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Oztas G, Akca SO. Levels of nursing support and satisfaction of parents with children having pediatric inpatient care. J Pediatr Nurs 2024; 77:e24-e30. [PMID: 38461118 DOI: 10.1016/j.pedn.2024.03.004] [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: 11/12/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE This study aims to investigate the level of inpatient child-care satisfaction of parents. MATERIAL AND METHOD This descriptive, correlational and cross-sectional study consisted of 143 parents whose children were monitored as inpatients between December 2019 and February 2020 in the pediatric clinics. The data were collected with introductory information form, Nurse-Parent Support Tool (NPST) and Pediatric Quality of Life Healthcare Satisfaction Inventory (PedsQL-HCSS). In the analysis of the research, Cronbach's Alpha, independent groups t-test (student t-test), One-way analysis of variance (ANOVA), Mann-Whitney U test, Kruskall-Wallis and Spearman Correlation were used. RESULTS The average NPST score of the parents in the study is 64.16 ± 20.75, and the PedsQL-HCSS average score is 55.22 ± 24.22, which is at a moderate level. In parents' perception of nurse support level, the emotional support factor has the lowest score and the information and communication support factor has the highest score. Regarding the health care satisfaction levels of parents, the factor of emotional needs has the lowest score while the general satisfaction factor has the highest score. As parents' ages increase, their perception of nurse support in providing quality care also increases (p < 0.05). The NPST total score and PedsQL-HCSS information score of parents of children with chronic diseases are lower than those with acute diseases (p < 0.05). There is a high level positive correlation between the NPST total score and the PedsQL-HCSS general satisfaction score (r = 0.712, p < 0.001), and between the NPST total score and the PedsQL-HCSS total score (r = 0.755, p < 0.001). CONCLUSION Parents of hospitalized children reported a medium level of satisfaction with their health treatment and support from nurses. Emotional support scored lowest among parents' perceptions of nurse help, whereas information and communication support scored highest. The subscale measuring emotional needs had the lowest score among parents' satisfaction with healthcare, while general satisfaction factor had the highest score. Parents' satisfaction with health care was found to increase in parallel with their perception of nurse support. IMPLICATIONS FOR PRACTICE When parents of hospitalized children receive nursing assistance, their stress and anxiety levels are lowered, which in turn boosts their confidence in the nurses and their satisfaction with health services, which consequently has a favorable impact on the child's care and treatment.
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Affiliation(s)
- Gulay Oztas
- Yozgat Bozok University, Faculty of Health Sciences- Department of Pediatric Nursing
| | - Selen Ozakar Akca
- Hitit University, Faculty of Health Sciences- Department of Pediatric Nursing.
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Boztepe H, Çınar Özbay S, Akçam A, Kanbay Y. The pediatric provider communication skills assessment scale. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:307-315. [PMID: 37394543 DOI: 10.1111/jcap.12433] [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: 04/22/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
PROBLEM Building rapport and trust between healthcare professional and patient/parents would improve satisfaction of patient/parents. The purpose of this study was to develop "The Pediatric Provider Communication Skills Assessment Scale" in this study. METHODS A trial form, with linguistic and psychometric validation and consisting of 44 statements, was administered to a sample of 325 individuals. Data were collected between January 20 and October 22, 2021. The validity of the scale was concluded after examining its construct validity and internal validity. "Exploratory factor analysis" was used for determining construct validity, and "comparison of lower-upper groups" for internal validity. "Cronbach's α reliability coefficient" and "split half test consistency coefficient" were calculated for testing the reliability of the scale. FINDINGS The Pediatric Provider Communication Skills Assessment Scale that we developed consists of one dimension and 20 items, and the variance it can explain was calculated as 62.3%. The Cronbach α reliability coefficient of the scale was calculated as 0.90, indicating high reliability. CONCLUSIONS According to the findings, "The Pediatric Provider Communication Skills Assessment Scale" is a scale with features that can measure in a valid and reliable way, with high variance and a low number of items. The study aims to develop the "The Pediatric Provider Communication Skills Assessment Scale," and present it to the literature as a validated and reliable new objective measurement tool. This study will enable us to understand more about the complex communication processes involved in pediatric care and how these may influence care delivery.
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Affiliation(s)
- Handan Boztepe
- Department of Nursing, Faculty of Health Sciences, Atilim University, Ankara, Turkey
| | - Sevil Çınar Özbay
- Emergency Aid and Disaster Management, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Aysun Akçam
- Department of Turkish Language Teaching, Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| | - Yalçın Kanbay
- Department of Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
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Morera-Balaguer J, Lillo-Navarro C, de Oliveira-Sousa SL, Montilla-Herrador J, Escolar-Reina P, Rodríguez-Nogueira Ó, Medina-Mirapeix F. Parents of children with disabilities' perceptions regarding the quality of interaction with Health professionals working in early intervention: A qualitative descriptive study. J Clin Nurs 2023; 32:6519-6532. [PMID: 36380463 DOI: 10.1111/jocn.16580] [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: 07/08/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to explore the perceptions of parents of children with physical disabilities concerning the quality of their interaction with health professionals in early intervention programs. BACKGROUND Despite the consensus on the need for Patient and Family-Centered Care, there are still difficulties when executing such care. The quality of interaction among patients, families, and professionals is essential to facilitate the implementation of the programs. DESIGN A qualitative descriptive study with thematic analysis using a Modified Grounded Theory approach. METHODS Data were collected through seven focus groups with 28 parents of children with physical disabilities who were undergoing early intervention programs in three centres. The study followed the COREQ guidelines and checklist. RESULTS Two themes emerged from the experiences: 'exchange of information and education', which included all the activities, procedures, exercises and skills taught by the professionals to help parents care for their child; and 'interpersonal skills', which focused on the way the professional relates with the child and the parents. Several subthemes emerged within each theme. CONCLUSIONS This study identified which elements of the professional-parent interaction are considered by parents when evaluating the quality of their interaction with the health care provider of their children. RELEVANCE TO CLINICAL PRACTICE The results of this study bring to light certain behaviours and interactions that health professionals should consider in order to improve the perceptions of parents of children with disabilities regarding the quality of interaction in the context of early childhood intervention. PATIENT OR PUBLIC CONTRIBUTION Parents contributed to the data collected. Early intervention professionals were involved in participant checking to ensure the rigour of the study.
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Affiliation(s)
| | - Carmen Lillo-Navarro
- Department of Pathology and Surgery and Center for Translational Research in Physical Therapy (CEIT), University Miguel Hernandez, Alicante, Spain
| | - Silvana-Loana de Oliveira-Sousa
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Joaquina Montilla-Herrador
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Pilar Escolar-Reina
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Óscar Rodríguez-Nogueira
- University of León, Health Sciences School, Nursing and Physical Therapy Department, León, Spain
| | - Francesc Medina-Mirapeix
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
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4
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Wu JM, Tam MT, Page PM, Lamb EA, Jordan I, Chambers CT, Robillard JM. Pain management communication between parents and nurses after pediatric outpatient surgery. J Pediatr Nurs 2022; 65:e87-e92. [PMID: 35459566 DOI: 10.1016/j.pedn.2022.03.008] [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: 10/19/2021] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to explore parent-nurse pain management communication during a child's discharge process following pediatric outpatient surgery. DESIGN AND METHODS Thirty-two clinical encounters at discharge between parents (N = 40) and nurses (N = 25) at BC Children's Hospital were audio recorded and transcribed verbatim. Content analysis was applied on the audio recordings and corresponding transcripts using MAXQDA qualitative research software and Microsoft Excel. RESULTS Overall, nurses delivered pain management instructions at an average sixth grade readability level and frequently used communication elements of reassurance, optimism, and question-asking. Less consistent communication elements included open-ended questions, interruptions, and promotion of parental decision-making. Parents most frequently asked one to five questions, with pain medication being the most inquired topic. CONCLUSIONS Several strengths of the nurse communication approach were identified, and parent questions highlighted a need for greater understanding around pain medication. PRACTICE IMPLICATIONS These findings will help guide effective pain management communication and care for young patients and their families.
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Affiliation(s)
- Julia M Wu
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, British Columbia, Canada; BC Children's and Women's Hospital, Vancouver, British Columbia, Canada.
| | - Mallorie T Tam
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, British Columbia, Canada; BC Children's and Women's Hospital, Vancouver, British Columbia, Canada.
| | - Patricia M Page
- BC Children's Hospital, Vancouver, British Columbia, Canada.
| | - Elizabeth A Lamb
- Department of Procedure and Surgical Services, BC Children's Hospital, Vancouver, British Columbia, Canada.
| | - Isabel Jordan
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Christine T Chambers
- Dalhousie University, Department of Pediatrics, Halifax, Nova Scotia, Canada; IWK Health Centre, Centre for Pediatric Pain Research, Halifax, Nova Scotia, Canada.
| | - Julie M Robillard
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, British Columbia, Canada; BC Children's and Women's Hospital, Vancouver, British Columbia, Canada.
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Azak M, Aksucu G, Çağlar S. The Effect of Parental Presence on Pain Levels of Children During Invasive Procedures: A Systematic Review. Pain Manag Nurs 2022; 23:682-688. [PMID: 35523626 DOI: 10.1016/j.pmn.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 11/20/2022]
Abstract
AIM This systematic review was conducted to determine the effect of parental presence on the child's pain intensity during invasive procedures. DESIGN A systematic review. METHOD The systematic review was conducted in July 2019 and updated in December 2020 to include the latest research published during the publication process by scanning the articles in English. Scopus, Pubmed, Cochrane, Science Direct, MedLine databases were used for scanning. The keywords "parental presence", "family presence", "parent involvement", "invasive procedures", "venipuncture", "painful procedures", "child", "children", "pediatric" were used in the scanning. Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol was followed to prepare the study and the report, and the systematic review was created according to the patient, intervention, comparison, outcomes (PICOS) strategy. RESULTS A total of 248 articles were reached, and the full texts of 18 articles were evaluated for eligibility. After the articles excluded by the full-text search were eliminated, six studies, involving 730 children with a sample aged between 0-12 years, were included in the analysis. In 4 studies, it was determined that having a parent with the child during the invasive procedure significantly decreased the pain level, and in 2 studies, there was no statistically significant decrease in the pain level of the children. CONCLUSIONS Parental presence and parental involvement during invasive procedures effectively reduced the children's pain levels. Since the number of studies with a high level of evidence regarding the effect of family participation on pain level is limited, it is recommended to conduct more randomized controlled studies.
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Affiliation(s)
- Merve Azak
- Department of Pediatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gözde Aksucu
- Department of Nursing, Faculty of Health Sciences, Beykent University, Istanbul, Turkey.
| | - Seda Çağlar
- Department of Pediatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Venkatraman K, Vijayalakshmi V, Sudarsanam N, Manoharan A. Designing Dynamic Interventions to Improve Adherence in Pediatric Long-Term Treatment - The Role of Perceived Value of the Physician by Primary Caregivers. HEALTH COMMUNICATION 2021; 36:1825-1840. [PMID: 32731759 DOI: 10.1080/10410236.2020.1796284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Primary Caregivers are the fulcrum in the physician-caregiver-child triad. Existing literature discusses static multi-component interventions in detail. In long-term treatments, dynamic intervention design is needed as the environment and situations of the families are dynamic. The objectives of this study are (a) to identify the components of the primary caregiver's perception of the physician's value with reference to the effectiveness of consultation and relationships with the former and with the child; (b) to establish the role of this perception in designing dynamic interventions, and (c) to describe the perception's potential influence on adherence. A PRISMA, chronological, and morphological analysis of the literature is carried out about caregivers' adherence in the pediatric long-term treatment context. We define communication and consultation as the functional, whereas relationship as the emotional component of the caregiver's perception of the physician. We propose a theoretical model that incorporates intervention as an integral component of care. Adherence happens as a response to changing situations and hence fluctuates. Hence, a dynamic intervention design to benefit the child should be incorporated into care through the caregiver-physician bridge. Future research should explore how intervention needs change and the driving reasons for understanding the static and dynamic components of interventions.
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Affiliation(s)
| | - V Vijayalakshmi
- Department of Management Studies, Indian Institute of Technology, Madras
| | - Nandan Sudarsanam
- Department of Management Studies, Indian Institute of Technology, Madras
| | - Anand Manoharan
- Department of Clinical Research, Kanchi Kamakoti CHILDS Trust Hospital
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Chan SH, Shorey S. Healthcare professionals' sense of coherence of parental involvement in neonatal intensive care units: A framework synthesis. Res Nurs Health 2021; 44:875-890. [PMID: 34414586 DOI: 10.1002/nur.22178] [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: 05/18/2021] [Revised: 08/01/2021] [Accepted: 08/07/2021] [Indexed: 11/08/2022]
Abstract
Family-centered care is recognized as the gold standard in pediatric healthcare practice. However, despite the acknowledgment of its benefits and importance, inconsistent and questionable implementation persists in neonatal intensive care units (NICUs) without a consolidated understanding of healthcare professionals' experiences. Therefore, this review aims to explore and consolidate healthcare professionals' perspectives on parental participation in the NICU. A systematic review of qualitative studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven electronic databases were searched from their respective dates of inception until December 30, 2020. Twenty-eight studies were included in this review. The analysis was conducted via a framework synthesis approach using Antonovsky's Sense of Coherence theory. Three over-arching themes, guided by Antonovsky's Sense of Coherence theory emerged: (1) "Comprehensibility of parental involvement in family-centered care," (2) "Manageability of parental involvement in care and decision-making," and (3) "Meaningfulness of parental involvement in shared decision-making in neonatal care," with nine corresponding subthemes. Healthcare professionals had mixed views of parental involvement, recognizing the benefits attributed to infants and parents, but were greatly hindered by organizational, environmental, and personal obstacles that weakened their sense of coherence in coping with the situation, making them feel unconfident and unprepared to involve parents in care. To cope, more integrated and formalized support was required. Organizational, environmental, and policy changes, as well as psychological support, were strategies identified to enhance healthcare professionals' sense of coherence, and consequently, their ability to cope.
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Affiliation(s)
- Shu Hui Chan
- Nursing Division, KK Women's and Children's Hospital, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore, Singapore
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Ochoa CY, Miller KA, Baezconde-Garbanati L, Slaughter RI, Hamilton AS, Milam JE. Parental Cancer-related Information Seeking, Health Communication and Satisfaction with Medical Providers of Childhood Cancer Survivors: Differences by Race/Ethnicity and Language Preference. JOURNAL OF HEALTH COMMUNICATION 2021; 26:83-91. [PMID: 33688790 PMCID: PMC8547415 DOI: 10.1080/10810730.2021.1895919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
For childhood cancer survivors (CCS), parents play an important role in communicating with providers and conveying patient's needs. This exploratory study examined the prevalence of cancer-related information-seeking among parents of CCS and investigated the association between parents' race/ethnicity and language preference with health communication and satisfaction with child's medical providers. One hundred and sixty CCS and their parents from two hospitals in Los Angeles County were recruited from the SEER registry. Multivariable logistic regression analyses assessed associations between parents' race/ethnicity and language preference and their health communication with their child and with their child's medical care providers. Among the parents, 29% were Spanish-speaking Hispanics, 27% English-speaking Hispanics, and 43% English-speaking non-Hispanics. Regardless of language preference, Hispanic parents were more likely than non-Hispanic parents to receive health information about their CCS's cancer from hospital sources versus the internet. There was no difference by ethnicity/language in parent satisfaction with their CCS's medical provider. Spanish-speaking Hispanic parents were more likely to report talking to their CCS about the need for cancer-related follow-up care compared to non-Hispanic English-speaking parents. These findings point to the potential importance of parents' ethnicity and language for sources of health information and frequency of communication with their CCS about their cancer care.
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Affiliation(s)
- Carol Y. Ochoa
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kimberly A. Miller
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rhona I. Slaughter
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Ann S. Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joel E. Milam
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Brown EA, Egberts M, Wardhani R, De Young A, Kimble R, Griffin B, Storey K, Kenardy J. Parent and Clinician Communication During Paediatric Burn Wound Care: A Qualitative Study. J Pediatr Nurs 2020; 55:147-154. [PMID: 32950822 DOI: 10.1016/j.pedn.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To thematically describe parent-clinician communication during a child's first burn dressing change following emergency department presentation. DESIGN AND METHODS An observational study of parent-clinician communication during the first burn dressing change at a tertiary children's hospital. Verbal communication between those present at the dressing change for 87 families, was audio recorded. The recordings were transcribed verbatim and transcripts were analysed within NVivo11 qualitative data analysis software using qualitative content analysis. FINDINGS Three themes, underpinned by parent-clinician rapport-building, were identified. Firstly, knowledge sharing was demonstrated: Clinicians frequently informed the parent about the state of the child's wound, what the procedure will involve, and need for future treatment. Comparatively, parents informed the clinician about their child's temperament and coping since the accident. Secondly, child procedural distress management was discussed: Clinicians and parents had expectations about the likelihood of procedural distress, which was also related to communication about how to prevent and interpret procedural distress (i.e., pain/fear). Finally, parents communicated to clinicians about their own distress, worry and uncertainty, from the accident and wound care. Parents also communicated guilt and blame in relation to injury responsibility. CONCLUSIONS This study provides a description of parent-clinician communication during paediatric burn wound care. PRACTICAL IMPLICATIONS The results can assist healthcare professionals to be prepared for a range of conversations with parents during potentially distressing paediatric medical procedures.
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Affiliation(s)
- Erin A Brown
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Marthe Egberts
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Department of Clinical Psychology, Utrecht University, the Netherlands.
| | - Rachmania Wardhani
- School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Alexandra De Young
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Queensland Health, QLD, Australia.
| | | | - Kristen Storey
- Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Queensland Health, QLD, Australia.
| | - Justin Kenardy
- School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
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Caring for Children Who Are Technology-Dependent and Their Families: The Application of Watson's Caring Science to Guide Nursing Practice. ANS Adv Nurs Sci 2020; 42:E13-E23. [PMID: 30531350 DOI: 10.1097/ans.0000000000000238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Advancements in the medical field have resulted in an increased number of children with complex chronic conditions that may depend on technology to sustain or optimize life. Given that nurses provide substantial physical and emotional care for these children and families during their frequent hospitalizations, the development of an authentic caring relationship is imperative. A critical review of the literature examining the experiences and unmet care needs of this population was carried out and analyzed using Watson's Caring Science to explore how nurses can create an authentic caring relationship and environment for children who are technology-dependent and their families.
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O'Toole JK, Alvarado-Little W, Ledford CJW. Communication with Diverse Patients: Addressing Culture and Language. Pediatr Clin North Am 2019; 66:791-804. [PMID: 31230623 DOI: 10.1016/j.pcl.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Effective communication is key when providing quality health care. The dynamics of communication within the health care team and with the patient and family can be challenging. These challenges stem from the sharing of complex information, highly emotional topics, and health literacy barriers. Linguistic and cultural barriers can further aggravate these challenges. This section provides an overview of linguistic and cultural challenges related to patient-provider communication, strategies for effective communication with patients with limited English Proficiency via the use of interpreter services, and tips for how to teach these skills to health care providers.
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Affiliation(s)
- Jennifer K O'Toole
- Departments of Pediatrics and Internal Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 5018, Cincinnati, OH 45229-3039, USA.
| | - Wilma Alvarado-Little
- New York State Department of Health, Office of Minority Affairs and Health Disparities Prevention, 9th Floor Corning Tower, ESP, Albany, NY 12237, USA
| | - Christy J W Ledford
- Department of Family Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Lee DSK, Hussin EOD. The effectiveness of a structured nursing intervention program on maternal stress and ability among mothers of premature infants in a neonatal intensive care unit. J Clin Nurs 2018; 28:641-649. [PMID: 30182455 DOI: 10.1111/jocn.14659] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/22/2018] [Accepted: 08/29/2018] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To investigate the effectiveness of a structured nursing intervention program on maternal stress and NICU-related maternal ability after the admission of premature infants to a neonatal intensive care unit (NICU). BACKGROUND Mothers of premature infants may face stress having premature infants, and their infants may be admitted to the NICU for a few weeks or months. The mothers' experience of stress would be worse if they have low knowledge and poor NICU-related maternal ability. Mothers of infants admitted to the NICU require well-planned interventions to cope with psychological matters arising after an infant hospitalisation. DESIGN Quasi-experimental design. METHODS A total of 216 mothers were consecutively assigned to control and intervention groups. Each group consisted of 108 mothers. The mothers in both groups received questionnaire concerning maternal stress and NICU-related ability during their first visit to NICU (within 48 hr of admission). A structured nursing intervention was implemented for 10 days on mothers in the intervention group. The control group continued to receive existing practice nursing care. Mothers of both groups were again given the questionnaire on maternal stress and NICU-related ability after 14 days of admission. RESULTS In the intervention group, the difference between the mean total score of maternal stress and parental role and relationship subscale decreased significantly, compared to the control group (p = 0.04; p = 0.01) respectively. Maternal ability improved significantly in mothers in the intervention group 2 weeks postintervention, p < 0.001. CONCLUSION A structured nursing intervention for mothers could significantly reduce maternal stress and promote maternal NICU-related abilities. RELEVANCE TO CLINICAL PRACTICE The results of the study could help neonatal nurses to develop an appropriate nursing intervention for parents with premature infants in the NICU.
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Affiliation(s)
- Swee Leong Ong
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,School of Nursing, Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mahmoud Danaee
- Academic Enhancement And Leadership Development Centre (ADeC), Deputy Vice Chancellor (academic & International) Office, Kuala Lumpur, Malaysia
| | - Kim Lam Soh
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, UPM, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Education, UPM, Serdang, Malaysia
| | - Daphne Siew Kee Lee
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Emni Omar Daw Hussin
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Iranian mothers' Experiences with Children Undergoing Hemodialysis: A Hermeneutic Phenomenological Study. J Pediatr Nurs 2018; 42:e19-e25. [PMID: 29958764 DOI: 10.1016/j.pedn.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 06/16/2018] [Accepted: 06/17/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To describe Iranian mothers' perspectives regarding hemodialysis for their children. DESIGN AND METHODS This qualitative study was conducted using the hermeneutic phenomenological approach. The sample consisted of 11 mothers, among whom five were interviewed once and six were interviewed twice, for a total of 17 interviews. The data were then analyzed using van Manen's (1997) method. RESULTS Five themes emerged from the data: mothers enclosed by child care, emotional and psychological tension, acceptance and contrivance, the entire family being a victim of a sick child, and self-devotion. CONCLUSION The results indicated that the mothers of children undergoing hemodialysis experience multiple stresses in the physical, emotional-psychological, social, and economic dimensions. PRACTICAL IMPLICATIONS Nurses are the healthcare team members who most frequently interact with mothers of children undergoing hemodialysis. They are therefore positioned favorably to provide the information and emotional support needed by these mothers. Nurses are also among the frontline professionals who can provide services designed to assess the physical, psychological, and economic requirements of these mothers and their families.
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Mariani A, Peycelon M, Clermidi P, Bellon M, Skhiri A, Bonnard A. Safety Assessment for Thoracoscopic Day Case Surgery in Children with Congenital Pulmonary Malformation. J Laparoendosc Adv Surg Tech A 2018; 28:1129-1134. [DOI: 10.1089/lap.2017.0721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Aurora Mariani
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP, Paris, France
| | - Matthieu Peycelon
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP, Paris, France
| | - Pauline Clermidi
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP, Paris, France
| | - Myriam Bellon
- Department of Anesthesiology, Robert Debré Hospital, AP-HP, Paris, France
| | - Alia Skhiri
- Department of Anesthesiology, Robert Debré Hospital, AP-HP, Paris, France
| | - Arnaud Bonnard
- Department of Pediatric Surgery, Robert Debré Hospital, AP-HP, Paris, France
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Pourghaznein T, Heydari A, Manzari Z, ValizadehZare N. "Immersion in an Ocean of Psychological Tension:" The Voices of Mothers with Children Undergoing Hemodialysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:253-260. [PMID: 30034483 PMCID: PMC6034527 DOI: 10.4103/ijnmr.ijnmr_156_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Compared with other renal replacement therapies, hemodialysis treatment can impose restrictions on children with chronic renal failure and their mothers. Such pediatric illness can also lead to negative effects on mothers' physical and mental health. Knowledge about mothers' experiences can aid medical teams to support mothers in playing their roles as care managers. Providing supports to mothers can exert significant effects on mothers' health status and indirectly improve patient outcomes and whole family functioning. This study was aimed at understanding the meanings of care for children undergoing hemodialysis based on mothers' lived experiences. MATERIALS AND METHODS This study is a qualitative research using hermeneutic phenomenology. A total of 17 interviews were conducted with 11 mothers of children undergoing hemodialysis. The interview sessions were recorded and transcribed, after which the data were analyzed using van Manen's methodology. RESULTS The main themes identified in this study was "immersion in an ocean of psychological tension," which suggests that the mothers of the children undergoing hemodialysis are overwhelmed by the numerous psychological pressures that they encounter during their children's treatment. This theme was constituted by the subthemes "bewilderment between hope and despair," "endless concerns," "agony and sorrow," and "a sense of being ignored." CONCLUSIONS The findings indicated the need to implement multilateral support measures that align with the educational, emotional-psychological, and financial needs of mothers with children receiving hemodialysis treatment. Such measures should be taken with the participation of multidisciplinary teams.
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Affiliation(s)
- Tayebeh Pourghaznein
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Heydari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - ZahraSadat Manzari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh ValizadehZare
- Department of Operating Room, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Azevêdo AVDS, Lançoni Júnior AC, Crepaldi MA. Interação equipe de enfermagem, família, e criança hospitalizada: revisão integrativa. CIENCIA & SAUDE COLETIVA 2017; 22:3653-3666. [DOI: 10.1590/1413-812320172211.26362015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 03/09/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo tem o objetivo de apresentar uma revisão integrativa de artigos científicos, referentes à produção nacional e internacional, sobre interação equipe de enfermagem, família, e criança hospitalizada. Foram realizadas consultas nas bases de dados Bireme, Lilacs, Medline, IBECS, Psyc Info, Science Direct, e Web of Science (2008-2013), o que permitiu identificar 31 artigos, os quais são representados pelos seguintes eixos temáticos: Relação interpessoal, Comunicação e Cuidado. O estabelecimento de relações interpessoais, de maneira técnica e formal, ocasiona dificuldades na comunicação e nas ações destinadas ao cuidado. O cuidado foi o tema predominante nestas pesquisas, acompanhantes reivindicam dos profissionais de saúde uma atenção ampliada às necessidades da criança e da família, e maior envolvimento de todos no processo de cuidado. Os resultados sugerem a necessidade da equipe de saúde reconhecer a dinâmica vivenciada pela díade (criança/acompanhante), para que possibilite desenvolver a atenção integral que favoreça a inclusão da família e da criança por meio de estratégias de humanização.
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Kelly MM, Hoonakker PLT. Getting on the Same Page: Opportunities to Improve Parent-Provider Communication. Hosp Pediatr 2017; 7:562-563. [PMID: 28768683 DOI: 10.1542/hpeds.2017-0080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Michelle M Kelly
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, and .,Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin
| | - Peter L T Hoonakker
- Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin
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Khan A, Furtak SL, Melvin P, Rogers JE, Schuster MA, Landrigan CP. Parent-Provider Miscommunications in Hospitalized Children. Hosp Pediatr 2017; 7:505-515. [PMID: 28768684 DOI: 10.1542/hpeds.2016-0190] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Miscommunications lead to medical errors and suboptimal hospital experience. Parent-provider miscommunications are understudied. OBJECTIVES (1) Examine characteristics of parent-provider miscommunications about hospitalized children, (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience, and (3) compare parent and attending physician reports of parent-provider miscommunications. METHODS Prospective cohort study of 471 parents of 0- to 17-year-old medical inpatients in a pediatric hospital between May 1, 2013 and October 1, 2014. At discharge, parents reported parent-provider miscommunication and type (selecting all applicable responses), overall experience, and errors during hospitalization. During discharge billing, the attending physicians (n = 52) of a subset of patients (n = 217) also reported miscommunications, enabling comparison of parent and attending physician reports. We used logistic regression to examine characteristics of parent-reported miscommunications; McNemar's test to examine associations between miscommunications, errors, and top-box (eg, "excellent") experience; and generalized estimating equations to compare parent- and attending physician-reported miscommunication rates. RESULTS Parents completed 406 surveys (86.2% response rate). 15.3% of parents (n = 62) reported miscommunications. Parents of patients with nonpublic insurance (odds ratio: 1.99; 95% confidence interval: 1.03-3.85) and longer lengths of stay (odds ratio: 1.12; 95% confidence interval: 1.02-1.23) more commonly reported miscommunications. Parents reporting miscommunications were 5.3 times more likely to report errors and 78.6% less likely to report top-box overall experience (P < .001 for both). Among patients with both parent and attending physician surveys, 16.1% (n = 35) of parents and 3.7% (n = 8) of attending physicians reported miscommunications (P < .001). Both parents and attending physicians attributed miscommunications most often to family receipt of conflicting information. CONCLUSIONS Parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
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Affiliation(s)
- Alisa Khan
- Division of General Pediatrics, .,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and
| | | | | | - Jayne E Rogers
- Department of Nursing, Boston Children's Hospital, Boston, Massachusetts
| | - Mark A Schuster
- Division of General Pediatrics.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and
| | - Christopher P Landrigan
- Division of General Pediatrics.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and.,Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Canary HE, Wilkins V. Beyond Hospital Discharge Mechanics: Managing the Discharge Paradox and Bridging the Care Chasm. QUALITATIVE HEALTH RESEARCH 2017; 27:1225-1235. [PMID: 28682741 DOI: 10.1177/1049732316679811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hospital discharge processes are complex and confusing, and can detrimentally affect patients, families, and providers. This qualitative study investigated pediatric hospital discharge experiences from the perspectives of parents of children with acute and chronic health conditions, primary care providers, and hospitalists. Focus groups and interviews with parents, primary care providers, and hospitalists were used to explore discharge experiences and ideas for improvement offered by participants. Using an iterative approach to analyze data resulted in five major themes for discharge experiences: (a) discharge problems, (b) teamwork, (c) ideal discharge, (d) care chasm, and (e) discharge paradox. The first three themes concern practical issues, whereas the last two themes reflect negative emotional experiences as well as practical problems encountered in the discharge process. Improvements in communication were viewed as a primary strategy for improving the discharge process for better outcomes for patients, their families, and providers.
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Giambra BK, Broome ME, Sabourin T, Buelow J, Stiffler D. Integration of Parent and Nurse Perspectives of Communication to Plan Care for Technology Dependent Children: The Theory of Shared Communication. J Pediatr Nurs 2017; 34:29-35. [PMID: 28169035 DOI: 10.1016/j.pedn.2017.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/30/2017] [Accepted: 01/30/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this qualitative research study was to expand our understanding of the process of communication between parents of hospitalized technology dependent children and their nurses originally detailed in the Theory of Shared Communication (TSC). DESIGN AND METHODS This grounded theory study was conducted with five parents of technology dependent children hospitalized in a large Midwestern children's hospital and nine nurses who care for technology dependent children admitted to the same hospital during July and August 2013. Semi-structured interviews and journals (parents only), field notes and a demographic survey were used to collect data which was analyzed using constant comparative analysis. RESULTS Parents verified the concepts of the TSC and relationships among them. Nurses' perceptions of communication with parents reflected the same parent identified and verified concepts upon which the TSC was originally grounded including respect for own and other's expertise, asking, listening, explaining, advocating, verifying understanding and negotiating roles to achieve mutual understanding of the child's plan of care. The nurses' perceptions differed stylistically but not categorically from those of the parents. CONCLUSIONS The addition of the nurse's perspectives to the verified TSC expands our understanding of this process of communication. PRACTICE IMPLICATIONS With the integration of nurse and parent perspectives, the TSC can be used to enhance communication and care for hospitalized technology dependent children and their families.
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Affiliation(s)
- Barbara K Giambra
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039, United States.
| | - Marion E Broome
- Indiana University, School of Nursing, 1111 Middle Drive, Indianapolis, IN 46202, United States
| | - Teresa Sabourin
- University of Cincinnati, 2600 Clifton Ave, Cincinnati, OH 45221, United States
| | - Janice Buelow
- Indiana University, School of Nursing, 1111 Middle Drive, Indianapolis, IN 46202, United States
| | - Deborah Stiffler
- Indiana University, School of Nursing, 1111 Middle Drive, Indianapolis, IN 46202, United States
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21
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Hashimoto H. Effects of a Support Program on Nurses’ Communication with Hospitalized Children’s Families. Compr Child Adolesc Nurs 2017; 40:173-187. [DOI: 10.1080/24694193.2017.1307473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hiroko Hashimoto
- Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima City, Japan
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Borrott N, Kinney S, Newall F, Williams A, Cranswick N, Wong I, Manias E. Medication communication between nurses and doctors for paediatric acute care: An ethnographic study. J Clin Nurs 2017; 26:1978-1992. [DOI: 10.1111/jocn.13606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Narelle Borrott
- Melbourne School of Health Sciences The University of Melbourne Parkville VIC Australia
| | - Sharon Kinney
- Nursing Research The Royal Children's Hospital Melbourne Parkville VIC Australia
- Departments of Nursing and Paediatrics The University of Melbourne Parkville VIC Australia
| | - Fiona Newall
- Nursing Research The Royal Children's Hospital Melbourne Parkville VIC Australia
- Departments of Nursing and Paediatrics The University of Melbourne Parkville VIC Australia
- Murdoch Childrens Research Institute Parkville VIC Australia
- Clinical Haematology Royal Children's Hospital Parkville VIC Australia
| | - Allison Williams
- School of Nursing and Midwifery Monash University Clayton VIC Australia
| | - Noel Cranswick
- Clinical Pharmacology Unit Department of Medicine Royal Children's Hospital Parkville VIC Australia
- Australian Paediatric Pharmacology Research Unit (APPRU) Murdoch Childrens Research Institute & The Royal Children's Hospital Parkville VIC Australia
- The University of Melbourne Parkville VIC Australia
| | - Ian Wong
- School of Pharmacy University College London London UK
| | - Elizabeth Manias
- School of Nursing and Midwifery Faculty of Health Deakin University Burwood VIC Australia
- The Royal Melbourne Hospital The University of Melbourne Parkville VIC Australia
- Melbourne School of Health Sciences The University of Melbourne Burwood VIC Australia
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KOHLSDORF M, COSTA JUNIOR ÁL, MARQUES FD. Effects of pre-consultation lists on the communicative behavior of children with cancer and their caregivers. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2016. [DOI: 10.1590/1982-02752016000400006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract This cross-sectional study present effects of pre-consultation lists on caregivers' and children's communicative behavior. Thirty-two dyads caregiver-child took part in this research, divided in three groups concerning the study design: Baseline 1, Intervention phase, and Baseline 2. Children and caregivers were individually interviewed before consultations on pediatric cancer treatment, in order to list doubts, expectations, and estimated issues to the medical visit. These themes were written down on a sheet of paper, attached to the child´s medical record cover, and would then be used as a memo in the following consultation. Results show that pre-consultation lists produced no effects on children's behavior, however the procedure was associated to specific doubts discussed by caregivers regarding dietary recommendations, coping with side effects, child development, biological aspects of cancer, and school activities. This study presents a low cost procedure that may contribute to tailor communication in pediatric settings.
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Jönsson L, Lundqvist P, Hallström I. Parents HRQOL, Their Satisfaction with Care, and Children Over the Age of Eight’s Experiences of Family Support Two Years Subsequent to the Child’s Diagnosis with Type 1 Diabetes. Compr Child Adolesc Nurs 2016. [DOI: 10.1080/24694193.2016.1241837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Baird J, Rehm RS, Hinds PS, Baggott C, Davies B. Do You Know My Child? Continuity of Nursing Care in the Pediatric Intensive Care Unit. Nurs Res 2016; 65:142-50. [PMID: 26938363 PMCID: PMC4780357 DOI: 10.1097/nnr.0000000000000135] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parents of children with complex, chronic conditions report a desire for continuity of care, but relatively little is known about the ways in which nursing continuity of care occurs and the extent to which it is delivered in the inpatient setting. OBJECTIVES The objective of this analysis, which arose from a study on best practices in parent/nurse interactions in the pediatric intensive care unit (PICU), was to explore the delivery of continuity of nursing care in the PICU from the perspective of both parents and nurses. METHODS A qualitative, grounded theory study using situational analysis was conducted with seven parents and 12 nurse participants from a single PICU. Data sources included in-depth interviews, observation, and organizational written materials. Data were coded and analyzed using memoing and situational and positional maps to highlight emerging themes, context, and positions within the data. RESULTS Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen. Nurses understood this need but faced both contextual and personal challenges to achieving continuity, including fluctuations in staffing needs, training demands, fear of emotional entanglement, and concern for missed learning opportunities. DISCUSSION Continuity of nursing care is highly valued by parents of children with complex chronic condition in the PICU, but significant barriers to optimal delivery exist within the current critical care environment. Mechanisms for supporting nurses to deliver continuity of care are needed, as are alternative ways to help parents feel that all nurses caring for their child have the knowledge necessary to deliver safe and compassionate care.
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Affiliation(s)
- Jennifer Baird
- Jennifer Baird, PhD, MSW, RN, is Research Fellow, Boston Children's Hospital, Massachusetts. Roberta S. Rehm, PhD, RN, FAAN, is Associate Professor, School of Nursing, University of California, San Francisco. Pamela S. Hinds, PhD, RN, FAAN, is Director, Nursing Research and Quality Outcomes, Children's National Medical Center, Washington, DC. Christina Baggott, PhD, RN, PNP-BC, is Clinical Research Nurse Practitioner, Pediatric Oncology, Stanford University, Palo Alto, California. Betty Davies, PhD, RN, FAAN, is Professor Emeritus, School of Nursing, University of Victoria, British Columbia, Canada
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Khan A, Rogers JE, Melvin P, Furtak SL, Faboyede GM, Schuster MA, Landrigan CP. Physician and Nurse Nighttime Communication and Parents' Hospital Experience. Pediatrics 2015; 136:e1249-58. [PMID: 26504131 PMCID: PMC5439977 DOI: 10.1542/peds.2015-2391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Night teams of hospital providers have become more common in the wake of resident physician duty hour changes. We sought to examine relationships between nighttime communication and parents' inpatient experience. METHODS We conducted a prospective cohort study of parents (n = 471) of pediatric inpatients (0-17 years) from May 2013 to October 2014. Parents rated their overall experience, understanding of the medical plan, quality of nighttime doctors' and nurses' communication with them, and quality of nighttime communication between doctors and nurses. We tested the reliability of each of these 5 constructs (Cronbach's α for each >.8). Using logistic regression models, we examined rates and predictors of top-rated hospital experience. RESULTS Parents completed 398 surveys (84.5% response rate). A total of 42.5% of parents reported a top overall experience construct score. On multivariable analysis, top-rated overall experience scores were associated with higher scores for communication and experience with nighttime doctors (odds ratio [OR] 1.86; 95% confidence interval [CI], 1.12-3.08), for communication and experience with nighttime nurses (OR 6.47; 95% CI, 2.88-14.54), and for nighttime doctor-nurse interaction (OR 2.66; 95% CI, 1.26-5.64) (P < .05 for each). Parents provided the highest percentage of top ratings for the individual item pertaining to whether nurses listened to their concerns (70.5% strongly agreed) and the lowest such ratings for regular communication with nighttime doctors (31.4% excellent). CONCLUSIONS Parent communication with nighttime providers and parents' perceptions of communication and teamwork between these providers may be important drivers of parent experience. As hospitals seek to improve the patient-centeredness of care, improving nighttime communication and teamwork will be valuable to explore.
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Affiliation(s)
- Alisa Khan
- Division of General Pediatrics, Department of Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and
| | - Jayne E. Rogers
- Department of Nursing, Boston Children’s Hospital, Boston, Massachusetts
| | - Patrice Melvin
- Center for Patient Safety and Quality Research, Boston Children’s Hospital, Boston, Massachusetts
| | - Stephannie L. Furtak
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - G. Mayowa Faboyede
- Clinical Research Center, Boston Children’s Hospital, Boston, Massachusetts
| | - Mark A. Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Christopher P. Landrigan
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts,Division of Sleep Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Kohlsdorf M, Costa Junior ÁL. A proposal for a behavioral pre-consultation: Analysis of the use of a protocol during consultations. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2015. [DOI: 10.1590/0103-166x2015000200007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze how physicians, caregivers, and children use protocols regarding estimated issues to medical visits, procedure named pre-consultation lists, along treatment for childhood cancer. Three pediatricians and 24 dyads child-caregiver took part; each pair was interviewed before medical visits in order to report doubts, needs and issues estimated to the consultation. This list was attached to child's medical record as a memo of themes to discuss in the next medical visit. Results show that two physicians included effectively this file in their consultations and discussed a great amount of issues listed by caregivers and patients. Children did not refer to the listed issues, but parents, in smaller amounts, discussed the themes in the protocol. This procedure contributed to insert the child in consultations and it may facilitate the focus on specific themes, however the physician's main role in managing communication during pediatric medical visits is highlighted.
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Fisher MJ, Broome ME, Friesth BM, Magee T, Frankel RM. The effectiveness of a brief intervention for emotion-focused nurse-parent communication. PATIENT EDUCATION AND COUNSELING 2014; 96:72-78. [PMID: 24797409 DOI: 10.1016/j.pec.2014.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 04/02/2014] [Accepted: 04/05/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE A child's hospitalization is stressful for both the children and their parents. Nurse-parent communication during stressful hospitalizations requires skilled nurse communicators. Brief methods of training emotion-focused communication for newly licensed nurses are needed, but as yet are rare. The purpose of this study was to evaluate the effectiveness of a validated brief communication training (Four Habits Model) session using simulation for newly licensed pediatric nurses. METHODS Quantitative and qualitative methods provided data for this experimental study, using a group-by-trials repeated measures ANOVA design. The intervention group participated in a 1-h three-part education simulation session and the control group observed a 1-h video. RESULTS Compared with the controls, the intervention group improved significantly in four of five areas: preparation, communication skills, relationships, and confidence. Experience level had minimal effect. Over half of the nurses in the intervention group reported using one or more of the Four Habits in clinical practice. CONCLUSIONS The findings of this study suggest that a 1-h Four Habits communication-training program improves newly licensed nurses' self-perception of their preparation for emotion-focused conversations with parents. PRACTICE IMPLICATIONS The findings of this study suggest that the Four Habits Model can be useful in communication training with nurses.
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Affiliation(s)
- Mark J Fisher
- College of Nursing, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, USA.
| | | | | | - Tracy Magee
- School of Nursing, Indiana University, Indianapolis, USA
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Ayala J, Howe C, Dumser S, Buzby M, Murphy K. Partnerships with providers: reflections from parents of children with type 1 diabetes. West J Nurs Res 2014; 36:1238-53. [PMID: 24457181 DOI: 10.1177/0193945913518848] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixty-three parents with a child or an adolescent with type 1 diabetes participated in this study that focused on what helped them "live well with diabetes." Beyond medical expertise, parents described a partnering relationship with their provider as one of the factors that supported their efforts to live well with diabetes. Parents reported that a partnership was enhanced when the provider had the ability to understand the dynamic nature of the journey in living with diabetes, connect with their family and set the tone by inviting them to openly communicate about all aspects of family life impacting diabetes care, recognize when and how the provider may have to assume the role of Captain of the Ship in times of need, and empathize and respond therapeutically to intense emotions inherent in managing diabetes over time.
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Affiliation(s)
- Judith Ayala
- The Children's Hospital of Philadelphia, PA, USA
| | - Carol Howe
- The Children's Hospital of Philadelphia, PA, USA
| | - Susan Dumser
- The Children's Hospital of Philadelphia, PA, USA
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30
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Giambra BK, Sabourin T, Broome ME, Buelow J. The theory of shared communication: how parents of technology-dependent children communicate with nurses on the inpatient unit. J Pediatr Nurs 2014; 29:14-22. [PMID: 23583360 DOI: 10.1016/j.pedn.2013.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 11/16/2022]
Abstract
Care may be compromised for hospitalized technology-dependent children if nurses do not communicate with parents to include their knowledge in the child's plan of care. A qualitative study using grounded theory methodology was undertaken to identify parental perceptions and experiences of communication with nurses. The Theory of Shared Communication was the result of this study and includes questioning, listening, explaining, advocating, verifying understanding and negotiating roles to achieve the outcome of mutual understanding of the child's plan of care. Nurses should be aware of parent perceptions about communication when working with families to optimize the care they provide.
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Affiliation(s)
| | | | | | - Janice Buelow
- Indiana University, School of Nursing, Indianapolis, IN
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Kohlsdorf M, Costa-Junior ÁL. Comunicação em pediatria: revisão sistemática de literatura. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2013. [DOI: 10.1590/s0103-166x2013000400007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A qualidade da comunicação em Pediatria influencia diretamente o sucesso do tratamento, ao promover níveis satisfatórios de adesão, retenção de informações e acolhimento a demandas biopsicossociais. Constituiu objetivo deste trabalho realizar uma revisão sistemática da literatura referente à comunicação em pediatria publicada entre 2000 e 2010. Foram selecionados trabalhos incluídos nas bases de dados PubMed/MedLine, Bireme/BVS e ScienceDirect, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e SciELO. Os 61 trabalhos selecionados indicam prevalência de delineamentos descritivos e técnicas de análise qualitativas e quantitativas, em detrimento de estudos experimentais e uso de técnicas mistas para análise de dados. A literatura indica a importância da inclusão do paciente pediátrico no processo de comunicação e do acolhimento a demandas psicossociais, destacando que programas para melhoria da comunicação têm obtido bons resultados. Destaca-se a importância de estudos sistemáticos que possibilitem compreender os fatores envolvidos na comunicação em pediatria e a inserção de programas psicossociais eficientes.
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Tavallali AG, Kabir ZN, Jirwe M. Ethnic Swedish Parents' experiences of minority ethnic nurses' cultural competence in Swedish paediatric care. Scand J Caring Sci 2013; 28:255-63. [DOI: 10.1111/scs.12051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Azar G. Tavallali
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Zarina Nahar Kabir
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Maria Jirwe
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
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Telephone follow-up for pediatric ambulatory surgery: parent and provider satisfaction. J Pediatr Nurs 2012; 27:715-24. [PMID: 22414540 DOI: 10.1016/j.pedn.2012.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 01/28/2012] [Accepted: 02/04/2012] [Indexed: 11/21/2022]
Abstract
Traditional 4- to 6-week clinic follow-up after pediatric ambulatory surgery does not rapidly identify complications and is often a burden for parents. Telephone follow-up offers support and is preferred in a variety of adult populations, but there is little research in pediatrics to support this practice. This article describes a practice change involving a standardized telephone follow-up protocol by a pediatric nurse practitioner to parents within 1 week of their child's ambulatory surgery. An interview survey method was used to evaluate parent satisfaction with telephone follow-up and desire for a clinic visit. Staff satisfaction and resource utilization are also described.
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Fisher MJ, Taylor EA, High PL. Parent–Nursing Student Communication Practice: Role-Play and Learning Outcomes. J Nurs Educ 2012; 51:115-9. [DOI: 10.3928/01484834-20111216-04] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 11/09/2011] [Indexed: 11/20/2022]
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Pediatric nursing research: creating partnerships with parents to improve the health of children and adolescents. J Pediatr Nurs 2011; 26:95-6. [PMID: 21256419 DOI: 10.1016/j.pedn.2010.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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