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Interaction between healthcare professionals and the pediatric patient in an adult intensive care unit : An observational study

Nilsson, Helena LU orcid ; Jönsson, Lisbeth LU ; Jakobsson, Ulf LU orcid and Lundqvist, Pia LU (2026) In Intensive and Critical Care Nursing 96.
Abstract

Aims: To describe healthcare professionals’ interactions with pediatric patients at an adult ICU. Methods: This non-participant naturalistic observational study was conducted at two adult ICUs in Sweden. Inclusion criteria were children aged 0–15 years, where both the child and the parent could speak and understand Swedish or English. Children undergoing palliative care were excluded. The observations encompassed both day and night shifts, capturing interactions during various procedures. The total observation time was 38 h and 12 min. The observation field notes were transferred to a narrative text, which was analyzed using a reflexive thematic analysis. Findings: The healthcare professional’s ability to interact with the child at the... (More)

Aims: To describe healthcare professionals’ interactions with pediatric patients at an adult ICU. Methods: This non-participant naturalistic observational study was conducted at two adult ICUs in Sweden. Inclusion criteria were children aged 0–15 years, where both the child and the parent could speak and understand Swedish or English. Children undergoing palliative care were excluded. The observations encompassed both day and night shifts, capturing interactions during various procedures. The total observation time was 38 h and 12 min. The observation field notes were transferred to a narrative text, which was analyzed using a reflexive thematic analysis. Findings: The healthcare professional’s ability to interact with the child at the adult ICU was influenced by the child́s illness, environmental factors, and the healthcare professional’s mindset. Three themes summarize the healthcare professionals’ approaches: A variation in the sensitivity to the child’s expressions; Parent as a gateway to the child; Attempting to give the child room for action. Conclusions: This study showed that healthcare professionals within the adult ICU had awareness that the child has special needs different from those of the adult patient. The interactions seemed to be more related to each individual situation rather than a working framework like the person and family-centered approach. This assumption, that the child’s perspective was not consistently considered, may increase the likelihood that care practices are based on an adult-oriented perspective rather than a child-centered perspective. Implications for clinical practice: These findings emphasize the need to meet the child’s needs, improve the quality of care, and focus on family-centered care for children in adult high–tech healthcare settings, underscoring that incorporating a child’s perspective is not a choice but an essential requirement.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Family-centered care, Intensive care, Interaction, Nurse–patient relation
in
Intensive and Critical Care Nursing
volume
96
article number
104469
publisher
Elsevier
external identifiers
  • scopus:105041987076
  • pmid:42314324
ISSN
0964-3397
DOI
10.1016/j.iccn.2026.104469
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/
id
c7b7b0e6-7150-4001-987f-4f2fc2fa69c2
date added to LUP
2026-07-21 12:57:08
date last changed
2026-08-04 13:21:09
@article{c7b7b0e6-7150-4001-987f-4f2fc2fa69c2,
  abstract     = {{<p>Aims: To describe healthcare professionals’ interactions with pediatric patients at an adult ICU. Methods: This non-participant naturalistic observational study was conducted at two adult ICUs in Sweden. Inclusion criteria were children aged 0–15 years, where both the child and the parent could speak and understand Swedish or English. Children undergoing palliative care were excluded. The observations encompassed both day and night shifts, capturing interactions during various procedures. The total observation time was 38 h and 12 min. The observation field notes were transferred to a narrative text, which was analyzed using a reflexive thematic analysis. Findings: The healthcare professional’s ability to interact with the child at the adult ICU was influenced by the child́s illness, environmental factors, and the healthcare professional’s mindset. Three themes summarize the healthcare professionals’ approaches: A variation in the sensitivity to the child’s expressions; Parent as a gateway to the child; Attempting to give the child room for action. Conclusions: This study showed that healthcare professionals within the adult ICU had awareness that the child has special needs different from those of the adult patient. The interactions seemed to be more related to each individual situation rather than a working framework like the person and family-centered approach. This assumption, that the child’s perspective was not consistently considered, may increase the likelihood that care practices are based on an adult-oriented perspective rather than a child-centered perspective. Implications for clinical practice: These findings emphasize the need to meet the child’s needs, improve the quality of care, and focus on family-centered care for children in adult high–tech healthcare settings, underscoring that incorporating a child’s perspective is not a choice but an essential requirement.</p>}},
  author       = {{Nilsson, Helena and Jönsson, Lisbeth and Jakobsson, Ulf and Lundqvist, Pia}},
  issn         = {{0964-3397}},
  keywords     = {{Child; Family-centered care; Intensive care; Interaction; Nurse–patient relation}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Intensive and Critical Care Nursing}},
  title        = {{Interaction between healthcare professionals and the pediatric patient in an adult intensive care unit : An observational study}},
  url          = {{http://dx.doi.org/10.1016/j.iccn.2026.104469}},
  doi          = {{10.1016/j.iccn.2026.104469}},
  volume       = {{96}},
  year         = {{2026}},
}