Communication challenges caused by wearing masks and strategies used by pediatric nurses during the COVID-۱۹ pandemic: A qualitative study

Purpose The COVID-۱۹ pandemic and the use of facemasks have caused many communication challenges for pediatric nurses. The purpose of this study was to investigate these challenges and the strategies that nurses use to overcome them during the nursing care of sick children. Design and methods This was a qualitative study using conventional content analysis. The nurses were selected by purpose-based sampling and interviewed semi-structurally between April and June ۲۰۲۳ at the Children's Educational Therapy Center in Tabriz, Iran. The sample size was determined by the data saturation principle. The report of this research followed the COREQ guidelines. Results Twelve nurses were interviewed. The analysis revealed four main categories: "Disturbances in communication", "Disturbances in trust", "Disturbances in providing care", and "Nurses' strategies to mitigate the challenges of mask usage." To solve the challenges caused by the mask, nurses used solutions such as removing the mask and mitigating the adverse effects of mask usage they used. Effective communication between the nurse and the sick child, as an integral part of care, is one factor that determines the quality of care and the provision of humanistic care. The presence of communication barriers can disrupt this interaction, instilling fear and confusion in the child during the care process, which hinders the creation of trust. Therefore, by searching for the hidden meaning of the data, the theme "Humanistic care requires trust-based communication" was discerned. This theme underscores the notion that trust-based communication is indispensable for the provision of humanistic care. To overcome the challenges of mask usage, nurses employed strategies to ensure effective and compassionate care. In low-risk situations, they occasionally removed their masks to show their faces and smile, which helped comfort children and build trust. Transparent and cartoon-themed masks were also used to improve communication. Nurses emphasized physical presence, touch, and humor to connect with children, especially those too young to understand verbal explanations. They personalized attire, used name tags and photo IDs, and engaged mothers to help gain the child's trust. Educational strategies included using dolls, videos, and written instructions to explain procedures in a child-friendly way. Conclusions This study highlights the communication challenges faced by pediatric nurses due to mask-wearing during the COVID-۱۹ pandemic. Despite these challenges, nurses have developed innovative strategies to improve communication and build trust with their young patients. Further research is needed to evaluate the effectiveness and feasibility of these strategies.