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Rodgers’ evolutionary model of concept analysis was used to develop definitions of children’s nursing and their special needs, from which the inherent qualities of children’s nurses were extrapolated and tested in a variety of ways. Firstly selectors of children’s nursing students evaluated the suitability of six hypothetical candidates, in a self administered postal questionnaire. There was some agreement on the identified pre-requisite qualities. Secondly a content analysis of 25 job descriptions for newly qualified children’s nurses, using NUD*IST was undertaken, to determine English NHS Trusts’ expectations. Across the sample there was agreement on the role of the children’s nurse, confirming the definition derived from the concept analysis. There was less agreement between trusts in the manner in which these expectations were expressed. New regulations for nurse education were introduced during the time of this study and the government published new standards for children’s health services. Therefore a final concept analysis of children’s nursing at the start of the 21st century was undertaken. A number of implications for children’s nursing selection and further development of the identified qualities of potential students were identified. The definition of children’s nursing should continue to be debated as the role develops and becomes increasingly expressed in terms of competencies.

This is a study concerning the social history of paediatric nursing between 1920 and 1970. Oral history data was collected from past nurses of children and from people who had been in hospital as children within the period in question. The study explores the professional orientation of nurses and their role within the micro-culture of the acute hospital, their relationship with doctors on the one hand and with the child and family on the other. It is found that until the later years of the period 1920-1970, paediatric nursing was a regimented discipline, whose professional identity was intimately associated with that of medicine and with notions of 'science' and 'professionalism'. In practice, 'science' meant practicing the 'known way' as described in the literature of the time and which had been passed down by word of mouth and which could not be exposed to critique or review. 'Professionalism' meant being respectful and obedient to senior nurses and to doctors. This created a situation where nursing could not initiate change and as a result, failed to provide social and psychological care appropriate to the child and family. Nursing failed to question and develop its own practice and what changes did take place were the result of other agencies' manipulation of nursing for their own ends. The nurse participants express a strong sense of value for their work history and are proud of what they achieved. Nursing is seen as a demanding and challenging occupation, to which the system of discipline and hierarchy presented most of the challenges. Nursing was an emotionally rewarding area of work, the nurse participants obtaining most satisfaction from being able to 'nurse the child better'. Nurses cared about the children but failed to realise that the emotional neutrality associated with their professionalism was interpreted by the children as a lack of affection. It is found that the child participants tended to be traumatised by their hospital experiences. The cause of this trauma is found to be the way in which nurses practiced according to a scientific and professional paradigm. Unwittingly, this last resulted in the nurses being perceived by the child participants as lacking in affection or emotional 'care' for them as children. Many of the participants remain confused and troubled by this aspect of their experience. By the end of the period 1920-1970 the system of discipline and hierarchy was being disassembled and nursing began to evaluate itself and subject itself to scientific scrutiny. At the same time, paediatric nursing did change to become more child and family orientated and it began to present a more 'human' face to the child patients and their families. These changes are identified with broader changes in society to which paediatric nursing did eventually become aligned.

The aim of this study is to examine key features within the cultural context in a Canadian Paediatric Intensive Care Unit (PICU) environment as experienced by nurses, and to identify what these influences are and how they shape nurses’ intentions to remain at critically ill children’s bed-sides for the duration of their careers. This is a qualitative study which follows a critical ethnographic approach. Over 20 hours of observation and face-to-face semi-structured interviews were conducted. Approximately one third of the nursing population at the research site PICU were interviewed (N=31). Participants describe a complex process of becoming an expert PICU nurse that involved several stages. By the time participants became experts in this PICU they believed they had significantly narrowed the power imbalance that exists between nursing and medicine. This study illuminates the role both formal and informal education plays in breaking the power barrier for nurses in the PICU. This level of expertise and mutual respect between professions aids in retaining nurses in the PICU. The lack of autonomy and/or respect shown to nurses by administrators appears to be one of the major stressors in nurses’ working lives and can lead to attrition from the PICU. Family Centred Care (FCC) is practiced in paediatrics and certainly accentuated in the PICU as there is usually only one patient assigned per nurse, who thus afforded the time to provide comprehensive care to both the child and the family. This is considered one of the satisfiers for nurses in the PICU and tends to encourage retention of nurses in the PICU. However, FCC was found to be an inadequate term to truly encompass the type of holistic care provided by nurses in the PICU.

Orientadora: Profª. Drª. Verônica de Azevedo Mazza / Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação Mestrado Profissional em Enfermagem. Defesa: Curitiba, 20/12/2016 / Inclui referências : f.116-129 / Área de concentração: Prática profissional em enfermagem / Linha de Pesquisa: Processo de cuidar em saúde e enfermagem / Resumo: A família experiencia inúmeras emoções ao vivenciar o internamento do prematuro na Unidade de Terapia Intensiva Neonatal, logo busca informações na internet a fim de se aproximar do contexto da unidade intensivista, entender a situação enfrentada e complementar as informações dadas pelos profissionais de saúde. Trata-se de um estudo exploratório com abordagem qualitativa, cujos objetivos são identificar as necessidades e fontes de informação sobre saúde/doença das famílias de prematuros internados em Unidade de Terapia Intensiva Neonatal e analisar o uso de informações on-line sobre saúde/doença por famílias de prematuros internados em Unidade de Terapia Intensiva Neonatal. O estudo foi realizado em uma Unidade de Terapia Intensiva Neonatal do município de Curitiba. Os participantes foram 33 familiares de recém-nascidos internados na referida unidade. A coleta de dados ocorreu no período de abril a julho de 2016, por meio de entrevista semiestruturada, em qual constou a caracterização da família e do recém-nascido, e questões norteadoras relacionadas a vivência dos entrevistados quanto ao uso de informações sobre saúde/doença on-line. Os dados foram analisados conforme os passos propostos por Creswell (2010) e com a finalidade de aprimorar a análise das informações utilizou-se o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires®. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Setor de Ciências da Saúde da Universidade Federal do Paraná e pelo Comitê de Ética em Pesquisa da instituição coparticipante. Ademais, a elaboração do estudo procurou atender aos passos recomendados pelo Critérios Consolidados para Relatar uma Pesquisa Qualitativa. No resultado deste estudo apresenta-se a caracterização das famílias e dos recém-nascidos internados na Unidade de Terapia Intensiva Neonatal e as quatro categorias que emergiram da análise, intituladas: Emoções vivenciadas no internamento do prematuro no ambiente intensivista; Informação, fluxo, conexões e potencialidades; Informações de saúde/doença on-line: entre sites e conteúdos; Necessidade de informação: "eu quero saber". As famílias são envoltas por emoções diversas durante o internamento do filho, bem como suas necessidades informativas são amplas e a partir dessas, os familiares são impulsionados a procurar dados na internet, os quais são utilizados para diversos fins. Além disso, a maioria das famílias desconhece os sites que consulta e identifica apenas a ferramenta de busca utilizada para encontrar as fontes. Conclui-se que o acesso à internet é impossível de ser restrito e controlado, por isso cabe aos profissionais de saúde orientar os sujeitos e construir uma relação linear e de confiança, a fim de subsidiar o cuidado de enfermagem à família em consonância com suas necessidades, anseios e realidade. Palavras chave: Informação de saúde ao consumidor. Recém-nascido. Unidades de Terapia Intensiva Neonatal. Família. / Abstract: The family experiences innumerable emotions when experiencing the hospitalization of prematurity in the Neonatal Intensive Care Unit, soon searches for information on the Internet in order to approach the context of the intensivist unit, understand the faced' situation confronted and complement the information given by health professionals. This is an exploratory study with a qualitative approach, which objectives are to identify the needs and sources of information about health/illness used by families of premature infants hospitalized in a Neonatal Intensive Care Unit and to analyze the use of online information about health/illness by families of premature infants admitted to the Neonatal Intensive Care Unit. The study accomplished out in a Neonatal Intensive Care Unit of the city of Curitiba. Participants were 33 relatives of newborns admitted to the unit. Data collection took place in the period from April to July 2016, through a semi-structured interview, which consisted the characterization of the family and the newborn, and guiding questions related to the interviewees' experience regarding the use of information about health/illness online. The data were analyzed according to the steps proposed by Creswell (2010) and with the purpose of improving the analysis of the information used the Interface for Multidimensional Analysis of Textes et de Questionnaires® software. The study approved by the Ethics Committee on Research of the Health Sciences Sector of the Federal University of Paraná and by the Ethics Committee of the participating institution. In addition, the elaboration of the study sought to follow the steps recommended by the Consolidated Criteria for Reporting a Qualitative Research. In the result of this study, we present the characterization of families and newborns hospitalized in the Neonatal Intensive Care Unit and the four categories that emerged from the analysis, entitled: Emotions experienced in the hospitalization of the premature in the Intensive Care Unit; Information, flow, connections and potentialities; Online health/illness information: between sites and content; Need for information: "I want to know". Families surrounded by different emotions during the hospitalization of the son, as well as their informational needs are broad and from these, family members driven to look for data on the Internet, which are used for various purposes. In addition, most families are unaware of the sites they query and only identify the search tool used to find the sources. Concluded that access to the internet is impossible to be restricted and controlled, so it is up to health professionals to guide the subjects and build a linear and trustful relationship in order to subsidize nursing care to the family in line with their needs, wishes and reality. Keywords: Consumer health information. Newborn. Neonatal Intensive Care Units. Family.