1. Objectifs

Intentions :
Cette thèse par articles est composée de 4 articles. Le troisième article fait l’objet de cette fiche. L’objectif général de la thèse est «d’explorer l’expérience vécue des infirmières(iers) d’une unité de soins intensifs pédiatriques concernant des changements environnementaux et d’amélioration continue.» (p. 8) L’objectif du troisième article est d’examiner l’expérience des infirmières(iers) en lien avec les soins aux familles dans une unité de soins intensifs pédiatriques à la suite d’un projet de transformation de l’hôpital.

2. Méthode

Échantillon/Matériau :
The study takes place at Hôpital Sainte-Justine in Montréal. «The study site is a 32 single-patient intensive and intermediate care bed PICU [pediatric intensive care unit], in a large Canadian pediatric hospital located in an urban setting employing 125 nurses.» (p. 129) «The study participants were 15 PICU nurses who experienced both the old and the new infrastructure of the unit […].» (p. 129) «The data collection methods for this study consisted of individual interviews, photographs, participant observation, and document review.» (p. 130) «Data was collected over a six-month period (September 2018 – March 2019) […].» (p. 130-131)

Instruments :
Guide d’entretien
Grille d’observation

Type de traitement des données :
Analyse de contenu

3. Résumé

The results of the study show that «[d]espite pride in offering a family-friendly environment, nurses’ practice prejudiced a family focus in favour of patient-centered care. Nurses in this study negotiated physical and practice spaces with families by interpreting that nurses do not belong in the home-like patient room, and exhibiting gatekeeping comportments.» (p. 126) «Whereas the home-like feel of the patient room benefits the child and family, nurses’ interpretation of patient’s room as the family’s home makes them reluctant to go in. This can have consequences for quality of care since nurses are mostly nursing at a distance, limiting certain means of evaluation, like touch, and inhibiting profound engagement in family life.» (p. 140-141) «Nurses actually engage in a complex process of negotiating the physical and care environments with families. They constantly interpret and reinterpret where each party belongs in terms of physical spaces, as well as their involvement in clinical care. […] In the context of the current study, where nurses interpreted families as encroaching on nurses’ space, nurses similarly engaged in gatekeeping comportments. Nurses protected what they identified as belonging to them through enforcing rules and controlling access to clinical care.» (p. 142)