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1. Acknowledging communication
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Nurse activities
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Communication and interaction
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Child response
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Addressing fear
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Nurse: “So, what you might do when I give you the shot; is to choose to look at it, or you can look at mummy or daddy, but it might hurt, right?”
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Becoming engaged
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Suggesting coping-strategy; time to reflect
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Child: “Yes” (nods)
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Nurse: “When you feel the needle stick, you might squeeze your mother’s hand as hard as you feel it”
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Guiding the child (and parents)
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Child: “And I can think that when its finished; it’s finished, and it’s a week until next time..”
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Nurse: “Yes”
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Showing confidence
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Child: “… and then, it might not hurt so much …” (Case1)
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2. Ambiguous communication
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Nurse activities
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Communication and interaction
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Child response
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Addressing fear
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Child: “Shows an insecure smile (non-verbal fear)
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Nurse: “I do understand if you worry about the needle-injection, it might hurt”
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Not time to become engaged
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Suggesting coping-strategy; unclear, no time to reflect
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Nurse: “Do you want to look at it or to mummy or ….?”
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Child: “I don’t know”
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Nurse: “You do as you like, what you think is best – okay? (no answer) here it is; just like a pen don’t you think? The medication is in here; not so much - and you can see that this is the one getting yellow – right? (hearing the nurse take a deep breath) -, then it’s nice and quiet”
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Taking control
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Child: Whispers something impossible to hear
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Nurse: “Shall we just have it done? Yes, I will give it here”
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Crying
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Child: “Oh – (cries quietly)”
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Surrendering
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Praising the child
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Nurse: “Do you want me to count before I do it?
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Child: (no answer)
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Nurse: (Gives the shot). There we are (with laud voice) – very brave!”
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Talking about the experience
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Child: “Yes”
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Showing relief and embarrassment (confused)
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Nurse: “How does it feel? Was it painful?”
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Child: “It didn’t hurt so much” (Case 7)
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3. Disregarding communication
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Nurse activities
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Communication and interaction
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Child response
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Reassuring
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Child: “The needle stick will hurt”
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Continuing to express fear
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Parent 1: “It will be over soon”
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Child: Speaks in a very low voice
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Suggesting coping strategy; unclear, and persuading
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Nurse: “You will hardly notice anything”
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Child: “Yes, but I don’t dare”
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Parent 2: “Come on, you can hold on to me”
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Crying
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Child: “I don’t dare” –(cries)
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Protesting
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Parent 2: “Breath”
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Child: “I don’t want to” – (cries)
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Offering a prize
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Nurse: “I will find you a prize afterwards”
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Child: “I don’t want to” – (cries softer) (Case5)
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Surrendering
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