Initial Identification And Investigation Of Interventions Core To Pediatric Oncology Nursing Based On Nursing Interventions Classification(NIC-6^th)

ObjectiveTo identify the core interventions performed by pediatric oncology nurses;To explore differences and similarities on pediatric oncology nursing practice through comparing core nursing interventions between China and America;To know the clinical application of the core interventions performed by pediatric oncology nurses;To provide reference for the standardization of pediatric oncology nursing,and for promotion of the practice,education,human resource management of pediatric oncology nursing.MethodsThis study has three partsThe first part of this study was the translation of the updated part of Nursing Interventions Classification(NIC-6th)according to the translation guideline from the International Council of Nursing.The second part of this study was a Delphi study and a comparative study.The questionnaire was derived from NIC-6th based on the Chinese version of NIC-5th and the translation in the first part.A 10-member expert panel engaged in a 2-round survey to identify the pediatric oncology nursing core interventions from 2 aspects:the representation of practice(R)and the frequency of application(F).All the experts were the members of Nursing group of Chinese Anti-cancer Association Children Cancer Group.Interventions,which R*F>16,and chosen by more than one half hospitals,were selected as core interventions.Then,using the classic four steps of comparative pedagogy developed by Bereday G,the interventions core to pediatric oncology nursing were described,interpreted,collocated and compared between two countries.The third part of this study was a descriptive study.A questionnaire of application frequency of 82 core interventions,conducted by experts consensus based on Nursing Interventions Classification(NIC-6tn)was send to all the pediatric oncology nurses from 5 nation wide selected hospitals in January 2016.ResultsIn the translation part,64 nursing interventions were translated into Chinese and the validity of the translation was 0.93.In the Delphi part,82 interventions were selected as core interventions to pediatric oncology nursing,which covered 7 domains(physiological basic,physiological complex,behavior,safety,family,health system and society)and 24 classes.24 interventions were the same as ones of 42 core pediatric oncology nursing interventions from NIC-6t'.The sensitivity was 57.1%and the specificity was 65.5%.Comparing practice domains,Chinese and American pediatric oncology nurses both preferred to physiological complex domain(China 30.5%,America 33.3%),behavior domain(China 31.7%,America 33.3%)and family domain(China 17.1%,America 23.8%).As to classes,Chinese pediatric oncology nurses performed more interventions related to patient education(20.7%),risk management(12.2%)and childrearing care(13.4%),while American nurses performed more of coping assistance(14.3%)and lifespan care(14.3%).In the survey study,295 clinical nurses participated in total in this study(the completion rate was 88.86%),and 285 questionnaires were valid(the efficiency was 96.61%).The application rate of 82 core interventions were from 83.86%to 100%,97.56%interventions were applied at least once a day by more than 50%of the pediatric oncology nurses.There were differences between North China and East,West,South China in basic and complex physiology domain,and differences between North China and East China in family domain.As to professional grade,intermediate grade nurses performed frequently in basic physiology domain compared to other grade nurses.There was no significant difference according to department,position and education level in domains.ConclusionChinese pediatric oncology nursing core interventions were 82 interventions,24 classes,7 domains.Chinese and American pediatric oncology nursing core interventions showed similarities between China and America in domains,but significant differences in classes.The further development of Chinese pediatric oncology nursing core interventions rely on refining interventions,expanding items related to "family-centered" care,and to be sustainable and with Chinese characteristics.Core interventions of pediatric oncology nursing were frequently performed in practice,showing difference by the groups of regions,especially North China.Professional grade of intermediate nurses showed difference from others.The group showed no difference between position or education level,even though both should relate to professional grades.