Enhance the Emotional Dimension of Caring
Year: 2025
Type: article
Abstract: INTRODUCTION The health and illness experiences of children and their families are often characterized by intense emotions that reflect suffering and vulnerability. Across children’s different development stages, illness and clinical procedures pose emotional challenges that may cause considerable distress.1,2 Consequently, pediatric nursing care involves specific strategies and tools to help children regulate their emotional responses, distinguishing it from the care provided to adults and older clients. Evidence from psychology, psychiatry, and neuroscience underscores the fundamental role of affection in supporting healthy and harmonious child development; therefore, pediatric nursing emphasizes emotionally attuned and sensitive practices grounded in a culture of affection.2-4 Building on this understanding, nurses who care for children and their families—with the therapeutic aim to alleviate emotional burdens and support emotional regulation—consider emotional needs equally as important as physiological and other health care requirements. Moreover, nurses place significant value on positively transforming the child’s and family’s health care experiences, recognizing these moments as opportunities for learning and development.1 Emotional care involves understanding children’s emotions across developmental stages, recognizing how these emotions are shared within families, and supporting adaptive emotional regulation.2 However, nurses frequently absorb the intense emotionality and suffering of their clients, which can impact their well-being and contribute to emotional exhaustion.2,3,5,6 The last global pandemic, Coronavirus Disease 2019 (COVID-19), has exacerbated these challenges, generating profound emotional experiences—marked by anxiety, fear, distress, anger, loneliness, and isolation—for children and their families. This situation further underscores the crucial importance of emotional nursing care in pediatric settings, as well as the necessity for nurses to manage their own emotions effectively.5 The emotional dimension of nursing is grounded in a holistic and integrative approach to the human being.2 Children and their families are multidimensional individuals who experience a wide range of emotions that significantly influence their well-being, reinforcing the necessity of rejecting Statement of Significance What is known or assumed to be true about this topic? Pediatric nursing is often marked by significant emotional complexity, which requires nurses to engage in emotional management. Providing compassionate care relies on understanding the emotional experiences of clients, including children and their families, as well as the nurses’ ability to handle those emotional responses. Establishing practice guidelines based on nursing research and theoretical frameworks is essential for enhancing clinical outcomes, health services, and health care economics. What this article adds? Health care institutions and nurses must recognize and value the emotional aspects of nursing. By doing so, the emotional labor involved in nursing can be integrated into reflective practice and supported by scientific evidence. It is essential to develop models of care that guide and empower nurses in addressing emotional challenges specific to pediatric nursing and health care. The application of the Emotional Labor Model in Pediatric Nursing has the potential to encourage discussions, research, and changes in practice among pediatric nurses, administrators, researchers, and nursing education programs.fragmented or reductionist perspectives. A humanized approach to care—rooted in the ethical principle of human dignity—emphasizes emotionally attuned and compassionate support.3 In light of these principles, the notion of emotional neutrality in nursing practice is increasingly challenged. Contemporary nursing science recognizes the centrality of human emotions in health care.3,5-7 Consequently, care provision demands an attentive and emotionally responsive approach, with the nurse-client relationship playing a pivotal role in facilitating both the expression and management of emotions.1-3,7 Emotional labor in nursing8 represents the operationalization of this emotional dimension. It is defined as an autonomous intervention and/or a set of strategies or tools aimed at facilitating clients’ emotional regulation, managing nurses’ own emotions, expressing emotions appropriately, and cultivating the capacity to provide emotional care.9,10 To achieve this and enhance care quality, emotional labor should be integrated into nursing education and training programs,1,8-10 fostering the development of nurses’ emotional competencies. Research on emotional labor in nursing has yielded several conceptual models and frameworks to guide understanding and practice, including the Healthcare Model of Emotional Labor,11 the Four Typologies of Emotional Labor,12 the Emotional Labor Process Model,13 and the Authentic Emotional Labor Model.14 However, in pediatric care, the unique characteristics of clients and nurse-client interactions require a distinctive model.2,11,15 Considering this gap, this paper introduces the Emotional Labor Model in Pediatric Nursing (ELMPN), outlining its foundation, key care categories, expected outcomes, and applicability in strengthening the emotional dimension of pediatric care. THE ELMPN: A MODEL OF CARE The ELMPN is characterized by its comprehensive approach to conceptualizing and operationalizing emotional labor within the field of pediatrics. The model encompasses 5 categories of care, each imbued with an affective-emotional dimension and designed to consciously facilitate the management of emotionality among clients (children and families) and nurses. These categories are as follows1: Promote a safe and affectionate environment. Nurture care with affection. Facilitate clients’ emotional management. Build stability in the relationship. Regulate own emotional disposition to care (see Figure 1) Figure 1.: Schematic representation of the ELMPN: relationship among the 5 care categories.1 The 5 care categories of the ELMPN are adaptable to different pediatric settings and children’s developmental stages, making the model a flexible framework for enhancing nursing practice with children and families. Its distinctiveness lies in the management of both clients’ and nurses’ emotions, supporting nurses’ personal and professional development, promoting emotional well-being and humanized care, and embodying the concept of triple centrality. Here, triple centrality refers to the emphasis placed on 3 interrelated domains: (1) the child/family, (2) the nurse, and (3) the child/family-nurse relationship. In domain (1), centrality is reflected in care categories such as Promote a safe and affectionate environment, Nurture care with affection, and Facilitate clients’ emotional management. In domain (2), it is represented by the category Regulate own emotional disposition to care. In domain (3), centrality is evident in the category Build stability in the relationship. The ELMPN serves as both a conceptual and practical framework for pediatric nurses, guiding the management of emotionality throughout the health-disease continuum. It emphasizes the emotional well-being of pediatric clients, acknowledges nurses’ own emotional responses, and promotes the regulation of emotions during nurse-client interactions. The model highlights the potential for emotional experiences to be transformed into opportunities for positive growth and personal development, thereby enhancing the quality of care and fostering a more humanizing health care environment. When applying the ELMPN, pediatric nurses tailor their interactions according to the children’s developmental stage. For example, within the category Facilitate clients’ emotional management, 2 primary emotional management strategies are employed: anticipatory and reactive. In anticipatory emotion management, nurses take proactive steps to prevent emotional distress during care procedures. For infants, this may involve approaching the crib slowly, using gentle touch, maintaining a calm tone of voice, and smiling to convey safety. Nurses may also ask the mother to hold the baby with affective restraint during procedures such as medication administration, minimizing fear or irritation. Toddlers, who are beginning to assert independence and engage in symbolic play, often benefit from imaginative approaches. For instance, if a toddler is playing with a toy stroller, the nurse might join the game, comment on the stroller’s color, or introduce the procedure by saying something like, “We’re going to energize your stroller with a magic liquid through this little tube,” to explain intravenous medication. Preschoolers, who are more verbal and imaginative, can be engaged by initiating conversations about their drawings, pets, or favorite games. Treatments or procedures may be framed as part of a play scenario—such as checking a doll’s temperature or giving medicine to a teddy bear—to promote cooperation through storytelling and role-play. School-aged children, possessing increased cognitive abilities and curiosity, benefit from clear, age-appropriate explanations. Nurses can use simple vocabulary, books, or illustrations to explain procedures and encourage questions. In addition, nurses promote trust and reduce anxiety by showing openness and honest responses. Adolescents, capable of abstract thinking and often emotionally sensitive, require verbal explanations. Nurses create space for questions, clarify doubts, and support emotional expression, while also observing emotional lability, which is common during this stage. 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Source: Advances in Nursing Science
Author: Paula Manuela Jorge Diogo
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415225542