Improvement of care by video interaction guidance: proof of the pudding

Burn injuries and their care are punishing experiences for hospitalized children. It is thought

that if nurses have more skills to interact with children during the recurring medical events, the

necessary wound care could be less distressing and painful for the children (Nillson et al.,

2011). To modify behaviour of burn nurses video interaction guidance (VIG) has been used in

the past couple of years in the burn centre in Groningen. The aim of this study is to gain further

evidence on the effect of video interaction guidance on the interaction between nurse and child

(process) and moreover on the effect on the distress of a child during wound care procedures

(outcome). To this end, at the burn centre of the Maasstad Hospital in Rotterdam, eleven

nurses will be randomly selected and allocated to receive VIG (4 nurses) or not (7 nurses). Of

the nurses receiving VIG, 3 wound dressing chances will be videotaped before they receive

VIG and three after they have received VIG. To assess whether VIG changes the interaction

between nurse and child during wound care procedures (process), the anonymised tapes are

then scored using the taxonomy by two experienced raters. To investigate whether the

interactional behaviour of nurses during wound care procedures is related to the pain and

distress experienced by the child an observation scale, the tapes are scored by a third

independent rater using the COMFORT behaviour scale (COMFORT-B).

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Video interaction guidance is an intervention where the nurses are guided to reflect on video clips of their own successful interactions. In short, adult-child interactions are filmed and edited to produce a short film. In subsequent video review sessions, the interaction is discussed and feedback is given by a certified video interaction guider. By collaboratively reflecting on what happens during interactions, focussing on the positive, change in behaviour can be brought about (Caris-Verhallen et al., 2000).The filming will take place during wound care procedures. In total three review sessions will be held. In between nurses can put their newly learned skills into practice. Before session 2 and 3 new recordings of wound care procedure will be made.