‘Visible‐ness’: the nature of communication for children admitted to a specialist children's hospital in the Republic of Ireland

Abstract

This article presents the core concept of 'visible-ness' that emerged from an ethnographic study, which explored the nature of communication, for children (for ease of reading children refers to children and young people), admitted to a children's hospital in the Republic of Ireland. The importance of engaging with both child and family has been espoused as fundamental in promoting 'family'-centred care. To date, studies have almost exclusively explored parents' and nurses' perspectives of the nature of parent participation and nurse-parent interactions and relationships. Although there is evidence of an emerging body of knowledge, which explores children's perspectives of their information, and communication needs, little is known empirically about the communication process between children and members of the health care team in inpatient hospital settings. The principles of ethnography underpinned the study design. Fieldwork took place over four months in one 35-bedded children's ward. Forty-nine children, ranging in ages from 6 to 16 years with a variety of medical and surgical conditions, participated. Various modes of data collection were employed, namely semi-participant observations, unstructured interviews, draw and write technique and a child-friendly 'stick a star' quiz. The core concept to emerge was that of 'visible-ness'. 'Visible-ness' existed along a continuum consisting of two polar ends, 'being overshadowed' and 'being at the forefront'. These polar ends illuminated the degree to which children were, or wanted to be, included in the communication process and the extent to which children's agenda was addressed. This study provides empirical insight into children's experiences of communication in an inpatient hospital setting. A key recommendation calls for the development of communication assessment strategies to determine the 'ideal' position children would like to occupy, at any given point in time, along the 'visible-ness' continuum. This study emphasises the need for all health professionals to embrace the individualism of each child patient with regard to their specific communication needs.