This literature review follows a method adapted from Parahoo’s framework for a systematic review process (Parahoo 2006). As this literature review is intended to support the study of children’s views of being nursed at home, a specific research question to guide the literature review was not set. However, the steps that Parahoo suggests for a review of literature have been followed:
• Define terms.
• Design a search strategy including setting inclusion/exclusion criteria.
• Search evidence.
• Select items to review.
• Synthesise the evidence.
• Appraise evidence.
• Conclude and make recommendations in terms of the current study.
(adapted from Parahoo 2006 p 137) Although a number of approaches have been suggested for reviewing literature (Creswell 2003, Hart 2001), these all seem to follow similar processes. Parahoo’s suggested framework is as systematic and logical as those recommended by other authors.
2.2.1. Defining terms
Terms which need to be defined are: children, nursing and community setting. In the context of this study “children” is used as short hand term for children and young people. It assumes a 0-19 age range in line with the National Service Framework for Children (Department of Health, 2004a), while appreciating that childhood is
socially constructed. This means persons born before 1988 might be assigned the label adult, while those born after 1988 may be labelled as a child, given that at the time of writing those born after 1988 would be aged 0-19 years.
Children’s nursing is meant to reflect nursing care, which meets the needs of children, using the Royal College of Nursing definition of Nursing (2003):
“Nursing is the use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.”
Children’s nursing is used in preference to paediatric nursing, as paediatrics is the study of children’s illness and arguably objectifies children by taking a view of children as defined by medical labels (Shaw 1996).
Community settings refer to children receiving nursing care in a space outside the institution of a hospital. This is normally the child’s own home, but may include their school or a GP practice, or community health centre.
2.2.2. Search strategy
An electronic search was conducted using the following databases; British Nursing Index 1985-2007
Journal Ovid full Text 2007 EMBASE 1988-week 46 2007
International Bibliography of Social Science 1951-week 2 2007 Medline 1950-Week 1 November 2007
Psychoinfo 1967- week 2 November 2007
A keyword search was undertaken by combining the words children and nursing with the following keywords; perception, views, conceptions, social construction, therapeutic relationship and image. This was repeated as a search of words in the title of papers with the addition of the terms nurse and child. Both these searches were limited to papers on children aged 0-18 years old.
However, only one study was identified from this electronic search strategy - While and Dyson (2000), therefore the strategy was supplemented by hand searching of the following nursing journals;
Journal of Paediatric Nursing Journal of Child Health Care Journal of Clinical Nursing Journal of Advanced Nursing
To ensure the quality of the reported studies, only peer reviewed journals were used. Copies of the journals from the past 10 years were hand searched, or the content list for each issue was reviewed online.
The author’s experience as a children’s nurse and of teaching children’s nursing had made him familiar with a number of sources. Other sources were recommended by colleagues, students and practitioners in the field of children’s nursing and research, for which grateful thanks are due. This informal searching brought so called grey literature and policy documents into the review. Although grey literature and policy documents may not be peer reviewed they can offer useful insights (Oermann et al 2008). Including these sources may also reduce publishing bias. Peer reviewed, published work may be biased because studies are only published if they fit with the editor’s and peer reviewers conceptions of what is worthy of publication. This may exclude studies which have negative findings (Stern and Simes 1997). Studies were either included or excluded from the review using the following criteria:
Inclusion criteria Rationale
Studies that reported the views of children (0-19) on or about nursing, or some aspect of nurses, or nursing care either in hospital and, or community settings.
Relevance to area of study
Written in English and reporting studies conducted in developed western, minority countries
Findings are more likely to be transferable/of relevance to a British cultural context of nursing children. Studies not limited by age or
methodology
Studies into children’s views are rare therefore including all sources increased the number of studies available.
Exclusion Criteria Rationale Studies that only report views of adults
of nursing, or some aspect of nurses, or nursing care.
This study is focused on children’s views, and does not accept adult’s views are a proxy for those of children. Studies not written in English and
which report on studies conducted in developing, non western, majority countries.
The cultural context of childhood may make these studies less transferable/of relevance to British nursing practice.
The lack of studies taking a children’s perspective of receiving nursing care at home, has led to the inclusion criteria for this review being set wide, to capture as many aspects of the phenomenon as possible. It is acknowledged that some of the methods used to identify sources, such as personal contacts from teaching children’s nursing, may mean that some sources may not be accessible to any one wishing to repeat this literature review. However, these methods have added to the breadth of the review and highlighted aspects which conventional search strategies, such as electronic searching and hand searching, did not reveal.
2.2.3. Synthesis, appraisal and conclusions
The studies which relate directly to children’s views of receiving nursing care were organised into issues and are presented in the section on children’s experience of nursing care below. The strength of the evidence base is considered in the section, “Evidence base and methodological issues” (section 2.4.).