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Perceptions of the nurse’s role by hospitalized children with chronic conditions Eikelhof, Elisa Mary

Abstract

This study investigated the relationship between cognitive development and children’s understanding of the hospital nurse’s role. A group of 35 hospitalized children with chronic conditions and without neurological deficits, aged 4 to 10 years, were given three tasks (i.e., the Nurse’s Role Task, the Balance Beam Task, and the Task of Intrapersonal Understanding), scored for developmental level using Case’s (1992) neo-Piagetian theory of cognitive development as a framework. A full sample of 4—year—olds was not pursued due to the distracting hospital environment which, in combination with the shorter attention span of the 4-year-olds, rendered the interviews extremely difficult to complete. Descriptive results indicated a moderately advanced understanding of the hospital nurse’s role by 8— and lO—year—olds, being on the order of one—third of a substage (i.e., approximately 8 months ahead in development), whereas 4— and 6—year—olds showed an age— appropriate level of understanding of the hospital nurse’s role. Analysis of Variance indicated a statistically significant effect for age on all three tasks (p < .01). Six levels of social—cognitive development in understanding the hospital nurse’s role were found, which were, in successive order: (1) Roles of the nurse as scripted actions (i.e., 4-year-old level), (2) Roles of the nurse as motivated action sequences (i.e., 6—year—old level), (3) Roles of the nurse as planned action sequences (i.e., 8— year—old level), (4) Roles of the nurse as generalized dispositions toward action (i.e., 10—year-old level), (5) Roles of the nurse as demonstrating logically planned decisions towards action (i.e., 12-year—old level), and (6) Roles of the nurse as demonstrating logically planned action sequences (i.e., 14—year—old level). Furthermore, results indicate that a few 6- and 8-year-olds and the majority of l0—year—olds could give an accurate description of the duties of the hospital nurse, that is, 1) nurses are there to help children, 2) nurses have a responsibility for the well-being of their patients, 3) nurses want to improve the physical and emotional health of their patients, 4) nurses also see their own shortcomings in their care for children and have good intentions, and 5) nurses are human and have their own feelings, thoughts, doubts, and ideas. Suggestions for future research have been provided in order to further improve communication between health care professionals and hospitalized children with chronic conditions.

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