Real voices: A participatory action research study to explore the support provided to children visiting adult patients in hospital.

Abstract

Background: There is evidence that a supportive and open approach to children visiting adult relatives in hospitals has positive benefits for the children, patient, families and healthcare staff. Despite this, many children (<17 years) are still restricted from visiting.
Aim: To identify and critically explore the issues around children visiting adult relatives in hospital and ways to improve visiting opportunities.
Method: A Participatory Action Research (PAR) design was chosen, as it both identifies challenges and change opportunities through collaboration with participants. Two informal consultation focus groups with children were held prior to the study. These confirmed issues relating to children visiting adult relatives which informed the research with nursing staff in a large teaching hospital. Three PAR cycles were conducted during the study using a series of focus groups. Adult and children’s registered nurses, and local college students participated.
Findings: Findings showed that there was variation and inconsistency in visiting practice across all areas of the hospital. A number of reasons for the exclusion or restriction of children, such as presumed hospital policy, were offered by staff. Staff identified a need for specific education and resources, and a number of remedial actions were implemented. Multidisciplinary focus groups provided the opportunity for active learning through knowledge transferability, and encouraged individual nurses to challenge their own assumptions. The college students reported that they did not feel welcome in hospitals and were often ignored. They identified that being acknowledged by nursing staff would give them confidence and help ensure they felt included.
Conclusion: Nurses’ lack of knowledge of hospital policies and excessive concern about protection of the child, deter nurses from relaxed visiting for children which in turn leads to children feeling excluded and anxious. Adult nurses need to challenge their own and other peoples’ assumptions and values in relation to family centred care and child visitation to hospitals. A structured holistic approach needs to be established and implemented in all clinical areas. Multidisciplinary working and learning opportunities should be encouraged.