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van Oort P, Maaskant J, Luttik ML, Eskes A. Impact of a patient and family participation education program on hospital nurses' attitudes and competencies: A controlled before-after study. PEC INNOVATION 2024; 4:100249. [PMID: 38225931 PMCID: PMC10788253 DOI: 10.1016/j.pecinn.2023.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024]
Abstract
Objective We designed a Patient and Family Participation Education Program (PFEP) with the aim of fostering a positive attitude and enhancing the competencies of hospital nurses required for effective patient and family participation in care. Methods In a Dutch university hospital, we conducted a before-after study. The PFEP comprising three courses: family conversation, supporting shared decision-making, and health literacy. We assessed nursing attitudes using the FINC-NA questionnaire and competencies with a separate questionnaire before and three months after the program. Changes in attitudes and competencies were analyzed using regression analysis. Results Twenty-two nurses participated in the education group, and 58 participated as controls.After three months, the change scores for the education group were statistically significantly higher on the total attitude score (FINC-NA) compared to the control group. Moreover, in six out of twelve competencies, the education group demonstrated significantly higher scores than the control group. Conclusion The educational program appeared effective in promoting nurses' attitudes and feelings of competencies towards patient and family-centered care. Innovation A blended education program focusing on patient and family has potential value for implementation in hospital care settings, especially for hospitals aiming to cultivate a more patient- and family-centered environment.
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Affiliation(s)
- Peter van Oort
- Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
- Amsterdam University of Applied Sciences, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands
| | - Jolanda Maaskant
- Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Internal Medicine, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Public Health, Amsterdam, the Netherlands
| | - Marie Louise Luttik
- Hanze University of Applied Sciences, Research Group Nursing Diagnostics, Professorship Family Care, Groningen, the Netherlands
| | - Anne Eskes
- Amsterdam University of Applied Sciences, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Public Health, Amsterdam, the Netherlands
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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Franck LS, Magaña J, Bisgaard R, Lothe B, Sun Y, Morton CH. Mobile-enhanced Family Integrated Care for preterm infants: A qualitative study of parents' views. PEC INNOVATION 2024; 4:100284. [PMID: 38737891 PMCID: PMC11087992 DOI: 10.1016/j.pecinn.2024.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/14/2024]
Abstract
Objective The Family Integrated Care (FICare) model improves outcomes for preterm infants and parents compared with family-centered care (FCC). FICare with mobile technology (mFICare) may improve uptake and impact. Research on FICare in the United States (US) is scarce and little is known about parents' experience. Methods We conducted qualitative interviews with nine parents, exploring their NICU experiences, participation in and perceptions of the mFICare program. A directed content analysis approach was used, and common themes were derived from the data. Results Overall, parents had positive NICU experiences and found mFICare helpful in meeting three common parenting priorities: actively caring for their infant, learning how to care for their infant, and learning about the clinical status of their infant. They described alignment and misalignment with mFICare components relative to their personal parenting priorities and offered suggestions for improvement. Nurses were noted to play key roles in providing or facilitating parent support and encouragement to participate in mFICare and parenting activities. Conclusion The mFICare program showed potential for parental acceptance and participation in US NICUs. Innovation The mFICare model is an innovation in neonatal care that can advance the consistent delivery of NICU family-centered care planning and caregiving.Clinical Trial Registration:NCT03418870 01/02/2018.
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Affiliation(s)
- Linda S. Franck
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Jazzelle Magaña
- Department of Pediatrics, Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | | | - Yao Sun
- Division of Neonatology, University of California San Francisco, San Francisco, CA, USA
| | - Christine H. Morton
- Department of Pediatrics, Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Domingue JL, Jacob JD. Discursive constructions of family functions in forensic psychiatry: A critical ethnographic perspective. Health (London) 2024; 28:526-541. [PMID: 37391908 PMCID: PMC11149389 DOI: 10.1177/13634593231185263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Significant barriers remain regarding the implementation of family-centred approaches in the domain of forensic psychiatry despite their effectiveness at increasing adherence to treatment, improving attendance to medical appointments, decreasing readmission rates and reducing episodes of relapse. We attribute these barriers to a fundamental gap in our understanding of the family function and its role within the forensic psychiatric system. Despite requesting to be included and considered as partners, some families feel excluded and sidelined, which causes distress, incomprehension and disengagement. We approached this tension at the discursive level through a critical ethnography of the Review Board and the work of Foucault on psychiatric power, which provided us with a unique opportunity to understand how the role of families are constructed and sustained in the Canadian forensic psychiatric system. To do so, we mobilized data stemming from ethnographic observations and documentary artifacts entitled 'reasons for disposition'. Data analysis allowed us to identify two discursive constructions of familial functions: (1) families as repositories of information and (2) families as supervisory agents. These results have implications for health care professionals and administrators in forensic psychiatry who are increasingly adhering to family-centred care models without questioning what such care or what such family engagement entails.
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Jesus TS, Struhar J, Zhang M, Lee D, Stern BZ, Heinemann AW, Jordan N, Deutsch A. Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness. Int J Qual Health Care 2024; 36:mzae053. [PMID: 38907579 DOI: 10.1093/intqhc/mzae053] [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: 02/08/2024] [Revised: 05/14/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024] Open
Abstract
Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol. Eligibility included studies in English (2015-2023) assessing the impact of NRTF and data relay on standardized patient-reported experience measures as a primary outcome. Eligibility and quality appraisals were performed by two independent reviewers. An expert former patient (Patient and Family Advisory Council and communication sciences background) helped interpret the results. Eight papers met review eligibility criteria, including three randomized controlled trials (RCTs) and one non-randomized study. Three of these studies involved in-person NRTF prior to data relay (patient-level data for immediate corrective action or aggregated and peer-compared) and led to significantly better results in all or some of the experience measures. In turn, a kiosk-based NRTF achieved no better experience results. The remaining studies were pre-post designs with mixed or neutral results and greater risks of bias. In-person NRTF on the patient experience followed by rapid data relay to their providers, either patient-level or provider-level as peer-compared, can improve the patient experience of care. Reviewed kiosk-based or self-reported approaches combined with data relay were not effective. Further research should determine which approach (e.g. who conducts the in-person NRTF) will provide better, more efficient improvements and under which circumstances.
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Affiliation(s)
- Tiago S Jesus
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W 10th Ave, Columbus, OH 43210, United States
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, United States
| | - Jan Struhar
- Nerve, Muscle and Bone Innovation Center & Oncology Innovation Center, Shirley Ryan AbilityLab, 355 E Erie St, Chicago, IL 60611, United States
| | - Manrui Zhang
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, United States
| | - Dongwook Lee
- Center for Child Development & Research, Sensory EL, ROK; Dept. of Physical Medicine and Rehabilitation Medicine, Korehab Clinic, Building 64 - Ground Floor, F Block - Dubai Healthcare City, Dubai, UAE
| | - Brocha Z Stern
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St, Chicago, IL 60611, United States
- Department of Physical Medicine and Rehabilitation Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, United States
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, United States
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, 5000 5th Ave, Hines, IL 60141, United States
| | - Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St, Chicago, IL 60611, United States
- Department of Physical Medicine and Rehabilitation Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, United States
- Center for Health Care Outcomes, RTI International, 10 S. Riverside Plaza #875, Chicago, IL 60606, United States
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Joo Y, Jang Y, Kwon OY. Contents and effectiveness of patient- and family-centred care interventions in adult intensive care units: A systematic review. Nurs Crit Care 2024. [PMID: 38899600 DOI: 10.1111/nicc.13105] [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: 10/18/2023] [Revised: 04/16/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The need and values of patient- and family-centred care (PFCC) have been globally increasing in the health care landscape. However, the concept of PFCC and the components in adult intensive care units (ICUs) remain wide-ranging. AIM To elucidate the core concepts of PFCC interventions and evaluate the effects of the interventions in adult ICUs. STUDY DESIGN We searched electronic databases (PubMed, Cochrane Central, CINAHL, EMBASE, PsycINFO, RISS, KMbase and KoreaMed) from inception to 20 June 2022, for all studies on PFCC interventions. Three authors independently conducted data screening and extraction. The core concepts and the effects of PFCC interventions in adult ICUs were examined. The effects of patient- and family-centred care interventions in adult ICUs were examined. The quality of the included studies was evaluated using the Mixed Methods Appraisal Tool. RESULTS Overall, 3507 records were identified, and 14 full-text articles were assessed. Participants in the included studies were patients and/or their family members in adult ICUs. The main concepts of the studies were participation and information-sharing. Only two studies used collaboration as the main concept of intervention. PFCC interventions have shown positive outcomes for patients, including increased satisfaction, improvement of patient health status and reduced incidence of complications. They have also been beneficial for families, leading to higher satisfaction levels and decreased anxiety. Additionally, these interventions have positively impacted health care providers by enhancing satisfaction and improving rounding efficiency. Moreover, they have influenced health care utilization by decreasing hospital costs and length of stay. CONCLUSIONS This review highlights the advantages of PFCC interventions for patients, families and health care providers in adult ICUs. Future research should focus on developing strategies to incorporate collaboration more comprehensively as a core concept in the implementation of PFCC interventions. RELEVANCE TO CLINICAL PRACTICE Future research endeavours must prioritize collaborative efforts involving health care providers, patients and their families by deploying an array of strategies within the intensive care unit setting.
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Affiliation(s)
- Youngshin Joo
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Yeonsoo Jang
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Oh Young Kwon
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
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Musters SCW, Kreca SM, van Dieren S, van der Wal-Huisman H, Romijn JA, Chaboyer W, Nieveen van Dijkum EJM, Eskes AM, Besselink MGH, Bakker CA, van Langen R, Heidsma C, Ouwens M, Hendriks MJ, van Leeuwen BL, de Jong M, Hoekstra R, Blaauw E, Smith R, Schreuder M. Surgical outcomes in surgical oncology patients who participated in a family involvement program. Surgery 2024:S0039-6060(24)00301-5. [PMID: 38897885 DOI: 10.1016/j.surg.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND There is a lack of evidence regarding the relationship between family involvement and outcomes in gastrointestinal oncology patients after surgery. To evaluate the effect of a family involvement program for patients undergoing oncologic gastrointestinal surgery on unplanned readmissions within 30 days after surgery. METHODS A multicenter patient-preference cohort study compared 2 groups: patients who participated in the family involvement program versus usual care. The program comprised involvement of family caregivers in care and training of health care professionals in family-centered care. Multivariable regression analyses were used to evaluate the effect of the FIP on the number of unplanned readmissions up to 30 days after surgery. Secondary outcomes included complications sensitive to fundamental care activities, emergency department visits, intensive care unit admissions, hospital length of stay, and the need for professional home care after discharge. RESULTS Of the 301 patients included, 152 chose the family involvement program, and 149 chose usual care. Postoperative readmissions occurred in 25 (16.4%) patients in the family involvement program group, and 15 (10.1%) in the usual care group (P = .11). A significant reduction of 16.2% was observed in the need for professional home care after discharge in the family involvement program group (P < .01). No significant differences were found between the 2 groups in the other secondary outcomes. CONCLUSION The family involvement program did not reduce the number of unplanned readmissions, but it led to a substantial reduction in-home care, which suggests an economic benefit from a societal perspective. Implementation of the family involvement program should, therefore, be considered in clinical practice.
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Affiliation(s)
- Selma C W Musters
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Sani M Kreca
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Susan van Dieren
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | | | | | - Wendy Chaboyer
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia
| | - Els J M Nieveen van Dijkum
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands
| | - Anne M Eskes
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands.
| | - Marc G H Besselink
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Chris A Bakker
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Rosanna van Langen
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Charlotte Heidsma
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marjan Ouwens
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marie-José Hendriks
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Barbara L van Leeuwen
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Maarten de Jong
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Rommy Hoekstra
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Eline Blaauw
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Reggie Smith
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marthe Schreuder
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
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Woldring JM, Paans W, Gans R, Dorland L, Luttik ML. Families' importance in nursing care-families' opinions: a cross-sectional survey study in the homecare setting. Arch Public Health 2024; 82:87. [PMID: 38886839 PMCID: PMC11181553 DOI: 10.1186/s13690-024-01314-4] [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: 01/30/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Informal care is an essential part of support provided in the homecare setting. To ensure effective healthcare provision, good communication and collaboration between informal and formal care providers are crucial. To achieve this aim, it is necessary to have a clear understanding of the perspectives of all stakeholders. In the scientific literature, limited knowledge is available regarding family members' opinions about their involvement in care. To date, no instruments have been developed that accurately measure these opinions. This study aims to elucidate the opinions of family members about their involvement in nursing care. METHODS A cross-sectional survey approach was employed. The methodological steps in this study were (1) convert the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) from a nurses' perspective to a family perspective and thus develop the Families' Importance in Nursing Care-Families' Opinions (FINC-FO) and (2) measure families' opinions regarding their involvement in home nursing care. The questionnaire was sent to 3,800 patients with activated patient portals, which accounts for about 17% of the total patient base. Responses were received from 1,339 family members, a response rate of 35%. RESULTS The developed FINC-FO questionnaire showed homogeneity and internal consistency. The results of the questionnaire indicate that family members consider it important to be involved in care and that they wish to be acknowledged as participants in discussions about care (planning) but are less inclined to actively participate in the provision of care by nurses. Family members expressed less explicit opinions about their own support needs. Factors such as level of education, type of partnership, and amount of care provided are seemingly associated with these opinions. CONCLUSIONS Family members in the homecare setting wish to be involved in discussions about care (planning). The transition in care from primarily formal to more informal care necessitates an awareness and clear definition-on part of both healthcare professionals and families-of their respective roles in the provision of care. Communication about wishes, expectations, and the need for support in care is essential to ensure quality of care and that the family can sustain caregiving.
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Affiliation(s)
- Josien M Woldring
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands.
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
| | - Wolter Paans
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
- Department of Critical Care, University Medical Centre Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Reinold Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Laura Dorland
- Merkbaar Beter, PO Box 102, Espria, Beilen, 9410 AC, the Netherlands
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
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Digby R, Kramer S, Yuan V, Ozavci G, Bucknall TK. Patients in isolation, their physical, environmental and mental health: An exploratory study. J Clin Nurs 2024. [PMID: 38887821 DOI: 10.1111/jocn.17295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/08/2024] [Accepted: 05/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Strict patient isolation in hospital is associated with adverse health outcomes. However, there is a lack of high-quality evidence for effective interventions to improve safety and quality of care for these patients. AIMS To identify patient reported areas for improvement in the care of patients in hospital isolation and to determine the feasibility of collecting patient reported outcomes using validated tools. METHODS Design An exploratory mixed methods study. Setting A major metropolitan teaching hospital in Melbourne, Australia. Participants Patients in hospital isolation for transmissible infections. Data collection Data were collected by (1) phone interviews with patients in isolation and (2) seven validated measurement tools to assess cognition, loneliness, nutritional status, quality of life, anxiety and depression and physical activity. Data were collected between September and December 2021. Data analysis Interviews were transcribed and analysed using thematic analysis. Quantitative data were analysed descriptively including participant characteristics and outcome data. RESULTS Participants identified areas for improvement including activities to decrease boredom, more contact with staff to mitigate loneliness and increase comfort care, and formalised communication about clinical treatment and discharge plan. Patients with gastrointestinal symptoms were happier to be alone. There were operational challenges within the health service including delays and miscommunication. Only 70% of the participants completed all questionnaires. CONCLUSION This study identified areas for improvement in care of patients in isolation and demonstrated that collecting patient reported outcomes using validated tools was feasible. The results of this research will inform development of an intervention to manage adverse effects. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Patients in hospital isolation require additional consideration to ensure that their needs are met to avoid adverse outcomes. The patient experience and comfort can be negatively affected when fundamental care is lacking. REPORTING METHOD (EQUATOR) EQUATOR guidelines for Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS). PATIENT OR PUBLIC CONTRIBUTION Thirteen patients in hospital isolation agreed to participate in this study, sharing their experiences through interviews and assessment.
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Affiliation(s)
- Robin Digby
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Sharon Kramer
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Vicky Yuan
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Guncag Ozavci
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Tracey K Bucknall
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
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Alrø AB, Svenningsen H, Nedergaard HK, Jensen HI, Dreyer P. Patients' and relatives' experiences of cognitive impairment following an intensive care unit admission. A qualitative study. Aust Crit Care 2024:S1036-7314(24)00091-2. [PMID: 38839438 DOI: 10.1016/j.aucc.2024.05.004] [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: 02/02/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Cognitive impairment poses a significant challenge following critical illness in the intensive care unit. A knowledge gap exists concerning how patients experience cognitive impairments. OBJECTIVES The aim was to explore patients' and relatives' experiences of patients' cognitive impairment due to critical illness following an intensive care unit admission. METHODS A qualitative multicentre study was conducted in Denmark with 3- and 6-month follow-ups using single and dyadic interviews. A phenomenological hermeneutic approach was adopted using a Ricoeur-inspired textual in-depth analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used. RESULTS Three themes emerged from interviews with 18 patients and 14 relatives: 'It feels like living in a parallel world', 'Getting back to a normal everyday life with a vulnerable self', and 'Managing everyday life using self-invented strategies'. Patients used self-invented strategies to manage their vulnerability and newly acquired cognitive impairments when no help or support was provided specifically targeting their cognitive impairments. Not being as cognitively capable as they previously had been turned their lives upside down. Losing control and not being themselves made them vulnerable. Patients did not want to burden others. However, support from relatives was invaluable in their recovery and rehabilitation. CONCLUSIONS Patients experienced multiple cognitive impairments affecting their adaption to everyday life. They strove to overcome their vulnerability using a variety of self-invented strategies and activities.
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Affiliation(s)
- Anette Bjerregaard Alrø
- Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Aarhus University, Institute of Public Health, Section of Nursing, Bartholins Alle' 2, 3. sal, Building 1260, 8000 Aarhus C, Denmark.
| | - Helle Svenningsen
- Research Centre for Health and Welfare Technology, VIA University College, Campus Aarhus N, Hedeager 2, Aarhus N, Denmark.
| | - Helene Korvenius Nedergaard
- Department of Anaesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Sygehusvej 24, 6000 Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19,3., 5000 Odense C, Denmark.
| | - Hanne Irene Jensen
- Departments of Anaesthesiology and Intensive Care, Kolding Hospital, University Hospital of Southern Denmark, Denmark; Departments of Anaesthesiology and Intensive Care, Vejle Hospital, University Hospital of Southern Denmark, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Pia Dreyer
- Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Aarhus University, Institute of Public Health, Section of Nursing, Bartholins Alle' 2, 3. sal, Building 1260, 8000 Aarhus C, Denmark.
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10
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Sweileh WM. Analysis and mapping the research landscape on patient-centred care in the context of chronic disease management. J Eval Clin Pract 2024; 30:638-650. [PMID: 38567707 DOI: 10.1111/jep.13988] [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] [Received: 06/17/2023] [Revised: 02/07/2024] [Accepted: 03/18/2024] [Indexed: 05/25/2024]
Abstract
RATIONALE Patient-centred care has emerged as a transformative approach in managing chronic diseases, aiming to actively involve patients in their healthcare decisions. AIMS AND OBJECTIVES This study was conducted to analyse and map the research landscape on patient-centred care in the context of chronic disease management. METHODS This study used Scopus to retrieve the relevant articles. The analysis focused on the growth pattern, highly cited articles, randomised clinical trials, patients and providers perspectives, facilitators and barriers, frequent author keywords, emerging topics, and prolific countries and journals in the field. RESULTS In total, 926 research articles met the inclusion criteria. There was a notable increase in the number of publications over time. Cancer had the highest number of articles (n = 379, 40.9%), followed by diabetes mellitus, and mental health and psychiatric conditions. Studies on patient-centred care in diabetic patients received the highest number of citations. The results identified 52 randomised controlled trials that covered four major themes: patient-centred care for diabetes management, shared decision-making in mental health and primary care, shared decision-making in cancer care, and economic evaluation and cost-effectiveness. The study identified 51 studies that examined the impact of tools such as computer-based systems, decision aids, smartphone apps, and online tools to improve patient-centred outcomes. A map of author keywords showed that renal dialysis, HIV, and atrial fibrillation were the most recent topics in the field. Researchers from the United States contributed to more than half of the retrieved publications. The top active journals included "Patient Education and Counselling" and "Health Expectations". CONCLUSION This study provides valuable insights into the research landscape of patient-centred care within the context of chronic diseases. The current study provided a comprehensive overview of the research landscape on patient-centred care, which can empower patients by raising their awareness about clinical experiences and outcomes.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology and Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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11
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Poojari DP, Umakanth S, Maiya GA, Rao BK, Khurana S, Kumaran D S, Attal R, Brien M. Effect of family-centered care interventions on well-being of caregivers of children with cerebral palsy: a systematic review. F1000Res 2024; 12:790. [PMID: 38911944 PMCID: PMC11193087 DOI: 10.12688/f1000research.133314.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/25/2024] Open
Abstract
Background Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective. Methods This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data. Results The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies. Conclusion FCC interventions were found to be effective in improving caregivers' satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver's mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.
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Affiliation(s)
- Deepalaxmi Paresh Poojari
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, Manipal, Karnataka, 576101, India
| | - G. Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sonia Khurana
- Department of Physical therapy, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Senthil Kumaran D
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Radhika Attal
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, Tamil Nadu, India
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12
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Jesus TS, Stern BZ, Lee D, Zhang M, Struhar J, Heinemann AW, Jordan N, Deutsch A. Systematic review of contemporary interventions for improving discharge support and transitions of care from the patient experience perspective. PLoS One 2024; 19:e0299176. [PMID: 38771768 PMCID: PMC11108181 DOI: 10.1371/journal.pone.0299176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/03/2024] [Indexed: 05/23/2024] Open
Abstract
AIM To synthesize the impact of improvement interventions related to care coordination, discharge support and care transitions on patient experience measures. METHOD Systematic review. Searches were completed in six scientific databases, five specialty journals, and through snowballing. Eligibility included studies published in English (2015-2023) focused on improving care coordination, discharge support, or transitional care assessed by standardized patient experience measures as a primary outcome. Two independent reviewers made eligibility decisions and performed quality appraisals. RESULTS Of 1240 papers initially screened, 16 were included. Seven studies focused on care coordination activities, including three randomized controlled trials [RCTs]. These studies used enhanced supports such as improvement coaching or tailoring for vulnerable populations within Patient-Centered Medical Homes or other primary care sites. Intervention effectiveness was mixed or neutral relative to standard or models of care or simpler supports (e.g., improvement tool). Eight studies, including three RCTs, focused on enhanced discharge support, including patient education (e.g., teach back) and telephone follow-up; mixed or neutral results on the patient experience were also found and with more substantive risks of bias. One pragmatic trial on a transitional care intervention, using a navigator support, found significant changes only for the subset of uninsured patients and in one patient experience outcome, and had challenges with implementation fidelity. CONCLUSION Enhanced supports for improving care coordination, discharge education, and post-discharge follow-up had mixed or neutral effectiveness for improving the patient experience with care, compared to standard care or simpler improvement approaches. There is a need to advance the body of evidence on how to improve the patient experience with discharge support and transitional approaches.
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Affiliation(s)
- Tiago S. Jesus
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Education in Health Science, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Brocha Z. Stern
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Dongwook Lee
- Center for Child Development & Research, Sensory EL, ROK, Dept. of Physical Medicine and Rehabilitation Medicine, Korehab Clinic, Dubai, UAE
| | - Manrui Zhang
- Center for Education in Health Science, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jan Struhar
- Nerve, Muscle and Bone Innovation Center & Oncology Innovation Center, Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | - Allen W. Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine and Rehabilitation Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Dept. of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, Illinois, United States of America
| | - Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine and Rehabilitation Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Center for Health Care Outcomes, RTI International, Chicago, Illinois, United States of America
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13
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Moradi T, Rezaei M, Alavi NM. Delegating care as a double-edged sword for quality of nursing care: a qualitative study. BMC Health Serv Res 2024; 24:592. [PMID: 38715066 PMCID: PMC11075185 DOI: 10.1186/s12913-024-11054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.
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Affiliation(s)
- Tayebeh Moradi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahboubeh Rezaei
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| | - Negin Masoudi Alavi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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14
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Mwale D, Manda-Taylor L, Langton J, Likumbo A, van Hensbroek MB, Calis J, Janssens W, Pell C. The role of healthcare providers and caregivers in monitoring critically ill children: a qualitative study in a tertiary hospital, southern Malawi. BMC Health Serv Res 2024; 24:595. [PMID: 38714998 PMCID: PMC11077805 DOI: 10.1186/s12913-024-11050-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Critically ill children require close monitoring to facilitate timely interventions throughout their hospitalisation. In low- and middle-income countries with a high disease burden, scarce paediatric critical care resources complicates effective monitoring. This study describes the monitoring practices for critically ill children in a paediatric high-dependency unit (HDU) in Malawi and examines factors affecting this vital process. METHODS A formative qualitative study based on 21 in-depth interviews of healthcare providers (n = 12) and caregivers of critically ill children (n = 9) in the HDU along with structured observations of the monitoring process. Interviews were transcribed and translated for thematic content analysis. RESULTS The monitoring of critically ill children admitted to the HDU was intermittent, using devices and through clinical observations. Healthcare providers prioritised the most critically ill children for more frequent monitoring. The ward layout, power outages, lack of human resources and limited familiarity with available monitoring devices, affected monitoring. Caregivers, who were present throughout admission, were involved informally in monitoring and flagging possible deterioration of their child to the healthcare staff. CONCLUSION Barriers to the monitoring of critically ill children in the HDU were related to ward layout and infrastructure, availability of accurate monitoring devices and limited human resources. Potential interventions include training healthcare providers to prioritise the most critically ill children, allocate and effectively employ available devices, and supporting caregivers to play a more formal role in escalation.
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Affiliation(s)
- Daniel Mwale
- Kamuzu University of Health Sciences, Blantyre, Malawi.
- Training Research Unit of Excellence, Blantyre, Malawi.
| | - Lucinda Manda-Taylor
- Kamuzu University of Health Sciences, Blantyre, Malawi
- Training Research Unit of Excellence, Blantyre, Malawi
| | | | - Alice Likumbo
- Training Research Unit of Excellence, Blantyre, Malawi
| | - Michael Boele van Hensbroek
- Department of Paediatric Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, Meibergdreef, NL, the Netherlands
| | - Job Calis
- Department of Paediatric Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, Meibergdreef, NL, the Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciencies, Blantyre, Malawi
| | - Wendy Janssens
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Department of Economics, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Christopher Pell
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Department of Global Health Amsterdam, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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15
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Jeong H, Lee W, Jang SG, Pyo J, Choi EY, Baek SJ, Ock M. Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea. Curr Med Res Opin 2024:1-9. [PMID: 38646669 DOI: 10.1080/03007995.2024.2346334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND To ensure effective patient engagement, patients' efforts, partnerships with healthcare professionals, and the organisation's role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals' perception of patient engagement and compared the findings with that determined for the public in a previous study. METHODS An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher's exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study. RESULTS The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 86% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals' hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as "medical dispute mediation and arbitration programs", "fall prevention", and "infection prevention", there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses' perception being particularly more positive than that of physicians. CONCLUSIONS The healthcare professionals' perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public's perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.
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Affiliation(s)
- Hyeran Jeong
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | | | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Seung Ju Baek
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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16
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Beres LK, Underwood A, Le Tourneau N, Kemp CG, Kore G, Yaeger L, Li J, Aaron A, Keene C, Mallela DP, Khalifa BAA, Mody A, Schwartz SR, Baral S, Mwamba C, Sikombe K, Eshun-Wilson I, Geng EH, Lavoie MCC. Person-centred interventions to improve patient-provider relationships for HIV services in low- and middle-income countries: a systematic review. J Int AIDS Soc 2024; 27:e26258. [PMID: 38740547 DOI: 10.1002/jia2.26258] [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: 09/28/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Person-centred care (PCC) has been recognized as a critical element in delivering quality and responsive health services. The patient-provider relationship, conceptualized at the core of PCC in multiple models, remains largely unexamined in HIV care. We conducted a systematic review to better understand the types of PCC interventions implemented to improve patient-provider interactions and how these interventions have improved HIV care continuum outcomes and person-reported outcomes (PROs) among people living with HIV in low- and middle-income countries. METHODS We searched databases, conference proceedings and conducted manual targeted searches to identify randomized trials and observational studies published up to January 2023. The PCC search terms were guided by the Integrative Model of Patient-Centeredness by Scholl. We included person-centred interventions aiming to enhance the patient-provider interactions. We included HIV care continuum outcomes and PROs. RESULTS We included 28 unique studies: 18 (64.3%) were quantitative, eight (28.6.%) were mixed methods and two (7.1%) were qualitative. Within PCC patient-provider interventions, we inductively identified five categories of PCC interventions: (1) providing friendly and welcoming services; (2) patient empowerment and improved communication skills (e.g. supporting patient-led skills such as health literacy and approaches when communicating with a provider); (3) improved individualized counselling and patient-centred communication (e.g. supporting provider skills such as training on motivational interviewing); (4) audit and feedback; and (5) provider sensitisation to patient experiences and identities. Among the included studies with a comparison arm and effect size reported, 62.5% reported a significant positive effect of the intervention on at least one HIV care continuum outcome, and 100% reported a positive effect of the intervention on at least one of the included PROs. DISCUSSION Among published HIV PCC interventions, there is heterogeneity in the components of PCC addressed, the actors involved and the expected outcomes. While results are also heterogeneous across clinical and PROs, there is more evidence for significant improvement in PROs. Further research is necessary to better understand the clinical implications of PCC, with fewer studies measuring linkage or long-term retention or viral suppression. CONCLUSIONS Improved understanding of PCC domains, mechanisms and consistency of measurement will advance PCC research and implementation.
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Affiliation(s)
- Laura K Beres
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Ashley Underwood
- Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Noelle Le Tourneau
- Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | | | - Gauri Kore
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lauren Yaeger
- Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Jingjia Li
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alec Aaron
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Banda A A Khalifa
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aaloke Mody
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | | | - Stefan Baral
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chanda Mwamba
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Kombatende Sikombe
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Ingrid Eshun-Wilson
- Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Elvin H Geng
- Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Marie-Claude C Lavoie
- Center for International Health Education and Biosecurity, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Wu QL, Brannon GE. Collaborative Care and Healthcare Usage in Families with Pediatric Patients During COVID-19: A Secondary Analysis of National Survey of Children's Health (NSCH) Data. HEALTH COMMUNICATION 2024; 39:1053-1065. [PMID: 37069500 DOI: 10.1080/10410236.2023.2201746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes.
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Piil K, Locatelli G, Skovhus SL, Tolver A, Jarden M. A Shifting Paradigm Toward Family-Centered Care in Neuro-Oncology: A Longitudinal Quasi-Experimental Mixed-Methods Feasibility Study. JOURNAL OF FAMILY NURSING 2024; 30:127-144. [PMID: 38531858 DOI: 10.1177/10748407241236678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Roskilde University, Denmark
| | | | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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19
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Wang Z, Yu S, Liu Y, Han Y, Zhao W, Zhang W. Effectiveness of family centred interventions for family caregivers: A systematic review and meta-analysis of randomized controlled trials. J Clin Nurs 2024; 33:1958-1975. [PMID: 38439168 DOI: 10.1111/jocn.17091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
AIMS AND OBJECTIVES To examine the effectiveness of family-centred interventions among family caregivers. BACKGROUND Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers. DESIGN A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist. METHODS Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. RESULTS This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=-0.79, 95% CI[-1.22,-0.36], p = 0.0003) than on adult patients (SMD=-0.37, 95% CI [-0.61,-0.12], p = 0.004). CONCLUSIONS Family-centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning. RELEVANCE TO CLINICAL PRACTICE Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers. TRIAL REGISTRATION DETAILS The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).
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Affiliation(s)
- Ziqi Wang
- School of Nursing, Jilin University, Changchun, China
| | - Shuanghan Yu
- School of Nursing, Jilin University, Changchun, China
| | - Yantong Liu
- School of Nursing, Jilin University, Changchun, China
| | - Yujie Han
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, China
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20
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Kreca SM, Albers IS, Musters SCW, van Dijkum EJMN, Tuinman PR, Eskes AM. The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery: a root cause analysis from a prospective multicenter study in the Netherlands. Patient Saf Surg 2024; 18:14. [PMID: 38689336 PMCID: PMC11061973 DOI: 10.1186/s13037-024-00399-8] [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: 02/28/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients' healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients' healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. METHODS This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. RESULTS Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1-2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. CONCLUSION Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.
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Affiliation(s)
- Sani Marijke Kreca
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands.
| | - Iris Sophie Albers
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Anesthesiology, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Selma Clazina Wilhelmina Musters
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Els Jaqueline Maria Nieveen van Dijkum
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Pieter Roel Tuinman
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, G01 2.03 Gold Coast campus Griffith University, Gold Coast, QLD, 4222, Australia
- Department of Intensive Care Amsterdam cardiovascular Sciences Amsterdam institute for Infection and Immunity, Amsterdam UMC location Vrije Universiteit Amsterdam NL, Amsterdam, The Netherlands
| | - Anne Maria Eskes
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands.
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, G01 2.03 Gold Coast campus Griffith University, Gold Coast, QLD, 4222, Australia.
- Intensive Care, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands.
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
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21
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Morris G, Maliqi B, Lattof SR, Strong J, Yaqub N. Private sector quality of care for maternal, new-born, and child health in low-and-middle-income countries: a secondary review. Front Glob Womens Health 2024; 5:1369792. [PMID: 38707636 PMCID: PMC11066217 DOI: 10.3389/fgwh.2024.1369792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/21/2024] [Indexed: 05/07/2024] Open
Abstract
The private sector has emerged as a crucial source of maternal, newborn, and child health (MNCH) care in many low- and middle-income countries (LMICs). Quality within the MNCH private sector varies and has not been established systematically. This study systematically reviews findings on private-sector delivery of quality MNCH care in LMICs through the six domains of quality care (QoC) (i.e., efficiency, equity, effectiveness, people-centered care, safety, and timeliness). We registered the systematic review with PROSPERO international prospective register of systematic reviews (registration number CRD42019143383) and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement for clear and transparent reporting of systematic reviews and meta-analyses. Searches were conducted in eight electronic databases and two websites. For inclusion, studies in LMICs must have examined at least one of the following outcomes using qualitative, quantitative, and/or mixed-methods: maternal morbidity, maternal mortality, newborn morbidity, newborn mortality, child morbidity, child mortality, service utilization, quality of care, and/or experience of care including respectful care. Outcome data was extracted for descriptive statistics and thematic analysis. Of the 139 included studies, 110 studies reported data on QoC. Most studies reporting on QoC occurred in India (19.3%), Uganda (12.3%), and Bangladesh (8.8%). Effectiveness was the most widely measured quality domain with 55 data points, followed by people-centered care (n = 52), safety (n = 47), timeliness (n = 31), equity (n = 24), and efficiency (n = 4). The review showed inconsistencies in care quality across private and public facilities, with quality varying across the six domains. Factors such as training, guidelines, and technical competence influenced the quality. There were also variations in how domains like "people-centered care" have been understood and measured over time. The review underscores the need for clearer definitions of "quality" and practical QoC measures, central to the success of Sustainable Development Goals (SDGs) and equitable health outcomes. This research addresses how quality MNCH care has been defined and operationalized to understand how quality is delivered across the private health sector and the larger health system. Numerous variables and metrics under each QoC domain highlight the difficulty in systematizing QoC. These findings have practical significance to both researchers and policymakers. Systematic Review Registration https://bmjopen.bmj.com/content/10/2/e033141.long, Identifier [CRD42019143383].
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Affiliation(s)
- Georgina Morris
- Department of International Development, London School of Economics and Political Science, London, United Kingdom
| | - Blerta Maliqi
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Samantha R. Lattof
- Department of International Development, London School of Economics and Political Science, London, United Kingdom
| | - Joe Strong
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Nuhu Yaqub
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
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22
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Mestre TD, Lopes MJ, Mestre DM, Ferreira RF, Costa AP, Caldeira EV. Impact of family-centered care in families with children with intellectual disability: A systematic review. Heliyon 2024; 10:e28241. [PMID: 38560242 PMCID: PMC10981057 DOI: 10.1016/j.heliyon.2024.e28241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Background Family-Centered Care (FCC) is an approach to healthcare planning, delivery and evaluation, based on beneficial partnerships between health professionals, patients and families. FCC may be particularly relevant for families with children with intellectual disability (ID), given their needs of continuum care. Objective To identify which components of the FCC are practiced and which health outcomes are considered effective in families with children with ID. Method A systematic review guided by the PRISMA STATEMENT 2020 approach and the STROBE reporting guidelines was performed on specific databases through the EBSCOhost Web platform: MEDLINE with Full Text, CINAHL PLUS with Full Text, Academic Search Complete and Psychology and Behavioral Sciences Collection. Peer-reviewed articles published in English or Portuguese languages from 2018 to September 2023 were retrieved. Methodological quality was established using the Quality Assessment Tool for Observational, Cohort and Cross-Sectional Studies - NHLBI, NIH. Results Ten studies met the eligibility criteria and were synthetized. The results revealed nine components, reflecting the way FCC was developed: shared decision-making; family education; respect for culture; family engagement; recognition of the family's needs, characteristics and interests; specialized care support; social and emotional support; family functionality; and family seen as a unit. The health outcomes demonstrate effective gains in improving children's health through family satisfaction with health services. Also achieved psychological and social benefits, with improved family well-being and quality of life, favoring family empowerment. Conclusions The evidence suggests that FCC components involves an effective partnership between the family and health professionals as the main key in developing care plans, as well as the experience that the family unit brings to the delivery of care. FCC approach include all family members as decision-makers, providing emotional, physical and instrumental levels of support. Health outcomes emerged in three strands; for children with ID, families and health services.
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Affiliation(s)
- Teresa Dionísio Mestre
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre [CHRC], Portugal
- University of Évora – Health Department, Portugal
| | | | - Rogério Ferrinho Ferreira
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Ana Pedro Costa
- Comprehensive Health Research Centre [CHRC], Portugal
- Local Health Unit of Lower Alentejo [ULSBA], Beja, Portugal
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23
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Musters SC, Coolen CM, Jongerden IP, Schijven MP, Maaskant JM, Eskes AM. Experiences of healthcare professionals, patients and families with video calls to stimulate patient- and family-centred care during hospitalization: A scoping review. J Clin Nurs 2024. [PMID: 38597356 DOI: 10.1111/jocn.17155] [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: 10/30/2023] [Revised: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
AIM To synthesize the literature on the experiences of patients, families and healthcare professionals with video calls during hospital admission. Second, to investigate facilitators and barriers of implementation of video calls in hospital wards. DESIGN Scoping review. METHODS PubMed, CINAHL and Google Scholar were searched for relevant publications in the period between 2011 and 2023. Publications were selected if they focused on experiences of patients, families or healthcare professionals with video calls between patients and their families; or between families of hospitalized patients and healthcare professionals. Quantitative and qualitative data were summarized in data charting forms. RESULTS Forty-three studies were included. Patients and families were satisfied with video calls as it facilitated daily communication. Family members felt more engaged and felt they could provide support to their loved ones during admission. Healthcare professionals experienced video calls as an effective way to communicate when in-person visits were not allowed. However, they felt that video calls were emotionally difficult as it was hard to provide support at distance and to use communication skills effectively. Assigning local champions and training of healthcare professionals were identified as facilitators for implementation. Technical issues and increased workload were mentioned as main barriers. CONCLUSION Patients, families and healthcare professionals consider video calls as a good alternative when in-person visits are not allowed. Healthcare professionals experience more hesitation towards video calls during admission, as it increases perceived workload. In addition, they are uncertain whether video calls are as effective as in-person conservations. IMPLICATIONS FOR THE CLINICAL PRACTICE When implementing video calls in hospital wards, policymakers and healthcare professionals should select strategies that address the positive aspects of family involvement at distance and the use of digital communication skills. PATIENT CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Selma C Musters
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Celeste M Coolen
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Amsterdam Public Health, Amsterdam, The Netherlands
- Department of Internal Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anne M Eskes
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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24
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Westerling U, Hellgren M, Hermansson L, Strid EN. Informal caregivers' experiences of support from a tailored primary healthcare unit for older adults - A focus group study. Scand J Caring Sci 2024. [PMID: 38591362 DOI: 10.1111/scs.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/01/2024] [Accepted: 03/23/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Informal caregivers are an essential part of health and social care systems worldwide. As such, they may need professional support. AIM The aim of this study was to describe informal caregivers' experiences and need for support from a tailored primary health care (PHC) unit. METHODS This is a qualitative descriptive study using data collected from five semi-structured focus group discussions with a purposeful sample of 16 informal caregivers of older relatives. Respondents were recruited from a tailored PHC unit for people aged 75 years or older in a region in central Sweden. The data were analysed by qualitative content analysis with an abductive approach, based on the principles of the patient- and family-centred care framework. RESULTS The overarching theme was 'Striving for partnership'. The findings indicate that informal caregivers to some extent felt supported by the healthcare professionals. However, the caregivers expressed a need to be further acknowledged by the professionals in order to participate in the care of their older relatives in the way they wanted. Moreover, insufficient information regarding the older adult's health condition and care provided by the professionals had a negative impact on the caregiver's participation in care. CONCLUSIONS Informal caregivers have unmet needs for support and strive for a partnership with the PHC professionals. PHC professionals should be more attentive and invite informal caregivers to participate in the care of the older adult in order to meet their support needs and build an equal partnership. The patient- and family-centred care framework may be of guidance when providing care for older adults in a PHC context.
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Affiliation(s)
- Ulrika Westerling
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mikko Hellgren
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Kumla Primary Health Care Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Liselotte Hermansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Emma Nilsing Strid
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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25
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van Gils AM, Rhodius-Meester HFM, Handgraaf D, Hendriksen HMA, van Strien A, Schoonenboom N, Schipper A, Kleijer M, Griffioen A, Muller M, Tolonen A, Lötjönen J, van der Flier WM, Visser LNC. Use of a digital tool to support the diagnostic process in memory clinics-a usability study. Alzheimers Res Ther 2024; 16:75. [PMID: 38589933 PMCID: PMC11003066 DOI: 10.1186/s13195-024-01433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Both memory clinic professionals and patients see value in digital tools, yet these hardly find their way to clinical practice. We explored the usability of a digital tool to support the diagnostic work-up in daily memory clinic practice. We evaluated four modules that integrate multi-modal patient data (1.cognitive test; cCOG, and 2. MRI quantification; cMRI) into useful diagnostic information for clinicians (3. cDSI) and understandable and personalized information for patients (4. patient report). METHODS We conducted a mixed-methods study in five Dutch memory clinics. Fourteen clinicians (11 geriatric specialists/residents, two neurologists, one nurse practitioner) were invited to integrate the tool into routine care with 43 new memory clinic patients. We evaluated usability and user experiences through quantitative data from questionnaires (patients, care partners, clinicians), enriched with thematically analyzed qualitative data from interviews (clinicians). RESULTS We observed wide variation in tool use among clinicians. Our core findings were that clinicians: 1) were mainly positive about the patient report, since it contributes to patient-centered and personalized communication. This was endorsed by patients and care partners, who indicated that the patient report was useful and understandable and helped them to better understand their diagnosis, 2) considered the tool acceptable in addition to their own clinical competence, 3) indicated that the usefulness of the tool depended on the patient population and purpose of the diagnostic process, 4) addressed facilitators (ease of use, practice makes perfect) and barriers (high workload, lack of experience, data unavailability). CONCLUSION This multicenter usability study revealed a willingness to adopt a digital tool to support the diagnostic process in memory clinics. Clinicians, patients, and care partners appreciated the personalized diagnostic report. More attention to education and training of clinicians is needed to utilize the full functionality of the tool and foster implementation in actual daily practice. These findings provide an important step towards a lasting adoption of digital tools in memory clinic practice.
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Affiliation(s)
- Aniek M van Gils
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands.
| | - Hanneke F M Rhodius-Meester
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Dédé Handgraaf
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
| | - Heleen M A Hendriksen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
| | - Astrid van Strien
- Department of Geriatric medicine, Jeroen Bosch Ziekenhuis, Den Bosch, The Netherlands
| | | | - Annemieke Schipper
- Department of Neurology, HagaZiekenhuis, location Zoetermeer, Zoetermeer, The Netherlands
| | - Mariska Kleijer
- Department of Neurology, HagaZiekenhuis, location Zoetermeer, Zoetermeer, The Netherlands
| | - Annemiek Griffioen
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Majon Muller
- Department of Internal Medicine, Geriatric Medicine Section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | | | | | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Epidemiology and Data Sciences, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Leonie N C Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam/AMC, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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26
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Skaczkowski G, Orbell S, Wilson C. "Life Without Symptoms" or "Being Able to Enjoy Life": What does it Mean to be "Well" After Cancer? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:204-210. [PMID: 38155282 DOI: 10.1007/s13187-023-02397-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To achieve wellness in cancer survivorship, researchers and clinicians need a better understanding of what it means to live "well", from the perspective of cancer survivors themselves. METHODS Australian and UK cancer survivors (N = 376) diagnosed in the previous five years, were asked "What does it mean to be well?", with an open-ended text response. Responses were coded using content analysis. Demographics, time since diagnosis, coping style and symptom level were also assessed. RESULTS Descriptions of what it meant to be "well" were coded as absence-focused (living without negative impacts of illness, 32.7%) or presence-focused (living with health, function, or wellbeing, 37.8%). A further 29.5% of responses contained both elements. Lower symptom level and higher use of a fatalism coping style were associated with presence-focused definitions of being well. CONCLUSIONS More meaningful conversations with cancer survivors about their goals for care would be facilitated by a better understanding of what it means to them to be "well". As symptoms change over the course of survivorship, it may be necessary to re-examine each survivor's goals of care.
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Affiliation(s)
- Gemma Skaczkowski
- School of Psychology & Public Health, La Trobe University, Bundoora, Australia.
- Olivia Newton-John Cancer Wellness & Research Centre, Heidelberg, Australia.
- Allied Health & Human Performance, University of South, Adelaide, Australia.
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, UK
| | - Carlene Wilson
- School of Psychology & Public Health, La Trobe University, Bundoora, Australia
- Olivia Newton-John Cancer Wellness & Research Centre, Heidelberg, Australia
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27
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Bjerregaard Alrø A, Svenningsen H, Korvenius Nedergaard H, Irene Jensen H, Dreyer P. Cognitive impairment in intensive care unit patients: A qualitative exploration through observations and interviews. Intensive Crit Care Nurs 2024; 81:103611. [PMID: 38154430 DOI: 10.1016/j.iccn.2023.103611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/17/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES Many patients experience cognitive impairments while being admitted to an intensive care unit due to critical illness affecting their well-being and rehabilitation. Little is known about how patients experience cognitive impairments. This study aimed to explore patients' and relatives' experiences of patients' cognitive impairments while in the intensive care unit. RESEARCH METHODOLOGY A multi-centre qualitative study, inspired by Ricoeur's phenomenological-hermeneutic approach, was conducted at four intensive care units at two hospitals in Denmark. Data collection encompassed participant observation and semi-structured single or dyadic interviews with 20 patients and 15 relatives, conducted in the intensive care units. The Consolidated Criteria for Reporting Qualitative Research checklist was used. FINDINGS Four themes emerged during the analysis: 'Having a hazy memory and a foggy brain', 'Frustrations due to difficulties in speaking', 'An altered sense of self' and 'A feeling of disconnect between body and mind'. In the intensive care unit, patients experienced multiple cognitive impairments across several cognitive domains, significantly affecting their overall well-being. CONCLUSIONS The findings provided a nuanced exploration of how patients in the intensive care unit grapple with cognitive impairments, leaving them feeling exposed and vulnerable due to increased dependency and loss of dignity. Relatives' presence and help was a huge support during admission. IMPLICATIONS FOR CLINICAL PRACTICE This study highlights patients' and relatives' experiences of patients' cognitive impairments in the intensive care units. There is a need for nurses and allied healthcare professionals to address and manage reduced cognition in intensive care unit patients. This is particularly important to underpin recovery and rehabilitation processes, improve quality of life and optimise patients' return to everyday life. Future research must investigate how and when intensive care patients would benefit from preventive initiatives and initiatives to support recovery and rehabilitation of cognitive impairments.
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Affiliation(s)
- Anette Bjerregaard Alrø
- Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Aarhus University, Institute of Public Health, Section of Nursing, Bartholins Alle' 2, 3. sal, building 1260, 8000 Aarhus C, Denmark.
| | - Helle Svenningsen
- Research Centre for Health and Welfare Technology, VIA University College, Campus Aarhus N, Hedeager 2, Aarhus N, Denmark.
| | - Helene Korvenius Nedergaard
- Department of Anaesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Sygehusvej 24, 6000 Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19,3, 5000 Odense C, Denmark.
| | - Hanne Irene Jensen
- Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19,3, 5000 Odense C, Denmark; Departments of Anaesthesiology and Intensive Care, Kolding Hospital, University Hospital of Southern Denmark, Denmark; Departments of Anaesthesiology and Intensive Care, Vejle Hospital, University Hospital of Southern Denmark, Denmark.
| | - Pia Dreyer
- Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Aarhus University, Institute of Public Health, Section of Nursing, Bartholins Alle' 2, 3. sal, building 1260, 8000 Aarhus C, Denmark; Bergen University, Norway.
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28
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Stavropoulou A, Daniil M, Gerogianni G, Vasilopoulos G, Fasoi G, Papageorgiou D, Dafogianni C, Kelesi M. Nurses' Views on Caring for Lonely Patients During the Pandemic: A Qualitative Study. Cureus 2024; 16:e57639. [PMID: 38707112 PMCID: PMC11070056 DOI: 10.7759/cureus.57639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND The implementation of safety measures in hospitals due to the COVID-19 pandemic, including family visitation restrictions, forced the family to be absent during the patient's hospitalization. Nurses were confronted with new roles and responsibilities, as caring for lonely patients was a new phenomenon that emerged during the pandemic. PURPOSE The purpose of this study was to explore the nurses' views on caring for lonely patients during the COVID-19 pandemic. METHODS A qualitative research method based on an inductive content analysis approach was used. Data collection was carried out using semi-structured interviews. The sample consisted of 11 nurses who worked in COVID-19 wards and units. Content analysis was used to analyze the interview data. RESULTS The analysis of the data revealed three main themes: 1) caring for the patient and the family; 2) extending conventional care; and 3) developing supportive mechanisms for better care. Caring for lonely patients brought about changes in patients's management and care and significantly affected communication patterns as well as nurses' roles and responsibilities. Providing care beyond limits, supporting care through the utilization of new technologies, and transforming organization and care were mentioned as areas of challenge for nursing practice. Conclusions: Maintaining communication and supporting the family's involvement in patient care are considered to be equal to healing for the lonely patient. Reshaping working conditions and caring practices to meet the needs of the nurses, the patients, and their families during health crises may contribute positively to the provision of holistic care for patients and their families.
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Affiliation(s)
| | | | | | | | - Georgia Fasoi
- Department of Nursing, University of West Attica, Athens, GRC
| | | | | | - Martha Kelesi
- Department of Nursing, University of West Attica, Athens, GRC
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29
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Kozlowska O, Tallett A, Bond S, Mansbridge SE, Aveyard H, Jenkinson C, Dudbridge A, McRobert N, Lumb A, Rea R, Tan GD, Walthall H. Developing and exploring the validity of a patient reported experience measure for adult inpatient diabetes care. Diabet Med 2024; 41:e15266. [PMID: 38150334 DOI: 10.1111/dme.15266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
AIM To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. METHOD 27 in-depth interviews were conducted to inform the development of the 42-item PREM which was cognitively tested with 10 people. A refined 38-item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. RESULTS The PREM had low drop-out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. CONCLUSIONS This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality.
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Affiliation(s)
- Olga Kozlowska
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | | | - Samuel Bond
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Sarah E Mansbridge
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Helen Aveyard
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Nicky McRobert
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alistair Lumb
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Rustam Rea
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Garry D Tan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Helen Walthall
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Moona H, Mimmi T, Helvi K, Outi K. Long- and short-term frequent attenders' perceptions of patient-centredness in Finnish primary healthcare: A cross-sectional survey and the equivalence of the factor structure of the 36-item patient-centred primary care instrument. Scand J Caring Sci 2024. [PMID: 38523061 DOI: 10.1111/scs.13256] [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: 07/25/2023] [Revised: 02/13/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
AIM The study aimed to compare long- and short-term frequent attenders' (FAs) perceptions of patient-centredness and to assess the equivalence of the factor structure of patient-centred primary care (PCPC) instrument for long- and short-term FAs. METHODS A cross-sectional survey of long-term (n = 234) and short-term (n = 261) FAs within the primary healthcare of one city in Finland. The data collected in January-July 2020 via 'the 36-item PCPC instrument' were analysed using Pearson's chi-squared test, Mann-Whitney U-test, Cronbach's alpha, and multigroup confirmatory factor analysis (MGCFA). RESULTS Long-term FAs had worse perceptions of patient-centredness than short-term FAs across all subscales: patients' preferences, physical comfort, coordination of care, continuity and transition, emotional support, access to care, information and education, and family and friends. The MGCFA indicated a good fit for the predicted eight-factor model. CONCLUSIONS Long-term FAs' care needs are currently not being met, indicating the need for considering how the way healthcare services are arranged and care is provided affects prolonged and high care needs. Various dimensions of patient-centredness need to be addressed when developing not only FAs' care but also wider service paths. A distinction should be made between long- and short-term frequent attendance when identifying and addressing FAs' service needs.
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Affiliation(s)
- Huhtakangas Moona
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tolvanen Mimmi
- Northern Finland Birth Cohort, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kyngäs Helvi
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kanste Outi
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
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Alqarawi N, Alhalal E. Nurses' practices of children and family-centered care for chronically ill children: A cross-sectional study. J Pediatr Nurs 2024; 77:172-179. [PMID: 38522211 DOI: 10.1016/j.pedn.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE There is limited evidence of children and family-centered care (CFCC) practice in different cultural contexts, particularly regarding the factors that predict it among nurses providing care to chronically ill children. Also, the CFCC's impact on the quality of care has not been well studied. This study aimed to test a hypothesized model in which nurses' attributes and care environments predict CFCC, thereby increasing the quality of nursing care. DESIGN AND METHODS A multicenter cross-sectional study recruited a convenience sample of 405 nurses caring for chronically ill children in Saudi Arabia for an online survey between February 2023 and August 2023. Structural Equation Modeling evaluated the hypothesized model. RESULTS The hypothesized model fits the data based on the fit indices. Care environment affected CFCC (β = 0.831, p = .000), while nursing attributes only indirectly affected CFCC practices through the mediating effect of the work environment (β = 0.553, p = .000). The CFCC practices positively affect the quality of nursing care (β = 0.636, p = .000). CONCLUSIONS Nursing attributes impact the work environment, which affects the practice of CFCC and enhances the quality of care for chronically ill children. Investing in nurses' attributes and a positive work environment is crucial for nursing leaders to enhance CFCC practice and the quality of care. PRACTICAL IMPLICATIONS The findings of this study can be used to shape policies and develop interventions to improve nursing CFCC practices and promote better quality of care for chronically ill children.
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Affiliation(s)
- Nada Alqarawi
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Eman Alhalal
- Community and mental health nursing, Nursing college, King Saud University Riyadh, Saudi Arabia
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Lotfalipoor R, Jafaraghaee F, Kazemnejad Leyli E, Ghorbani Vajargah P, Karkhah S, Javadi-Pashaki N. Effect of family-centered care on the anxiety levels among family members of patients undergoing cardiac surgery: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:1370-1375. [PMID: 38463075 PMCID: PMC10923300 DOI: 10.1097/ms9.0000000000001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/22/2023] [Indexed: 03/12/2024] Open
Abstract
Background The present study aims to determine the effect of family-centered care on anxiety levels among family members of patients undergoing cardiac surgery. Materials and methods This study was a randomized clinical trial study that was conducted on the families of Iranian cardiac surgery patients. In the intervention group, family-centered care was implemented, and the content of the intervention included providing informational and emotional support to the family member and the family member's participation in patient care according to the set framework. Results A total of 144 family members of patients undergoing cardiac surgery were included in this study. Among the 144 family members, 71 were in the intervention group, and 73 were in the control group. The changes in the state anxiety score before and after the intervention were significant between the two groups, and the changes were higher in the control group (P=0.043). Also, there was no significant difference in the changes in trait anxiety before and after the intervention between the two groups (P>0.05). Conclusion In general, the high prevalence of anxiety in patients' families has negative functional consequences on both patients and their families. To reduce the level of anxiety, special attention should be paid to knowing the effective factors and appropriate coping methods. Nevertheless, it is important to note that additional research is warranted to delve deeper into this matter in future studies.
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Affiliation(s)
| | | | | | | | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
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Morawska A, Etel E, Mitchell AE. Effects of comorbid asthma and eczema on child and family quality of life. J Child Health Care 2024; 28:69-85. [PMID: 35570795 DOI: 10.1177/13674935221097213] [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: 11/15/2022]
Abstract
Paediatric chronic health conditions are associated with poorer psychological wellbeing and quality of life for children and families. This study investigated differences in child and parent/family quality of life between families of children with asthma only, eczema only, or both asthma and eczema, and tested predictors of child and parent/family quality of life. A convenience sample of 106 families completed parent-report measures of child and parent/family quality of life, child emotional and behavioural difficulties, parent adjustment and parenting practices. Between-groups ANOVAs indicated no differences for child quality of life, whereas parent/family quality of life was worse for those with eczema only compared to asthma only. Multiple linear regression revealed that child emotional difficulties predicted worse child quality of life, whereas worse parent adjustment, child emotional difficulties and eczema only (compared to both asthma and eczema) predicted worse parent quality of life. Results suggest that families of children with eczema may be at particular risk for impaired parent/family quality of life. Interventions that take a family-centred approach to improving child and parent adjustment should be investigated as an adjunct to medical treatment to reduce the impact of chronic health conditions on quality of life for children and families.
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Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Evren Etel
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
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Saputra R, Setyorini, Rasmanah M, Nuraida, Suryati, Lidyawati Y. Strengthening family bonds through end-of-life conversations: Understanding the importance of emotional support and open communication. Palliat Support Care 2024:1-2. [PMID: 38419207 DOI: 10.1017/s1478951524000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Rikas Saputra
- Department of Islamic Guidance and Counselling, Faculty of Da'wah and Communication, Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Setyorini
- Department of Guidance and Counselling, Faculty of Teacher Training and Education Satya Wacana University, Salatiga, Indonesia
| | - Manah Rasmanah
- Department of Islamic Guidance and Counselling, Faculty of Da'wah and Communication, Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Nuraida
- Department of Islamic Guidance and Counselling, Faculty of Da'wah and Communication, Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Suryati
- Department of Islamic Guidance and Counselling, Faculty of Da'wah and Communication, Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Yenni Lidyawati
- Department of Indonesian Language and Literature, Faculty of Teacher Training and Education, Sriwijaya University, Palembang, Indonesia
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Oakley C, Ream E. Role of the Nurse in Patient Education and Engagement and Its Importance in Advanced Breast Cancer. Semin Oncol Nurs 2024; 40:151556. [PMID: 38087678 DOI: 10.1016/j.soncn.2023.151556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To show how people with cancer, including those with advanced breast cancer, engage with information and self-management and how cancer nurses can support patients to manage important aspects of care. Epstein and Street's patient-centered communication in cancer care (PCC) model provides a useful framework. The model incorporates six domains representing core mediating functions of patient-centered communication (Fostering healing relationships, Exchanging information, Responding to emotions, Managing uncertainty, Making decisions, and Enabling self-management) and additional moderating factors for PCC and health outcomes. DATA SOURCES Data sources include peer-reviewed articles sourced from electronic databases. CONCLUSION Common complex interrelated reasons for poor engagement include fear, denial, fatalism, bereavement, advanced disease, and poor clinician-patient relationships. This can have serious implications for physical and emotional outcomes. Facilitators include open, trusting relationships between patients and nurses, timing of information, focusing on patients' agendas, and understanding emotional concerns, beliefs, and motivations. Supporting patients and carers to work together, through evidence-based interventions and tailoring approaches, for example to older people, are important. IMPLICATIONS FOR NURSING PRACTICE Patient information and engagement are important aspects of cancer nursing. Interventions are largely based on behavior change theory, but new translational research is needed to demonstrate effectiveness. Nurses need education on how to develop skills to effectively manage this complex process to effectively engage and educate patients.
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Affiliation(s)
- Catherine Oakley
- Chemotherapy Nurse Consultant, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, UK.
| | - Emma Ream
- Professor of Supportive Cancer Care and Director of Research, School of Health Sciences, University of Surrey, Guildford, UK
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Wu QL, Brannon GE. What's after COVID-19?: Communication pathways influencing future use of telehealth. PATIENT EDUCATION AND COUNSELING 2024; 118:108025. [PMID: 37852153 DOI: 10.1016/j.pec.2023.108025] [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: 07/29/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE Telehealth usage for healthcare encounters has increased dramatically due to the coronavirus disease (COVID-19) precautions. As the pandemic health threat subsides, it is important to understand how telehealth encounters are perceived by users. In this study, we explore how patient-centered communication (PCC), and media and organizational factors, influence patients' intentions to use telehealth in the future. METHODS An online survey was conducted among 326 adult patients who reported visiting a healthcare provider using telehealth within the past 12 months. Structural equation modeling explored how contextual factors influenced patients' adoption of telehealth. RESULTS PCC and ease of use indirectly predicted telehealth adoption through enhanced patient satisfaction and sense of care continuity. Sense of security indirectly predicted telehealth adoption via its association with enhanced rating of care quality. CONCLUSION The functionality of telehealth technology does not solely determine patients' telehealth adoption. Instead, positive healthcare experiences, facilitated by organizational support, quality media designs, as well as patient-centered communication, are associated with telehealth adoption. PRACTICE IMPLICATIONS Healthcare providers should strategically improve telehealth-related communication processes that can lead to better patient health outcomes.
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Affiliation(s)
- Qiwei Luna Wu
- School of Communication, Cleveland State University, USA.
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Skelton E, Cromb D, Smith A, van Poppel MPM, Morland C, Harrison G, Rutherford M, Malamateniou C, Ayers S. "It's not just the medical aspects that are important": A qualitative exploration of first-time parents' experiences of antenatal imaging and their influence on parent-fetal bonding. Radiography (Lond) 2024; 30:288-295. [PMID: 38064765 DOI: 10.1016/j.radi.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Antenatal imaging provides clinical information regarding fetal growth and development. The additional benefit afforded by imaging for expectant parents in developing an emotional connection (bond) to the unborn baby is also acknowledged. However, the relationship between imaging and bonding is not fully understood, particularly where there are differing parental and pregnancy circumstances, for example use of advanced imaging techniques or the prenatal diagnosis of a congenital fetal condition. This study aimed to explore the role of antenatal imaging in enhancing the developing parent-fetal bond in first-time parents. METHODS A descriptive, qualitative methodology was used. Semi-structured telephone interviews were conducted with first-time expectant parents attending a London hospital for clinical ultrasound (n = 20) or research MRI (n = 8) imaging during pregnancy. The sample included parents receiving specialist antenatal care for a diagnosed fetal cardiac condition (n = 8). Thematic analysis was conducted. RESULTS The analysis generated three themes: 1) Our baby, our scan too; 2) Destination parenthood; and 3) Being in the dark, then finding the light. These themes highlight the important, but transient role of antenatal imaging in enhancing parent-fetal bonding, as well as the differing care needs of expectant parents. The integral role of healthcare professionals in providing a personalised, supportive, imaging experience to facilitate bonding is also reflected. CONCLUSION Adopting parent-centred care approaches which involve expectant parents in fetal imaging influences bonding by helping parents to consider the reality of their impending parenthood. Knowledge acquired during scans is used to create an identity for the unborn baby, which parents can develop an emotional connection to. IMPLICATIONS FOR PRACTICE To optimise the potential for enhanced parent-fetal bonding, care provision in fetal imaging should be tailored to the individual needs of expectant parents.
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Affiliation(s)
- E Skelton
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, EC1V 0HB, UK.
| | - D Cromb
- Perinatal Imaging and Health, King's College London, SE1 7EH, UK; Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - A Smith
- Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - M P M van Poppel
- Perinatal Imaging and Health, King's College London, SE1 7EH, UK; Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - C Morland
- Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - G Harrison
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, EC1V 0HB, UK; Society and College of Radiographers, London, SE1 2EW, UK
| | - M Rutherford
- Perinatal Imaging and Health, King's College London, SE1 7EH, UK
| | - C Malamateniou
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, EC1V 0HB, UK
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences City, University of London, EC1V 0HB, UK
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Mestre TD, Caldeira EV, Lopes MJ. Family Self-Care in Chronic Disease Management: An Evolving Care Pattern? SAGE Open Nurs 2024; 10:23779608231226069. [PMID: 38322621 PMCID: PMC10846051 DOI: 10.1177/23779608231226069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Self-care emerges in the family context, despite being seen as an individual determinant of health. The family, understood as a system and social unit, converges to a pattern of self-care and not to a sum of it, assuming relevance at certain moments of the life cycle, particularly in the management of chronic disease. Purpose To perform the transposition of individual self-care to the family self-care, considering the current family's needs and characteristics, by adopting family self-care as the core concept of a care pattern as a determinant of family health. Conclusion The family unit is the most influential factor in the health status of individuals, and it will be through family self-care behaviors that families can be healthier by managing their diseases more effectively. They seek to achieve family health, maintaining health through health promotion and disease management practices, always mediated by family self-care behaviors.
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Affiliation(s)
- Teresa Dionísio Mestre
- Comprehensive Health Research Centre [CHRC], Évora, Portugal
- Health Department, Polytechnic Institute of Beja, Beja, Portugal
| | - Ermelinda Valente Caldeira
- Comprehensive Health Research Centre [CHRC], Évora, Portugal
- Department of Nursing, University of Évora, Évora, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre [CHRC], Évora, Portugal
- Department of Nursing, University of Évora, Évora, Portugal
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Palomares González L, Hernández Caravaca I, Gómez García CI, Sánchez-Solís de Querol M. A presença dos pais durante procedimentos pediátricos invasivos: depende de quê? Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6101.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumo Objetivo: o atendimento centrado na família durante procedimentos invasivos tem sido endossado por muitas organizações profissionais de saúde. O objetivo deste estudo foi avaliar as atitudes dos profissionais de saúde em relação à presença dos pais durante o procedimento invasivo realizado em seus filhos. Método: os prestadores de serviços de saúde pediátricos (divididos em categorias profissionais e faixa etária) de um dos maiores hospitais da Espanha foram solicitados a preencher um questionário e escrever comentários de texto livre. Resultados: a pesquisa foi respondida por 227 pessoas. A maioria (72%) dos participantes, em suas respostas, relatou que os pais algumas vezes estão presentes durante as intervenções, embora houvesse diferenças entre as categorias profissionais a esse respeito. Os procedimentos em que os pais estavam presentes eram aqueles considerados “menos invasivos” (96% dos casos), enquanto apenas 4% estavam presentes naqueles considerados “mais invasivos”. Quanto mais velho o profissional, a presença dos pais foi considerada menos necessária. Conclusão: as atitudes em relação à presença dos pais durante o procedimento pediátrico invasivo são influenciadas pela categoria profissional, a idade do prestador de serviço de saúde e a invasividade do procedimento.
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Palomares González L, Hernández Caravaca I, Gómez García CI, Sánchez-Solís de Querol M. Presencia de los padres durante procedimientos pediátricos invasivos: ¿De qué depende? Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6101.3827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumen Objetivo: la atención centrada en la familia durante procedimientos invasivos ha sido respaldada por muchas organizaciones profesionales dedicadas al cuidado de la salud. El objetivo de este estudio fue evaluar las actitudes de los profesionales de la salud con respecto a la presencia de los padres durante los procedimientos invasivos realizados en niños. Método: a los prestadores de atención médica en Pediatría (divididos en categorías profesionales y rangos de edad) de uno de los hospitales más importantes de España se les solicitó que respondieran un cuestionario y redactaran comentarios de texto libre. Resultados: un total de 227 profesionales respondieron la encuesta. En sus respuestas, la mayoría (72%) de los participantes informó que, en ocasiones, los padres están presentes durante las intervenciones, aunque se registraron diferencias entre las distintas categorías profesionales al respecto. Los procedimientos en los que los padres estuvieron presentes se consideraron como “menos invasivos” (96% de los casos), mientras que solamente el 4% estuvo presente en los considerados “más invasivos”. A mayor edad de los profesionales, menos necesaria se consideró la presencia de los padres. Conclusión: las actitudes con respecto a la presencia de los padres durante procedimientos pediátricos invasivos se vieron influenciadas por la categoría profesional, la edad del prestador de salud y la invasividad de los procedimientos.
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Levy S. 'And then there was silence': shaping practice through the experience of parents' emotions. J Res Nurs 2023; 28:596-605. [PMID: 38162715 PMCID: PMC10756170 DOI: 10.1177/17449871231216057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background Spina bifida, the most common Neural Tube Defect occurring around 28 days following conception, is often discovered in a routine ultrasound examination. Nurses offer continuous support for families who care for children with disabilities, associated with this diagnosis. Aim To articulate and analyse parents' recollection of the emotions they experienced when they were informed by professionals that their unborn baby may have neurological disabilities. Method Qualitative study, using participatory visual narrative method, engaging parents caring for young children with Spina bifida. Results The emotions parents described, surfacing at the point of diagnosis, and the crafted stories they shared, demonstrated the significance and the long-lasting impact of their experience. Disclosing sensitive information and the way it is shared has a significant role in shaping how families adjust to caring for disabled children. Conclusion Role and care transitions of parents who choose to keep their babies, despite their impending disability, is a lengthy and complex process. Nurses should be aware of and informed by the origin story, to offer appropriate support throughout this period. Policies to promote integration with services delivered by 'not for profit' organisations will benefit family-focused and person-centred care.
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Affiliation(s)
- Sharon Levy
- CPD Lead, Usher Institute, Edinburgh University, Edinburgh, UK
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Lei X, Xiang J, Chen X, Pan W. Effect of the home care model in orthopedic wounds management. J Family Med Prim Care 2023; 12:3285-3290. [PMID: 38361869 PMCID: PMC10866231 DOI: 10.4103/jfmpc.jfmpc_876_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 02/17/2024] Open
Abstract
Objective To explore the effect of home care on orthopedic wound management. Materials and Methods Patients with orthopedic wounds admitted from January 2020 to December 2022 were divided into a control group and a nursing group, with 23 cases in each group. After discharge, the control group was given routine health guidance and the nursing group was given home care. The mood score of the two groups of patients was evaluated, the time and cost were compared, and the patients' degree of trust and satisfaction with the medical staff were investigated. Results The patients received home care had higher scores in mood, degree of trust and satisfaction with medical staff, and spent less time (P < .05). However, the cost was significantly higher than that of the control group (P < .05). Conclusions Home care for patients with orthopedic wounds can significantly reduce the time spent on medical treatment. Moreover, improve patients' moods and trust and satisfaction with medical staff in a certain extent. However, better service often means more economic cost.
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Affiliation(s)
- Xinhuan Lei
- Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Jie Xiang
- Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiaoxiao Chen
- Department of Operation Room, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Wenjun Pan
- Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
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Ali S, Maki C, Rahimi A, Ma K, Yaskina M, Wong H, Stang A, Principi T, Poonai N, Gouin S, Froese R. N. S, Clerc P, Carciumaru R, Alqurashi W, Rajagopal M, Kammerer E, Leung J, Wright B, Scott SD. Family caregivers' emotional and communication needs in Canadian pediatric emergency departments. PLoS One 2023; 18:e0294597. [PMID: 37992020 PMCID: PMC10664925 DOI: 10.1371/journal.pone.0294597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/04/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES To describe the extent to which caregivers' emotional and communication needs were met during pediatric emergency department (PED) visits. Secondary objectives included describing the association of caregiver emotional needs, satisfaction with care, and comfort in caring for their child's illness at the time of discharge with demographic characteristics, caregiver experiences, and ED visit details. STUDY DESIGN Electronic surveys with medical record review were deployed at ten Canadian PEDs from October 2018 -March 2020. A convenience sample of families with children <18 years presenting to a PED were enrolled, for one week every three months, for one year per site. Caregivers completed one in-PED survey and a follow-up survey, up to seven days post-visit. RESULTS This study recruited 2005 caregivers who self-identified as mothers (74.3%, 1462/1969); mean age was 37.8 years (SD 7.7). 71.7% (1081/1507) of caregivers felt their emotional needs were met. 86.4% (1293/1496) identified communication with the doctor as good/very good and 83.4% (1249/1498) with their child's nurse. Caregiver involvement in their child's care was reported as good/very good 85.6% (1271/1485) of the time. 81.8% (1074/1313) of caregivers felt comfortable in caring for their child at home at the time of discharge. Lower caregiver anxiety scores, caregiver involvement in their child's care, satisfactory updates, and having questions adequately addressed positively impacted caregiver emotional needs and increased caregiver comfort in caring for their child's illness at home. CONCLUSION Approximately 30% of caregivers presenting to PEDs have unmet emotional needs, over 15% had unmet communication needs, and 15% felt inadequately involved in their child's care. Family caregiver involvement in care and good communication from PED staff are key elements in improving overall patient experience and satisfaction.
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Affiliation(s)
- Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Women & Children’s Health Research Institute (WCHRI), Edmonton, Alberta, Canada
| | - Claudia Maki
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Asa Rahimi
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Keon Ma
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maryna Yaskina
- Women & Children’s Health Research Institute (WCHRI), Edmonton, Alberta, Canada
| | - Helen Wong
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Antonia Stang
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tania Principi
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Naveen Poonai
- Department of Emergency Medicine, Section of Pediatric Emergency Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | - Sylvia Froese R. N.
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul Clerc
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia
| | - Redjana Carciumaru
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Waleed Alqurashi
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Manasi Rajagopal
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Elise Kammerer
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Julie Leung
- Community Engagement Stakeholder, Edmonton, Alberta, Canada
| | - Bruce Wright
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Women & Children’s Health Research Institute (WCHRI), Edmonton, Alberta, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Cam H, Wennlöf B, Gillespie U, Franzon K, Nielsen EI, Ling M, Lindner KJ, Kempen TGH, Kälvemark Sporrong S. The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals' views. BMC Health Serv Res 2023; 23:1211. [PMID: 37932683 PMCID: PMC10626684 DOI: 10.1186/s12913-023-10192-5] [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: 03/29/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Hospital discharge of older patients is a high-risk situation in terms of patient safety. Due to the fragmentation of the healthcare system, communication and coordination between stakeholders are required at discharge. The aim of this study was to explore communication in general and medication information transfer in particular at hospital discharge of older patients from the perspective of healthcare professionals (HCPs) across different organisations within the healthcare system. METHODS We conducted a qualitative study using focus group and individual or group interviews with HCPs (physicians, nurses and pharmacists) across different healthcare organisations in Sweden. Data were collected from September to October 2021. A semi-structured interview guide including questions on current medication communication practices, possible improvements and feedback on suggestions for alternative processes was used. The data were analysed thematically, guided by the systematic text condensation method. RESULTS In total, four focus group and three semi-structured interviews were conducted with 23 HCPs. Three main themes were identified: 1) Support systems that help and hinder describes the use of support systems in the discharge process to compensate for the fragmentation of the healthcare system and the impact of these systems on HCPs' communication; 2) Communication between two separate worlds depicts the difficulties in communication experienced by HCPs in different healthcare organisations and how they cope with them; and 3) The large number of medically complex patients disrupts the communication reveals how the highly pressurised healthcare system impacts on HCPs' communication at hospital discharge. CONCLUSIONS Communication at hospital discharge is hindered by the fragmented, highly pressurised healthcare system. HCPs are at risk of moral distress when coping with communication difficulties. Improved communication methods at hospital discharge are needed for the benefit of both patients and HCPs.
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Affiliation(s)
- Henrik Cam
- Hospital Pharmacy Department, Uppsala University Hospital, Uppsala, Sweden.
- Department of Pharmacy, Uppsala University, Uppsala, Sweden.
| | - Björn Wennlöf
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- Närvården Viksäng-Irsta, Region Västmanland, Västerås, Sweden
| | - Ulrika Gillespie
- Hospital Pharmacy Department, Uppsala University Hospital, Uppsala, Sweden
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Kristin Franzon
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | - Mia Ling
- Department of Pharmacy, Region Västmanland, Västerås, Sweden
| | | | - Thomas Gerardus Hendrik Kempen
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Sofia Kälvemark Sporrong
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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Horner S, Benbrook K, Hoffman M, Libutti L. Implementing Guidelines for NICU Parent Presence: Effects on Parent and Infant Stress. J Perinat Neonatal Nurs 2023:00005237-990000000-00024. [PMID: 37967272 DOI: 10.1097/jpn.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Relationships between parents and infants are essential for mitigating stressors encountered in neonatal intensive care units (NICUs) and are supported by parent presence and engagement. PURPOSE The purpose of this study was to compare NICU parent and infant outcomes pre- and postimplementation of an intervention aimed at increasing parent presence and engagement in the NICU. This family-centered care intervention consisted of communicating specific guidelines for parent presence. METHODS Data related to parent presence, skin-to-skin care, and breastfeeding; parental stress; infant outcomes including weight gain, length of stay, feeding status at discharge, and stress; and unit-level outcomes were collected from a convenience sample of 40 NICU families recruited preimplementation and compared with data for 38 NICU families recruited postimplementation of specific guidelines for parent presence. To establish comparability of groups, infants were assigned scores using the Neonatal Medical Index. RESULTS Parent presence, engagement in skin-to-skin care, and breastfeeding rates were not significantly different between groups. Stress-related outcomes were significantly decreased in NICU mothers, fathers, and infants, and infant feeding outcomes were improved in the postintervention group. CONCLUSIONS Specific guidelines for parent presence may represent an invitation for parents to engage with their NICU infants and may positively impact parent and infant stress.
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Affiliation(s)
- Susan Horner
- Neonatal Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Kostiuk S, Winkler L, Ha C, Dalidowicz M, Naylen Hobach J, Obafemi W, Cameron A, Press M. Creating successful patient partnerships in healthcare education to potentially improve students' understanding of patient-centered care. J Prof Nurs 2023; 49:40-43. [PMID: 38042560 DOI: 10.1016/j.profnurs.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 08/05/2023] [Accepted: 08/15/2023] [Indexed: 12/04/2023]
Abstract
Healthcare systems around the world are constantly evolving to meet the diverse needs of the people they serve. Patient-centered care is recognized as a crucial element in providing high-quality care (Najafizada et al., 2021; Anderson & Gagliardi, 2021; Kwame & Petrucka, 2021). However, there is a recognized need to enhance patient-centered care's application in practice (Edgman-Levitan & Schoenbaum, 2021; Macarthur et al., 2021). To improve healthcare students' understanding of patient-centered care in practice, educational institutions can adopt innovative approaches to teaching. One strategy that shows promise is to include patient partners in the education of healthcare curricula (Merav and Ohad, 2017; Jury, 2022). By engaging patient partners, students can gain valuable insights into the care needs of individuals living with various conditions and then hopefully implement that into their practice. To effectively involve patient partners in healthcare curricula, educational organizations should establish patient partnership programs that foster meaningful collaboration. Involving patient partners in the creation, design, delivery, and evaluation of patient partnership programs may enhance partnerships and sustain active participation. Through collaborative efforts with patient partners, educational institutions can create policies that support and prioritize patient engagement, ultimately enriching the learning experience for students and promoting patient-centered care in practice.
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Affiliation(s)
- Sarah Kostiuk
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada.
| | - Leah Winkler
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Chau Ha
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Michelle Dalidowicz
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Jayne Naylen Hobach
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Wumi Obafemi
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Anita Cameron
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
| | - Madeline Press
- Saskatchewan Polytechnic, Regina Campus, Treaty 4 Territory and Homelands of the Metis, People, 4635 Wascana Pky, PO Box 556, Regina, SK S4P 3A3, Canada
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Brummel B, van Heumen C, Smits A, van den Berg M, Ezendam NPM, Pijnenborg JMA, de van der Schueren MAE, Wilkinson SA, van der Meij BS. Barriers to and facilitators of a healthy lifestyle for patients with gynecological cancer: a systematic review of qualitative and quantitative research with healthcare providers and patients. Maturitas 2023; 177:107801. [PMID: 37541112 DOI: 10.1016/j.maturitas.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/06/2023]
Abstract
The prevalence of an unhealthy lifestyle among patients with gynecological cancer is high and associated with increased risk of all-cause mortality. Although lifestyle changes have the potential to improve outcomes, lifestyle counseling is not routinely integrated into standard care. This review explores research on the barriers to and facilitators of both the promotion of healthy lifestyles by healthcare providers (HCPs) and healthy lifestyle changes by patients with gynecological cancer. The Theoretical Domains Framework (TDF) was used to deductively code the identified factors for a comprehensive understanding of the barriers and facilitators. A search across five databases yielded a total of 12,687 unique studies, of which 43 were included in the review. Of these 43, 39 included gynecological cancer patients and only 6 included HCPs. Among the barriers identified for HCPs, most studies evaluated barriers regarding weight loss counseling. Limited knowledge, reluctance to address weight loss, skepticism about the benefits, and workload concerns were commonly reported barriers for HCPs. HCPs will benefit from education and training in lifestyle counseling, including effective communication skills like motivational interviewing. Gynecological cancer patients lacked tools, support, knowledge, and faced mental health issues, environmental constraints, and physical limitations. The review emphasizes the importance of addressing these barriers and utilizing identified facilitators, such as social support, to promote and support healthy lifestyle behaviors on the part of patients and their promotion by HCPs. Future research should focus not only on patients but also on supporting HCPs and implementing necessary changes in current practices.
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Affiliation(s)
- Bo Brummel
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands
| | - Cindy van Heumen
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands
| | - Anke Smits
- Department of Obstetrics & Gynecology, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Manon van den Berg
- Department of Gastroenterology and Hepatology- Dietetics, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Nicole P M Ezendam
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands; Netherlands Comprehensive Cancer Organisation, 5612 HZ Eindhoven, the Netherlands
| | | | - Marian A E de van der Schueren
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands
| | - Shelley A Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospital, South Brisbane 4101, Australia; Lifestyle Maternity, Brisbane, QLD 4069, Australia
| | - Barbara S van der Meij
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, QLD 4226, Australia.
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Abid MH. Reducing Unplanned Readmissions in Pediatric Hospitals: Applying Patient and Family-Centered Care. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2023; 6:99-100. [PMID: 38404456 PMCID: PMC10887472 DOI: 10.36401/jqsh-23-x6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 02/27/2024]
Affiliation(s)
- Muhammad Hasan Abid
- Regional Patient Experience Division, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospitals, Taif, Saudi Arabia
- Fellow, Institute for Healthcare Improvement, Boston, MA
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Bazaliński D, Przybek-Mita J, Pytlak K, Kardyś D, Bazaliński A, Kucharzewski M, Więch P. Larval Wound Therapy: Possibilities and Potential Limitations-A Literature Review. J Clin Med 2023; 12:6862. [PMID: 37959326 PMCID: PMC10647679 DOI: 10.3390/jcm12216862] [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: 09/27/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Patient-centered care (PCC) is recognized as a standard in healthcare for determining high quality. Honoring patients' values, experiences, needs, and preferences in devising, coordinating, and delivering care underscores the enhancement of the therapeutic rapport between patients and healthcare providers. Wound treatment involves a multi-stage process encompassing diagnostics and local wound dressing, which reduces the risk of infection through a coordinated interdisciplinary team. Within this team, nurses undertake specific professional functions and roles. The implementation of local therapy using innovative and scientifically substantiated methods may be hindered by a deficit of knowledge or inappropriate knowledge among staff and patients themselves. This study presents the challenges concerning the care of patients with chronic wounds treated using Lucilia sericata larvae, based on a review of the current scientific literature. A critical analysis of the literature spanning from 2002 to 2022 was conducted using the Medline, PubMed, Cochrane, and Termedia databases, employing keywords such as "maggot debridement therapy" in relation to acceptance and perception. As a result of the preliminary selection, 472 papers were identified, of which 12 publications were included in the development of this concept. The acquired data were organized and presented in the concluding section in the form of tables, accompanied by descriptions and references to individual studies. Negative psychological and somatic sensations were among the most prominent challenges among patients treated with Maggot Debridement Therapy (MDT). Pain related to peripheral ischemia or infection in this group of patients requires pain prophylaxis, including hyperalgesia and allodynia, in order to improve method tolerance. On the other hand, augmenting patients' understanding of MDT diminishes negative emotions, reinforces positive behaviors, and mitigates anxiety levels. MDT constitutes an effective and safe method. Its widespread use for chronic wounds requires substantial knowledge among healthcare professionals and patient education, along with that of their caregivers, to develop a positive attitude.
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Affiliation(s)
- Dariusz Bazaliński
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland; (D.B.); (K.P.)
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Joanna Przybek-Mita
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland;
- Postgraduate Nursing and Midwifery Education Centre, 35-083 Rzeszów, Poland
| | - Kamila Pytlak
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland; (D.B.); (K.P.)
| | - Daria Kardyś
- Frederic Chopin Provincial Clinical Hospital No. 1, 35-055 Rzeszów, Poland;
| | - Adrian Bazaliński
- Student Scientific Association of Nurses, Sanok State University, 38-500 Sanok, Poland;
| | - Marek Kucharzewski
- Collegium Medicum, Jan Długosz Częstochowa University, 42-200 Częstochowa, Poland;
| | - Paweł Więch
- Institute of Health Protection, State University of Applied Sciences in Przemyśl, 37-700 Przemyśl, Poland
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Hartviksen TA, Aspfors J, Uhrenfeldt L. Suffering while resigning to an unacceptable violation of dignity. Nurs Ethics 2023:9697330231209295. [PMID: 37867258 DOI: 10.1177/09697330231209295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
BACKGROUND The interaction of health personnel with relatives is linked to the quality of care results in nursing homes. However, there is limited knowledge of how relatives perceive being an integral part of the nursing home context. This secondary analysis has its starting point in an ethical concern about relatives' experiences in a previous study. AIM To critically discuss relatives' experiences of suffering when their next of kin live in a nursing home in a rural arctic context. RESEARCH DESIGN, PARTICIPANTS AND CONTEXT The critical hermeneutic stance is informed by Habermas. The secondary analysis is conducted on original data from five semi-structured focus groups with 18 relatives of residents of two nursing homes in a rural part of Norway. The theoretical framework concerning dignity, well-being, and suffering, as developed by Galvin and Todres, contrasts the analysis. ETHICAL CONSIDERATIONS The study followed the principles of the Helsinki Declaration. It was approved by the Norwegian Center for Research Data (NSD) (reg. no. 993360). FINDINGS The main theme of this study is: suffering while resigning to an unacceptable violation of dignity. This theme is deepened by two subthemes: (a) suffering while adapting to a relationship of dependence and (b) suffering while accepting the unacceptable. CONCLUSIONS Relatives experience suffering as a cross-pressure in their struggle to interact responsibly with health personnel in nursing homes. This may have a negative outcome, where relatives end up adapting to being silent witnesses to missed care and a violation of dignity.
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