Pediatric nursing care with post-divorce families : a multiple segment factorial vignette investigation

Abstract

Recent trends in family formation and dissolution necessitate adapting healthcare procedures to better serve contemporary families. This study investigated nurse responses to variability in children's family structure and common post-divorce coparenting or custody dynamics. Data from 150 nurses were collected using an online survey made up of a series of short vignettes describing a hypothetical child patient newly diagnosed with a chronic illness (type 1 diabetes) and their family. Follow-up interviews with a subset of 23 nurses who participated in the online survey were used to explore how nurses navigated the hypothetical situations presented in the online survey, and factors that might ease or inhibit their interactions. Results provided evidence that nurses' perceived preparedness for working with patients differed across post-divorce family structures, and that complications regarding coparenting conflicts and custody disagreements reduced nurses' perceived preparedness. A grounded theory was developed positing that how nurses' respond to parents depends on whether they were more relationally-oriented or educationally-oriented in their beliefs about working with families. Further statistical tests revealed that education may influence the orientation nurses endorse. Implications for practice, theory, and future research are discussed.