Decreasing the distress: Choosing nurses' interventions congruent with coping behaviors in children

Hospital procedures can create great stress for children causing lasting effects on a child's social, physical, and emotional development. The purpose of this study was to explore the interventions nurses use with children, based on the children's coping behaviors. Sixty-two pediatric nurses participated in the study. Pediatric nurses were asked to select which interventions were most appropriate for a child in each of two vignettes. One scenario represented a child using approach coping, and the second represented a child using avoidant coping. Nurses were also asked which child behaviors led them to select the interventions they did. The Congruent Intervention Measure (CIM) was created for this study to measure the number of responses nurses gave for each vignette that matched the coping style of the child. The total score (CIM) for each scenario yielded the outcome variables. Each of the two outcome variables (CIMS and CIMR) were regressed on the predictor variables (stepwise regression) in order to determine the variance due to each separate variable. Nurses' average accuracy in matching interventions to children's coping was 58%. That accuracy did not increase with pediatric experience or education. The results suggest that nurses are not attempting to match interventions to children's coping styles in clinical practice. It would be important to alert nurses of the benefits of matching interventions to coping. These results indicate a need to further explore how nurses choose to support children's coping. This research was funded by the Nova Scotia Health Research Foundation.