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      ‘Smiles and laughter and all those really great things’: Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability

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          Abstract

          Aim

          To understand what constitutes a good experience of care for inpatient children and young people with intellectual disability as perceived by nursing staff.

          Design

          Interpretive qualitative study.

          Methods

          Focus groups with clinical nursing staff from speciality neurological/neurosurgical and adolescent medicine wards across two specialist tertiary children's hospitals in Australia were conducted between March and May 2021. Data analysis followed interpretative analysis methods to develop themes and codes which were mapped to a conceptual model of safe care.

          Results

          Six focus groups with 29 nurses of varying experience levels were conducted over 3 months. Themes and codes were mapped to the six themes of the conceptual model: use rapport, know the child, negotiate roles, shared learning, build trust and relationships, and past experiences. The analysis revealed two new themes that extended the conceptual model to include; the unique role of a paediatric nurse, and joy and job satisfaction, with a third contextual theme, impacts of COVID‐19 pandemic restrictions. With the perspectives of paediatric nurses incorporated into the model we have enhanced our model of safe care specifically for inpatient paediatric nursing care of children and young people with intellectual disability.

          Conclusion

          Including perceptions of paediatric nurses confirmed the position of the child with intellectual disability being at the centre of safe care, where care is delivered as a partnership between nursing staff, child or young person and their parents/family and the hospital systems and processes.

          Impact

          The enhanced model offers a specialized framework for clinical staff and health managers to optimize the delivery of safe care for children and young people with intellectual disability in hospital.

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          Most cited references43

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          Whatever happened to qualitative description?

          The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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            Are We There Yet? Data Saturation in Qualitative Research

            Failure to reach data saturation has an impact on the quality of the research conducted and hampers content validity. The aim of a study should include what determines when data saturation is achieved, for a small study will reach saturation more rapidly than a larger study. Data saturation is reached when there is enough information to replicate the study when the ability to obtain additional new information has been attained, and when further coding is no longer feasible. The following article critiques two qualitative studies for data saturation: Wolcott (2004) and Landau and Drori (2008). Failure to reach data saturation has a negative impact on the validity on one’s research. The intended audience is novice student researchers.
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              Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry.

              Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced. This landmark contribution to qualitative research remains in use today, with only minor modifications in format. Despite the significance of this contribution over the past four decades, the strategies recommended to achieve trustworthiness have not been critically examined. Recommendations for where, why, and how to use these strategies have not been developed, and how well they achieve their intended goal has not been examined. We do not know, for example, what impact these strategies have on the completed research. In this article, I critique these strategies. I recommend that qualitative researchers return to the terminology of social sciences, using rigor, reliability, validity, and generalizability. I then make recommendations for the appropriate use of the strategies recommended to achieve rigor: prolonged engagement, persistent observation, and thick, rich description; inter-rater reliability, negative case analysis; peer review or debriefing; clarifying researcher bias; member checking; external audits; and triangulation.
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                Author and article information

                Contributors
                l.mimmo@student.unsw.edu.au , laurel.mimmo@health.nsw.gov.au , @Laurel_Mimmo
                @NoraSamirSYD
                @j_travaglia
                @WoolfendenSusan
                @reemaharrison
                Journal
                J Adv Nurs
                J Adv Nurs
                10.1111/(ISSN)1365-2648
                JAN
                Journal of Advanced Nursing
                John Wiley and Sons Inc. (Hoboken )
                0309-2402
                1365-2648
                22 April 2022
                September 2022
                : 78
                : 9 ( doiID: 10.1111/jan.v78.9 )
                : 2933-2948
                Affiliations
                [ 1 ] Clinical Governance Unit The Sydney Children's Hospitals Network Sydney NSW Australia
                [ 2 ] Population Child Health Research Group School of Women's and Children's Health Faculty of Medicine University of New South Wales Sydney NSW Australia
                [ 3 ] Centre for Health Services Management Faculty of Health University of Technology Sydney Sydney NSW Australia
                [ 4 ] Centre for Health Systems and Safety Research Australian Institute of Health Innovation Faculty of Medicine, Health and Human Sciences Macquarie University Sydney NSW Australia
                Author notes
                [*] [* ] Correspondence

                Laurel Mimmo, c/o Sydney Children's Hospital, Randwick, Clinical Governance Unit, Level 0, South Wing, High Street, Randwick, NSW 2031, Australia.

                Email: l.mimmo@ 123456student.unsw.edu.au ; laurel.mimmo@ 123456health.nsw.gov.au

                Author information
                https://orcid.org/0000-0001-7738-8275
                Article
                JAN15256 JAN-2021-1819.R3
                10.1111/jan.15256
                9544709
                35451515
                33c7d0f0-12b7-4573-b402-6faaa3f69bd2
                © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 February 2022
                : 01 October 2021
                : 23 March 2022
                Page count
                Figures: 3, Tables: 8, Pages: 16, Words: 9707
                Funding
                Funded by: Australian Government Research Training Program
                Funded by: Maridulu Budyari Gumal, Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Translational Research Fellowship Scheme
                Funded by: University of New South Wales , doi 10.13039/501100001773;
                Categories
                Original Research: Empirical Research ‐ Qualitative
                Research Papers
                Original Research: Empirical Research–Qualitative
                Custom metadata
                2.0
                September 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                Nursing
                brilliant care,child life therapy,children,healthcare quality,hospital,intellectual disability,nurses/midwives/nursing,paediatrics,patient experience,young people

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