The Relationship between Paediatric Nurses’ Knowledge, Attitude, and Practice about Atraumatic Care of Hospitalized Children in Indonesia
DOI:
https://doi.org/10.31674/mjn.2024.v16i02.003Abstract
Background: The main stressors of the hospitalised children's are separation from family, loss of control, pain, and the unfamiliar hospital environment. Atraumatic care is therapeutic care provided through interventions that eliminate or reduce the psychological and physical distress experienced by children and families. Objective: The objective of this study was to describe the Indonesian nurses' knowledge, attitudes, and practices regarding atraumatic care for hospitalised children and to identify the factors affecting the nurses’ practice of atraumatic care. Methods: This descriptive correlation study was held in a regional general hospital. Totally, 70 of 44 nurses in paediatric wards and 26 nurses in the Paediatric Intensive Care Unit PICU completed a 20-question multiple-choice scale of knowledge about atraumatic care and a 30-item scale of attitude towards atraumatic care. The behaviours were observed using a 25-item Nurses' Practice Scale for Atraumatic Care. Results: Compared to their colleagues in other units, the nurses in the PICU (12.65±2.79) had the best knowledge, and the nurses in the paediatric wards had the best attitude (98.19±9.76) and practice (63.09±10.64) toward providing atraumatic care. Hierarchical linear regression revealed that nurses who were working in the paediatric wards (B = 7.826, SE = 3.254, p = 0.019) and females (B = 9.814, SE = 3.481, = 0.006) had better knowledge (B = 1.068, SE = 0.622, p = 0.010) and attitude (B = 0.237, SE = 0.139, p = 0.029) and significantly better practice scores in providing atraumatic care than those who were working in the PICU and male. Conclusion: Trainings regarding the provision of atraumatic care for hospitalised children should be developed for the nurses to improve their knowledge and attitude so they can provide optimal care to minimise the impact of hospitalisation on children.
Keywords:
Attitude to Health, Knowledge, Nurse, Paediatric, Professional PracticeDownloads
References
Achora, S., & Labrague, L. J. (2019). An integrative review on knowledge and attitudes of nurses toward palliative care: Implications for practice. Journal of Hospice & Palliative Nursing, 21(1), 29-37. https://doi.org/10.1097/NJH.0000000000000481
Alotaibi, K., Higgins, I., & Chan, S. (2019). Nurses' knowledge and attitude toward paediatric pain management: A cross-sectional study. Pain Management Nursing, 20(2), 118-125. https://doi.org/10.1016/j.pmn.2018.09.001
Anyasor, C. O., & Oluwatoyin, A. (2017). Nurses’ knowledge, attitude and perceived barrier towards the implementation of nursing process at a general hospital in Lagos state, Nigeria. age, 21(30), 31-40. https://www.ijiras.com/2017/Vol_4-Issue_8/paper_56.pdf . Accessed on 28th February, 2024.
Ayello, E. A., & Meaney, G. (2003). Replicating a survey of pressure ulcer content in nursing textbooks. Journal of Wound Ostomy & Continence Nursing, 30(5), 266-271. https://doi.org/10.1067/mjw.2003.147
Biresaw, H., Asfaw, N., & Zewdu, F. (2020). Knowledge and attitude of nurses towards patient safety and its associated factors. International Journal of Africa Nursing Sciences, 13. https://doi.org/10.1016/j.ijans.2020.100229
Basak, S., & Srimani, S. (2020). Knowledge and skills of auxiliary nurse and midwives (ANMS) on identification of birth defects, developmental delays and disabilities among preschool children in West Bengal. Malaysian Journal of Medical Research (MJMR), 4(3), 35-41. https://doi.org/10.31674/mjmr.2020.v04i03.006
Cırık, V. A., Ciftcioglu S., & Efe, E. (2019). Knowledge, practice and beliefs of paediatric nurses about pain. The Journal of Pediatric Research, 6(3), 220-227. https://doi.org/10.4274/jpr.galenos.2019.48344
Crable, J., Highfield, M. E. F., & Patmon, F. (2021). Evidence-based practice knowledge, attitudes, practices, and barriers. Nursing 2024, 51(9), 58-65. https://doi.org/10.1097/01.Nurse.0000754000.05371.65
de Breving, R. M., Ismanto, A. Y., & Onibala, F. (2015). Pengaruh penerapan atraumatic care terhadap respon kecemasan anak yang mengalami hospitalisasi di RSU pancaran kasih gmim manado dan RSUP Prof. Dr. RD Kandou Manado. (The effect of implementing atraumatic care on the anxiety response of children who are hospitalized at the Radian Kasih Hospital, GMIM Manado and Prof. Hospital. Dr. RD Kandou Manado). Jurnal Keperawatan, 3(2). https://doi.org/10.35790/jkp.v3i2.7450
Deng, Q., Zhang, Y., Li, Q., Wang, H., & Xu, X. (2018). Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses. Journal of Clinical Nursing, 27(21-22), 4100-4111. https://doi.org/10.1111/jocn.14556
Doiron, M. L., & Peck, J. L. (2022). The role of nursing in the school setting to lead efforts to impact child trafficking: An integrative review. Journal of School Nursing 38(1), 5-20. https://doi.org/10.1177/1059840520987533
Efendi, & Kurniati, A. (2021). Human resources for health country profile of Indonesia 2019. Jakarta: Ministry of Health, 2019. https://doi.org/10.6084/m9.figshare.14528700.v1
Ekim, A., & Ocakci, A. F. (2013). Knowledge and attitudes regarding pain management of paediatric nurses in Turkey. Pain Management Nursing, 14(4), e262-e267. https://doi.org/10.1016/j.pmn.2012.02.004
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
Hagos, F., Alemseged, F., Balcha, F., Berhe, S., & Aregay, A. (2014). Application of nursing process and its affecting factors among nurses working in Mekelle zone hospitals, northern Ethiopia. Nursing Research and Practice. https://doi.org/10.1155/2014/675212
Handayani, A., & Daulima, N. H. C. (2020). Parental presence in the implementation of atraumatic care during children's hospitalization. Pediatric Reports, 12(Suppl 1), https://doi.org/10.4081/pr.2020.8693
Hockenberry, M. J., Rodgers, C. C., & Wilson, D. M. (2020). Wong’s Essentials of Paediatric Nursing. Elsevier Mosby, UK. https://repository.poltekkes-kaltim.ac.id/638/1/Wong%E2%80%99s%20Essentials%20of%20Pediatric%20Nursing%20by%20Marilyn%20J.%20Hockenberry%20Cheryl%20C.%20Rodgers%20David%20M.%20Wilson%20(z-lib.org).pdf. Accessed on 20th January, 2024
Hossain, M. S. (2010). Nurses’ knowledge and attitudes, and pain management practice of post-operative children in Bangladesh (Doctoral dissertation, Prince of Songkla University, Thailand). https://core.ac.uk/download/pdf/14979706.pdf . Accessed on 19th December, 2023.
Huff, L., Hamlin, A., Wolski, D., McClure, T., Eliades, A. B., Weaver, L., & Shelestak, D. (2009). Atraumatic care: EMLA cream and application of heat to facilitate peripheral venous cannulation in children. Issues in Comprehensive Pediatric Nursing, 32(2), 65-76. https://doi.org/10.1080/01460860902737418
Islam, S. (2009). Nurses’ knowledge, attitude, and practice regarding pressure ulcer prevention for hospitalized patients at rajshahi medical college hospital in Bangladesh. https://core.ac.uk/reader/14979710 . Accessed on 19th August, 2023
Kemenkes. (2023a). Indonesian Health Profile 2023. https://kemkes-go-id.translate.goog/eng/indonesia-health-profile 2023?
Kemenkes. (2023b). Survei Kesehatan Indonesia (SKI), 2023. [Indonesian Health Survey (SKI)] https://www.badankebijakan.kemkes.go.id/hasil-ski-2023/. Accessed on 11th August, 2023.
Lerwick, J. L. (2016). Minimizing paediatric healthcare-induced anxiety and trauma. World Journal of Clinical Pediatrics, 5(2), 143-150. https://doi.org/10.5409/wjcp.v5.i2.143
Mandal, I., Basu, I., & De, M. (2020). Role of nursing professionals in making hospital stay effective and less stressful for patients with ASD: A brief overview. International Journal of Advancement in Life Sciences Research, 3(1), 1-9, https://doi.org/10.31632/ijalsr.20.v03i01.001
Mediani, H. S., Hendrawati, S., & Shidqi, N. N. (2019). The knowledge and attitude of nurses in the implementation of atraumatic care in hospitalized children in Indonesia. Journal of Nursing and Health Science, 8(1), 51-56. https://www.iosrjournals.org/iosr-jnhs/papers/vol8-issue1/Series-7/E0801075156.pdf . Accessed on 24th January, 2024.
Norton‐Westwood, D. (2012). The health‐care environment through the eyes of a child—does it soothe or provoke anxiety? International Journal of Nursing Practice, 18(1), 7-11. https://doi.org/10.1111/j.1440-172X.2011.01995.x
Paliadelis, P., Cruickshank, M., Wainohu, D., Winskill, R., & Stevens, H. (2005). Implementing family-centred care: an exploration of the beliefs and practices of paediatric nurses. The Australian Journal of Advanced Nursing: A Quarterly Publication of the Royal Australian Nursing Federation, 23(1), 31-36. https://www.ajan.com.au/archive/Vol23/Vol23.1-4.pdf
Pancorbo-Hidalgo, P. L., Garcia-Fernandez, F. P., Lopez-Medina, I. M., & Lopez-Ortega, J. (2007). Pressure ulcer care in Spain: nurses' knowledge and clinical practice. Journal of Advanced Nursing, 58(4), 327-338. https://doi.org/10.1111/j.1365-2648.2007.04236.x
Pascareli-Carlos, A. M., Martins, L. F., Silva Gonçalves, M. d., Pettorossi Imparato, J. C., & Tedesco, T. K. (2021). Pain perception of children after restorative treatments: Atraumatic restorative treatment versus chemo mechanical removal - A noninferiority randomized clinical trial. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 39(2), 202-207. https://doi.org/10.4103/jisppd.jisppd_426_20
Peng, N. H., Lao, A. H., Chen, C. H., Lee, M. C., Chiang, L. W., Chang, Y. C., & Liu, H. F. (2020). Knowledge and attitudes of paediatric clinicians regarding paediatric pain management. Journal for Specialists in Pediatric Nursing, 25(4). https://doi.org/10.1111/jspn.12302
Potter, P. A., & Perry, A. G. (2022). Fundamentals of nursing, 7th ed. Elsevier Mosby, UK. https://doi.org/https://evolve.elsevier.com/cs/product/9780323810340
Pratiwi, A. (2013). Persepsi orang tua tentang penerapan prinsip perawatan atraumatik di ruang ibnu sina rs pku muhammadiyah yogyakarta (Parents' Perceptions regarding the Implementation of Atraumatic Care Principles in the Ibnu Sina Room at Rs Pku Muhammadiyah Yogyakarta), (Doctoral dissertation, Universitas Muhammadiyah Yogyakarta). https://etd.umy.ac.id/id/eprint/11819. Accessed on 11th August, 2023.
Rahmah, & Santoso, T. (2014). Pengetahuan perawat tentang atraumatic care di rs pku bantul dan yogyakarta, magna medica, 1(1), 48-53. The Level of Nurse Knowledge About the Atraumatic Care at The PKU Muhammadiyah Bantul and Yogyakarta Hospital, Magna Medica, 1(1), 48-53. http://repository.umy.ac.id/handle/123456789/6367. Accessed on 11th August, 2023.
Rehn, M., Chew, M. S., Olkkola, K. T., Sverrison, K. Ö., Yli-Hankala, A., & Møller, M. H. (2019). Clinical practice guideline on atraumatic (pencil-point) vs conventional needles for lumbar puncture: Endorsement by the scandinavian society of anaesthesiology and intensive care medicine. Acta Anaesthesiologica Scandinavica, 63(4), 438-439. https://doi.org/10.1111/aas.13312
Rokach, A. (2016). Psychological, emotional and physical experiences of hospitalized children. Clinical Case Reports and Reviews, 2(4), 399-401. https://doi.org/10.15761/ccrr.1000227
Rollins, J., Drescher, J., & Kelleher, M. L. (2011). Exploring the ability of a drawing by proxy intervention to improve quality of life for hospitalized children. Arts & Health, 4(1), 55-69. https://doi.org/10.1080/17533015.2011.564194
Sartain, S. A., Clarke, C. L., & Heyman, R. (2000). Hearing the voices of children with chronic illness. Journal of Advanced Nursing, 32(4), 913-921. https://doi.org/10.1046/j.1365-2648.2000.01556.x
Shilpashree, K. B., Chaithra, V., Bhat, A., & Krishnamurthy, A. (2021). Survival rate and cost-effectiveness of conventional and atraumatic restorative treatment restorations among anganwadi preschool children in Bengaluru City: A Follow-up Study. Indian Journal of Community Medicine, 46(2), 226-231. https://doi.org/10.4103/ijcm.IJCM_226_20
Surastiningsih, N., Hayati, H., & Waluyanti, F. (2014). Gambaran pengetahuan perawat tentang atraumatic care di ruang rawat anak RSAB Harapan Kita Jakarta = Overview of a traumatic care nurse in pediatric ward RSAB Harapan Kita Hospital Jakarta. UI - Skripsi Membership https://lib.ui.ac.id/detail?id=20387770&lokasi=lokal. Accessed on 10th January, 2024.
Suminar, C., Yulianti, M., & Kurnaesih, L. (2022). Knowledge and attitude factors of nurses dealing with atraumatic application care to child patient. Jurnal Ilmu Kesehatan, 10(1), 40-49. https://doi.org/10.30650/jik.v10i1.3241
Tagele, T. D., Berhe, Y. W., & Lema, G. F. (2023). Knowledge and attitude towards pediatric pain management among nurses at Ethiopian tertiary hospitals; a multi-center study. BMC Nursing, 22(1), 84. https://doi.org/10.1186/s12912-023-01234-8
Twamley, K., Craig, F., Kelly, P., Hollowell, D. R., Mendoza, P., & Bluebond-Langner, M. (2014). Underlying barriers to referral to paediatric palliative care services: Knowledge and attitudes of health care professionals in a paediatric tertiary care centre in the United Kingdom. Journal of Child Health Care, 18(1), 19-30. https://doi.org/10.1177/1367493512468363
Utami, R. (2013). Hubungan penerapan atraumatic care dengan tingkat kepuasan orang tua anak selama proses hospitalisasi di ruang anak rsd balung jember. [Relationship between implementation of atraumatic care with parent’s satisfactory level during the hospitalization process at the child care spaces at balung regional hospital Jember]. Repositary Universitas Jember, Indonesia. http://repository.unej.ac.id/handle/123456789/7698 . Accessed on 11th August, 2023.
Vincent, C. C. N. (2020). Knowledge, attitude and practice of nursing process among nurses in Imo State University teaching hospital, Orlu, Imo State, Nigeria. EC Nursing and Healthcare, 2(4), 10-6. https://www.scribd.com/document/687586320/ECNH-02-00053. Accessed on 11th August, 2023.
Wang, Y. L., & Lo, L. H. (2006). Therapeutic play. Hu li za zhi The Journal of Nursing, 53(3), 79-83. https://europepmc.org/article/med/16767627. Accessed on 20th January, 2024.
World Health Organization. (2024, March 4). Making older persons visible in the sustainable development goals’ monitoring framework and indicators. https://www.who.int/publications/i/item/9789240090248 . Accessed on 24th February, 2024.
Wong, C. L., Ip, W. Y., Kwok, B. M. C., Choi, K. C., Ng, B. K. W., & Chan, C. W. H. (2018). Effects of therapeutic play on children undergoing cast-removal procedures: A randomised controlled trial. BMJ Open, 8(7). https://doi.org/10.1136/bmjopen-2017-021071
Yulianti, M., & Kurnaesih, L. (2022). Knowledge and attitude factors of nurses dealing with atraumatic application care to child patient. Jurnal Ilmu Kesehatan, 10(1), 40-49. https://doi.org/10.3126/jnps.v42i3.46172
Yubonpunt, P., Jadsada, K., Viwattanakulvanid, P., & Kanchana, R. (2021). Effect of multi-component program on promoting safety of hospitalized children. Journal of Evidence-based Care, 11(1), 51-61. https://doi.org/10.22038/EBCJ.2021.58644.2527
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