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Kaitsalmi J, Vehkakoski T, Karlsson L, Salanterä S. Nurses and the disabled child's perspective in the anaesthesia procedure preparation process using a picture schedule. Int J Qual Stud Health Well-being 2024; 19:2356927. [PMID: 38801136 PMCID: PMC11134046 DOI: 10.1080/17482631.2024.2356927] [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: 09/01/2023] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE This study's purpose was to investigate how nurses, using a picture schedule, enable or hinder the realization of disabled children's agency in the preparation for an MRI procedure carried out under general anaesthesia. METHODS A qualitative observation study was used to explore the interaction of nurses and children. The data consisted of video recordings of 25 preparation situations of 3 (3-8 years old) children (with challenges in communication and/or cognitive skills) with 4 nurses. Verbal and nonverbal communication was analysed with interventionist applied conversation analysis. RESULTS What was most crucial was how the picture schedule was used during the interaction. Reciprocal information sharing, responding to the child's initiatives by negotiating and allowing the child to take physical action with the picture schedule enabled the realization of the child's agency. CONCLUSIONS The preparation process should aim to help the child prepare in his/her own way. The preparation tools should encourage reciprocal interaction in informing and in responding to the children's initiatives. The preparation practices should include enough time for the child's initiatives and physical participation. The results can be used in assessing preparation tools and how they are used from the perspective of the child's agency.
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Affiliation(s)
| | - Tanja Vehkakoski
- Department of Education, University of Jyväskylä, Jyväskylä Yliopisto, Finland
| | - Liisa Karlsson
- Faculty of Educational Sciences, Department of Education, University of Helsinki, Helsingin Yliopisto, Finland
| | - Sanna Salanterä
- Department of Nursing Science, University of Turku, Turku, Finland
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2
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Choueiry J, Chartrand J, Harrison D, Don A. Pain care for children with cognitive impairment: A parent-nurse partnership. J Pediatr Nurs 2024; 77:e139-e149. [PMID: 38599999 DOI: 10.1016/j.pedn.2024.04.002] [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: 10/23/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE To explore nurses' experiences of establishing partnerships with parents for pain care of hospitalized children with cognitive impairment (CI) and identify related facilitators and barriers. DESIGN AND METHODS In this qualitative, interpretive descriptive study, individual semi-structured interviews were conducted via videoconferencing with pediatric nurses from inpatient wards in a Canadian pediatric quaternary hospital. Verbatim transcripts were analyzed using an inductive, data-driven thematic analysis approach. RESULTS Eleven nurses were interviewed. The overarching theme was Assessing Pain as an Outsider: "A Complete Guessing Game". Seven major themes were identified.: Relying on Parent Expertise for Pain Assessment, Brainstorming with Parents for Pain Treatment, Supporting Parents as Advocates for Pain Care, Individualizing Pain Care with Parents, Involving the Child in Pain Care: A Spectrum, Barriers to Partnership in Pain Care and Facilitators to Partnership in Pain Care. CONCLUSIONS Nurses described the many ways they involve parents as partners in pain care. However, nurses shared strong feelings of uncertainty associated with pain care in children with CI. Consequently, nurses felt the need to rely on parents for appropriately assessing and treating pain in children with CI. Findings highlighted the practice and education gaps that may contribute to nurses' uncertainty and reliance on parents. PRACTICE IMPLICATIONS By identifying related practice and education gaps, healthcare organizations can implement strategies to further support nurses in establishing partnerships and potentially optimize pain care practices.
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Affiliation(s)
- Juliana Choueiry
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada; Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.
| | - Julie Chartrand
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada
| | - Denise Harrison
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria 3053, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3053, Australia
| | - Anna Don
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Department of Nursing, School of Health, and Community Studies, Algonquin College, 1385 Woodroffe Ave, K2G 1V8 Ottawa, Ontario, Canada
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3
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Oulton K, Gibson F, Kenten C, Russell J, Carr L, Hassiotis A, Kelly P, Kerry S, Tuffrey-Wijne I, Whiting M, Wray J. Being a child with intellectual disabilities in hospital: The need for an individualised approach to care. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13153. [PMID: 37792824 DOI: 10.1111/jar.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 08/08/2023] [Accepted: 08/13/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. AIM To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. METHODS Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. RESULTS AND CONCLUSIONS The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed.
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Affiliation(s)
- Kate Oulton
- School of Health Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Charlotte Kenten
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Jessica Russell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucinda Carr
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Angela Hassiotis
- UCL Division of Psychiatry, University College London, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sam Kerry
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Mark Whiting
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hertfordshire, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Kelleher E, Martin AM, Caples M, Wills T. Acute service and disability service providers experiences of joint working to improve health care experiences of people with an intellectual disability compared to non-joint working: A mixed-method systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231209345. [PMID: 37864518 DOI: 10.1177/17446295231209345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Persons with intellectual disabilities require frequent access to acute services. Many also access disability services within the community. Reports and enquiries have highlighted the sub-optimal healthcare provided to this group when accessing healthcare in acute services. Joint working between acute and disability services has been identified as a measure to improve healthcare for this group. A mixed method systematic review was undertaken to explore current evidence of joint working between both service providers. Twelve publications were included, and the data were analysed using thematic analysis. Confusion around responsibility and limited training in acute services prevented joint working from occurring. Information-sharing is pivotal in promoting joint-working, but measures which facilitated it were not always used. Albeit acute services demonstrated a strong commitment to deliver quality care to those with intellectual disabilities. Much of the available research captures the experiences of staff in acute services. There is a paucity of research available exploring experiences of disability service providers.
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Cullen-Prince P, Leigh H. A day surgery admissions pathway for children and young people with learning disabilities. Nurs Child Young People 2023; 35:28-33. [PMID: 36062300 DOI: 10.7748/ncyp.2022.e1438] [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: 12/24/2021] [Indexed: 05/05/2023]
Abstract
Following feedback from parents and carers, a new pathway was developed by staff in the paediatric day surgery unit of a hospital in England for admitting children and young people with learning disabilities, some of whom are autistic. This article describes the All About Me pathway, which supports individualised admission planning and uses an interdisciplinary approach to enable multiple examinations or procedures to be completed under a single anaesthetic. The authors explain how the All About Me team works with families, schools and caregivers to gain a greater understanding of each child and young person. This enables the team to make reasonable adjustments to the environment and admission process to maximise the chance of a successful admission. Families have reported that the pathway has made significant improvements to their experience of healthcare services. The pathway continues to develop and has become the focus of a quality improvement project which is expected to demonstrate cost savings.
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Affiliation(s)
- Philippa Cullen-Prince
- paediatrics, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, England
| | - Helen Leigh
- paediatrics, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, England
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6
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Murdoch L, Chang Y. Parental experiences of caring for children who have learning disabilities and procedural anxiety in hospital: An interpretive phenomenological study. Child Care Health Dev 2022; 48:809-819. [PMID: 35194826 PMCID: PMC9543230 DOI: 10.1111/cch.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/30/2022] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children with learning disabilities (LD) are more likely to have health conditions that require hospital attendance than children without LD. Like all children, they can experience fear and distress related to procedural anxiety. Parents play a key role in managing procedural anxiety in children with LD. No previous published qualitative studies have explored parental experiences of caring for a child with LD and procedural anxiety in hospital. OBJECTIVES To explore how parents experienced caring for their child with LD and procedural anxiety in hospital. METHODS A purposive sample of six participants were recruited through a Facebook group for parents of children with LD. Remote semi-structured interviews were conducted via telephone, Microsoft Teams or Whatsapp. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS Five key themes were generated: (1) Emotional toll: parents characterized their experiences as highly emotional; reporting feeling stressed, anxious and worried. (2) Restraint and holding: parents spoke of their experiences of restraint which was largely viewed as negative and sometimes inappropriate. (3) Advocacy: parents articulated their responsibility as advocates for their children. (4) Going it alone: parents were extremely proactive in managing their child's anxieties but some also felt highly-pressurized and isolated. (5) Inconsistency and uncertainty: parents experienced inconsistency and uncertainty in their children's care from healthcare professionals which led to anxiety and frustration. CONCLUSION Parents of children with both LD and procedural anxiety experienced many challenges. Parents' expertise must be utilized by clinicians when caring for children with LD and procedural anxiety whilst ensuring appropriate support for parents. Nurses require specific training in psychosocial interventions to enhance care for children with LD and procedural anxiety. Further research identifying effective nursing strategies to enhance parental experiences would be beneficial to improve care to this patient group.
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Affiliation(s)
- Lauren Murdoch
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
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7
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Mimmo L, Hodgins M, Samir N, Travaglia J, Woolfenden S, Harrison R. 'Smiles and laughter and all those really great things': Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability. J Adv Nurs 2022; 78:2933-2948. [PMID: 35451515 PMCID: PMC9544709 DOI: 10.1111/jan.15256] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/11/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
AIM To understand what constitutes a good experience of care for inpatient children and young people with intellectual disability as perceived by nursing staff. DESIGN Interpretive qualitative study. METHODS Focus groups with clinical nursing staff from speciality neurological/neurosurgical and adolescent medicine wards across two specialist tertiary children's hospitals in Australia were conducted between March and May 2021. Data analysis followed interpretative analysis methods to develop themes and codes which were mapped to a conceptual model of safe care. RESULTS Six focus groups with 29 nurses of varying experience levels were conducted over 3 months. Themes and codes were mapped to the six themes of the conceptual model: use rapport, know the child, negotiate roles, shared learning, build trust and relationships, and past experiences. The analysis revealed two new themes that extended the conceptual model to include; the unique role of a paediatric nurse, and joy and job satisfaction, with a third contextual theme, impacts of COVID-19 pandemic restrictions. With the perspectives of paediatric nurses incorporated into the model we have enhanced our model of safe care specifically for inpatient paediatric nursing care of children and young people with intellectual disability. CONCLUSION Including perceptions of paediatric nurses confirmed the position of the child with intellectual disability being at the centre of safe care, where care is delivered as a partnership between nursing staff, child or young person and their parents/family and the hospital systems and processes. IMPACT The enhanced model offers a specialized framework for clinical staff and health managers to optimize the delivery of safe care for children and young people with intellectual disability in hospital.
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Affiliation(s)
- Laurel Mimmo
- Clinical Governance UnitThe Sydney Children's Hospitals NetworkSydneyNSWAustralia
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Michael Hodgins
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Nora Samir
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Joanne Travaglia
- Centre for Health Services ManagementFaculty of HealthUniversity of Technology SydneySydneyNSWAustralia
| | - Susan Woolfenden
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Reema Harrison
- Centre for Health Systems and Safety ResearchAustralian Institute of Health InnovationFaculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
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Stensson M, Norderyd J, Van Riper M, Marks L, Björk M. Dental health care for children with Down syndrome: Parents' description of their children's needs in dental health care settings. Eur J Oral Sci 2022; 130:e12859. [PMID: 35218581 PMCID: PMC9303609 DOI: 10.1111/eos.12859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/18/2022] [Indexed: 01/17/2023]
Abstract
A visit to the dental clinic may be challenging for a child with Down syndrome due to medical and oral health problems as well as communication problems. The aim of the present study was to explore how parents of children with Down syndrome describe their child's needs in the dental health care setting. In a survey concerning parental experiences with dental health care in Sweden, free comments were analysed with content analysis and resulted in five categories: “Need for continuity of care in dental health care”; “Need for dental health care professionals to have knowledge and expertise in caring for children with Down syndrome and other disabilities”; “Need for dental health care professionals to use a caring approach with children with Down syndrome”; “Need for the child with Down syndrome to be prepared to participate in their dental health care visit” and “Need for the child with Down syndrome to be given the same rights as typically developing children”. To support children with Down syndrome in an optimal way, dental health care needs to be tailored to meet the child's unique needs. In addition, dental health care professionals need knowledge of and expertise in the care of children with Down syndrome.
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Affiliation(s)
- Malin Stensson
- Centre of Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden.,CHILD Research Group, SIDR, Jönköping University, Jönköping, Sweden
| | - Johanna Norderyd
- CHILD Research Group, SIDR, Jönköping University, Jönköping, Sweden.,National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Marcia Van Riper
- School of Nursing, The University of North Carolina at Chapel Hill, North Carolina, USA
| | - Luc Marks
- Center for Dentistry and Oral hygiene, University Medical Centre, University of Groningen, Groningen, The Netherlands.,Dept. of Special Care in Dentistry, Oral Health Sciences, University of Gent, Gent, Belgium
| | - Maria Björk
- CHILD Research Group, SIDR, Jönköping University, Jönköping, Sweden.,Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden
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9
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Ong N, Long JC, Weise J, Walton M. Responding to safe care: Healthcare staff experiences caring for a child with intellectual disability in hospital. Implications for practice and training. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:675-690. [DOI: 10.1111/jar.12978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 11/07/2021] [Accepted: 01/09/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Natalie Ong
- Child Development Unit, Children's Hospital Westmead Clinical School University of Sydney Sydney New South Wales Australia
| | - Janet C. Long
- Australian Institute of Health Innovation Macquarie University Sydney New South Wales Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry University of New South Wales Sydney New South Wales Australia
| | - Merrilyn Walton
- Department of Public Health, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
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Wilkinson K, Gumm R, Hambly H, Logan S, Morris C. Implementation of training to improve communication with disabled children on the ward: A feasibility study. Health Expect 2021; 24:1433-1442. [PMID: 34048632 PMCID: PMC8369114 DOI: 10.1111/hex.13283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/13/2021] [Accepted: 05/02/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Parents of disabled children report poorer inpatient experiences when they stay in hospital, and some staff report finding communicating with disabled children challenging. This study tested the feasibility of implementing a training package for staff on paediatric wards to improve communication with disabled children, especially those with communication difficulties, and their families. The package was developed with parent carers and clinicians, and comprises a manual, a video of parent carers talking about real experiences, discussion points and local resources. The 50-minutes training is intended for in-house delivery by local facilitators. METHODS Thirteen training sessions were delivered in paediatric wards across four hospitals in England, totalling 123 staff who took part. Participants completed questionnaires before (n = 109) and after (n = 36) training, and a sample of champions (senior clinicians) and facilitators were interviewed at the end of the study. RESULTS Facilitators found the training easy to deliver, and participants felt they took away important messages to improve their practice. After the training, further changes were reported at an organizational level, including offering further training and reviewing practices. CONCLUSIONS This study provides supporting evidence for the implementation of a low-cost, minimal-resource training package to support staff communication with children and their families in hospitals. It provides promising indication of impact on behavioural change at the individual and organizational level. PATIENT AND PUBLIC CONTRIBUTION Parent carers identified the need and helped to develop the training, including featuring in the training video. They were also consulted throughout the study on research design, delivery and reporting.
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Affiliation(s)
- Kath Wilkinson
- Peninsula Childhood Disability Research Unit (PenCRU) and National Institute of Health Research Applied Research Collaboration for the South West Peninsula (penARC), University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gumm
- Sheffield Children's NHS Foundation TrustSheffieldUK
| | - Helen Hambly
- Peninsula Childhood Disability Research Unit (PenCRU) and National Institute of Health Research Applied Research Collaboration for the South West Peninsula (penARC), University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Stuart Logan
- Peninsula Childhood Disability Research Unit (PenCRU) and National Institute of Health Research Applied Research Collaboration for the South West Peninsula (penARC), University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU) and National Institute of Health Research Applied Research Collaboration for the South West Peninsula (penARC), University of Exeter Medical SchoolUniversity of ExeterExeterUK
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Bynoe S, Collin J, Clark LL. Reducing restrictive practice: a pertinent issue for children's services. ACTA ACUST UNITED AC 2021; 30:70-73. [PMID: 33433280 DOI: 10.12968/bjon.2021.30.1.70] [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: 11/11/2022]
Abstract
The reduction of restrictive practice has gained momentum in mental health services and it is now becoming evident in mainstream adult services. There remains confusion as to the definition of 'restrictive practices' across all sectors of health care, including the difference between 'restrictive practices' (such as attitudes of control, limit setting and unnecessary ward rules) and 'restrictive interventions' (including physical, chemical or mechanical restraint). This article highlights the relevance of restrictive practice to children's nursing and argues that the principles apply across all health provision. Acts of restrictive practice may result in challenging behaviour, or even restrictive interventions, strategies to minimise both restrictive practice and subsequent acts of challenging behaviour are explored. Behavioural support plans adopting a bio-psycho-pharmaco-social approach have been shown to be effective in both mental health and adult nursing and are recommended for use in children's nursing.
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Affiliation(s)
- Sheena Bynoe
- Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Jacqueline Collin
- was Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, at the time of writing
| | - Louise L Clark
- Senior Teaching Fellow, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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12
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Oulton K, Sell D, Gibson F. Hospitalized children with intellectual disability: Parents as partners in their care. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:917-926. [PMID: 32072753 DOI: 10.1111/jar.12713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 01/11/2020] [Accepted: 01/28/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Limited evidence exists of what hospital care is like for parents of children and young people (CYP) with intellectual disability (ID). Effective collaboration is often missing, with parents lacking trust in professionals, with feelings of being expected to care and consequently unable to leave their child. This paper focuses on what parents want from their relationship with healthcare professionals. METHOD An ethnographic approach was used, including in-depth interviews and informal discussions with nine parents of CYP with intellectual disability. Researcher voice poems are interspersed with quotations to illustrate key findings. RESULTS Parents described the need for a genuine partnership with professionals. They identified seven elements that ideally characterize this partnership: Preparation, Accessibility, Reliability, Trust, Negotiation, Expertise and Respect (PARTNER). CONCLUSION Children and young people with intellectual disability and their parents are frequent users of healthcare services. Getting it right from the outset is important to establish their trust in the system.
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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13
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Mimmo L, Woolfenden S, Travaglia J, Harrison R. Partnerships for safe care: A meta-narrative of the experience for the parent of a child with Intellectual Disability in hospital. Health Expect 2019; 22:1199-1212. [PMID: 31560839 PMCID: PMC6882263 DOI: 10.1111/hex.12968] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/18/2019] [Accepted: 08/30/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To systematically identify and synthesize peer-reviewed qualitative evidence of the parental experience of hospitalization with a child with Intellectual Disability. SEARCH STRATEGY Key words, synonyms and MeSH subject headings that related to the three key concepts of parental experience, children with Intellectual Disability and hospital settings were applied to six electronic databases: Medline, CINAHL, Embase, PsycINFO, Scopus and Web of Science. Titles and abstracts of publications between January 2000 and February 2019 were screened for relevance. INCLUSION CRITERIA Empirical qualitative research involved participants aged 0-18 years, involved children with Intellectual Disability, involved participants hospitalized as an in-patient and involved participants focused on parent perspective. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesized using a meta-narrative approach. RESULTS Eleven publications met the inclusion criteria. Data synthesis revealed three research traditions contributing to this meta-narrative: Paediatric Nursing Practice, Intellectual Disability Healthcare and Patient Experience. A total of five themes were identified: (a) being more than a parent, (b) importance of role negotiation, (c) building trust and relationships, (d) the cumulative effect of previous experiences of hospitalization and (e) knowing the child as an individual. DISCUSSION AND CONCLUSION This review presents a working model for professional-parent partnership for the safe care of children with Intellectual Disability in hospital. Shifting paediatric healthcare to whole of hospital/multidisciplinary models of care that centre on the child will necessitate partnerships with the parent to identify and manage the needs of the child with Intellectual Disability, in order to achieve safe and equitable care for these children.
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Affiliation(s)
- Laurel Mimmo
- Faculty of MedicineSchool of Public Health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
- Clinical Governance UnitSydney Children's Hospitals NetworkSydneyNew South WalesAustralia
| | - Susan Woolfenden
- Community Child HealthSydney Children's HospitalSydneyNew South WalesAustralia
- Faculty of MedicineSchool of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Joanne Travaglia
- Faculty of HealthCentre for Health Services ManagementUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Reema Harrison
- Faculty of MedicineSchool of Public Health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
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14
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Lewis P, Wilson NJ, Jaques H, O'Reilly K, Wiese M. A qualitative study of nurses' perspectives of caring for children with intellectual disability and their families in a paediatric acute care setting. J Child Health Care 2019; 23:639-651. [PMID: 31359791 DOI: 10.1177/1367493519867234] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Children with intellectual disability (ID) experience chronic and pervasive limitations across intellectual and adaptive functioning. They are also at risk of developing co-morbidities. They are likely to be hospitalised more frequently and for longer periods of time than other children. The purpose of this study was to understand the experiences of nurses when caring for children and teenagers with ID in an acute paediatric hospital setting. The aim of the research was to inform future directions for the delivery of equitable and effective care for this vulnerable population. This study used a qualitative thematic analysis of individual interviews conducted with eight registered and enrolled nurses who provided care to children and adolescents with ID in an Australian paediatric acute hospital setting. Themes which emerged from this analysis were (1) Recognising similarities and managing differences; (2) Nurse-parent relationships; and (3) Caring for children with ID requires additional time. This study highlights that navigating care delivery and relationships when working with young people with ID and their caregivers in an acute care setting is complex. Nursing children with ID in hospital requires sophisticated skills. To ensure quality healthcare for patients with ID, a range of strategies are proposed.
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Affiliation(s)
- Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Hayden Jaques
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Kate O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Michele Wiese
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
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Bates A, Forrester-Jones R, McCarthy M. Specialist hospital treatment and care as reported by children with intellectual disabilities and a cleft lip and/or palate, their parents and healthcare professionals. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:283-295. [PMID: 31578815 DOI: 10.1111/jar.12672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 07/26/2019] [Accepted: 08/29/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Research into hospital treatment and care of children with intellectual disabilities is extremely limited, but available literature points to difficulties. Some children have a co-occurring condition alongside an intellectual disability which requires ongoing treatment, such as a cleft lip/palate. To date, their experiences remain untapped. METHOD Semi-structured interviews with 23 participants; five children with intellectual disabilities (aged 11-16), their parents (n = 9) and nine healthcare professionals working in cleft care. Thematic analysis determined patterns across the data. RESULTS Three key themes were found: struggles (stress and distress, and power imbalance), tensions (perceived levels of choice and control in decision making, lack of training around intellectual disability assumptions and jargon) and good practice (appropriate communication and information, and tailored treatment). CONCLUSION Good practice was evident, but was ad hoc. Individualized treatment and communication based upon children's needs are required as is further investigation into general anaesthetic induction for children with intellectual disabilities.
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Affiliation(s)
- Amanda Bates
- Centre for Health Services Studies, University of Kent, Canterbury, UK
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Morriss-Roberts C, Oulton K, Sell D, Wray J, Gibson F. How should health service researchers respect children's personal data under GDPR? THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:696-697. [PMID: 30236373 DOI: 10.1016/s2352-4642(18)30271-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Chris Morriss-Roberts
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, UK.
| | - Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, UK
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, UK; Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Guildford, UK
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Oulton K, Gibson F, Carr L, Hassiotis A, Jewitt C, Kenten C, Russell J, Whiting M, Tuffrey-Wijne I, Wray J. Mapping staff perspectives towards the delivery of hospital care for children and young people with and without learning disabilities in England: a mixed methods national study. BMC Health Serv Res 2018; 18:203. [PMID: 29566681 PMCID: PMC5865304 DOI: 10.1186/s12913-018-2970-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 02/27/2018] [Indexed: 11/16/2022] Open
Abstract
Background Children and young people (CYP) with learning disabilities (LD) are a vulnerable population with increased risk of abuse and accidental injury and whose parents have reported concerns about the quality, safety and accessibility of their hospital care. The Care Quality Commission’s (CQC) view of best practice for this group of patients includes: access to senior LD nurse provision; a clearly visible flagging system for identifying them; the use of hospital passports; and defined communication strategies (Glasper, Comp Child Adolesc Nurs 40:63-67, 2017). What remains unclear is whether these recommendations are being applied and if so, what difference they are making. Furthermore, what we do not know is whether parental concerns of CYP with LD differ from parents of other children with long-term conditions. The aims of this study were to 1) describe the organisational context for healthcare delivery to CYP with LD and their families and 2) compare staff perceptions of their ability to identify the needs of CYP with and without LD and their families and provide high quality care to effectively meet these needs. Methods Individual interviews (n = 65) and anonymised online survey (n = 2261) were conducted with hospital staff working with CYP in 15 children’s and 9 non-children’s hospitals in England. The majority of interviews were conducted over the telephone and recorded and transcribed verbatim. Health Research Authority was obtained and verbal or written consent for data collection was obtained from all interview participants. Results The nature and extent of organisational policies, systems and practices in place within hospitals to support the care of CYP with LD differs across England and some uncertainty exists within and across hospitals as to what is currently available and accessed. Staff perceived that those with LD were included less, valued less, and less safe than CYP without LD. They also reported having less confidence, capability and capacity to meet the needs of this population compared to those without LD. Conclusion Findings indicate inequality with regards the provision of high quality hospital care to children and young people with LD that meets their needs. There is a pressing need to understand the impact this has on them and their families. Trial registration The study has been registered on the NIHR CRN portfolio 20461 (Phase 1), 31336 (Phases 2-4). Electronic supplementary material The online version of this article (10.1186/s12913-018-2970-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, UK.
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, UK.,School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Lucinda Carr
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Angela Hassiotis
- UCL Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Carey Jewitt
- UCL Knowledge Lab, Institute of Education, 23-29 Emerald Street, London, WC1N 3QS, UK
| | - Charlotte Kenten
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, UK
| | - Jessica Russell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, UK
| | - Mark Whiting
- Health Research Building, University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Irene Tuffrey-Wijne
- Faculty of Health, Social Care and Education, Kingston University and St George's University of London, 6th floor Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, UK
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Oulton K, Sell D, Gibson F. "LEARN"ing what is important to children and young people with intellectual disabilities when they are in hospital. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:792-803. [PMID: 29336507 DOI: 10.1111/jar.12433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The need to review health service provision for children and young people (CYP) with disabilities and their families in the United Kingdom has been expressed in multiple reports: the most consistent message being that services need to be tailored to meet their individual needs. Our aim was to understand the hospital-related needs and experiences of CYP with intellectual disabilities. METHOD An ethnographic study of a neurosciences ward and outpatient department was conducted within a paediatric tertiary hospital setting. RESULTS Five themes, developed using the acronym LEARN, explained what is important to CYP with intellectual disabilities in hospital: (i) little things make the biggest difference, (ii) eliminate unnecessary waiting, (iii) avoid boredom, (iv) routine and home comforts are key and (v) never assume. CONCLUSIONS It is imperative that the present authors continue to challenge the idea that it is acceptable to exclude CYP with intellectual disabilities from research because of their inability to participate.
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Affiliation(s)
- K Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - D Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - F Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,School of Health Sciences, University of Surrey, Guilford, Surrey, UK
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Northway R, Rees S, Davies M, Williams S. Hospital passports, patient safety and person-centred care: A review of documents currently used for people with intellectual disabilities in the UK. J Clin Nurs 2017; 26:5160-5168. [PMID: 28881074 DOI: 10.1111/jocn.14065] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review hospital passports currently in use for people with intellectual disabilities in the UK and to make recommendations for practice. BACKGROUND Hospital passports have been introduced internationally to address communication barriers that may limit access to appropriate health care for people with intellectual disabilities. They are viewed as promoting patient safety and person-centred care but their format may vary, they are not always used appropriately, and hence, their effectiveness may be limited. DESIGN Qualitative content analysis. METHODS Sixty hospital passports in use in the UK were reviewed against a coding frame by two members of the research team. Areas of interest included key patient and primary care information, support network details, consent and capacity, support required in relation to activities of daily living, length of the document and completion details. Results were entered into Excel. RESULTS Considerable variation was found between documents in terms of terminology, length and format. Most included information regarding communication and support needs although some omitted important information such as allergies, risk assessment and need for reasonable adjustments. CONCLUSIONS Considerable variation exists between current hospital passports, which may limit their effectiveness: key information required may not be included and/or it may not be easy to locate. Greater standardisation of documents is required, but this process should include input from all key stakeholders. RELEVANCE TO CLINICAL PRACTICE Internationally nurses provide care for people with intellectual disabilities and others with communication difficulties. Hospital passports are one way of enhancing safety and person-centred care, need to be accessed and used as a basis for care planning. However, variation in format may limit this effectiveness and nurses should work with others to develop a more standardised approach, which better meets the needs of all stakeholders.
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Affiliation(s)
- Ruth Northway
- School of Care Sciences, University of South Wales, Pontypridd, UK
| | - Stacey Rees
- School of Care Sciences, University of South Wales, Pontypridd, UK
| | - Michelle Davies
- Llanfrechfa Grange, Aneurin Bevan University Health Board, Llanfrechfa, Cwmbran, UK
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Gumm R, Thomas E, Lloyd C, Hambly H, Tomlinson R, Logan S, Morris C. Improving communication between staff and disabled children in hospital wards: testing the feasibility of a training intervention developed through intervention mapping. BMJ Paediatr Open 2017; 1:e000103. [PMID: 29637132 PMCID: PMC5862175 DOI: 10.1136/bmjpo-2017-000103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To develop and test the feasibility of a novel parent-inspired training intervention for hospital ward staff to improve communication with disabled children when inpatients. DESIGN Training content and delivery strategies were informed by the iterative process of Intervention Mapping and developed in collaboration with parents of disabled children. SETTING UK University Hospital children's ward. SUBJECTS 80 medical, nursing, allied health professionals, clerical and housekeeping staff on a children's ward. METHODS Themes identified in previous qualitative research formed the basis of the training. Learning objectives included prioritising communication, cultivating empathy, improving knowledge and developing confidence. Participant feedback was used to refine content and delivery. Intervention documentation adheres to the Template for Intervention Description and Replication checklist. RESULTS Highlighting mandated National Health Service policies and involving the hospital Patient and Carer Experience Group facilitated management support for the training. Eighty staff participated in one of four 1-hour sessions. A paediatric registrar and nurse delivered sessions to mixed groups of staff. General feedback was very positive. The intervention, fully documented in a manual, includes videos of parent carers discussing hospital experiences, interactive tasks, small group discussion, personal reflection and intention planning. Generic and local resources were provided. CONCLUSION It was feasible to deliver this new communication training to hospital ward staff and it was positively received. Early feedback was encouraging and indicates a commitment to behaviour change. Further piloting is required to establish the transferability of the intervention to other hospitals, followed by consideration of downstream markers to evaluate the effects on disabled children's inpatient experience. Organisational and cultural change is required to support individual behaviour change.
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Affiliation(s)
- Rebecca Gumm
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Eleanor Thomas
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Claire Lloyd
- PenCRU (Peninsula Cerebra Research Unit) and PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Helen Hambly
- PenCRU (Peninsula Cerebra Research Unit) and PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Richard Tomlinson
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Stuart Logan
- PenCRU (Peninsula Cerebra Research Unit) and PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Christopher Morris
- PenCRU (Peninsula Cerebra Research Unit) and PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Seliner B, Latal B, Spirig R. When children with profound multiple disabilities are hospitalized: A cross-sectional survey of parental burden of care, quality of life of parents and their hospitalized children, and satisfaction with family-centered care. J SPEC PEDIATR NURS 2016; 21:147-57. [PMID: 27319801 DOI: 10.1111/jspn.12150] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 05/05/2016] [Accepted: 05/26/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE We aimed to assess parental burden of care, satisfaction with family-centered care, and quality of life (HRQoL) of parents and their hospitalized children with profound intellectual and multiple disabilities (PIMD), and determine the relationship among these factors. DESIGN A cross-sectional study using printed questionnaires and qualitative questions was undertaken at a Swiss University Children's Hospital. RESULTS The 117 parents (98 mothers, 19 fathers) studied indicated a substantial impact on burden of care and parental health-related quality of life. Significant correlations with the hospitalized children's well-being were rs = .408 for burden of care and rs -.368 for quality of life. Qualitative results showed parents struggling to safeguard their children and worrying most about the children's well-being. PRACTICE IMPLICATIONS Health professionals need to be aware of parental burden and that the perception of the children's well-being and the parents' efforts determine their support needs. Easing parents' burden and fostering confidence in the hospitalized children's well-being requires coordination of care provided by advanced nurse specialists, with an institutional framework that clarifies parental collaboration.
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Affiliation(s)
- Brigitte Seliner
- APN Rehabilitation, University Children's Hospital, Zurich, Switzerland
| | - Bea Latal
- Professor Physician, and Head of Developmental Pediatrics, University Children's Hospital, Zurich, Switzerland
| | - Rebecca Spirig
- Professor and Executive Director of Nursing and Allied Health Care Professions, University Hospital, Zurich, Switzerland
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Translational research: the multidimensional scope of pediatric nursing. J Pediatr Nurs 2015; 30:262-5. [PMID: 25475225 DOI: 10.1016/j.pedn.2014.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 11/17/2014] [Indexed: 11/22/2022]
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