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Inaugural Commonwealth Nurses Conference

Our health: our common wealth 10-11 March 2012 London UK

In collaboration with the 9th CNF Europe Region Conference

Supported by the Royal College of Nursing UK

Mr TONIO PACE

Undergoing tonsillectomy: experiences of parents and children in Malta

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Undergoing Tonsillectomy:

Experiences of

Parents and Children in Malta

Tonio Pace

Nursing Officer Mater Dei Hospital - Malta

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Introduction

1.About Malta

2.Tonsils & Tonsillectomies

3.Methodology

4.Findings

5.Discussion/Recommendations

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About Malta

•Archipelago of islands

•90 km away from Sicily

•Population: 379,563

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Mater Dei Hospital – 825 Beds

Acute General

Hospital

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The Tonsils

• Made up of lymphatic tissue and are located at the

back of the mouth.

• Part of the lymphatic system, which is responsible for

fighting infection.

• Tonsillitis - tonsils become inflamed and cause fever,

sore throat, dysphagia and swelling of the lymph

nodes in the neck (Medical University of South Carolina, 2006).

• Recurrent acute infection or chronic inflammations are

indications for surgery.

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Tonsillectomy

• A common surgical procedure on children (Hellier, Knight, Hern and Waddell, 1999).

• It often entails an overnight stay in hospital as the

tonsils are removed under GA.

• In Malta, tonsillectomy is a relatively common

surgical intervention (+/- 400) yearly.

• Possibility of serious complications such as a post

tonsil bleed and/or pain, nausea and vomiting (Drake-Lee and Stokes,1998).

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Aim of the Study

• To investigate the experiences of parents and

children undergoing tonsillectomy.

• To find out how parents and children were prepared

for admission to hospital.

• To inquire about the main events that parents and

children experienced during the perioperative phase.

• To elicit the views of parents and children regarding

their discharge from hospital.

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Methodology

• Descriptive Exploratory Study

• Permission obtained from Local University Research

Ethics Board

• Sample: 10 parents and 10 children from the E.N.T

ward undergoing tonsillectomy

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Methodology

• A survey research design was used, where one was

aimed at the parents while another for children

• Consent signed by each parent

• Tool piloted on four parents and four children

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Findings

• Doctors viewed as the source who gave information.

• Nurses did not give information about surgery.

• Parents and children felt welcomed by staff.

• Ward environment although clean, but not child

friendly.

• Visiting hours need readjusting for children.

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Findings

• Parents need to tell their children about

hospitalization and surgery.

• Parents urged to accompany child to theatre.

• Child recalled being awaken by the parent.

• Parent being with the child showed a psychological

benefit.

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Findings

• Parents need to be well informed prior to discharge.

• Parents and children were eager to return home.

• Most children referred negatively to their hospital

experience.

• When children are well prepared and are allowed

to play, they view it less negatively.

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Discussion

• Nurses tend to let the doctor give the information.

• Admission and stay in hospital was a positive one.

• Good rapport between all parties is vital for the

child’s care.

• Medical jargon not suitable for lay people.

• Parents need to be left to decide on whether they

should accompany their child to theatre or not.

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Discussion

• Children get frustrated due to long waiting times and

hunger before surgery.

• All children reacted differently after surgery.

• Parents felt that their presence was beneficial.

• Parents who did not complain may have not, so as

not to compromise their child’s care.

• Children in hospital seem to have mostly missed their

immediate family member.

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Recommendations

• Information should be available and adaptable for

children.

• A theatre nurse can visit child a day before surgery

and/or introduce short tours to operating theatres.

• Section of ward to be adapted for children

providing toys, books, etc.

• Visiting hours for children need to be revised.

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Recommendations

• Awareness on parental participation.

• Discharge planning - both verbal and written.

• Staff need to listen more to parent/child's worries.

Further Research

• A larger study for further insight;

– On child’s views on the information needed,

– On whether long waiting affects the child psychologically,

– On nurses on how they should deal with children in a

mixed aged ward.

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THANK YOU