019). Applying cryotherapy and balloon inflation technique to reduce pain of arteriovenous fistula cannulation among children undergoing hemodialysis. International Journal of Nursing Didactics, 9(05), 29-35.

Fornaro, D. S., Della Pelle, C., & Buccione, E. (2022). Parental participation in care during Neonatal Intensive Care Unit stay: a validation study. Infermieristica Journal, 1(2), 81-88.

Foster, T. D., Decker, K. B., Vaterlaus, J. M., & Belleville, A. (2020). How early intervention practitioners describe family‐centred practice: A collective broadening of the definition. Child: Care, Health and Development, 46(3), 268-274.

Gaspar, T., Cerqueira, A., Guedes, F. B., & de Matos, M. G. (2022). Parental Emotional Support, Family Functioning and Children's Quality of Life. Psychological Studies, 67(2), 189-199.

Gheshlaghi, P. A., Farahani, Z. B., Anboohi, S. Z., Nasiri, M., Ziapour, A., & Garosi, V. H. (2021). Effect of family presence on pain and anxiety levels among patients during invasive nursing procedures in an emergency department at a public hospital in Western Iran. African Journal of Emergency Medicine, 11(1), 31-36.

Gramszlo, C., Karpyn, A., Christofferson, J., McWhorter, L. G., Demianczyk, A. C., Lihn, S. L., ... & Sood, E. (2020). Supporting parenting during infant hospitalisation for CHD. Cardiology in the Young, 30(10), 1422-1428.

Handayani, A., & Daulima, N. H. C. (2020). Parental presence in the implementation of atraumatic care during children’s hospitalization. Pediatric Reports, 12(s1), 8693.

Hassan, E. A. F., & Hassan, A. M. (2023). Impact of a Traumatic Care Technique on Pain and Fear among Hospitalized Children Undergoing Intravenous Medication. International Journal of Health Sciences, 11(1), 11-22.

Hsu, M. F., Whu, Y. W., Lin, I. C., Liu, C. Y., Lai, F. C., Liu, P. C., & Chen, C. W. (2022). Effectiveness of virtual reality interactive play for children during intravenous placement: A randomized controlled trial. Asian Nursing Research, 16(2), 87-93.

Ilmiasih, R., & Ningsih, N. S. (2022). Application of Atraumatic Care Philosophy to Children in Hospitals a Literature Review. MedRxiv, 2022-07.

Islaeli, I., Said, F. M., Nambiar, N., & Umar, N. S. (2023). Development and Validation of a Revised VAS-Anxiety Measurement Tools for Preschool Hospitalized Children. The Malaysian Journal of Nursing (MJN), 14(3), 46-54.

Jerofke-Owen, T. A., McAndrew, N. S., Gralton, K. S., Totka, J. P., Weiss, M. E., Fial, A. V., & Sawin, K. J. (2022). Engagement of families in the care of hospitalized pediatric patients: a scoping review. Journal of Family Nursing, 28(2), 151-171.

Jordan, A., Carter, B., & Vasileiou, K. (2021). “Pain talk”: A triadic collaboration in which nurses promote opportunities for engaging children and their parents about managing children’s pain. Paediatric and Neonatal Pain, 3(3), 123-133.

Lerwick, J. L. (2016). Minimizing pediatric healthcare-induced anxiety and trauma. World Journal of Clinical Pediatrics, 5(2), 143.

Lim, S. J., & Bang, K. S. (2023). The perceptions and performance of family-centered care among pediatric nurses at a children's hospital in South Korea: a descriptive study. Child Health Nursing Research, 29(3), 207.

Matula, S. T., Irving, S. Y., Deatrick, J. A., Steenhoff, A. P., & Polomano, R. C. (2022). The perceptions and practices of parents and children on acute pain management among hospitalized children in two Botswana referral hospitals. Journal of Pediatric Nursing, 65, e35-e42.

Mahato, P., Shrestha, R., Karn, B. K., Chaudhary, A. K., & Singh, R. (2022). Knowledge and Attitude of Nurses on Implementation of Atraumatic Care among Hospitalized Children in Eastern Nepal: A Cross-sectional Study. Journal of Nepal Paediatric Society, 42(3), 24-28.

Moore, B. J., Freeman, W. J., & Jiang, H. J. (2019). Costs of pediatric hospital stays, 2016. Accessed on 22nd January, 2023

Osman, N. L. (2022). A Rare Case of Chest Pain in Children. Malaysian Journal of Medical Research (MJMR), 6(4), 26-27.

Páll, N., Gorove, E., & Baji, I. (2021). Psychological support of hospitalised children and their parents in Hungary. KONTAKT-Journal of Nursing & Social Sciences Related to Health & Illness, 23(2).

Palomares González, L., Hernández Caravaca, I., Gómez García, C. I., & Sánchez-Solís de Querol, M. (2023). Parental presence during invasive pediatric procedures: what does it depend on?. Revista Latino-Americana de Enfermagem, 31, e3828.

Pelcovitz, M., Bennett, S., Desai, P., Schild, J., Beaumont, R., Walkup, J., ... & Chiu, A. (2023, February). High rates of anxiety among adolescents in a partial hospitalization program. In Child & Youth Care Forum, 52(1), 105-122. New York: Springer US.

Perdani, A. L., Mutiar, A., & Nazmudin, Y. (2021). The Impact of Implementation Virtual Reality (VR) on Pain Levels Among Children with Invasive Procedures: A Literature Review. KnE Life Sciences, 713-718.

Potts, D. A., Davis, K. F., Elci, O. U., & Fein, J. A. (2019). A vibrating cold device to reduce pain in the pediatric emergency department: a randomized clinical trial. Pediatric Emergency Care, 35(6), 419-425.

Rennick, J. E., St-Sauveur, I., Knox, A. M., & Ruddy, M. (2019). Exploring the experiences of parent caregivers of children with chronic medical complexity during pediatric intensive care unit hospitalization: an interpretive descriptive study. BMC Pediatrics, 19(1), 1-10.

Rokach, A. (2016). Psychological, emotional and physical experiences of hospitalized children. Clin Case Rep Rev, 2(4), 399-401.

Romaniuk, D., O'Mara, L., & Akhtar-Danesh, N. (2014). Are parents doing what they want to do? Congruency between parents’ actual and desired participation in the care of their hospitalized child. Issues in Comprehensive Pediatric Nursing, 37(2), 103-121.

Sanyod, V., Pothiban, L., Mesukko, J., & Niyomkar, S. (2021). Factors predicting parent participation in caring for hospitalized children with chronic diseases. The Open Public Health Journal, 14(1).

Semerci, R., Akarsu, Ö., & Kılıç, D. (2023). The effect of buzzy and cold spray on pain, anxiety, and fear of children during venipuncture in pediatric emergency department in Turkey; A randomized controlled study. Journal of Pediatric Nursing, 68, e1-e7.

Seniwati, T., Wanda, D., & Nurhaeni, N. (2023). Effects of Patient and Family-Centered Care on Quality of Care in Pediatric Patients: A Systematic Review. Nurse Media Journal of Nursing, 13(1), 68-84.

Sundal, H., & Vatne, S. (2020). Parents’ and nurses’ ideal collaboration in treatment-centered and home-like care of hospitalized preschool children–a qualitative study. BMC Nursing, 19(1), 1-10.

Suparto, T. A., Somantri, B., Andriani, S., Puspita, A. P. W., Rohaedi, S., Amalia, L., ... & Sari, A. T. (2020, February). Parents’ Roles in Overcoming the Impact of Hospitalization on Preschool Children. In 4th International Conference on Sport Science, Health, and Physical Education (ICSSHPE 2019) (pp. 140-143). Atlantis Press.

The National Child Traumatic Stress Network. (2017). Family Engagement and Involvement in Trauma Mental Health. https://efaidnbmnnnibpcajpcglclefindmkaj/

van Oort, P. J., Maaskant, J. M., Smeulers, M., van Oostrum, N., Vermeulen, E., & van Goudoever, J. B. (2019). Participation of parents of hospitalized children in medical rounds: a qualitative study on contributory factors. Journal of Pediatric Nursing, 46, e44-e51.

Vasli, P., & Salsali, M. (2014). Parents’ participation in taking care of hospitalized children: A concept analysis with hybrid model. Iranian Journal of Nursing and Midwifery Research, 19(2), 139. . Accessed on 24th February, 2023

Widodo, S., & Poddar, S. (2020). Analysis of pre hospital emergency management in case of head injury. Enfermería Clínica, 30(5), 228–233.

Wong, D. L., Hockenberry, M. J., Wilson, D., Winkelstein, M. L., & Kline, N. E. (2003). Wong's nursing care of infants and children. (No Title). . Accessed on 22nd February 2023



How to Cite

Alfiyanti, D., Arief, Y. S., Ilya Krisnana, Mira Triharini, & Mariyam. (2024). Parents’ Participation in Atraumatic Care During Children Hospitalization: Systematic Review . The Malaysian Journal of Nursing (MJN), 15(3), 156-168.