Experiences of Nurses Providing Care to Burned Children Regarding Atraumatic Care Practices: A Qualitative Study

Research Article

Authors

DOI:

https://doi.org/10.5281/zenodo.17915075

Keywords:

Atraumatic care, Burn, Child, Nurse

Abstract

Introduction: In pediatric burn care, atraumatic approaches are crucial to reducing children’s stress, pain, and anxiety, yet nurses’ experiences in this area remain insufficiently explored.

Objective: The aim of this study was to explore the experiences of nurses providing care to burned children regarding atraumatic care practices.

Method: This phenomenological qualitative study was conducted between March-July 2025 in the pediatric surgery department of training and research hospital in western Turkey. Fifteen nurses who had at least one year of experience in pediatric burn care were selected through purposive sampling. Data were collected via in-depth individual interviews using a semi-structured interview form and analyzed using inductive content analysis with the support of MAXQDA software.

Results: Analysis revealed one main theme, “Atraumatic Care for Injured Children,” comprising three categories and thirteen codes. Nurses reported employing strategies such as distraction, breastfeeding for infants, collaboration with families, providing age-appropriate explanations, and understanding children’s emotions during painful procedures like burn dressing. These practices were perceived to reduce fear and stress, decrease pain perception, alleviate psychological trauma, enhance treatment compliance, foster a sense of security, and increase patient-family satisfaction. Additionally, nurses recommended increasing the availability of distraction tools (e.g., toys, bubble machines, audiovisual devices) and arranging child-friendly physical environments to strengthen atraumatic care practices.

Conclusion: Atraumatic care is a key nursing approach that supports both the physical and psychological well-being of burned children. To improve care quality, it is recommended to provide supportive resources, increase the number of distraction tools, and design child-friendly care environments.

References

Jeschke MG, Gauglitz GG. Pathophysiology of burn injuries. Handbook of burns. Vol. 1. Cham: Springer; 2020, doi:10.1007/978-3-030-18940-2_18

Knighton J. Burn. In: Lewis SL, Bucher L, Heitkemper MM, Harding MM., Kwong J, Roberts D, editors. Medical-surgical nursingE-book: assessment and management of clinical problems. St. Louis, Missouri: Elsevier Health Sciences; 2016

Lowell G, Quinlan K, Gottlieb LJ. Preventing unintentional scald burns: moving beyond tap water. Pediatrics. 2008;122(4):799–804

Pham TN, Cancio LC, Gibran NS. American Burn Association Practice Guidelines: Burn Shock Resuscitation. Journal of Burn Care and Research. 2008;29(1):257–66

WHO: Burns. Fact Sheet. Geneva; 2016. Available at: https://www.who.int/en/news-room/fact-sheets/detail/burns. (Accessed August 8, 2025).

Zhu, H., Wang, K., Liu, X., Ji, J., Yang, P., & Xu, F. Global burden of burns among children and adolescents: a trend analysis from the global burden of disease study 2019. Frontiers in Public Health, 2025;13: 1505023.

Demir, S., Bostancı, S. A., Erten, E. E., Çayhan, V. S., Öztorun, C., Altınok, M. K., ... & Şenel, E. Çocuklarda temas yanıkları; Bir çocuk yanık merkezinin 10 yıllık deneyimi. Ahi Evran Medical Journal, 2021;5(2): 146-151.

Özlü, Ö., & Basaran, A. Epidemiology and outcome of 1442 pediatric burn patients: A single-center experience. Turkish Journal of Trauma & Emergency Surgery, 2022;28(1): 57.

Zabihi MR, Bastani M, Rashtiani S, Yavari S, Akhoondian M, Farzan R. The role of nursing care during post-burn mood disorders: A narrative review. Journal of Nursing Reports in Clinical Practice, 2024;3(3): 279-289

Wang Y, Wong FKY, Bayuo J, Chung LYF, Zhang L, Wang T. Challenges faced by nurses and family members of burn patients: An integrative review. Nursing Open, 2023;10(6):3547-3560

Bayuo J, Agyei Bediako F, Allotey G, Kyei Baffour P. Developing support strategies for burn care nurses through an understanding of their experiences: a meta-ethnographic study. Int J Nurs Pract 2019;25:e12685

Neto J, Fernandes R, Andrade L, Fernandes I, Martins T, do Céu Barbieri-Figueiredo M, Lima L. Invasive procedures and atraumatic care in pediatric nursing practice: nurses’ perceptions. Frontiers in Pediatrics 2025;13:1543138

Cambiaso-Daniel J, Suman OE, Jaco M, Benjamin DA, Herndon DN. Teamwork for total burn care: burn centers and multidisciplinary burn teams. In: Herndon DN, editor. Total burn care. New York: Elsevier; 2018. p. 813.e11. doi:10.1016/B978-0-323-47661-4.00002-2

Benjamin DA, Jaco M. Burn nursing. In: Herndon DN, editor. Total burn care. New York: Elsevier; 2018. p. 355–63.e51. doi:10.1016/ B978-0-323-47661-4.00002-2

Haik J, Brown S, Liran A, Visentin D, Sokolov A, Zilinsky I, Kornhaber R. Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians. Neuropsychiatr Dis Treat 2017;13:1533–40. doi:10.2147/ NDT.S133181. PMID: 28670122; PMCID: PMC5478274

Kornhaber RA. The lived experience of nursing severe burns injury patients: a phenomenological inquiry. 2009, https://hekyll.services.adelaide.edu.au/dspace/ bitstream/2440/56331/9/01front.pdf (Accessed 24 July 2025)

Harrison RL, Reilly TM, Creswell JW. Methodological rigor in mixed methods: An application in management studies. Journal of Mixed Methods Research 2020;14(4): 473-495

Korkmaz İ. Population, sample, and sampling techniques in quantitative research. In B. Oral, A. Çoban (Eds), From theory to practice: Scientific research methods in education, Pegem Academy Publications, Ankara, 2020, pp.147-159.

Merriam SB, Grenier RS. Qualitative research in practice: Examples for discussion and analysis. San Francisco, CA: Jossey-Bass Publishers, 2019.

Pınar Y. An introduction to videography and video analysis in qualitative research. Pegem Academy, Ankara, 2022.

Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology, 2006;3(2):77-101. doi:10.1191/1478088706qp063oa

Dodgson JE. Reflexivity in qualitative research. J Hum Lact. 2019;35(2):220–2. doi:10.1177/0890334419830990

Lincoln YS, Guba EG. Naturalistic Inquiry. Beverly Hills, CA: Sage Publications, 1985, pp.289–331. doi:10.1016/0147-1767(85)90062-8

Kyngäs H, Kääriäinen M, Elo S. The Trustworthiness of Content Analysis. In: Kyngäs, H., Mikkonen, K., Kääriäinen, M. (eds) The Application of Content Analysis in Nursing Science Research. Springer, Cham. 2020;pp.41-48. doi:10.1007/978-3-030-30199-6_5

Koller D, Goldman RD. Distraction techniques for children undergoing procedures: A critical review of pediatric practice. Child: Care, Health and Development. 2023;49(2):187–196. Doi:10.1111/cch.13079

Birnie KA, Noel M, Parker JA, Chambers CT, Uman LS, Kisely SR. Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents. Journal of Pediatric Psychology 2018;43(8):903–918. doi:10.1093/jpepsy/jsy053

Zhang X, Cui C, Ren J, Cheng D, Wu W, Yu J. A randomized trial of a distraction-type intervention to assist in managing dressing changes for children experienced burns. Journal of advanced nursing 2019;76:3 doi:10.1111/jan.14278

Agustus JL, Golden HL, Callaghan MF, Bond RL, Benhamou E, Hailstone JC, Warren JD. Melody processing characterizes functional neuroanatomy in the aging brain. Frontiers in Neuroscience 2018;12:815

Lynn SJ, Malakataris A, Condon L, Maxwell R, Cleere C. Post-traumatic stress disorder: cognitive hypnotherapy, mindfulness, and acceptance-based treatment approaches. American Journal of Clinical Hypnosis 2012;54(4):311-330.

Shah PS, Aliwalas LL. Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database of Systematic Reviews, 2023;12:CD004950. doi:10.1002/14651858.CD004950.pub4

Cheraghi F, Shirinabadi Farahani A, Torkaman M, Rassouli M. The effect of visual–auditory distraction on pain and physiological indicators in school-age children during burn dressing change: A randomized controlled clinical trial. Journal of Pediatric Nursing, 2021;58:e81–e86. doi:10.1016/j.pedn.2020.11.016

Xiang H, Yabroff KR, Gielen A, McDonald CC, Carlson KF, Finch CF. Effect of smartphone-based virtual reality on pain during burn dressing changes in children: A randomized clinical trial. JAMA Network Open, 2021;4(6):e2112083. doi:10.1001/jamanetworkopen.2021.12083

Norouzkhani N, Farnia V, Yazdchi K, Hosseini S, Khodabakhsh M. Virtual reality for pain management in burn patients: A systematic review and meta-analysis. Pain Research and Management, 2022, 1–15. doi:10.1155/2022/3520972

Canbulat N, Inal S, Sönmezer H. Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian Nursing Research, 2014;8(1):23–28. Doi:10.1016/j.anr.2013.12.001

Inal S, Kelleci M, Canbulat N. Distraction cards reduce pain and anxiety during blood draw in children aged 6–12 years: A randomized controlled study. International Journal of Nursing Practice, 2012;18(2):210–219. Doi:10.1111/j.1440-172X.2012.02019.x

van der Heijden MJE, Oliai Araghi S, van Dijk M, Jeekel J, Hunink MGM. Do hospitalised premature infants benefit from live music interventions? A randomized controlled trial. Burns, 2018;44(4): 881–888. doi:10.1016/j.burns.2018.01.012

Lambert V, Coad J, Hicks P, Glacken M. Young children’s perspectives of ideal physical design features for hospital-built environments. Journal of Child Health Care, 2021;25(3): 447–459. doi:10.1177/1367493520917573

Coyne I, Holmström I, Söderbäck M. Centeredness in healthcare: A concept synthesis of family-centered care, person-centered care and child-centered care. Journal of Pediatric Nursing, 2016;31(3): 321–329. Doi:10.1016/j.pedn.2015.11.010

Shepley MM, Pasha S. Design for pediatric and neonatal critical care. New York: Routledge. 2013

Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, Joseph A. A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 2008;1(3):61–125. doi:10.1177/193758670800100306

Downloads

Published

2025-12-22

How to Cite

Karakaya Suzan, Özge, Çalışkan, M., & Çınar, N. (2025). Experiences of Nurses Providing Care to Burned Children Regarding Atraumatic Care Practices: A Qualitative Study: Research Article. Acta Medica Ruha, 3(4), 155–165. https://doi.org/10.5281/zenodo.17915075

Issue

Section

Research Articles