British hospital paedriatic care is more advanced than Australia's in some areas, according to preliminary results of a University of Queensland study.
For her PhD thesis with the University's Paediatrics and Child Health Department, Linda Shields surveyed parents and hospital staff in Australia, Britain and Indonesia about all aspects of child hospital care and is about to complete the same survey for Thailand.
Mrs Shields will then develop a paediatric care model which can be applied universally regardless of country or culture.
The thesis has identified several universal themes in child hospital care regardless of country, for example, that parents and staff believe children cope better in hospital if their parents are able to stay and that this should be a normal practice.
As expected, the thesis has found hospital care of children in Indonesia differs greatly from practices and attitudes in Australia and Britain. For example, while Australian and British parents are unanimous that parents should make the decisions regarding their children's care in hospital, only 55 percent of the Indonesian parents concurred with this statement, reflecting the high social status attributed to doctors in that country.
However, the study has also turned up surprising differences in attitudes and practices involved in caring for children in Australian and British hospitals, reflecting the greater emphasis given to paediatric care in hospitals in the U.K.
For example, while parents and staff in Australia and Britain were unanimous in their belief that parents should have a role in administering basic care such as feeding, bathing and comfort to their hospitalised children, the British sought a greater involvement in higher level care.
The thesis found that 53 percent of parents and 90 percent of staff at British hospitals believed parents should have a role in administering more complicated care such as needles and drips to their children compared with 36 percent of parents and 53 percent of staff in the Australian survey. The result for Indonesia was nine percent of parents and one percent of staff.
'This result reflects the different thinking about paediatric care in the United Kingdom as compared to Australia. The Indonesian result is not surprising given the high status of doctors and the belief that such procedures are solely the doctors' domain. But I had expected that attitudes in Australia and Britain would be similar,' Mrs Shields said.
She said another example of the wish for greater parental involvement in child hospital care was that 98 percent and 85 percent of British parents believed parents should be present and involved in the induction of and recovery from anaesthesia involving their children compared to 81 percent and 72 percent respectively of Australian parents.
Questionnaires were collected from 120 parents and 120 staff (doctors, nurses and allied health professionals such as physiotherapists) at five Indonesian hospitals, 220 parents and 220 staff at seven British hospitals and 330 parents and 330 staff at 12 Australian hospitals. Mrs Shields will gather 240 surveys and analysis for three hospitals in Thailand.
Mrs Shields said Britain maintained extremely high standards in child hospital care thanks largely to a strong lobby group known as Action for Sick Children. The group had attracted a groundswell of public and government support, raising awareness of the emotional and practical needs of sick children. Australia's equivalent organisation, the Association for the Welfare of Child Health, while strong in New South Wales, was recently forced to close its Queensland branch due to a lack of financial and practical support, she said.
A registered nurse for more than 30 years who currently works for the Mater Children's Hospital, Mrs Shields said Britain's excellent paediatric care standards stemmed from a virtual revolution in the area since research by Dr John Bowlby and James Robertson in the 1950s culminating in the 1959 Platt Report recommending measures such as parents being allowed to stay with their children in hospital and the establishment of school and play facilities within hospitals.
She said another reason why British hospital staff were more aware of the psychosocial needs of children and families in hospital was the higher incidence of paediatric qualifications. According to the study, 71 percent of the British staff had paediatric qualifications compared with only 31 percent of Australian staff.
'This reflects government awareness of the needs of children in hospital in Britain. In addition, all British hospitals which admit children must have at least two nurses with paediatric qualifications on duty whenever a child is admitted. In Australia, there is no such law, and no legal imperative on Australian nurses to gain a paediatric qualification,' she said.
Supervised by Department senior lecturer Dr Jim Nixon and co-supervised by senior lecturer Dr Judith Fitzpatrick, the PhD has been funded by a three-year, $48,000 National Health and Medical Research Council Dora Lush Memorial Scholarship, a $10,000 Queensland Nursing Council Research Grant, a $9000 Centaur Memorial Fellowship for Nurses grant and a $5000 Mater Children's Hospital grant.
For more information, contact Mrs Shields (telephone 07 3892 3363 or email l.shields@mailbox.uq.edu.au).
