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Reframing a sense of self: a constructivist grounded theory study of children’s admission to hospital for surgery


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Ford, K 2010 , 'Reframing a sense of self: a constructivist grounded theory study of children’s admission to hospital for surgery', PhD thesis, University of Tasmania.

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Children are significant users of healthcare and their needs are different to those of
adults. Whilst important gains have been made in children’s hospital care since the
last half of the 20th century, there is a recent trend to reduce dedicated paediatric
services in Australia. In order to provide healthcare services that are child centred
and that truly respond to the needs of children, children’s perspectives on their
healthcare are essential. Yet the inclusion of children’s perspectives in health
services and research is lacking. It is through listening to, and hearing children, that
health care can move closer to meeting their needs. This qualitative study explored
the experiences of 10 primary school aged children (six to twelve years of age)
admitted to hospital for surgery, from their perspective. A constructivist grounded
theory approach was used that incorporated flexible, child centred research
techniques including interviews and the ‘draw and write technique’.
This thesis presents a substantive theory: children’s reframing of their sense of selves
to incorporate the experiences of hospitalisation and surgery. The children were
active participants embedded within the phenomenon. Admission to hospital for
surgery presented a form of adversity for the children in what was an embodied
experience of contrasts. Major concepts of the experience were: ‘being scared’;
‘hurting’; and ‘having fun’. There were two major processes the children engaged in
for reframing their sense of self to incorporate the experience. The first was around
their meaning making activities, expressed as ‘coming to know’ and the second was
their ability to move on from the adversity and reintegrate the experience into their
normal lives, expressed as ‘bouncing back’. In order for the children to successfully
incorporate the experience into their sense of self, a supportive context or holding
environment was necessary, expressed as ‘being held’.
Children were the primary source of knowledge about their views and experiences
for this study. The findings highlight the importance of centring children’s healthcare
on the needs of children and their families. The findings suggest that ongoing
problems with paediatric practices continue to impact negatively on children’s
experiences of hospitalisation. Although there is a body of evidence about what
constitutes best practice, in reality, practices fall short of these recommendations.

Item Type: Thesis - PhD
Authors/Creators:Ford, K
Keywords: children's experience of hospital; constructivist grounded theory
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