Evaluation of the role development and implementation of advanced practice nurses in an Austrian university hospital: a mixed methods research protocol.

Pediatric nursing involves providing individualized care from birth through adolescence and requires the delivery of “developmentally appropriate nursing care.” Understanding children’s needs and emotions throughout the developmental continuum is a fundamental component of pediatric nursing []. Pediatric nurses serve as healthcare professionals who address the clinical conditions and health problems of children across developmental stages []. Hospitalization is a highly stressful experience for both children and their parents []. Children experience anxiety and fear in response to unfamiliar environments and medical procedures, often expressing resistance to healthcare providers through crying or restlessness []. Parents also experience heightened stress levels, such as depression, anxiety, and emotional instability, during their child’s hospitalization [,]. Accordingly, supporting parents’ emotional responses is considered an essential element in promoting children’s recovery and well-being []. Pediatric nursing is grounded in the principles of family-centered care, in which caregivers are regarded as active partners as well as recipients of nursing care. While this approach emphasizes partnership and shared decision-making, it may simultaneously impose additional emotional and relational demands on pediatric nurses [,]. Pediatric nurses are frequently exposed to high levels of emotional labor because they must respond to children’s diverse developmental and healthcare needs and the high expectations of parents []. Kim et al. [] in 2023 reported that parents often demand direct nursing care during hospitalization and expect nurses to understand and support their emotional circumstances. Pediatric nurses operate in a unique environment requiring complex partnerships with both children and their caregivers [,]. Recent studies indicate that these relational dynamics, combined with the demands of continuous coordination and communication with multiple healthcare professionals, act as primary stressors that distinguish their experience from that of general ward nurses [,]. Job stress is defined as negative emotions arising from the interaction between personal capabilities and the work environment, adversely affecting nurses’ physical, psychological, and social health []. Given these complexities, pediatric nurses are particularly vulnerable to job stress and emotional labor while providing individualized nursing care. Prolonged exposure to job stress impairs therapeutic relationships and increases the risk of nursing errors, ultimately compromising patient safety and the overall quality of care []. These findings underscore the critical need for effective strategies to manage job stress among pediatric nurses. However, most domestic and international studies to date have predominantly employed quantitative designs, focusing primarily on identifying correlations between predefined variables [,-]. Although these studies have contributed to identifying factors associated with job stress, they have limitations in capturing the lived experiences of pediatric nurses and the sociocultural context in which job stress occurs. Consequently, they provide limited insight into the contextual, relational, and experiential dimensions of job stress encountered in daily clinical practice []. In particular, the complex interactions among children’s developmental characteristics, caregivers’ expectations, organizational culture, and emotional labor in pediatric settings are difficult to fully capture through quantitative methods alone [,,].