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Healthcare professionals' experiences of situations during a procedure with a child with autism spectrum disorder in the high-technology environment
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
Jönköping University, School of Health and Welfare, HHJ, Department of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.ORCID iD: 0000-0003-2500-190x
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.ORCID iD: 0000-0001-7153-8543
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.ORCID iD: 0000-0003-4599-155X
2023 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 49, no 6, p. 1087-1095Article in journal (Refereed) Published
Abstract [en]

Background: High technological environments can be challenging for children with autism spectrum disorders (ASD), because they can be sensitive to new environments, new faces and changes in daily routines. Those children are frequent visitors in those settings, and due to their heightened healthcare needs and their comorbidities, it could constitute a challenge for healthcare professionals to encounter those children. Exploring the healthcare professionals' experiences can contribute to facilitate the procedure for a child with ASD. Method: A qualitative descriptive retrospective design with a critical incident technique has been used to capture the situations. Twenty healthcare professionals were interviewed about situations affecting the procedure in the high-technology environments, defined as anaesthesia and radiology departments. Result: The findings revealed both favourable situations and unfavourable situations affecting the procedure in the high-technology environment. The situations described by the healthcare professionals often involved their interactions with the child and the parents. The interactions were influenced by the parents' attitudes to the procedure and also the healthcare professionals and the parents' different expectations on the procedure. Other experiences described by the healthcare professionals were the unpredictability in different situations. Those situations were related to the child's unpredictable behaviour in those environments and also to the unpredictable effect of premedication provided to the child. Moreover, the result revealed the organizational prerequisites for facilitating a procedure, such as not feeling any time pressure when leading a child through a procedure. Conclusions: Interactions between healthcare professionals, children with ASD and parents in the high-technology environment are complex. Unpredictability characterizes situations when leading a child with ASD through a procedure. This place demands on the healthcare professional, the environment and the organization.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 49, no 6, p. 1087-1095
Keywords [en]
Autism Spectrum Disorder, Child, Critical incident technique, Experiences, Health Personnel, High technology environments
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-60171DOI: 10.1111/cch.13119ISI: 000961480000001PubMedID: 37009780Scopus ID: 2-s2.0-85151482671Local ID: HOA;;875845OAI: oai:DiVA.org:hj-60171DiVA, id: diva2:1751393
Available from: 2023-04-18 Created: 2023-04-18 Last updated: 2024-05-08Bibliographically approved
In thesis
1. Finding a pathway – through a procedure in a high-technology environment for a child with an autism spectrum disorder from the perspectives of parents and healthcare professionals
Open this publication in new window or tab >>Finding a pathway – through a procedure in a high-technology environment for a child with an autism spectrum disorder from the perspectives of parents and healthcare professionals
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis framed in the area of disability research describes the pathway for a child with autism spectrum disorder (ASD) through a procedure in a high-technology environment, anaesthesia or radiographic procedures from the perspectives of parents and healthcare professionals. Visiting healthcare services for such procedures can be challenging for a child with ASD partially because of all the stressors in the environment but also because of the preparation phase and the interruptions in the daily routines. Finding the most suitable pathway puts high demands on parents and healthcare professionals and the organisation.

This thesis aims to explore and deepen the understanding of the pathway of a child with ASD through a procedure in a high-technology environment from the perspectives of parents and healthcare professionals.

Four studies with different methods were conducted to achieve this overall aim, and the four studies had sub-aims connected to the overall aim. Study I explored the parent’s experience of procedures in the high-technology environment together with their child with ASD. Data were collected by a systematic literature review and were obtained from ten studies describing the parents’ experiences. Studies II and III used critical incident technique (CIT) to identify healthcare professionals’ different experiences of situations and actions when leading a child with ASD through a procedure. Twenty healthcare professionals were interviewed, and the interviews revealed over five hundred situations and actions. The situations and actions were then clustered and analysed separately. In Study IV, the parents described the path through a procedure from their own perspective and also from the child’s perspective. The analysis was conducted using reflexive thematic analysis.

The findings revealed the complexity of leading a child with ASD through a procedure, underscoring the interplay between the child's impairment and the demanding environment. Parents expressed a profound sense of responsibility for their child's well-being during procedures, and potential consequences of the procedure for the child. Healthcare professionals described a challenge in those situations in relation to the child, the parents, and organisational structures. Healthcare professionals have a great role in facilitating the child’s progress during a procedure in high-technology environments, and in collaboration with the parents the best outcome can be achieved.

Through the lens of the Person Process Context Time model (PPCT model) the findings contribute to a deeper understanding of the complexity of leading a child with the disabilities associated with ASD through an environment full of sensory stimuli. Additionally, the findings can contribute as a tool for healthcare professionals in such situations. The healthcare professionals also need to be aware of the burden and loneliness the parents feel in those situations and the tools they require to navigate through the procedure. Furthermore, this thesis underscores the importance of initiating discussions around the use, impact, and consequences of physical restraint during those procedures.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2024. p. 75
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 135
Keywords
children with autism, parents, healthcare professionals, high-technology environment, procedures, experiences
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-64162 (URN)978-91-88669-45-2 (ISBN)978-91-88669-46-9 (ISBN)
Public defence
2024-05-31, Forum Humanum, School of Health and Welfare, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-08 Created: 2024-05-08 Last updated: 2024-05-08Bibliographically approved

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Pettersson, EmelieMøller Christensen, BeritGimbler Berglund, IngalillHuus, Karina

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