Children's understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences.
Priscilla Alderson, Hannah Bellsham-Revell, Nathalie Dedieu and 3 others
PMID 36165269WHAT IT FOUND
In paediatric heart surgery teams, nurses and other staff described informing children, using play and models, and sharing small choices to build trust and cooperation.
They saw forced holding as a last resort.
Key findings
01The teams described informing and preparing children before surgery, and using distraction only alongside the child's understanding and willing cooperation.
02Among six interviewed children, four worried about memories of the anaesthetic gas, all reported anxieties about pain, five feared not getting back to normal, two feared tubes and wires, one feared waking during the operation, and three feared dying.
03Nurses were described as informers, supporters and advocates for children and parents, and nurses and doctors referred resisting children for play therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in only two London paediatric cardiology departments described as exceptional, with large teams, time, training and resources. The sample was small and qualitative: 45 professionals, 16 families observed, 13 adults in 12 families interviewed, and only six children interviewed. COVID-19 stopped direct contact after February 2020, so later data came from phone or online interviews and charity-run surveys and discussions. Interviewees may have given favourable accounts and may not represent other settings. The paper does not test whether informing, play or shared control improves consent, distress, delays or safety.
Declared interests
The supplied article text does not state author conflicts or funding; the publication type lists non-U.S. government research support.
The easy way to misread this
Do not read these practices as proven to reduce distress, delay or force. The study describes experiences and observations in two well-resourced teams. It does not test an intervention or report outcomes.