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García-Fernández J, Romero-García M, Benito-Aracil L, Pilar Delgado-Hito M. Humanisation in paediatric intensive care units: A narrative review. Intensive Crit Care Nurs 2024:103725. [PMID: 38824005 DOI: 10.1016/j.iccn.2024.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE To identify findings in the scientific literature relevant to the strategic lines proposed by the Humanising Intensive Care Project in the context of paediatric intensive care units. DESIGN Narrative review. METHODS A literature search was conducted in the databases PubMed, Scopus, CINHAL, and Cochrane Library. Specific indexing terms and search strategies adapted to each database were designed. The inclusion of publications was based on two criteria: 1) related to the paediatric intensive care unit and 2) addresses at least one of the topics related to the strategic lines of the Humanising Intensive Care Project. Study selection was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the quality of the included studies was assessed using the Mixed Method Appraisal tool. RESULTS A total of 100 articles from 19 different countries were included, covering the period between 2019 and 2021. Nineteen different design types were identified. Thirty-two studies were cross-sectional observational studies, while 15 had an experimental approach. The articles were distributed among the seven strategic lines of the Humanising Intensive Care Project. CONCLUSIONS Synthesising the knowledge related to humanisation in paediatric intensive care units will allow progress to be made in improving quality in these units. However, there is disparity in the amount of experimental research overall. IMPLICATIONS FOR CLINICAL PRACTICE There is a disparity in the available research related to the different strategic lines, and it is necessary to carry out more exhaustive research on topics such as the presence and participation of the family in care or the management of post-paediatric intensive care syndrome.
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Affiliation(s)
- Javier García-Fernández
- Multidisciplinary Nursing Research Group of the Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Marta Romero-García
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain; International Research Project for the Humanisation of Health Care, HU-CI Project: Humanising Intensive Care (HU-CI) Project, Collado Villalba, Madrid, Spain.
| | - Llúcia Benito-Aracil
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mª Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain; International Research Project for the Humanisation of Health Care, HU-CI Project: Humanising Intensive Care (HU-CI) Project, Collado Villalba, Madrid, Spain
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Lisanti AJ, Min J, Golfenshtein N, Marino BS, Curley MAQ, Medoff-Cooper B. Perceived family-centered care and post-traumatic stress in parents of infants cared for in the paediatric cardiac intensive care unit. Nurs Crit Care 2024. [PMID: 38816199 DOI: 10.1111/nicc.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Family-centred care (FCC), while a core value of paediatric hospitals, has not been well-studied in the paediatric cardiac intensive care unit (PCICU). AIMS To describe parents' perceptions of FCC provided by nurses in the PCICU during their infant's recovery from neonatal cardiac surgery and explore associations of perceptions of FCC on parent post-traumatic stress (PTS) 4 months post-discharge. STUDY DESIGN Data obtained from a previously conducted randomized clinical trial (RCT) on telehealth home monitoring after neonatal cardiac surgery at three free-standing paediatric hospitals were analysed from a subset of 164 parents who completed the FCC Scale at hospital discharge, which measures a parent's experience of nursing care that embodies core principles of FCC. The RCT intervention was provided after hospital discharge, having no influence on parent's perception of FCC. The intervention also had no effect on PTS. RESULTS Perceived FCC was lowest for items 'nurses helped me feel welcomed' and 'nurses helped me feel important in my child's care'. Having 12%-19% points lower perception of FCC at hospital discharge was associated with parent experience of six or more PTS symptoms, at least moderate PTS symptom severity, or PTS disorder diagnosis at 4-month follow-up. Every 10% increase in parental perceptions of FCC was associated with less PTS symptoms (β = -0.29, SE = 0.12; p = .02) and lower PTS symptom cluster scores of arousal (β = -0.18, SE = 0.08; p = .02). CONCLUSIONS Parents who perceived lower FCC during their infants' hospitalization were at increased risk for the development of PTS symptoms, more PTS symptom severity and PTS disorder diagnosis 4-months post-discharge. RELEVANCE TO CLINICAL PRACTICE Nurses have a prominent role to support the implementation of FCC for infants with cardiac defects and their parents. FCC may positively influence overall parent mental health and well-being, reducing the trauma and distress of the PCICU experience.
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Affiliation(s)
- Amy J Lisanti
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jungwon Min
- Department of Biomedical and Health Informatics, Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Bradley S Marino
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Martha A Q Curley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Barbara Medoff-Cooper
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Barnes S, Macdonald I, Rahmaty Z, de Goumoëns V, Grandjean C, Jaques C, Ramelet AS. Effectiveness and family experiences of interventions promoting partnerships between families and pediatric and neonatal intensive care units: a mixed methods systematic review. JBI Evid Synth 2024:02174543-990000000-00290. [PMID: 38505961 DOI: 10.11124/jbies-23-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE The objective of this mixed methods review was to examine the effectiveness and family experiences of interventions promoting partnerships between families and the multidisciplinary health care team in pediatric and neonatal intensive care units. INTRODUCTION Hospitalization of infants and children in neonatal intensive care units and pediatric intensive care units has a significant effect on their families, including increased stress, anxiety, and depression. Available evidence syntheses focused on specific family-centered care, but not on partnership, which is another aspect that may improve the families' outcomes and experiences. INCLUSION CRITERIA This review focused on effectiveness and experiences of interventions by health professionals in partnership with families of infants or children hospitalized in an intensive care unit. The type of intervention was a partnership between the health care team and the family, and focused on outcomes of stress, anxiety, depression, quality of life, attachment, or satisfaction with family-centered care. METHODS The JBI methodology for convergent segregated mixed methods systematic reviews was followed using the standardized JBI critical appraisal and data extraction tools. Ten databases were searched from January 2000 to April 2022. Findings of quantitative studies were statistically pooled through meta-analyses and those that could not pooled were reported in a narrative format. Qualitative studies were pooled through meta-synthesis. RESULTS This review included 6 qualitative and 42 quantitative studies. There was mixed methodological quality and all studies were included regardless of methodological quality. Meta-analyses showed positive improvements in anxiety, satisfaction with family-centered care, and stress, yet no conclusive effects in attachment and depression. These results should be interpreted with caution due to high heterogeneity. Qualitative analysis resulted in 2 synthesized findings: "Interventions that incorporate partnerships between families and the health care team can improve the family's experience and capacity to care for the child" and "Having a child in intensive care can be an experience of significant impact for families" Integration of quantitative and qualitative evidence revealed some congruence between findings; however, the paucity of qualitative evidence minimized the depth of this integration. CONCLUSIONS Partnership interventions can have a positive impact on parents of children in intensive care units, with improvements seen in stress, anxiety, and satisfaction with family-centered care. REVIEW REGISTRATION PROSPERO CRD42019137834.
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Affiliation(s)
- Shannon Barnes
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Ibo Macdonald
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Zahra Rahmaty
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Véronique de Goumoëns
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
- La Source School of Nursing, HES-SO, University of Applied Sciences and Arts Western Switzerland, Lausanne Switzerland
| | - Chantal Grandjean
- Pediatric Intensive Care Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Cécile Jaques
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
- Medical Library, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
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Sood E, Newburger JW, Anixt JS, Cassidy AR, Jackson JL, Jonas RA, Lisanti AJ, Lopez KN, Peyvandi S, Marino BS. Neurodevelopmental Outcomes for Individuals With Congenital Heart Disease: Updates in Neuroprotection, Risk-Stratification, Evaluation, and Management: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e997-e1022. [PMID: 38385268 DOI: 10.1161/cir.0000000000001211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Over the past decade, new research has advanced scientific knowledge of neurodevelopmental trajectories, factors that increase neurodevelopmental risk, and neuroprotective strategies for individuals with congenital heart disease. In addition, best practices for evaluation and management of developmental delays and disorders in this high-risk patient population have been formulated based on literature review and expert consensus. This American Heart Association scientific statement serves as an update to the 2012 statement on the evaluation and management of neurodevelopmental outcomes in children with congenital heart disease. It includes revised risk categories for developmental delay or disorder and an updated list of factors that increase neurodevelopmental risk in individuals with congenital heart disease according to current evidence, including genetic predisposition, fetal and perinatal factors, surgical and perioperative factors, socioeconomic disadvantage, and parental psychological distress. It also includes an updated algorithm for referral, evaluation, and management of individuals at high risk. Risk stratification of individuals with congenital heart disease with the updated categories and risk factors will identify a large and growing population of survivors at high risk for developmental delay or disorder and associated impacts across the life span. Critical next steps must include efforts to prevent and mitigate developmental delays and disorders. The goal of this scientific statement is to inform health care professionals caring for patients with congenital heart disease and other key stakeholders about the current state of knowledge of neurodevelopmental outcomes for individuals with congenital heart disease and best practices for neuroprotection, risk stratification, evaluation, and management.
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McKechnie AC, Elgersma KM, Ambrose MB, Sanchez Mejia AA, Shah KM, Iwaszko Wagner T, Trebilcock A, Hallock C. Nurse-guided Mobile Health Care Program to Reduce Emotional Distress Experienced by Parents of Infants Prenatally Diagnosed with Critical Congenital Heart Disease: A Pilot Study. PROGRESS IN PEDIATRIC CARDIOLOGY 2024; 72:101687. [PMID: 38130374 PMCID: PMC10732467 DOI: 10.1016/j.ppedcard.2023.101687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Background Following prenatal diagnosis of critical congenital heart disease (CCHD), parents encounter emotional distress while facing caregiving challenges. Supportive psycho-educational interventions using mobile health (mHealth) can make care more accessible. Objectives We tested a novel nurse-guided mHealth care program, Preparing Heart and Mind™ (PHM™), with the objectives of examining feasibility and estimating the effect of the intervention on parents' emotional distress. Methods This pilot study design randomized participants using a 2:1 intervention to control ratio. Analysis involved description of retention, and intervention attendance and engagement, and adjusted linear mixed models to estimate group differences in depressive (CES-D), anxiety (STAI-S), and traumatic stress (IES-r) symptoms. Results The sample included 55 parents (n=38 PHM™ group, n=17 control). Complete retention of 37 (67%) parents included 29 (76%) in the PHM™ group and 8 (47%) control. Most attrition was due to infant death (7 parents), transplant referral (2 parents), or postnatal diagnostic ineligibility (4 parents). For the PHM™ group, ≥96% of parents attended pre- and postnatal sessions and most (65%) messaged with the nurse. mHealth engagement was highest prenatally, with handling uncertainty the most viewed topic (average 94% pages viewed). In linear mixed models analyses, the PHM™ group had on average 4.84 points lower depression (95% CI: -10.68-1.04), 6.56 points lower anxiety (-14.04-0.92), and 6.28 points lower trauma (-14.44-1.88) scores by study end. Conclusion Findings suggest that a nurse-guided mHealth approach is feasible and may contribute to a clinically important reduction in parents' emotional distress.
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Affiliation(s)
- Anne Chevalier McKechnie
- University of Minnesota School of Nursing, Child and Family Health Cooperative, 6-138D Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Kristin M Elgersma
- University of Minnesota School of Nursing, Child and Family Health Cooperative, 6-138D Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Matthew B Ambrose
- University of Minnesota Medical School, Department of Pediatrics, 420 Delaware Street SE, Minneapolis, MN 55455
- M Health Fairview Maternal and Fetal Medicine Center, 606 24th Avenue South, Minneapolis, MN 55454
| | - Aura A Sanchez Mejia
- Baylor College of Medicine, Department of Pediatrics, 1 Baylor Plaza, Houston, TX 77030
- Texas Children's Hospital Maternal-Fetal Medicine, 6651 Main Street, Houston, TX 77030
| | - Kavisha M Shah
- University of Minnesota Medical School, Department of Pediatrics, 420 Delaware Street SE, Minneapolis, MN 55455
- M Health Fairview Maternal and Fetal Medicine Center, 606 24th Avenue South, Minneapolis, MN 55454
| | - Taylor Iwaszko Wagner
- University of Minnesota School of Nursing, Child and Family Health Cooperative, 6-138D Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Anna Trebilcock
- University of Minnesota School of Nursing, Child and Family Health Cooperative, 6-138D Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Carrie Hallock
- GetWell, 7700 Old Georgetown Rd., 4th Floor, Bethesda, MD 20814
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Uhm JY, Kim S. Development and Testing of the School Healthcare Partnership Scale for Parents. West J Nurs Res 2024; 46:219-228. [PMID: 38343038 DOI: 10.1177/01939459241230388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Cooperation between parents and school nurses is essential for the successful completion of school courses and a healthy school life for children with long-term conditions. Therefore, this study aimed to develop and test a scale to measure parental perceptions of partnerships between school nurses and parents in the school health care (SHC) system for children with type 1 diabetes (T1D). METHODS The content validity, factorial structure validity, convergent validity, discriminant validity, known-group validity, internal consistency reliability, and test-retest reliability of the School Healthcare Partnership Scale for Parents (SHCPS-P) were evaluated. Data were analyzed by performing exploratory factor analysis (EFA), Pearson's correlation, Cronbach's α, and independent t-tests. The total sample included 155 parents for the EFA and 49 parents for the stability test. Seventeen items, grouped into 3 dimensions, were extracted through principal axis factoring. RESULTS The total variance explained by these factors was 53.57%. The scale demonstrated a high correlation with parental satisfaction regarding school nursing and a moderate correlation with diabetes-related safety, thereby showing convergent validity. A low correlation with empathy demonstrated discriminant validity. A significant difference existed in the partnership scores in known-group comparisons. Cronbach's α was 0.95, and the test-retest correlation coefficient was 0.95, which showed reliability. CONCLUSIONS This study suggests that the SHCPS-P is a reliable and valid tool for measuring the perception of SHC partnership among parents of children with T1D and can be used as an indicator to measure parents' perspectives about SHC.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Suhee Kim
- School of Nursing, Research Institute of Nursing Science, Hallym University, Chuncheon-si, South Korea
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Lisanti AJ, Quinn R, Chittams JL, Laubacher M, Medoff-Cooper B, Demianczyk AC. Mental Health Symptoms in Parents of Infants 3 Months After Discharge Following Neonatal Cardiac Surgery. Am J Crit Care 2024; 33:20-28. [PMID: 38161171 PMCID: PMC10942723 DOI: 10.4037/ajcc2024404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Parents of newborns with congenital heart disease (CHD) are at risk for anxiety, depression, and post-traumatic stress. Few studies have examined whether modifiable factors that influence parents' mental health after discharge are present during postoperative care in the pediatric cardiac intensive care unit (PCICU). OBJECTIVE To describe mental health symptoms of parents of infants with CHD 3 months after PCICU discharge and to determine factors during the PCICU stay that are predictors of such symptoms. METHODS A longitudinal cohort pilot study of 56 parents (28 mother-father dyads) of 28 infants with CHD. During the first postoperative week after cardiac surgery, parents completed questionnaires measuring factors potentially influencing mental health. Three months after discharge, 42 parents of 22 infants completed validated measures of anxiety, depression, and posttraumatic stress. RESULTS Three months after discharge, 26% of parents had clinically elevated levels of anxiety symptoms, 21% had clinically significant levels of depressive symptoms, and 19% had posttraumatic stress symptoms. In multi-variable analysis, parental role alteration in the PCICU was predictive of anxiety (P = .002), depressive (P = .02), and posttraumatic stress (P = .02) symptoms 3 months after discharge. Higher education level was predictive of anxiety symptoms (P = .009). Postnatal CHD diagnosis was predictive of posttraumatic stress symptoms (P = .04). CONCLUSIONS Parental role alteration perceived by parents during the PCICU stay is a modifiable stressor contributing to adverse mental health symptoms 3 months after discharge. Interventions targeting parental role alteration in the PCICU are critically needed.
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Affiliation(s)
- Amy J. Lisanti
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104
- Children’s Hospital of Philadelphia, Research Institute, 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Ryan Quinn
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104
| | - Jesse L. Chittams
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104
| | - Megan Laubacher
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104
| | - Barbara Medoff-Cooper
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104
- Children’s Hospital of Philadelphia, Research Institute, 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Abigail C. Demianczyk
- Cleveland Clinic Children’s, Center for Pediatric Behavioral Health, 9500 Euclid Ave, Cleveland OH 44195
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McKechnie AC, Elgersma KM, Iwaszko Wagner T, Trebilcock A, Damico J, Sosa A, Ambrose MB, Shah K, Sanchez Mejia AA, Pridham KF. An mHealth, patient engagement approach to understand and address parents' mental health and caregiving needs after prenatal diagnosis of critical congenital heart disease. PEC INNOVATION 2023; 3:100213. [PMID: 37771461 PMCID: PMC10523263 DOI: 10.1016/j.pecinn.2023.100213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/10/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023]
Abstract
Objective To provide an overview of the development of the Preparing Heart and Mind™ (PHM™) care program designed for parents with a prenatal diagnosis of critical congenital heart disease (CCHD) and describe issues of parental concern, caregiving competencies, and type and timing of PHM™ topics. Methods Guided participation theory underpinned intervention development and a mixed methods pilot of a novel, nurse-guided mHealth intervention. Parents were enrolled from the third trimester of pregnancy-12 weeks postnatally. Online surveys, session transcripts, and app use were descriptively analyzed. Results The sample included 19 mothers/birthing persons and 15 caregiving partners randomized to the intervention group. In 49 sessions, mental health/wellbeing (94%) and condition-specific information (86%) were top issues. Many caregiving competencies were developed, with mothers/birthing persons often focused on feeding (86%). Regulating emotions and co-parenting consistently needed support. PHM™ topics of preparing for hospitalization (47%) and handling uncertainty (45%) were most discussed. Two cases further characterize findings. Conclusion Nurse-parent collaborative understanding of issues emphasized the need for mental health assessments. Prenatal intervention opportunities were underscored through discussions of caregiving issues and PHM™ topics. Innovation PHM™ represents an innovative approach that holds promise for supporting parents' mental health and caregiving needs outside the healthcare setting.
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Affiliation(s)
| | - Kristin M. Elgersma
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Taylor Iwaszko Wagner
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Anna Trebilcock
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Jenna Damico
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Alejandra Sosa
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew B. Ambrose
- Medical School, Pediatrics-Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Kavisha Shah
- Medical School, Pediatrics-Cardiology, University of Minnesota, Minneapolis, MN, USA
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Chung NR, Chae SM. Mothering children at a paediatric intensive care unit with strict visiting hours: A qualitative study. Nurs Crit Care 2023. [PMID: 37818784 DOI: 10.1111/nicc.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Although a child- and family-centred care (CFCC) philosophy has been emphasized and adopted for decades in paediatric critical care settings in several countries, numerous issues from parents' perspectives regarding the philosophy remain unresolved. To facilitate the full translation of CFCC into clinical practice, health care professionals need an in-depth understanding of family experiences. Real-life mothering experiences, including maternal roles and identities, remain largely unknown at paediatric intensive care units (PICUs) in the Republic of Korea, where family visitation, presence, and participation are restricted. AIM To explore mothering experiences at a PICU where family visitation is strictly constrained, and to identify maternal needs and values. STUDY DESIGN We conducted a qualitative descriptive study of eight individual in-depth interviews with seven mothers of hospitalized children. Qualitative data were analysed using inductive thematic analysis. FINDINGS Five major themes, along with four subthemes, emerged: (1) shifts in maternal roles and responsibilities, (2) shifts in interpersonal relationships, (3) desire for CFCC in the PICU, (4) practising self-defined mothering roles, and (5) reconstructing maternal identities. The themes revealed the experiences of becoming mothers of a child in a constrained PICU. Ultimately, mothers demanded that the unit improve its physical and cultural environments through, for example, liberalized family visitation and participation in the care of their children. CONCLUSIONS Nursing professionals should lead the charge for humanizing a restrictive PICU in the Republic of Korea by ensuring a safe and open environment and mothering continuity based on child- and family-centred holistic care. RELEVANCE TO CLINICAL PRACTICE Effective interventions must be developed and tested to globally establish and fully implement strong evidence-based CFCC in PICUs; constant co-commitment among children, families, health care professionals, and institutions is also necessary.
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Affiliation(s)
- Na-Ry Chung
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun-Mi Chae
- Seoul National University College of Nursing, The Research Institute of Nursing Science, Seoul, Republic of Korea
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Foster JR, Lee LA, Seabrook JA, Ryan M, Slumkoski C, Walls M, Betts LJ, Burgess SA, Moghadam N, Garros D. A survey of pediatric intensive care unit clinician experience with restricted family presence during COVID-19. Can J Anaesth 2023; 70:1669-1681. [PMID: 37610552 PMCID: PMC10600297 DOI: 10.1007/s12630-023-02547-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 08/24/2023] Open
Abstract
PURPOSE Limiting family presence runs counter to the family-centred values of Canadian pediatric intensive care units (PICUs). This study explores how implementing and enforcing COVID-19-related restricted family presence (RFP) policies impacted PICU clinicians nationally. METHODS We conducted a cross-sectional, online, self-administered survey of Canadian PICU clinicians to assess experience and opinions of restrictions, moral distress (Moral Distress Thermometer, range 0-10), and mental health impacts (Impact of Event Scale [IES], range 0-75 and attributable stress [five-point Likert scale]). For analysis, we used descriptive statistics, multivariate regression modelling, and a general inductive approach for free text. RESULTS Representing 17/19 Canadian PICUs, 368 of 388 respondents (94%) experienced RFP policies and were predominantly female (333/368, 91%), English speaking (338/368, 92%), and nurses (240/368, 65%). The mean (standard deviation [SD]) reported moral distress score was 4.5 (2.4) and was associated with perceived differential impact on families. The mean (SD) total IES score was 29.7 (10.5), suggesting moderate traumatic stress with 56% (176/317) reporting increased/significantly increased stress from restrictions related to separating families, denying access, and concern for family impacts. Incongruence between RFP policies/practices and PICU values was perceived by 66% of respondents (217/330). Most respondents (235/330, 71%) felt their opinions were not valued when implementing policies. Though respondents perceived that restrictions were implemented for the benefit of clinicians (252/332, 76%) and to protect families (236/315, 75%), 57% (188/332) disagreed that their RFP experience was mainly positive. CONCLUSION Pediatric intensive care unit-based RFP rules, largely designed and implemented without bedside clinician input, caused increased psychological burden for clinicians, characterized as moderate moral distress and trauma triggered by perceived impacts on families.
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Affiliation(s)
- Jennifer R Foster
- Department of Pediatric Critical Care, IWK Health Centre, 5850/5980 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada.
- Department of Critical Care, Dalhousie University, Halifax, NS, Canada.
- Department of Pediatrics, Western University, London, ON, Canada.
- Children's Health Research Institute and Lawson Health Research Institute, London, ON, Canada.
| | - Laurie A Lee
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Alberta Children's Hospital, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Jamie A Seabrook
- Department of Pediatrics, Western University, London, ON, Canada
- Children's Health Research Institute and Lawson Health Research Institute, London, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
| | - Molly Ryan
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
| | - Corey Slumkoski
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Martha Walls
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Laura J Betts
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
| | - Stacy A Burgess
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
- Children's Health Program, IWK Health, Halifax, NS, Canada
| | - Neda Moghadam
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Daniel Garros
- Stollery Children's Hospital, Pediatric Intensive Care Unit, Edmonton, AB, Canada
- Division of Critical Care, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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11
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Ay A, Koç G. The effect of nursing care and follow-up for mothers of infants undergoing congenital heart surgery: a quasi-experimental study. Cardiol Young 2023; 33:1649-1656. [PMID: 36124651 DOI: 10.1017/s1047951122002979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Improvements in congenital heart surgery have resulted in an increasing number of infants surviving, but there remain concerns about home care and difficulties experienced by mothers. This study was designed to evaluate the effect of nursing care and follow-up for the mothers of infants undergoing congenital heart surgery on anxiety, care burden, and self-efficacy. The study was designed as a quasi-experimental study with a pre-test and post-test control group design. The study included 40 mothers whose infants had undergone congenital heart surgery. Nursing care was provided to the mothers of the infants included in the study group through a total of six home follow-ups until the third month after surgery, guided by the North American Nursing Diagnosis Association and Nursing Diagnosis System and Nursing Interventions Classification. Data were collected through Care Needs Identification Form, Spielberger's State-Trait Anxiety Inventory, Zarit Burden Interview, and Parental Self-efficacy Scale. The mean State-Trait Anxiety Inventory and Zarit Burden Interview scores for the mothers in the intervention group decreased, while the mean Parental Self-efficacy Scale scores increased as the follow-up progressed and it was determined that by the third month, the difference between the mothers in the intervention group and those in the control group in terms of post-test State-Trait Anxiety Inventory, Zarit Burden Interview, and Parental Self-efficacy Scale had become statistically significant. Providing appropriate nursing care practices to the mothers of the infants had undergone congenital heart surgery in home setting has the potential to decrease the problems experienced by the mothers.
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Affiliation(s)
- Ayşe Ay
- Nursing Department, Faculty of Health Sciences, Başkent University, Ankara, Turkey
| | - Gülten Koç
- Obstetrics and Gynecologic Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
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12
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Abukari AS, Schmollgruber S. Concepts of family-centered care at the neonatal and paediatric intensive care unit: A scoping review. J Pediatr Nurs 2023:S0882-5963(23)00088-X. [PMID: 37120388 DOI: 10.1016/j.pedn.2023.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Understanding family-centred care (FCC) concepts is critical for its implementation in any context. The researchers synthesised studies on FCC in neonatal and paediatric critical care units in order to present its concepts and gaps in the literature to guide further research in the area. METHOD The study used the JBI methodology, and the PRISMA-ScR guidelines confirmed the final report. The search for material, with the use of library sources, used Medline via PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, and Wiley Library online for papers published in English from 2015 to 2019 and updated to 2023. RESULTS From 904 references, 61 studies were identified for inclusion. The majority of the studies (29; 55.77%) were qualitative ethnography and phenomenology. Four themes and ten subthemes emerged from the data to support the main concepts of FCC. CONCLUSION To guide its useful integration and implementation, more research on family-centred care in neonatal and paediatric intensive care units, involving families, staff, and managers, should be undertaken. PRACTICE IMPLICATION Findings presented in this review may provide a guide for nurses to adjust nursing interventions for critically ill neonates and children in intensive care units.
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Affiliation(s)
- Alhassan Sibdow Abukari
- Department of Nursing Education, School of Therapeutics, Faculty of Health Sciences, University of the Witwatersrand, Ghana; Department of Nursing, School of Nursing & Midwifery, Wisconsin International University, Ghana
| | - Shelley Schmollgruber
- Department of Nursing Education, School of Therapeutics, Faculty of Health Sciences, University of the Witwatersrand, Ghana.
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13
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Demers LA, Wright NM, Kopstick AJ, Niehaus CE, Hall TA, Williams CN, Riley AR. Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101575. [PMID: 36291511 PMCID: PMC9600460 DOI: 10.3390/children9101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022]
Abstract
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included.
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Affiliation(s)
- Lauren A. Demers
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Naomi M. Wright
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Psychology, University of Denver, Denver, CO 80208, USA
| | - Avi J. Kopstick
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Tech University Health Science Center El Paso, El Paso, TX 97705, USA
| | - Claire E. Niehaus
- Division of Psychology and Psychiatry, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Trevor A. Hall
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-503-418-2134
| | - Cydni N. Williams
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew R. Riley
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
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14
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Cai Q, Wang H, Chen D, Xu W, Yang R, Xu X. Effect of family-centred care on parental mental health and parent-infant interactions for preterm infants: a systematic review protocol. BMJ Open 2022; 12:e062004. [PMID: 36198456 PMCID: PMC9535193 DOI: 10.1136/bmjopen-2022-062004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Unexpected premature delivery and separation from preterm infants are common problems that parents of preterm infants must handle with. Parents of preterm infants may suffer from severe psychological distress. Family-centred care (FCC) can effectively ease parents' psychological distress and strengthen connections between parents and their preterm infants. The purpose of this systematic review will be to systematically review and evaluate the impacts of FCC interventions on the mental health of parents of preterm infants and the parent-infant relationship. METHODS AND ANALYSIS This protocol for this systematic review will be conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. We will search databases including PubMed, Embase, The Cochrane Library, CINAHL, Web of Science, PsycINFO, Scopus and ProQuest, CNKI, SinoMed and Wanfang Data from 1 July 2012 to 1 July 2022. An additional search of OpenGrey will be conducted to identify grey literature. Randomised controlled trials related to FCC inventions for preterm infants≤37 weeks' gestational age and their parents will be included, and the outcome measures will be parental mental health and parent-infant interaction. Two reviewers will independently conduct title and abstract screening, full-text screening, data extraction and study quality assessment. Risk of bias for the studies will be evaluated using the Cochrane Collaboration Risk of Bias V.2.0. Any disagreements will be solved by a third reviewer to reach a consensus. If appropriate, a meta-analysis will be conducted to assess the effect of FCC on parental mental health and parent-infant relationship. ETHICS AND DISSEMINATION Research ethics approval will not be required for this review since it will not involve the collection of primary data and will only use published literature. The results will be disseminated in a peer-reviewed journal through publication or by presentation at relevant academic conference. PROSPERO REGISTRATION NUMBER CRD42022299203.
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Affiliation(s)
- Qian Cai
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Hua Wang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Danqi Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenli Xu
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
| | - Rui Yang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinfen Xu
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
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15
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Experiences and contextual practices of family-centered care in Ghanaian nicus: a qualitative study of families and clinicians. BMC Health Serv Res 2022; 22:1051. [PMID: 35978324 PMCID: PMC9386929 DOI: 10.1186/s12913-022-08425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 07/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Families, whether at home or at the hospital, should be a vital part of newborn care. However, most families are excluded from hospital care, particularly in neonatal intensive care units (NICUs). This is incompatible with the concepts of Family-Centered Care (FCC) and may compromise care continuity and family satisfaction following discharge from neonatal intensive care facilities. The purpose of this study was to examine FCC practices in Ghanaian neonatal intensive care units and provide the experiences and contextual practices of FCC from the perspectives of families and clinicians. Methods The study qualitatively examined the contextual practices of FCC from the perspectives of families and clinicians in neonatal intensive care units using an exploratory descriptive design. With the help of MAXQDA software, 36 transcripts were generated and their contents were analyzed. Results Contextual practices of FCC, family experiences of FCC and clinician experiences of FCC emerged as three main categories from the data. Respect and dignity, culture and religion and a multidisciplinary approach were the contextual practices. Emotional stress, lack of information and coping strategies were all common family experiences. Support, counseling, education and financial problems have all been experienced by clinicians. Conclusions Shared decision-making, counseling and education, as well as respect/dignity amongst clinicians, managers and families using a multidisciplinary approach are the fundamental concepts of FCC approach in Ghana. Acceptance and integration of FCC approach into neonatal intensive care units may reduce the burden of care as well as improve the quality of care. Further studies are needed to map out strategies and interventions for the integration of FCC into intensive care units.
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16
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Factorial Validity of the Pediatric Nurse Parent Partnership Scale—Pediatric Nurses (PNPPS-PN). Healthcare (Basel) 2022; 10:healthcare10060991. [PMID: 35742042 PMCID: PMC9222722 DOI: 10.3390/healthcare10060991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
For the optimal growth and development of high-quality professional nursing care for hospitalized children, a partnership between pediatric nurses and parents within the context of the family is essential. The aim of the present study was to evaluate the factorial validity of the Pediatric Nurse Parent Partnership Scale for hospital pediatric nurses (PNPPS-PN) and to investigate the associations of its components with the Nursing Professional Value Scale and Compassion Competence Scale. This study used survey data from 236 pediatric nurses collected between March and June 2019. The seven-factor structure showed an acceptable to good fit in the confirmatory factor analysis, and the scale correlated as expected with measures of compassion competence and nursing professional values. The Cronbach’s α for the scale was 0.89, indicating good internal consistency reliability. The PNPPS-PN is a psychometrically sound instrument for assessing pediatric nurse-reported partnerships between pediatric nurses and parents in hospital settings.
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17
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Huang YL, Chen YK, Lin SH, Cao H, Chen Q. The effect of short music videos on needs satisfaction and separation anxiety of children's family members during COVID-19: The example of TikTok. Front Pediatr 2022; 10:990752. [PMID: 36160769 PMCID: PMC9491336 DOI: 10.3389/fped.2022.990752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effect of short music videos on needs satisfaction and separation anxiety of the family members of children with congenital heart disease (CHD) in the cardiac intensive care unit (CICU) during the COVID-19 pandemic. METHODS Eighty-seven children's family members were divided into the study group and the control group between February 2020 and March 2021. During the COVID-19 pandemic, the participants in the control group were visited by telephone, while the participants in the study group used the TikTok short music video application and WeChat as communication tools. After the intervention, the critical care family needs inventory (CCFNI) and separation anxiety scale (SAS) for all participants were recorded and analyzed. RESULTS There were no statistically significant differences in general characteristics or preintervention data between the two groups. However, the two dimensions of the support scale and information scale of the CCFNI in the study group were significantly different from those in the control group after the intervention (P = 0.008, and P = 0.021, respectively). There were significant differences in the three dimensions of the SAS between the two groups (P = 0.004, P = 0.007, and P = 0.041, respectively). CONCLUSION The visiting system of the ICU changed during the COVID-19 pandemic, and the use of the TikTok short music video application and WeChat was conducive to optimizing the CICU ward visiting process, reducing the separation anxiety of the family members of children in the CICU, and improving their needs satisfaction.
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Affiliation(s)
- Ya-Li Huang
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Yu-Kun Chen
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Shi-Hao Lin
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
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18
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LaRonde MP, Connor JA, Cerrato B, Chiloyan A, Lisanti AJ. Individualized Family-Centered Developmental Care for Infants With Congenital Heart Disease in the Intensive Care Unit. Am J Crit Care 2022; 31:e10-e19. [PMID: 34972853 DOI: 10.4037/ajcc2022124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Individualized family-centered developmental care (IFDC) is considered the standard of care for premature/medically fragile newborns and their families in intensive care units (ICUs). Such care for infants with congenital heart disease (CHD) varies. OBJECTIVE The Consortium for Congenital Cardiac Care- Measurement of Nursing Practice (C4-MNP) was surveyed to determine the state of IFDC for infants younger than 6 months with CHD in ICUs. METHODS An electronic survey was disseminated to 1 nurse at each participating center. The survey included questions on IFDC-related nursing practice, organized in 4 sections: demographics, nursing practice, interdisciplinary practice, and parent support. Data were summarized by using descriptive statistics. Differences in IFDC practices and IFDC-related education were assessed, and practices were compared across 3 clinical scenarios of varying infant acuity by using the χ2 test. RESULTS The response rate was 66% (25 centers). Most respondents (72%) did not have IFDC guidelines; 63% incorporated IFDC interventions and 67% documented IFDC practices. Only 29% reported that their ICU had a neurodevelopmental team. Significant differences were reported across the 3 clinical scenarios for 11 of 14 IFDC practices. Skin-to-skin holding was provided least often across all levels of acuity. Nurse education related to IFDC was associated with more use of IFDC (P < .05). CONCLUSION Practices related to IFDC vary among ICUs. Opportunities exist to develop IFDC guidelines for infants with CHD to inform clinical practice and nurse education. Next steps include convening a C4-MNP group to develop guidelines and implement IFDC initiatives for collaborative evaluation.
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Affiliation(s)
- Meena P. LaRonde
- Meena P. LaRonde is a staff nurse III, Cardiovascular Intensive Care Unit, Boston Children’s Hospital, Boston, Massachusetts
| | - Jean A. Connor
- Jean A. Connor is the director of nursing research, Cardiovascular and Critical Care Patient Services, Boston Children’s Hospital and an assistant professor of pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Cerrato
- Benjamin Cerrato is a project coordinator, Cardiovascular and Critical Care Patient Services, Boston Children’s Hospital
| | - Araz Chiloyan
- Araz Chiloyan is a quality improvement consultant, Department of Cardiology, Boston Children’s Hospital
| | - Amy Jo Lisanti
- Amy Jo Lisanti is a research assistant professor at the University of Pennsylvania School of Nursing, Department of Family and Community Health and a primary investigator at the Research Institute and Children’s Hospital of Philadelphia
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19
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Role alteration predicts anxiety and depressive symptoms in parents of infants with congenital heart disease: a pilot study. Cardiol Young 2021; 31:1842-1849. [PMID: 33818351 PMCID: PMC8490483 DOI: 10.1017/s1047951121001037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Parents of infants born with critical congenital heart disease are at risk for adverse mental health symptoms. The purpose of this study was to identify infant-, parent-, and environmental-based stressors for mothers and fathers after their infants' cardiac surgery, and to explore relationships between stressors and mental health symptoms of anxiety and depression. METHODS This study enrolled 28 biological mother-father dyads from families admitted to the paediatric cardiac intensive care unit for cardiac surgery at one free-standing children's hospital in the Northeast. Paired t-tests were used to examine group differences between mothers and fathers on perceived stressors and mental health symptoms, while linear mixed effects modelling was used to explore the predictive relationship between perceived stressors, personal factors, and mental health symptoms. RESULTS Mothers reported higher perceived stressor scores of parental role alteration (t = 4.03, p < 0.01) and infant appearance and behaviour (t = 2.61, p = 0.02), and total perceived stress (t = 2.29 p = 0.03), compared to fathers. Mothers also reported higher anxiety (t = 2.47, p = 0.02) and depressive symptoms (t = 3.25, p < 0.01) than fathers. In multivariable analysis, parental role alteration significantly predicted anxiety (t = 5.20, p < 0.01, d = 0.77) and depressive symptoms (t = 7.09, p < 0.01, d = 1.05) for mothers and fathers. The consensus subscale of the Dyadic Adjustment Scale also significantly predicted depressive symptoms (t = -2.42, p = 0.02, d = 0.04). CONCLUSION Parents were distressed during their infant's admission for surgical repair for critical congenital heart disease. Parental role alteration was significantly associated with parental anxiety and depressive symptoms, while poor relationship quality was associated with depressive symptoms, highlighting areas for potential nursing-led psychosocial led interventions.
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20
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Cohen N, Katz C. Preventing child maltreatment: Key conclusions from a systematic literature review of prevention programs for practitioners. CHILD ABUSE & NEGLECT 2021; 118:105138. [PMID: 34087537 DOI: 10.1016/j.chiabu.2021.105138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/11/2021] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
Child maltreatment (CM) is a worldwide social problem and there is a large consensus that its prevention is of crucial importance. The current literature review highlights CM prevention studies that target practitioners, with the aim of assessing the knowledge in this area, informing future efforts and benefiting the international task of mitigating CM. Specifically, the study presents key conclusions from prevention programs evaluated in peer-reviewed journals from the last decade selected using the PRISMA systematic literature review guidelines. Out of the 26 manuscripts that discussed prevention programs targeted at practitioners, 20 programs were identified. While sexual abuse prevention programs were the most common, followed by programs addressing general child maltreatment, only two studies addressed child physical abuse. More than a third of the prevention programs were interdisciplinary, while healthcare providers had the highest number of specifically tailored programs. The discussion addresses the considerable lack of detail in the relevant manuscripts and urges future efforts to further elaborate on necessary details to enable other researchers and practitioners to better assess and determine the congruence between child maltreatment research and prevention programs. Additionally, some methodological issues in the included manuscripts, such as the lack of control groups and the related challenges, are discussed.
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Affiliation(s)
- Noa Cohen
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, 69978, Israel.
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, 69978, Israel
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21
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Tesson S, Butow PN, Marshall K, Fonagy P, Kasparian NA. Parent-child bonding and attachment during pregnancy and early childhood following congenital heart disease diagnosis. Health Psychol Rev 2021; 16:378-411. [PMID: 33955329 DOI: 10.1080/17437199.2021.1927136] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diagnosis and treatment of congenital heart disease (CHD) can present challenges to the developing parent-child relationship due to periods of infant hospitalization and intensive medical care, parent-infant separations, child neurodevelopmental delay and feeding problems, and significant parent and child distress and trauma. Yet, the ways in which CHD may affect the parent-child relationship are not well-understood. We systematically reviewed the evidence on parental bonding, parent-child interaction, and child attachment following CHD diagnosis, according to a pre-registered protocol (CRD42019135687). Six electronic databases were searched for English-language studies comparing a cardiac sample (i.e., expectant parents or parents and their child aged 0-5 years with CHD) with a healthy comparison group on relational outcomes. Of 22 unique studies, most used parent-report measures (73%) and yielded mixed results for parental bonding and parent-child interaction quality. Observational results also varied, although most studies (4 of 6) found difficulties in parent-child interaction on one or more affective or behavioural domains (e.g., lower maternal sensitivity, lower infant responsiveness). Research on parental-fetal bonding, father-child relationships, and child attachment behaviour was lacking. Stronger evidence is needed to determine the nature, prevalence, and predictors of relational disruptions following CHD diagnosis, and to inform targeted screening, prevention, and early intervention programs for at-risk dyads.
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Affiliation(s)
- Stephanie Tesson
- School of Psychology, The University of Sydney, Sydney, Australia.,Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
| | - Phyllis N Butow
- School of Psychology, The University of Sydney, Sydney, Australia.,Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, Australia
| | - Kate Marshall
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Nadine A Kasparian
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia.,Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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22
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Yoo SY, Cho H. Exploring the Influences of Nurses' Partnership with Parents, Attitude to Families' Importance in Nursing Care, and Professional Self-Efficacy on Quality of Pediatric Nursing Care: A Path Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5452. [PMID: 32751100 PMCID: PMC7432871 DOI: 10.3390/ijerph17155452] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/24/2022]
Abstract
This study examined the effects of nurse-parent partnership, nurses' attitude to families' importance in nursing care, and nursing professional self-efficacy on the quality of pediatric nursing care. BACKGROUND The quality of pediatric nursing care based on family-centered care is defined by the qualitative care behavior of nurses from the perspective of hospitalized children and their families. METHODS The participants were 218 nurses in pediatric wards in hospitals. Data were collected using self-report questionnaires and analyzed using descriptive statistics, Pearson's correlation coefficient, and path analysis. RESULTS Among the factors influencing the perceived quality of respect, explanation, and skillfulness, nurse experience showed the greatest total effect. The nurse-parent partnership had the greatest direct effect on the quality of respect and the greatest total effect on kindness. Nursing professional self-efficacy showed the greatest direct effect on explanation and the largest total effect on nurse-parent partnership and nurses' attitude to families' importance in nursing care. CONCLUSIONS To improve the quality of pediatric nursing care, it is necessary to provide a working environment in which pediatric nurses can work continuously. Hospitals should also develop a program that enables proper collaboration between nurses and parents of hospitalized children and improves nursing professional self-efficacy.
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Affiliation(s)
- So Yeon Yoo
- Department of Nursing, Kyungil University, Gyeongsan 38428, Korea;
| | - Haeryun Cho
- Department of Nursing, Wonkwang University, Iksan 54538, Korea
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Barnes S, Rio L, de Goumoëns V, Grandjean C, Ramelet AS. Effectiveness and family experiences of interventions promoting partnerships between families and pediatric and neonatal intensive care units: a mixed methods systematic review protocol. JBI Evid Synth 2020; 18:1292-1298. [PMID: 32813377 DOI: 10.11124/jbisrir-d-19-00277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This mixed methods systematic review examines the effectiveness and family experiences of interventions that promote partnerships between parents and the multidisciplinary health care team in pediatric and neonatal intensive care units. INTRODUCTION The hospitalization of a child or infant in an intensive care unit can have considerable negative effects on them and their family. Family members can experience increased stress, anxiety or depression and detrimental impacts on quality of life and family functioning. Interventions that promote families as health care partners may improve negative outcomes arising from intensive care hospitalization. INCLUSION CRITERIA The review will include family members of pediatric or neonatal patients hospitalized in an intensive care unit. It will focus on interventions that promote partnership between families and multidisciplinary health care teams in pediatric and neonatal intensive care units and the family's experiences of these interventions. The outcomes of interest are stress, anxiety, depression, quality of life, family functioning, family empowerment or satisfaction with family-centered care. METHODS The proposed review will follow the JBI methodology for convergent segregated mixed methods systematic reviews. It will search for published and unpublished studies from eight different sources. Studies will be reviewed by title and abstract and potentially eligible studies will have full text retrieved for further review. Studies meeting the inclusion criteria will be assessed on methodological quality and the data will be extracted. Separate quantitative and qualitative analysis and synthesis will be performed and an overall analysis will be presented. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019137834.
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Affiliation(s)
- Shannon Barnes
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Noosaville, Australia
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Laura Rio
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
| | - Véronique de Goumoëns
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
- Department of Nursing, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Chantal Grandjean
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
| | - Anne-Sylvie Ramelet
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
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Gramszlo C, Karpyn A, Demianczyk AC, Shillingford A, Riegel E, Kazak AE, Sood E. Parent Perspectives on Family-Based Psychosocial Interventions for Congenital Heart Disease. J Pediatr 2020; 216:51-57.e2. [PMID: 31735417 PMCID: PMC6917908 DOI: 10.1016/j.jpeds.2019.09.059] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/21/2019] [Accepted: 09/18/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To identify parents' preferences for goals and structure of intervention programs to support the psychosocial needs of families impacted by congenital heart disease (CHD). STUDY DESIGN Information about parent priorities for psychosocial programs was obtained in this mixed-methods study conducted at a pediatric hospital in the Mid-Atlantic region of the US. Participants were parents (N = 34; 20 mothers, 14 fathers) of children with CHD between the ages of 1 and 3 years who had cardiac surgery at less than 6 months of age. Qualitative data were excerpts from semistructured interviews. Quantitative data were participant choices regarding their ideal psychosocial program resulting from a card sort. RESULTS Parents reported that psychosocial interventions should support partnership in their child's care, promote self-care, facilitate communication with providers, prepare parents for challenges after hospitalization, provide education about child neurodevelopment, and help parents engage social support. Parents reported needing formalized support across care, brief intervention models, in-person individualized or small group support, and involvement of multidisciplinary providers and peer mentors in the delivery of interventions. CONCLUSIONS Parents of children with CHD need psychosocial interventions that empower them to act as primary caregivers and effective advocates for their child. Individualized, formalized, and multidisciplinary approaches to psychosocial care are necessary to best accommodate the dynamic stressors related to parenting a child with CHD and may mitigate the impact of parent mental health problems on child outcomes.
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Affiliation(s)
- Colette Gramszlo
- Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Allison Karpyn
- Center for Research in Education and Social Policy, Department of Human Development and Family Sciences, University of Delaware, Newark, DE
| | - Abigail C. Demianczyk
- Department of Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Amanda Shillingford
- Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.,Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Erin Riegel
- Mended Little Hearts of Delaware, Wilmington, DE
| | - Anne E. Kazak
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA,Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE
| | - Erica Sood
- Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.,Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.,Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA,Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE
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Mental health care for parents of babies with congenital heart disease during intensive care unit admission: Systematic review and statement of best practice. Early Hum Dev 2019; 139:104837. [PMID: 31455569 DOI: 10.1016/j.earlhumdev.2019.104837] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Congenital heart disease (CHD) is one of the most common causes of infant admission to pediatric intensive care and is associated with profound psychological stress for mothers, fathers and their infants. Intensive care unit admission represents an opportunity to offer evidence-based strategies to prevent or minimize severe psychological distress and promote secure bonding and attachment, alongside high-quality infant medical care. OBJECTIVES We aimed to identify, synthesize and critically appraise published evidence on the efficacy and cost-effectiveness of mental health interventions delivered in neonatal, pediatric or cardiac intensive care units for parents of infants with CHD. A secondary goal was to develop recommendations for advancing health policy, practice and research in the field. METHODS In accordance with a prospectively registered protocol (CRD42019114507), six electronic databases were systematically searched for studies reporting results of a controlled trial of a mental health intervention for parents of infants aged 0-12 months with a congenital anomaly requiring intensive care unit admission. To maximize generalizability of results, trials involving infants with any type of structural congenital anomaly requiring surgery were included. Outcomes included intervention type, process, efficacy, and cost-effectiveness. RESULTS Across all forms of congenital anomaly, only five trials met inclusion criteria (four in CHD, one in gastrointestinal malformation). All interventions engaged parents face-to-face, but each had a distinct therapeutic approach (parent-infant interaction and bonding, early pediatric palliative care, psycho-education, parenting skills training, and family-centered nursing). Four of the five trials demonstrated efficacy in reducing maternal anxiety, although the quality of evidence was low. Positive results were also found for maternal coping, mother-infant attachment, parenting confidence and satisfaction with clinical care, as well as infant mental (but not psychomotor) development at 6 months. Mixed results were found for maternal depression and infant feeding. No evidence of efficacy was found for improving parent, infant or family quality of life, physical health or length of infant hospital stay, and there were no data on cost-effectiveness. CONCLUSIONS Stronger evidence for the efficacy of mental health interventions to buffer the effects of intensive care unit admission for parents of infants with CHD is urgently needed. Robust, high-quality trials are lacking, despite the established need and demand, and health policies prioritizing parent mental health care in the context of early childhood adversity are needed.
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David Vainberg L, Vardi A, Jacoby R. The Experiences of Parents of Children Undergoing Surgery for Congenital Heart Defects: A Holistic Model of Care. Front Psychol 2019; 10:2666. [PMID: 31827455 PMCID: PMC6890854 DOI: 10.3389/fpsyg.2019.02666] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/12/2019] [Indexed: 12/02/2022] Open
Abstract
The present article is based on a qualitative study focusing on parents of children born with congenital heart defects (CHDs) and hospitalized in the children's intensive care unit post-surgery. Our aim was to explore parents' subjective experiences as primary caregivers. Ten semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis according to the instructions of Smith and Osborn. Our analysis yielded eight categories which were grouped into four themes and two main superordinate themes: (1) dialectical tension between positive and negative experiences; and (2) fluctuations between the inner and the outer world. The two superordinate themes intersect such that parents report positive as well as negative experiences within both their inner and outer worlds. Based on our analysis, we found that the experience of having a child undergo surgery for a CHD can be regarded as a chaotic period characterized by uncertainty, confusion, and helplessness. It is therefore no surprise that many parents display negative psychological outcomes which extend beyond the period of hospitalization and may also affect their future parenting and coping. However, within this chaotic and stressful situation, parents had occasional supportive experiences which decreased their emotional distress and isolation and helped them throughout this difficult period. We thus conclude that the support offered to parents during the hospitalization period should be increased by trying to minimize their negative experiences and strengthen their inner coping abilities. These changes cannot be implemented without also addressing the needs of the medical staff in their role as caregivers. Therefore, we propose a holistic model of care which supports both parents as caregivers of children undergoing surgery for CHD and the medical staff involved in their care.
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Affiliation(s)
| | - Amir Vardi
- Pediatric Cardiac Intensive Care, The Edmond and Lilly Safra Children’s Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Rebecca Jacoby
- Medical Psychology Graduate Program, Stress, Hope and Cope Lab, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
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Kasparian NA. Heart care before birth: A psychobiological perspective on fetal cardiac diagnosis. PROGRESS IN PEDIATRIC CARDIOLOGY 2019. [DOI: 10.1016/j.ppedcard.2019.101142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Uhm JY, Choi MY. Mothers' needs regarding partnerships with nurses during care of infants with congenital heart defects in a paediatric cardiac intensive care unit. Intensive Crit Care Nurs 2019; 54:79-87. [PMID: 31353190 DOI: 10.1016/j.iccn.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 06/28/2019] [Accepted: 07/04/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We investigated mothers' needs in forming partnerships with nurses based on children's postoperative recovery in a paediatric cardiac intensive care unit. DESIGN This was a descriptive study using prospective data. SETTING Data were collected from 36 mothers enrolled in a mother-nurse partnership program. MAIN OUTCOME MEASURES We investigated mothers' need for information and participation activities using a self-made survey tool, as well as the duration of mothers' care participation and physical engagement and psychological connectedness. RESULTS The mothers desired information on their infants' postoperative stability in the early recovery phases and information on infants' transfer and care in the later phases. Mothers' mean duration of care participation increased as infants' recovery progressed (15.82 ± 8.76 minutes in the second phase of recovery to 29.46 ± 4.53 minutes in the fifth phase; F = 19.54, p < .001). Mothers' physical engagement and psychological connectedness also increased with infants' recovery (F = 200.95, p < .001; F = 93.27, p < .001, respectively). Mothers generally passively participated at first and gradually developed more positive and enthusiastic participation as infants recovered. CONCLUSION Infants' condition heavily influenced mothers' needs regarding partnerships. Thus, nurses must individually provide mothers with information and encourage them to participate in care.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Daegu Haany University, 1 Haanydaero, Gyeongsan-si, Gyeongsangbuk-Do 712-715, Republic of Korea.
| | - Mi-Young Choi
- Department of Nursing Science, Chungbuk National University, Chungdae-ro 1, Seowon-Gu, Cheongju, Chungbuk 28644, Republic of Korea.
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Latour JM, Coombs M. Family-centred care in the intensive care unit: More than just flexible visiting hours. Intensive Crit Care Nurs 2018; 50:1-2. [PMID: 30348476 DOI: 10.1016/j.iccn.2018.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Jos M Latour
- School of Nursing and Midwifery, Faculty of Health and Human Sciences, University of Plymouth, 8-11 Kirkby Place, Room 205, Drake Circus, Plymouth PL4 8AA, United Kingdom.
| | - Maureen Coombs
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Level 7 Clinical Services Block, Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand.
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