The Relationship between Pediatric Nurses’ Knowledge, Attitude and Practice about Atraumatic Care of Hospitalized Children in Indonesia

The main stressors of the hospitalized children are separation from family, loss of control, pain, and the unfamiliar hospital environment. Atraumatic care is therapeutic care provided through interventions that eliminate or reduce the psychological and physical distress experienced by children and families. This study was to describe the Indonesian nurses' knowledge, attitudes, and practices regarding atraumatic care for hospitalized children and to identify the factors affecting the nurses’ practice of atraumatic care. This descriptive correlation study was held in a regional general hospital. Totally, 70 of 44 nurses in paediatric wards and 26 nurses in the PICU completed a 20 multiple-choice question scale of knowledge about atraumatic care and a 30-item scale of attitude towards atraumatic care. The behaviours were observed using a 25-item Nurses' Practice Scale for Atraumatic Care. Compared to their colleagues in other units, the nurses in the PICU (12.65±2.79) had the best knowledge, and the nurses in the pediatric wards had the best attitude (98.19±9.76) and practice (63.09±10.64) toward providing atraumatic care. The Spearman Rank correlation analysis indicated that nurses with better levels of knowledge tended to have better attitudes (r = 0.317, p<0.001), and those who had better attitudes were more likely to implement atraumatic care (r = 0.428, p=0.03). Additionally, nurses with higher levels of knowledge are more likely to translate their knowledge into practice (r = 0.377, p<0.001). Hierarchical linear regression revealed that nurses who were working in the pediatric wards and were female and had better knowledge and attitude had significantly better practice scores in providing atraumatic care than those who were working in the PICU and were male. Trainings regarding the provision of atraumatic care for hospitalized children should be developed for the nurses to improve their knowledge and attitude so they can provide optimal care to minimize the impact of hospitalization on children.