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Zerpe AS, Ramklint M, Nowinski D, Öster C. Parental satisfaction with hospital care for children with non-syndromic craniosynostosis: A mixed-method study. J Pediatr Nurs 2024; 77:e465-e473. [PMID: 38762423 DOI: 10.1016/j.pedn.2024.05.011] [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: 10/17/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE The study aims to investigate factors influencing parents' satisfaction with hospital care for children with craniosynostosis during hospitalization for surgery. DESIGN AND METHODS A mixed-methods study with a convergent, parallel design was used. Ninety-five parents responded to the Swedish Pyramid Questionnaire for Treatment, a 25-item questionnaire with six quality domains. In addition, 20 parents were interviewed about their experiences. Frequencies were calculated, and content analysis was used to analyze free-text comments and transcribed interviews. RESULTS Parents' assessment of the overall quality of care was high (mean 87%, range 10-100%). They were most satisfied in the domain staff attitudes and less satisfied with information routines and participation. Content analysis of the interviews gave two overarching themes: Factors that parents experienced as facilitating good quality of care and Factors that parents experienced as impeding good quality of care. CONCLUSIONS Parents were generally satisfied with the care provided, and interviews captured parents´ views on important factors. Staff attitudes affected parents' perception of quality of care. PRACTICAL IMPLICATIONS Clear information and dialogue as well as making parents feel they are part of their child's team can result in higher satisfaction, and allowing families to stay together in the hospital can ease the hospitalization experience. Using a theoretical model can help in suggesting relevant caring actions based on parents' reported care experiences.
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Affiliation(s)
- Anna Stenson Zerpe
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University Hospital, Entrance 85, S-75185, Uppsala, Sweden.
| | - Mia Ramklint
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, Entrance 10, S-75185, Uppsala, Sweden
| | - Daniel Nowinski
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University Hospital, Entrance 85, S-75185, Uppsala, Sweden
| | - Caisa Öster
- Department of Medical Sciences, Psychiatry, Uppsala University Hospital, Entrance 10, S-75185, Uppsala, Sweden
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Antunes TPC, Jardim FG, de Oliveira Abreu CIP, de Abreu LC, Bezerra IMP. Chronic Pain Self-Management Strategies for Older Adults: An Integrative Review. Life (Basel) 2024; 14:707. [PMID: 38929690 PMCID: PMC11204825 DOI: 10.3390/life14060707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Due to the complex nature of chronic pain, especially in older adults, a biopsychosocial approach is more effective than an isolated approach for its management. Furthermore, when patients are actively engaged in their pain management, they are more likely to be successful than relying totally on others. OBJECTIVE To analyze the self-management strategies currently used by older adults with chronic pain. METHOD An integrative review was conducted through seven online databases, searching for scientific studies on this topic published in the last 10 years. RESULTS AND CONCLUSION Fifty-eight studies were included in the final sample. Research on chronic pain self-management for older adults has increased in recent years. Although a diversity of chronic physical painful conditions are being investigated, many conditions are still under-investigated. Online and in-person strategies are currently adopted, demonstrating similar results. Positive results are evidenced by strategies including health promotion, mind control, social participation and take-action fields. Major results come from a combination of strategies focusing on biopsychosocial aspects of pain management. Results include not only the reduction of pain itself, but increased self-efficacy, adoption of health behaviors and improvement of functionality, among others, i.e., improved QoL, despite pain.
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Affiliation(s)
- Thaiany Pedrozo Campos Antunes
- Public Policy and Local Development Department, Superior School of Sciences of the Santa Casa de Misericórdia de Vitória, Vitória 29045-402, Espirito Santo, Brazil; (T.P.C.A.); (F.G.J.); (L.C.d.A.)
| | - Fernanda Golçalves Jardim
- Public Policy and Local Development Department, Superior School of Sciences of the Santa Casa de Misericórdia de Vitória, Vitória 29045-402, Espirito Santo, Brazil; (T.P.C.A.); (F.G.J.); (L.C.d.A.)
| | | | - Luiz Carlos de Abreu
- Public Policy and Local Development Department, Superior School of Sciences of the Santa Casa de Misericórdia de Vitória, Vitória 29045-402, Espirito Santo, Brazil; (T.P.C.A.); (F.G.J.); (L.C.d.A.)
- Department of Preventive Medicine, Federal University of Espirito Santo, Vitória 29075-910, Espírito Santo, Brazil;
| | - Italla Maria Pinheiro Bezerra
- Public Policy and Local Development Department, Superior School of Sciences of the Santa Casa de Misericórdia de Vitória, Vitória 29045-402, Espirito Santo, Brazil; (T.P.C.A.); (F.G.J.); (L.C.d.A.)
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Yavari S, Vahidi M, Namdar Areshtanab H, Lotfi M, Jafarzadeh Kohneloo A. The Perceived Informational Needs of Family Caregivers of Children Hospitalized in a Burn Department: A Cross-sectional Study. J Burn Care Res 2024; 45:692-699. [PMID: 38315624 DOI: 10.1093/jbcr/irae016] [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: 07/26/2023] [Indexed: 02/07/2024]
Abstract
Children are most vulnerable to burn injuries, and their families are their most important source of support. Therefore, it is necessary to identify the information needs of such parents and support them to help children adapt to the new situation, recover to pre-accident conditions, and reintegrate into school and society. This study aimed to investigate the perceived information needs of family caregivers of children admitted to the burn wards of hospitals. This cross-sectional study was conducted on 200 family caregivers of children admitted to the burn ward of a hospital in Tabriz, Iran. Participants were selected through convenience sampling, and the required data were collected by using questionnaires on socio-demographic information, information needs, information resources, and information acquisition methods. The obtained data were analyzed statistically using descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistics (Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests). Results indicated that the greatest informational need among family caregivers was related to the child's condition. The treatment team was identified as the most important source of information for them. It was found that information should be provided in a comprehensive and understandable manner, while maintaining honesty and human dignity. The study findings contribute to our understanding of the specific information needs of family caregivers in managing the medical care of children with burns. These findings can serve as a basis for interventions and support services aimed at meeting the needs of these families and improving the quality of care for children with burns.
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Affiliation(s)
- Sima Yavari
- Department of Mental Health and Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Maryam Vahidi
- Department of Pediatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Hossein Namdar Areshtanab
- Department of Mental Health and Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Mojgan Lotfi
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Aarefeh Jafarzadeh Kohneloo
- Department of Biostatistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz 5165665931, Iran
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Earwaker M, Anderson N, Egli V. Developing nursing interventions in Paediatric Emergence Delirium: a scoping review. Contemp Nurse 2024; 60:82-95. [PMID: 38427706 DOI: 10.1080/10376178.2024.2319852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Children who experience Emergence Delirium following an anaesthetic are at an increased risk of injury, harm to the surgical site, delayed discharge from the recovery room/ post anaesthetic care unit, an increased length of stay in hospital, the requirement of additional nursing staff to care for them and may display additional emotional and behavioural upsets in the weeks following surgery. Many factors have been postulated to be associated with the development of Emergence Delirium in children. However, to date the strength and nature of these associations has not been thoroughly investigated nor discussed considering the specific implications for contemporary nursing practice. AIM The aim of this scoping review is to provide an overview of Emergence Delirium in children, and a critical synthesis of evidence informing development of nursing interventions to prevent or minimise paediatric Emergence Delirium. METHODS This scoping review was conducted guided by the PRISMA checklist. 14 peer-reviewed studies and guidelines published between 2000 and 2020 on Emergence Delirium in children and nursing practice were included in the deductive thematic analysis stage. RESULTS The results found the anxiety of the child, the post-operative phase, continuity of care and medication administration were key themes in the nursing management of Emergence Delirium. CONCLUSION There is opportunity for further research to be conducted on child Emergence Delirium in different hospital systems with further exploration of nurse-led interventions.
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Affiliation(s)
- M Earwaker
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
| | - N Anderson
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
| | - V Egli
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
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Carew M, Redley B, Bloomer MJ. Competing Tensions: Nurse Perceptions of Family-Centered Care and Parents' Needs in Neonatal Care. Adv Neonatal Care 2024; 24:35-42. [PMID: 38193725 DOI: 10.1097/anc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Family-centered care is founded upon collaboration between parents and healthcare professionals, caring for a child and parents as one entity. The unfamiliar neonatal environment and complexity of care can make family-centered care challenging. PURPOSE To explore neonatal nurses' perceptions of family-centered care and parents' cultural needs. METHODS This was a qualitative descriptive study using interviews to gather data from registered nurses, and analyzed using inductive content analysis. RESULTS Ten neonatal nurses participated in online interviews, lasting an average of 25 minutes. Parents' cultural needs were poorly understood and assumed synonymous with family-centered care. While all acknowledged the importance of family-centered care, most described tasks to parent-infant bonding, rather than a broader embodiment of family-centered care. In time of uncertainty, emergent clinical priorities took priority over a family-centered approach to care. Cultural care was poorly understood, and care tasks associated with supporting parent-infant bonding suggest further work is necessary to promote embodiment of family-centered care beyond individual tasks. While emergent clinical priorities and neonate well-being will always be the priority, finding a way to respond that concords with the ethos of family-centered care is also essential. IMPLICATIONS FOR PRACTICE AND RESEARCH Clear and consistent leadership is needed to demonstrate greater embodiment of family-centered care, which includes cultural care for parents. Strong leadership and targeted education are key to supporting this change. Further research is warranted to examine and observe practice, in particular how parents' cultural needs are assessed and integrated into family-centered care in neonatal settings.
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Affiliation(s)
- Maddison Carew
- Maternity Unit, Bass Coast Health, Wonthaggi, Victoria, Australia (Ms Carew); School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia (Ms Carew and Prof Redley); Health Complaints Commissioner, Melbourne, Victoria, 3000, Australia (Prof Redley); and School of Nursing and Midwifery, Griffith University, Nathan, Queensland, and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, and Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia (Prof Bloomer)
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Ghavi A, Hassankhani H, Powers K, Sawyer A, Karimi B, Kharidar M. Parental supporter during pediatric resuscitation: Qualitative exploration of caregivers' and healthcare professionals' experiences and perceptions. Int Emerg Nurs 2024; 72:101381. [PMID: 38086282 DOI: 10.1016/j.ienj.2023.101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 10/07/2023] [Accepted: 10/25/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Child resuscitation is a critical and stressful time for family caregivers and healthcare professionals. The aim of this study was to explore caregivers' and healthcare professionals' experiences and perceptions of a parental supporter during pediatric cardiopulmonary resuscitation to provide guidance to healthcare professionals on supporting parents and other family caregivers during resuscitation. METHODS This study used an exploratory descriptive qualitative approach. The setting was two large referral pediatric governmental hospitals. Participants were 17 caregivers who had experienced their child's resuscitation, and 13 healthcare professionals who served on resuscitation teams in emergency rooms or intensive care wards. Semi-structured, in-depth interviews were conducted and data were analyzed using thematic analysis. COREQ guidelines were followed. RESULTS Participants shared their experiences and perceptions of a parental supporter during pediatric resuscitation in three themes: 1) Requirement for the presence of a parental supporter, 2) Expectations of the parental supporter, and 3) Characteristics of the parental supporter. CONCLUSIONS Study findings highlight the need for a parental supporter during pediatric resuscitation; however, there is no defined parental supporter role in current guiding policies due to limited research on this role. More research on the parental supporter role is needed so effective policies and protocols can be developed to enhance family-centered care practices in pediatric emergency and acute care settings.
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Affiliation(s)
- Arezoo Ghavi
- Department of Pediatric Nursing, Ferdows Branch, Islamic Azad University, Ferdows, Iran.
| | - Hadi Hassankhani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kelly Powers
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Alexandra Sawyer
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Babak Karimi
- Department of Pediatrics, Fellowship in PICU, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masume Kharidar
- Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran
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Zali M, Rahmani A, Powers K, Hassankhani H, Namdar‐Areshtanab H, Gilani N. Nurses' experiences of provision family-centred care in the postresuscitation period: A qualitative study. Nurs Open 2023; 10:7215-7223. [PMID: 37608460 PMCID: PMC10563420 DOI: 10.1002/nop2.1974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/14/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
AIM This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period. DESIGN An exploratory-descriptive qualitative design was used. METHODS In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. RESULTS Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. CONCLUSION Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses. IMPLICATIONS FOR THE PROFESSION Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mahnaz Zali
- Department of Medical‐Surgical, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Azad Rahmani
- Department of Medical Surgical Nursing, Faculty of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Kelly Powers
- School of NursingUniversity of North Carolina at CharlotteCharlotteNorth CarolinaUSA
| | - Hadi Hassankhani
- Department of Medical‐Surgical, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Hossein Namdar‐Areshtanab
- Department of Psychology Nursing, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of HealthTabriz University of Medical SciencesTabrizIran
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Phiri PGMC, Chan CWH, Wong CL, Cheung AT, Shah S, Daradkeh FAK. The moderating effects of nurses' background characteristics on the relationship between family-centred care perception and practice for hospitalized children and their families in Malawi. J Pediatr Nurs 2023; 73:169-176. [PMID: 37696168 DOI: 10.1016/j.pedn.2023.09.004] [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: 03/20/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE Globally, limited information is available on the relationship between the perception and practice of family-centered care (FCC), and the moderating effects of nurses' background characteristics on this relationship. This study investigated the relationship between FCC perception and FCC practice and the moderating effects of the nurses' background characteristics on this relationship. DESIGN AND METHODS A cross-sectional study was conducted using a two-stage stratified sampling method. Data were collected from 444 nurses using the Family Centered Care Questionnaire-Revised and analyzed using IBM SPSS Version 25. The Hayes PROCESS macro model, version 3, was integrated into SPSS to examine the moderating effects at a significance level of 0.05. RESULTS The response rate was 98%, and a statistically significant positive association was found between FCC perception and FCC practice (r = 0.353, p < .001). Gender of a nurse (ΔR2 = 0.0206, p < .002), having children (ΔR2 = 0.0231, p < .001), experience (ΔR2 = 0.0107, p = .028), and working in a medical-surgical ward (ΔR2 = 0.0208, p = .008) had a statistically significant moderating effect on the relationship between FCC perception and FCC practice. CONCLUSION These findings provide minimal evidence of the existence of non-modifiable moderators of FCC. Future studies with modifiable moderators are therefore needed. PRACTICE IMPLICATIONS Understanding the moderating effects of nurses' background characteristics on the relationship between FCC perception and FCC practice may facilitate the development of FCC interventions that favor these background characteristics and facilitate the integration of FCC into routine policies and practices.
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Affiliation(s)
- Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Ankie T Cheung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Suleman Shah
- Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates
| | - Fares Ahmad Khalil Daradkeh
- Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates
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Chung NR, Chae SM. Mothering children at a paediatric intensive care unit with strict visiting hours: A qualitative study. Nurs Crit Care 2023. [PMID: 37818784 DOI: 10.1111/nicc.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Although a child- and family-centred care (CFCC) philosophy has been emphasized and adopted for decades in paediatric critical care settings in several countries, numerous issues from parents' perspectives regarding the philosophy remain unresolved. To facilitate the full translation of CFCC into clinical practice, health care professionals need an in-depth understanding of family experiences. Real-life mothering experiences, including maternal roles and identities, remain largely unknown at paediatric intensive care units (PICUs) in the Republic of Korea, where family visitation, presence, and participation are restricted. AIM To explore mothering experiences at a PICU where family visitation is strictly constrained, and to identify maternal needs and values. STUDY DESIGN We conducted a qualitative descriptive study of eight individual in-depth interviews with seven mothers of hospitalized children. Qualitative data were analysed using inductive thematic analysis. FINDINGS Five major themes, along with four subthemes, emerged: (1) shifts in maternal roles and responsibilities, (2) shifts in interpersonal relationships, (3) desire for CFCC in the PICU, (4) practising self-defined mothering roles, and (5) reconstructing maternal identities. The themes revealed the experiences of becoming mothers of a child in a constrained PICU. Ultimately, mothers demanded that the unit improve its physical and cultural environments through, for example, liberalized family visitation and participation in the care of their children. CONCLUSIONS Nursing professionals should lead the charge for humanizing a restrictive PICU in the Republic of Korea by ensuring a safe and open environment and mothering continuity based on child- and family-centred holistic care. RELEVANCE TO CLINICAL PRACTICE Effective interventions must be developed and tested to globally establish and fully implement strong evidence-based CFCC in PICUs; constant co-commitment among children, families, health care professionals, and institutions is also necessary.
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Affiliation(s)
- Na-Ry Chung
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun-Mi Chae
- Seoul National University College of Nursing, The Research Institute of Nursing Science, Seoul, Republic of Korea
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Ghavi A, Hassankhani H, Powers K. Resuscitation Team Members' Perceptions of Supporting Parents During Cardiopulmonary Resuscitation of Children: A Systematic Review. Dimens Crit Care Nurs 2023; 42:263-276. [PMID: 37523726 DOI: 10.1097/dcc.0000000000000597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Supporting parents is a crucial part of family-centered care in pediatric and neonate resuscitation. OBJECTIVES The aim of this systematic review was to appraise and synthesize studies conducted to determine resuscitation team members' perspectives of support for parents during pediatric and neonate resuscitation. METHODS The PRISMA model guided the systematic literature search of Google Scholar, PubMed, MEDLINE, CINAHL, Cochrane, and Scopus for studies published until May 2022. The authors independently screened all titles, abstracts, and full-text articles for eligibility. There was agreement about screened articles for inclusion. Full texts of all potentially relevant studies were evaluated for the rigor of the study design, sample, and analysis. This review included quantitative, qualitative, and mixed-methods studies. The quality of evidence across the included studies was assessed using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool as part of GRADE's (Recommendations Assessment, Development, and Evaluations) certainty rating process. RESULTS There were 978 articles located. After reviewing for relevancy, 141 full-text articles were assessed, and 13 articles met criteria and were included in this review (4 quantitative, 7 qualitative, and 2 mixed-methods design). Five themes were revealed to summarize resuscitation team members' perspectives of parental support in pediatric resuscitation: providing information to parents, family facilitator, emotional support, presence of parents during resuscitation, and spiritual and religious support. CONCLUSIONS The results of this systematic review can be used to improve support for parents by informing the education of resuscitation team members and clarifying policies and guidelines of resuscitation team roles to include support for parents.
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Wong CL, Phiri PGMC, Chan CWH, Tse M. Nurses' and Families' perceptions and practices and factors influencing the implementation of family-centred care for hospitalised children and their families. J Clin Nurs 2023; 32:6662-6676. [PMID: 37097007 DOI: 10.1111/jocn.16740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/26/2023]
Abstract
AIMS AND OBJECTIVES To explore the perceptions of family-centred care among nurses and the family members of hospitalised children and investigate the facilitators of and barriers to the implementation of family-centred care in Malawi. BACKGROUND In Malawi, approximately 34% of children have long-term illnesses that require hospitalisation. Family-centred care ensures that the delivery of healthcare is grounded in partnerships between healthcare providers, patients and their families, which can improve the psychological well-being of families. However, there is lack a good understanding of how families and nurses perceive this concept, its facilitators and the barriers. DESIGN This was an exploratory qualitative study. Data were analysed deductively and inductively using the five-step qualitative content analysis method. METHODS Twenty-nine nurses and 31 families were recruited. Data were collected through in-depth, semi-structured and face-to-face individual interviews. The study was reported using the COREQ checklist. RESULTS Both nurses and families of hospitalised children recognised the importance of nurse-family partnerships in family-centred care. Four themes emerged as follows: Perceptions of family-centred care, elements of family-centred care, facilitators of family-centred care and barriers to family-centred care. Specific information to families and the religious beliefs of families were identified as important facilitator and barrier to family-centred care, respectively. CONCLUSION The implementation of family-centred care is promising in Malawi, as it is positively perceived by nurses and families, and its implementation is consistent with the Institute for Patient and Family-Centred Care Framework. RELEVANCE TO CLINICAL PRACTICE Our findings present the best practices, gaps and challenges in the context of a low-income country regrading implementation of family-centred care. Education programmes on family-centred care are crucial for sustaining the current gains.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Applied Technoly, Fatima College of Health Sciences, Al Ain, Abu Dhabi, United Arab Emirates
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mankei Tse
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Neshat H, Hassankhani H, Negarandeh R, Jabraeili M, Hosseini MB, Mahallei M. Care providers' experiences regarding barriers to maternal participation in neonatal pain management. Nurs Crit Care 2023; 28:245-252. [PMID: 35789147 DOI: 10.1111/nicc.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/03/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mothers' involvement in the pain management of infants admitted to the intensive care unit can alleviate the infants' pain. Despite International guidelines, maternal involvement in neonatal pain management is low. Hence, investigating the perspectives of care providers (CPs) on barriers to maternal participation can be helpful in developing practice guidelines. AIMS The purpose of this study was to investigate the experiences of CPs on barriers to maternal involvement in neonatal pain management in the intensive care unit. DESIGN In this study, a qualitative design based on the content analysis approach was used. METHOD We included 24 nurses and physicians in the neonatal intensive care unit from February to September 2020. Data were collected through conducting 11 individual interviews and two focus group discussions with eight and five participants, respectively. RESULTS Three main categories and seven sub-categories were found, including maternal barriers (inadequate emotional readiness and unfamiliarity with role), CPs' barriers (time pressure, fear of family-care provider tension, and insufficient knowledge), and organizational barriers (neglected joint decision-making and restricted organizational participative policies). CONCLUSIONS The identified barriers could be classified into those related to mothers, care providers, and organizations. The lack of appropriate interaction and cooperation between parents and care-providers can affect the emergence of barriers related to the mothers and staff. RELEVANCE TO CLINICAL PRACTICE There is a lack of knowledge regarding neonatal pain management in the health care team and mothers. Educating mothers and CPs about the benefits and ways of mothers' participation can increase readiness and capabilities. Providing clear guidelines about family-centred care and promoting parent-CPs' interactions can increase the mothers' participation.
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Affiliation(s)
- Hanieh Neshat
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Hassankhani
- Emergency & Trauma Care Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Jabraeili
- Department of Pediatrics, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Majid Mahallei
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Brunt J, Alnababtah K. The experiences of parents witnessing their child's resuscitation in hospital. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:136-142. [PMID: 36763475 DOI: 10.12968/bjon.2023.32.3.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The purpose of this literature review is to explore parents' experiences of witnessing their child being resuscitated in hospital settings. METHODS An integrative literature review using the databases CINAHL, PubMed and PsycInfo to retrieve articles published between 2011 and 2021 on parent-witnessed resuscitation. RESULTS This review found strong evidence of the benefit of parents being present during their child's resuscitation, with three common themes emerging: need to be present, communication and seeing to believe. Parents and the healthcare team benefit from being present, and parents feel they have more positive experiences when they are allowed to choose their level of presence. CONCLUSION The benefits of parental witnessed resuscitation are shown throughout the review, however, this may not always be adopted in practice. Hospital policies or resuscitation training do not cover parent-witnessed resuscitation, therefore implementation of mandatory hospital policy regarding this issue should be introduced to practice to create continuity of high-quality care.
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Affiliation(s)
- Jessica Brunt
- Staff Nurse, Paediatric Intensive Care Unit, Birmingham Children's Hospital, Birmingham
| | - Kal Alnababtah
- Senior Lecturer, Birmingham City University, City South Campus, Birmingham
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Tenfelde K, Antheunis M, Krahmer E, Bunt JE. Using Digital Communication Technology to Improve Neonatal Care: Two-Part Explorative Needs Assessment. JMIR Pediatr Parent 2023; 6:e38435. [PMID: 36749606 PMCID: PMC9944133 DOI: 10.2196/38435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The birth of a premature infant and subsequent hospitalization are stressful events for parents. Therefore, accurate and easy-to-understand communication between parents and health care professionals is crucial during this period. Mobile health (mHealth) technologies have the potential to improve communication with parents at any time and place and possibly reduce their stress. OBJECTIVE We aimed to conduct a 2-part explorative needs assessment in which the interaction between the pediatrician and parents was examined along with their digital communication technology needs and interest in an mHealth app with the aim of improving interpersonal communication and information exchange. METHODS Overall, 19 consultations between parents of preterm infants and pediatricians were observed to determine which themes are discussed the most and the number of questions asked. Afterward, the parents and the pediatrician were interviewed to evaluate the process of communication and gauge their ideas about a neonatal communication mHealth app. RESULTS The observations revealed the following most prevalent themes: breastfeeding, criteria for discharge, medication, and parents' personal life. Interview data showed that the parents were satisfied with the communication with their pediatrician. Furthermore, both parents and pediatricians expected that a neonatal mHealth app could further improve the communication process and the hospital stay. Parents valued app features such as asking questions, growth graphs, a diary function, hospital-specific information, and medical rounds reports. CONCLUSIONS Both parents of hospitalized preterm infants and pediatricians expect that the hypothetical mHealth app has the potential to cater to the most prevalent themes and improve communication and information exchange. Recommendations for developing such an app and its possible features are also discussed. On the basis of these promising results, it is suggested to further develop and study the effects of the mHealth app together with all stakeholders.
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Affiliation(s)
- Kim Tenfelde
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Marjolijn Antheunis
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Jan Erik Bunt
- Department of Pediatrics, Elisabeth-Tweesteden Ziekenhuis, Tilburg, Netherlands
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Jarvis JM, Huntington T, Perry G, Zickmund S, Yang S, Galyean P, Pinto N, Watson RS, Olson LM, Fink EL, Maddux AB. Supporting families during pediatric critical illness: Opportunities identified in a multicenter, qualitative study. J Child Health Care 2023:13674935231154829. [PMID: 36749657 PMCID: PMC10404638 DOI: 10.1177/13674935231154829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Critical illness resulting in a pediatric intensive care unit (PICU) admission is a profoundly stressful experience for a child and their family. Increasing evidence for emotional and behavioral sequelae post-PICU emphasizes a need to provide better support for families throughout this period of care and recovery. The aim of this qualitative investigation was to identify salient and modifiable aspects of a critical care experience that can be addressed to better support families of critically ill children. Individual semi-structured interviews were conducted with 26 caregivers of children who survived a PICU admission. Interviews were audio-recorded and transcribed verbatim; themes were identified via thematic analysis. Caregivers were enrolled using convenience sampling from seven tertiary care PICUs in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Themes from caregiver interviews were identified within two overarching categories containing three themes each. Advice for future PICU families: (1) Be intentional about caring for your own well-being, (2) speak up, ask questions, and challenge decisions you're not comfortable with, and (3) continue to engage with your child. Characteristics of a satisfactory PICU experience: (1) A caregiver-provider relationship of mutual trust established through clear communication and respectful collaboration, (2) hospital environments that provide physical and social supports to maintain humanity in healthcare, and (3) preparing families for care transitions. Targeted, interdisciplinary approaches to partner with families during critical care may improve their PICU experience and contribute to improved long-term outcomes for PICU survivors.
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Affiliation(s)
- Jessica M Jarvis
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Taylor Huntington
- Department of Critical Care Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Grace Perry
- Department of Pediatrics, Pediatric Hospital Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Susan Zickmund
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Serena Yang
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Patrick Galyean
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Neethi Pinto
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - R. Scott Watson
- Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA and Center for Child Health, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Lenora M Olson
- Department of Pediatrics, Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
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16
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The uses of Patient Reported Experience Measures in health systems: A systematic narrative review. Health Policy 2023; 128:1-10. [PMID: 35934546 DOI: 10.1016/j.healthpol.2022.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 05/25/2022] [Accepted: 07/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Many governments have programmes collecting and reporting patient experience data, captured through Patient Reported Experience Measures (PREMs). Our study aims to capture and describe all the ways in which PREM data are used within healthcare systems, and explore the impacts of using PREMs at one level (e.g. national health system strategy) on other levels (e.g. providers). METHODS We conducted a narrative review, underpinned by a systematic search of the literature. RESULTS 1,711 unique entries were identified through the search process. After abstract screening, 142 articles were reviewed in full, resulting in 28 for final inclusion. A majority of papers describe uses of PREMs at the micro level, focussed on improving quality of front-line care. Meso-level uses were in quality-based financing or for performance improvement. Few macro-level uses were identified. We found limited evidence of the impact of meso‑ and macro- efforts to stimulate action to improve patient experience at the micro-level. CONCLUSIONS PREM data are used as performance information at all levels in health systems. The use of PREM data at macro- and meso‑ levels may have an effect in stimulating action at the micro-level, but there is a lack of systematic evidence, or evaluation of these micro-level actions. Longitudinal studies would help better understand how to improve patient experience, and interfaces between PREM scores and the wider associated positive outcomes.
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Çınar Özbay S, Özbay Ö, Boztepe H. Integrating Family-Centered Care to Child Health and Diseases Nursing Course via Distance Education. Compr Child Adolesc Nurs 2023; 46:83-97. [PMID: 36669153 DOI: 10.1080/24694193.2023.2166159] [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: 01/22/2023]
Abstract
The aim of this study was to determine the impact of an online Child Health and Diseases Nursing course emphasizing family-centered care upon the perceptions of nursing students toward family-centered care. A one-group pretest-posttest model was used in this study. The research participants consisted of 88 students studying at X University, Faculty of Health Sciences, Department of Nursing. While 67.1% of the students stated that there were obstacles in implementing family-centered care, 73.9% stated that there were no facilitating elements in implementing of family-centered care. A statistically significant difference was found between the mean scores of the students' posttest family-centered care attitude and parents' attitude at the end of the training. This study provides insights into family-centered care, which could be used in crafting policies and interventions in nursing education in Turkey. Such insights could foster positive perceptions of family-centered care among student nurses.
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Affiliation(s)
| | - Özkan Özbay
- Distance Education Application and Research Center, Artvin Coruh University, Artvin, Turkey
| | - Handan Boztepe
- Department of Nursing, Faculty of Health Sciences, Atilim University, Ankara, Turkey
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18
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Gupta D, October TW, Wolfe AHJ. Characteristics of Prognostic Statements During Family Conferences of Critically Ill Children. Pediatr Crit Care Med 2023; 24:34-40. [PMID: 36594798 DOI: 10.1097/pcc.0000000000003116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Discussion of prognosis is an essential component of decision-making family conferences in critical care. We do not know how clinicians convey prognosis to families of critically ill children. We, therefore, aimed to evaluate the frequency of prognostic statements and the message and meaning conveyed through each statement during PICU family conferences. DESIGN Retrospective, mixed-methods study. SETTING PICU of a single quaternary medical center. PATIENTS Critically ill children and their families participating in PICU family conferences of critical medical decision-making. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We analyzed 72 transcripts from audio-recorded PICU family conferences to identify prognostic statements. Descriptive, thematic content analysis was used to elucidate the message and meaning of each prognostic statement. Prognosis was not discussed in 26% (19/72) of family conferences. Of the other (53/72) conferences where prognostic statements were made, 60% (67/112) of statements conveyed a message (i.e., prognostic medical information) and a meaning (i.e., anticipated impact on patient/family). "Messages" of prognostic statements fell within eight themes: uncertain recovery, delayed recovery, progressive decline, escalation of support, attributable complications, no progress, irreversible, and probability of death. "Meanings" of prognostic statements fell within six themes: restoration of health, activities of daily living, additional equipment, prolonged care needs, brain dysfunction, and death. Broadly, clinicians discussed prognostic information in three categories: loss of Time (i.e., prolonged care needs), Function (i.e., additional medical equipment), or Cure (i.e., death). CONCLUSIONS Nearly in half of discussions (32/72, 44%) where families were asked to make critical medical decisions, clinicians did not provide a prognostic statement including a message and meaning. When discussed, prognostic information was conveyed in three categories: loss of time, function, or cure. Providing families context in this framework, particularly in times of uncertainty, may improve the family's ability to make informed, value-driven medical decisions for their child.
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Affiliation(s)
- Divya Gupta
- Department of Critical Care Medicine, Children's National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Tessie W October
- Department of Critical Care Medicine, Children's National Hospital, Washington, DC
| | - Amy H J Wolfe
- Department of Critical Care Medicine, Children's National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
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Milési C, Baudin F, Durand P, Emeriaud G, Essouri S, Pouyau R, Baleine J, Beldjilali S, Bordessoule A, Breinig S, Demaret P, Desprez P, Gaillard-Leroux B, Guichoux J, Guilbert AS, Guillot C, Jean S, Levy M, Noizet-Yverneau O, Rambaud J, Recher M, Reynaud S, Valla F, Radoui K, Faure MA, Ferraro G, Mortamet G. Clinical practice guidelines: management of severe bronchiolitis in infants under 12 months old admitted to a pediatric critical care unit. Intensive Care Med 2023; 49:5-25. [PMID: 36592200 DOI: 10.1007/s00134-022-06918-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/13/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE We present guidelines for the management of infants under 12 months of age with severe bronchiolitis with the aim of creating a series of pragmatic recommendations for a patient subgroup that is poorly individualized in national and international guidelines. METHODS Twenty-five French-speaking experts, all members of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French-speaking group of paediatric intensive and emergency care; GFRUP) (Algeria, Belgium, Canada, France, Switzerland), collaborated from 2021 to 2022 through teleconferences and face-to-face meetings. The guidelines cover five areas: (1) criteria for admission to a pediatric critical care unit, (2) environment and monitoring, (3) feeding and hydration, (4) ventilatory support and (5) adjuvant therapies. The questions were written in the Patient-Intervention-Comparison-Outcome (PICO) format. An extensive Anglophone and Francophone literature search indexed in the MEDLINE database via PubMed, Web of Science, Cochrane and Embase was performed using pre-established keywords. The texts were analyzed and classified according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. When this method did not apply, an expert opinion was given. Each of these recommendations was voted on by all the experts according to the Delphi methodology. RESULTS This group proposes 40 recommendations. The GRADE methodology could be applied for 17 of them (3 strong, 14 conditional) and an expert opinion was given for the remaining 23. All received strong approval during the first round of voting. CONCLUSION These guidelines cover the different aspects in the management of severe bronchiolitis in infants admitted to pediatric critical care units. Compared to the different ways to manage patients with severe bronchiolitis described in the literature, our original work proposes an overall less invasive approach in terms of monitoring and treatment.
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Affiliation(s)
- Christophe Milési
- Pediatric Intensive Care Unit, Montpellier University Hospital, Montpellier, France.
| | - Florent Baudin
- Pediatric Intensive Care Unit, Lyon Hospital Femme-Mère-Enfants, Bron, France
| | - Philippe Durand
- Pediatric Intensive Care Unit, Bicêtre Hospital, Assistance Publique des Hôpitaux de Paris, Kremlin-Bicêtre, France
| | - Guillaume Emeriaud
- Pediatric Intensive Care Unit, Sainte-Justine University Hospital, Montreal, Canada
| | - Sandrine Essouri
- Pediatric Department, Sainte-Justine University Hospital, Montreal, Canada
| | - Robin Pouyau
- Pediatric Intensive Care Unit, Lyon Hospital Femme-Mère-Enfants, Bron, France
| | - Julien Baleine
- Pediatric Intensive Care Unit, Montpellier University Hospital, Montpellier, France
| | - Sophie Beldjilali
- Pediatric Intensive Care Unit, La Timone University Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Alice Bordessoule
- Pediatric Intensive Care Unit, Geneva University Hospital, Geneva, Switzerland
| | - Sophie Breinig
- Pediatric Intensive Care Unit, Toulouse University Hospital, Toulouse, France
| | - Pierre Demaret
- Intensive Care Unit, Liège University Hospital, Liège, Belgium
| | - Philippe Desprez
- Pediatric Intensive Care Unit, Point-à-Pitre University Hospital, Point-à-Pitre, France
| | | | - Julie Guichoux
- Pediatric Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France
| | - Anne-Sophie Guilbert
- Pediatric Intensive Care Unit, Strasbourg University Hospital, Strasbourg, France
| | - Camille Guillot
- Pediatric Intensive Care Unit, Lille University Hospital, Lille, France
| | - Sandrine Jean
- Pediatric Intensive Care Unit, Trousseau Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Michael Levy
- Pediatric Intensive Care Unit, Robert Debré Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | | | - Jérôme Rambaud
- Pediatric Intensive Care Unit, Trousseau Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Morgan Recher
- Pediatric Intensive Care Unit, Lille University Hospital, Lille, France
| | - Stéphanie Reynaud
- Pediatric Intensive Care Unit, Lyon Hospital Femme-Mère-Enfants, Bron, France
| | - Fréderic Valla
- Pediatric Intensive Care Unit, Lyon Hospital Femme-Mère-Enfants, Bron, France
| | - Karim Radoui
- Pneumology EHS Pediatric Department, Faculté de Médecine d'Oran, Canastel, Oran, Algeria
| | | | - Guillaume Ferraro
- Pediatric Emergency Department, Nice University Hospital, Nice, France
| | - Guillaume Mortamet
- Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France
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Lyu Y, Xu Q, Yang Z, Liu J. Prediction of patient choice tendency in medical decision-making based on machine learning algorithm. Front Public Health 2023; 11:1087358. [PMID: 36908484 PMCID: PMC9998498 DOI: 10.3389/fpubh.2023.1087358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
Objective Machine learning (ML) algorithms, as an early branch of artificial intelligence technology, can effectively simulate human behavior by training on data from the training set. Machine learning algorithms were used in this study to predict patient choice tendencies in medical decision-making. Its goal was to help physicians understand patient preferences and to serve as a resource for the development of decision-making schemes in clinical treatment. As a result, physicians and patients can have better conversations at lower expenses, leading to better medical decisions. Method Patient medical decision-making tendencies were predicted by primary survey data obtained from 248 participants at third-level grade-A hospitals in China. Specifically, 12 predictor variables were set according to the literature review, and four types of outcome variables were set based on the optimization principle of clinical diagnosis and treatment. That is, the patient's medical decision-making tendency, which is classified as treatment effect, treatment cost, treatment side effect, and treatment experience. In conjunction with the study's data characteristics, three ML classification algorithms, decision tree (DT), k-nearest neighbor (KNN), and support vector machine (SVM), were used to predict patients' medical decision-making tendency, and the performance of the three types of algorithms was compared. Results The accuracy of the DT algorithm for predicting patients' choice tendency in medical decision making is 80% for treatment effect, 60% for treatment cost, 56% for treatment side effects, and 60% for treatment experience, followed by the KNN algorithm at 78%, 66%, 74%, 84%, and the SVM algorithm at 82%, 76%, 80%, 94%. At the same time, the comprehensive evaluation index F1-score of the DT algorithm are 0.80, 0.61, 0.58, 0.60, the KNN algorithm are 0.75, 0.65, 0.71, 0.84, and the SVM algorithm are 0.81, 0.74, 0.73, 0.94. Conclusion Among the three ML classification algorithms, SVM has the highest accuracy and the best performance. Therefore, the prediction results have certain reference values and guiding significance for physicians to formulate clinical treatment plans. The research results are helpful to promote the development and application of a patient-centered medical decision assistance system, to resolve the conflict of interests between physicians and patients and assist them to realize scientific decision-making.
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Affiliation(s)
- Yuwen Lyu
- Institute of Humanities and Social Sciences, Guangzhou Medical University, Guangzhou, China
| | - Qian Xu
- School of Health Management, Guangzhou Medical University, Guangzhou, China
| | - Zhenchao Yang
- The Eighth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junrong Liu
- Institute of Humanities and Social Sciences, Guangzhou Medical University, Guangzhou, China
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Cardoso SB, Oliveira ICDS, Souza TVD, Carmo SAD, Nascimento LDCN. Transformações da ambiência de Unidades de Terapia Intensiva Pediátrica na perspectiva dos enfermeiros. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.40562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: analisar o discurso dos enfermeiros acerca da ambiência da Unidade de Terapia Intensiva Pediátrica - UTIP e suas transformações com a presença do familiar/acompanhante. Método: pesquisa qualitativa, realizada por meio de um questionário com 28 enfermeiros de 3 UTIPs. Foi utilizado o software Iramuteq para o processamento dos dados. Para a análise, realizaram-se a Classificação Hierárquica Descendente e a análise temática. Resultados: os enfermeiros mencionaram a importância da ambiência da unidade e a necessidade da permanência do familiar. Entretanto, eles afirmam que o espaço físico não é apropriado para essa permanência. Ademais, a UTIP foi caracterizada como estressante, principalmente em relação à iluminação, aos ruídos, à temperatura e à falta de espaços para descanso e refeições. Conclusões: a ambiência influencia na assistência prestada à criança e sua família na UTIP, assim como nas relações interpessoais dos enfermeiros, principalmente com os familiares. Por isso, é imprescindível a participação do enfermeiro no processo de planejamento e construção da unidade, tornando a ambiência da unidade uma ferramenta facilitadora de produção de saúde.
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Uhm JY, Choi MY. School Nurse-Parent Partnership in School Health Care for Children with Type 1 Diabetes: A Hybrid Method Concept Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:282-291. [PMID: 36375806 DOI: 10.1016/j.anr.2022.11.001] [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: 06/27/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To define school nurse-parent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model. METHODS This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling. Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived. RESULTS School nurse-parent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needs-this entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family. CONCLUSION The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Republic of Korea
| | - Mi-Young Choi
- Department of Nursing Science, Chungbuk National University, Republic of Korea.
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Yang ES, Oh SK, Kim S, Chung IJ. The influence of parent and peer disapproval on youth marijuana use mediated by youth risk perception: Focusing on the state comparison. Drug Alcohol Depend 2022; 240:109641. [PMID: 36179508 DOI: 10.1016/j.drugalcdep.2022.109641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevention of youth marijuana use has become a national priority in the United States. This study examined the influence of parent and peer disapproval on youth marijuana use, mediated by youth risk perception. Because the legal status of marijuana use can influence individual perceptions of the drug, this study investigated differences in the mediating mechanism between youth living in states with medical marijuana legalization (MML) and those living in non-MML states. METHODS The 2019 National Survey of Drug Use and Health was used with a youth population aged 12-17 years (N = 2293). Structural equation modeling and bias-corrected bootstrapping were used to examine hypothesized path models and to evaluate the mediating effect of youth risk perception. RESULT Findings demonstrated that parent and peer disapproval significantly increased youth risk perception of marijuana and reduced youth marijuana use. Second, youth risk perception significantly mediated the association between parent and peer disapproval and youth marijuana use. Third, parent disapproval had a more significant direct effect on youth marijuana use, while peer disapproval had a more significant indirect effect on youth marijuana use via youth risk perception. Finally, the results showed a similar pattern in the mechanism between youths living in MML states compared with those in non-MML states in terms of significance and direction. CONCLUSION The findings suggested a need for improvements in marijuana related policies for both MML and non-MML states. Moreover, parent and peer focused strategies for education and prevention concerning marijuana use among youth are emphasized.
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Affiliation(s)
- Eunbyeor Sophie Yang
- School of Social Work, Portland State University, 1800 SW 6th Ave, Portland, OR 97201, USA.
| | - Su-Kyung Oh
- Department of Social Welfare, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, the Republic of Korea.
| | - Seohyun Kim
- Department of Social Welfare, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, the Republic of Korea.
| | - Ick-Joong Chung
- Department of Social Welfare, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, the Republic of Korea.
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Hopes expressed in birth plans by women diagnosed with fetal anomalies: a qualitative study in Japan. BMC Pregnancy Childbirth 2022; 22:788. [PMID: 36274153 PMCID: PMC9588248 DOI: 10.1186/s12884-022-05115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Recent advances in prenatal screening and diagnosis have resulted in an increasing number of women receiving a diagnosis of fetal anomalies. In this study, we aimed to clarify the hopes for childbirth and parenting of women diagnosed with fetal anomalies and to suggest a family-centered care tailored for this situation in perinatal settings. Methods A descriptive qualitative study was performed. We recruited women diagnosed with fetal anomalies who were over 22 years old, beyond 22 weeks of gestation, and had scheduled pregnancy and delivery management at a tertiary perinatal medical center specializing in neonatal and pediatric care in a metropolitan area of Japan from April 2019 to December 2019. Women who were willing to participate received support from a midwife to create birth plans. Data were collected from the documented birth plans submitted by 24 women and analyzed using content analysis. Results We identified three themes of women’s hopes based on the descriptions of the submitted birth plans: (1) Hopes as women who are expecting childbirth, (2) Hopes as mothers of a baby, (3) Hopes of being involved in the family needs. Several distinctive hopes were clarified in the context of the women’s challenging situations. In describing their hopes, the women were neither overoptimistic or overstated their actual situations, nor caused embarrassment to the healthcare providers. The importance of supporting their involvement in baby matters in the way each family wants also emerged. However, several barriers to fulfilling the women’s hopes were identified including the babies’ conditions and hospital regulations against family visits or presence. Conclusion All three themes identified in the study provide important insights for analyzing more deeply ways of implementing a family-centered care for women diagnosed with fetal anomalies in perinatal settings. To improve women’s engagement in decision-making as a team member, women’s hopes should be treated with dignity and respect, and included in the perinatal care of women with abnormal fetuses. Further research is needed to improve the inclusion of women’s hopes in their care in clinical settings. Trial registration UMIN Clinical Trials Registry: UMIN000033622 (First registration date: 03/08/2018). Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05115-x.
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Cho-Hee K, Min-Sun K, Yi-Ji M, Hee-Young S, Myung-Nam L, Kyung-Ah K. Content Analysis of Multifaceted Needs for Improving the Quality of Pediatric Palliative Care Among Parents of Children With Life-threatening Conditions. J Hosp Palliat Nurs 2022; 24:00129191-990000000-00047. [PMID: 36253898 DOI: 10.1097/njh.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to identify parental needs for pediatric palliative care and obtain their opinions on developing pediatric palliative care in South Korea. This qualitative research design used inductive and deductive methods. The data were collected through semistructured interviews. A total of 6 parents actively caring for a child with life-threatening conditions and 7 bereaved parents participated in this study. A total of 707 significant statements, 43 subthemes, and 16 themes according to 6 structured matrices (advance care planning and symptom control, psychological and spiritual care, supporting everyday lives, end-of-life care and bereavement support, delivery model of pediatric palliative care, and unmet needs within current services) on the care and bereavement experiences of parents of children with life-threatening conditions were derived. Palliative care for children is a multidisciplinary approach to evaluate, prevent, and manage multifaceted symptoms and to support children with life-threatening conditions and their families. Our findings suggest that parents of children with life-threatening conditions in South Korea present multidimensional needs across the diagnostic groups and the illness trajectories and inform policy makers and health care professionals to design a pediatric palliative care delivery model. Further studies examining the unmet needs are required to enhance the quality of pediatric palliative care.
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Andrade RC, Leite ACAB, Alvarenga WDA, Neris RR, Araújo JS, Polita NB, Silva-Rodrigues FM, De Bortoli PS, Jacob E, Nascimento LC. Parental psychosocial needs in Brazilian paediatric intensive care units. Intensive Crit Care Nurs 2022; 72:103277. [PMID: 35672209 DOI: 10.1016/j.iccn.2022.103277] [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: 08/06/2021] [Revised: 04/30/2022] [Accepted: 05/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Having children admitted in the intensive care unit is a demanding experience for parents. They encounter several difficulties during this process, and it is important to properly identify their psychosocial needs for the health team to address appropriately. OBJECTIVE The aim of the study is to identify the psychosocial needs encountered by parents of children in pediatric intensive care units in Brazil. METHODS A descriptive study with a qualitative approach was used to increase understanding of psychosocial experiences of parents. Individual semi-structured interviews were conducted with 11 parents of hospitalized children in pediatric intensive care units in Brazil. Thematic analysis was used to analyze the data. The university ethics review committee approved the research protocol. All parents were informed on study details and provided written consent prior to the interview. RESULTS Four themes were constructed: 1) Support from family and peers; 2) Support from the healthcare team; 3) Parental role; and 4) Emotional recovery. Parents expressed diverse psychosocial needs based on family and peer social support, child's clinical condition, as well as the structure, norms, and routines of health care teams during hospitalization. CONCLUSIONS The findings highlight the importance of nursing assessment of psychosocial experiences encountered by parents of children in pediatric intensive care units, which will guide planning of individualized interventions and to increase family-centered care in pediatric intensive care units.
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Affiliation(s)
- Rosyan Carvalho Andrade
- Centro Universitário de Lavras, Rua Padre José Poggel, 506, Centenario, Lavras, Minas Gerais 37200-000, Brazil
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Av. dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | | | - Rhyquelle Rhibna Neris
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Av. dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Jeferson Santos Araújo
- Universidade Federal da Fronteira Sul, Av. Fernando Machado, 108E, Centro, Chapecó, Santa Catarina 89801-501, Brazil
| | - Naiara Barros Polita
- Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR-445, Km 380, Campus Universitário, Londrina, Paraná, Brazil
| | | | - Paula Saud De Bortoli
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Av. dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Eufemia Jacob
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Dr, Los Angeles, CA 90095, United States
| | - Lucila Castanheira Nascimento
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Av. dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil.
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O'Toole S, Suarez C, Adair P, McAleese A, Willis S, McCormack D. A Systematic Review of the Factors Associated with Post-Traumatic Growth in Parents Following Admission of Their Child to the Intensive Care Unit. J Clin Psychol Med Settings 2022; 29:509-537. [PMID: 35526209 PMCID: PMC9399044 DOI: 10.1007/s10880-022-09880-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 12/01/2022]
Abstract
This systematic review aims to identify the demographic, clinical and psychological factors associated with post-traumatic growth (PTG) in parents following their child's admission to the intensive care unit (ICU). Papers published up to September 2021 were identified following a search of electronic databases (PubMed, Medline, Web of Science, PsycINFO, CINAHL, PTSDpubs and EMBASE). Studies were included if they involved a sample of parents whose children were previously admitted to ICU and reported correlational data. 1777 papers were reviewed. Fourteen studies were eligible for inclusion; four were deemed to be of good methodological quality, two were poor, and the remaining eight studies were fair. Factors associated with PTG were identified. Mothers, and parents of older children, experienced greater PTG. Parents who perceived their child's illness as more severe had greater PTG. Strong associations were uncovered between PTG and post-traumatic stress, psychological well-being and coping. PTG is commonly experienced by this population. Psychological factors are more commonly associated with PTG in comparison with demographic and clinical factors, suggesting that parents' subjective ICU experience may be greater associated with PTG than the objective reality.
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Affiliation(s)
- S O'Toole
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK.
| | - C Suarez
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK
| | - P Adair
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK
| | - A McAleese
- Clinical Psychology Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - S Willis
- Clinical Psychology Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - D McCormack
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK
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Ghavi A, Hassankhani H, Powers K, Arshadi-Bostanabad M, Namdar-Areshtanab H, Heidarzadeh M. Parental support needs during pediatric resuscitation: A systematic review. Int Emerg Nurs 2022; 63:101173. [DOI: 10.1016/j.ienj.2022.101173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/05/2022]
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Chasweka G, Majamanda MD, Namathanga A. The Cry to Be Involved: Experiences of Caregivers on Participation in Decision Making and Care Provision at Mercy James PICU in Blantyre, Malawi. Compr Child Adolesc Nurs 2022; 46:20-32. [PMID: 36971888 DOI: 10.1080/24694193.2022.2085821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
A child's illness and admission in a hospital are stressful and can negatively affect the child and his/her caregivers. The stress is further exacerbated when a child is critically ill and has been admitted to an intensive care unit (ICU). The effects can be reduced when caregivers of the sick children are present and involved in decision making and actual care of their hospitalized children, a care model called family-centered care. Malawi has adopted family-centered care model in the newly instituted Mercy James Pediatric ICU. Little is known about experiences of caregivers with FCC in Malawi. This qualitative study was therefore conducted to explore experiences of caregivers on their involvement in decision making and care at Mercy James Pediatric ICU in Blantyre, Malawi. This was a descriptive qualitative study with a sample size of fifteen participants, however, data saturation was reached with ten participants. One on one in-depth interviews were conducted among a purposively selected sample of ten caregivers whose children had been discharged from the PICU. Content analysis was deductively and manually undertaken to analyze data with the aid of delve software to organize the data. Findings show that not every caregiver was involved in the decision making of their children's care, and if they did, it was not adequate. Barriers to effective involvement such as using a foreign language had a negative impact on comprehensive involvement of caregivers in decision making for their children's care. All participants were, however, involved in the physical care of their children. It is important that health care workers should continuously encourage caregivers to get involved in the decision making and care of their children.
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Affiliation(s)
- Grace Chasweka
- Department of Nursing, Zomba Central Hospital, Zomba, Malawi
| | - Maureen Daisy Majamanda
- Department of Nursing, Kamuzu University of Health Sciences, Blantyre, Malawi
- Research Department, Consortium for Advanced Research Training in Africa, Nairobi, Kenya
| | - Annie Namathanga
- Department of Nursing, Kamuzu University of Health Sciences, Blantyre, Malawi
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Soltani N, Seyedrasooli A, Jabraeili M, Mousavi S. The effect of maternal multisensory stimulations on bath stress in premature infants: A randomized controlled clinical trial. Infant Behav Dev 2022; 67:101720. [PMID: 35561627 DOI: 10.1016/j.infbeh.2022.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/17/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
Abstract
Bathing in Neonatal Intensive Care Unit (NICU) is a stressful experience to preterm infants. Reducing this stress is an important challenge in bathing preterm infants. The aim of present study was to evaluate the effects of maternal supportive interventions on the stress caused by swaddled bathing in preterm infants. In this randomized clinical trial, 48 preterm infants randomly allocated into control and intervention groups. In intervention group the mothers were asked to initiate multisensory supportive interventions 5 min before and through swaddled bathing. In controls the mothers were only present during bathing. To determine the level of stress, infant responses were recorded by camera 5 min before bathing and 5 min after bathing. Then infants' stress measured by using Newborn Stress Scale (NSS). Finding was shown that the level of stress in control group was especially increased after bathing that was statistically significant (p < 0.001). Although there was an increase in stress among interventions but it was not statistically significant (p > 0.05). Considering the positive effects of multisensory interventions in decreasing the stress of preterm infants, it can be recommended as cost-free and non-pharmacological care during infants bathing.
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Affiliation(s)
- Nasim Soltani
- Master of Science Neonatal Intensive Care Nursing, Student Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Alehe Seyedrasooli
- Department of Medical surgical, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahnaz Jabraeili
- Department of Pediatrics, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Saeed Mousavi
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Faculty of Health Sciences, Tabriz, Iran.
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31
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Jerofke-Owen TA, McAndrew NS, Gralton KS, Totka JP, Weiss ME, Fial AV, Sawin KJ. Engagement of Families in the Care of Hospitalized Pediatric Patients: A Scoping Review. JOURNAL OF FAMILY NURSING 2022; 28:151-171. [PMID: 34605283 DOI: 10.1177/10748407211048894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies (N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse-patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.
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Affiliation(s)
| | - Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert Hospital & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Joan P Totka
- Marquette University, Milwaukee, WI, USA
- Children's Wisconsin, Milwaukee, USA
| | | | | | - Kathleen J Sawin
- University of Wisconsin-Milwaukee, USA
- Children's Wisconsin, Milwaukee, USA
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32
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Feldthusen C, Forsgren E, Wallström S, Andersson V, Löfqvist N, Sawatzky R, Öhlén J, J Ung E. Centredness in health care: A systematic overview of reviews. Health Expect 2022; 25:885-901. [PMID: 35261138 PMCID: PMC9122448 DOI: 10.1111/hex.13461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The introduction of effective, evidence‐based approaches to centredness in health care is hindered by the fact that research results are not easily accessible. This is partly due to the large volume of publications available and because the field is closely linked to and in some ways encompasses adjoining fields of research, for example, shared decision making and narrative medicine. In an attempt to survey the field of centredness in health care, a systematic overview of reviews was conducted with the purpose of illuminating how centredness in health care is presented in current reviews. Methods Searches for relevant reviews were conducted in the databases PubMed, Scopus, Cinahl, PsychINFO, Web of Science and EMBASE using terms connected to centredness in health care. Filters specific to review studies of all types and for inclusion of only English language results as well as a time frame of January 2017–December 2018, were applied. Results The search strategy identified 3697 unique reviews, of which 31 were included in the study. The synthesis of the results from the 31 reviews identified three interrelated main themes: Attributes of centredness (what centredness is), Translation from theory into practice (how centredness is done) and Evaluation of effects (possible ways of measuring effects of centredness). Three main attributes of centeredness found were: being unique, being heard and shared responsibility. Aspects involved in translating theory into practice were sufficient prerequisites, strategies for action and tools used in safeguarding practice. Further, a variety and breadth of measures of effects were found in the included reviews. Conclusions Our synthesis demonstrates that current synthesized research literature on centredness in health care is broad, as it focuses both on explorations of the conceptual basis and the practice, as well as measures of effects. This study provides an understanding of the commonalities identified in the reviews on centredness in healthcare overall, ranging from theory to practice and from practice to evaluation. Patient or Public Contribution Patient representatives were involved during the initiation of the project and in decisions about its focus, although no patient or public representatives made direct contributions to the review process.
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Affiliation(s)
- Caroline Feldthusen
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Emma Forsgren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Sara Wallström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Viktor Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Noah Löfqvist
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Richard Sawatzky
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,School of Nursing, Trinity Western University, Langley, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, British Columbia, Canada
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Eva J Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Saghafi F, West S, Lopez V, Cleary M. Mental Health Impacts of Family Members Isolated from Patients in the ICU during the Coronavirus Disease (COVID-19) Pandemic. Issues Ment Health Nurs 2022; 43:87-90. [PMID: 33956563 DOI: 10.1080/01612840.2021.1919807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Farida Saghafi
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Sancia West
- College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Violeta Lopez
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia.,School of Nursing, Hubei University of Medicine, Shiyan, China
| | - Michelle Cleary
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
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Lessa ARD, Bitercourt VN, Crestani F, Andrade GRH, Costa CAD, Garcia PCR. Impact of the COVID-19 Pandemic on Patient- and Family-Centered Care and on the Mental Health of Health Care Workers, Patients, and Families. Front Pediatr 2022; 10:880686. [PMID: 35903168 PMCID: PMC9321398 DOI: 10.3389/fped.2022.880686] [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: 02/21/2022] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
During the COVID-19 pandemic, hospitals around the world were forced to reorganize their processes in an attempt to contain the spread of the virus while still providing adequate care to patients. In the Pediatric Intensive Care Unit (PICU) setting, changes in family visitation protocols and restrictions on parent chaperones during hospitalization, as well as other changes, interfered with care. Based on a narrative review of the literature, supported by the authors' observations in practice, we aimed to describe the impact of the pandemic on patient and family-centered care (PFCC) in the PICU environment, especially regarding the presence of family members, family support, and communication with patients and their families, as well as the effects of changes in these practices on the mental health of those involved. In this context, several strategies were used to sustain PFCC, and, despite many challenges, attempts were made to achieve the bare-minimum goals of humanized care for patients, families, and providers alike.
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Affiliation(s)
- Alessandra Rodrigues Dias Lessa
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Victória Noremberg Bitercourt
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Francielly Crestani
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Gabriela Rupp Hanzen Andrade
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Caroline Abud Drumond Costa
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Pedro Celiny Ramos Garcia
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Phiri PGMC, Chan CWH, Wong CL, Choi KC, Ng MSN. Discrepancies between nurses' current and perceived necessary practices of family-centred care for hospitalised children and their families: A cross-sectional study. J Pediatr Nurs 2022; 62:e25-e31. [PMID: 34229915 DOI: 10.1016/j.pedn.2021.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/04/2021] [Accepted: 06/27/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE This study investigated (1) the discrepancies between the nurses' current and perceived necessary practices of family-centred care (FCC), and (2) the nurses' demographic characteristics associated with current and perceived necessary practices of FCC for hospitalised children and their families in Malawi. DESIGN AND METHODS A cross-sectional study involving 444 nurses was conducted. The Family-Centred Care Questionnaire-Revised was used to examine the discrepancies between the nurses' current and perceived necessary practices of FCC. Univariate and multivariate statistical analyses were performed to identify the nurses' demographic characteristics associated with current and perceived necessary practices of FCC. RESULTS The total mean score of the nurses' current practices of FCC (M = 34.78, SD = 7.06) was significantly lower than that of the nurses' practices of FCC that were perceived as necessary (M = 38.63, SD = 5.60, p < 0.001). The nurses who were over 40 years of age (regression coefficient, β = 9.162, p = 0.014), had a postgraduate qualification (β = 23.314, p < 0.001), were separated or widowed (β = 9.661, p = 0.029), had a Tumbuka cultural background (β = 12.984, p < 0.001), were Seventh-day Adventist members (β = 8.863, p = 0.026), and worked in mission hospitals (β = 16.401, p = 0.021) were more likely to implement current practices of FCC. Conversely, the nurses who were members of the Moslem, Buddhist, or Hindi religious denomination (β = 6.587, p = 0.040), had a Tonga or Ngonde cultural background (β = 6.625, p = 0.046), and were nurse midwife technicians (β = -23.528, p = 0.012) were more likely to implement practices of FCC that they perceived as necessary. CONCLUSION Significant differences between the nurses' current and perceived necessary practices of FCC suggested that there were barriers to implementing necessary practices of FCC. The nurses' cultural and religious backgrounds were predictors of current practices of FCC, and this finding could direct the future development and testing of FCC interventions in Malawi. PRACTICE IMPLICATIONS Continued educational activities and research on the factors that contributed to the discrepancies between the nurses' current and perceived necessary practices of FCC and their impact on FCC in Malawi are critical.
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Affiliation(s)
- Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Marques S N Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
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Dien R, Benzies KM, Zanoni P, Kurilova J. Alberta Family Integrated Care™ and Standard Care: A Qualitative Study of Mothers' Experiences of their Journeying to Home from the Neonatal Intensive Care Unit. Glob Qual Nurs Res 2022; 9:23333936221097113. [PMID: 35707318 PMCID: PMC9189529 DOI: 10.1177/23333936221097113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 12/04/2022] Open
Abstract
Globally, one in ten infants is born preterm. Most preterm infants require care in a level II Neonatal Intensive Care Unit (NICU), which are highly technological critical care environments that can be overwhelming for parents. Alberta Family Integrated Care (AB-FICare™) is an approach to care that provides strategies to integrate parents into their infant’s care team. This sub-study is the first to compare mothers’ experiences in the context of AB-FICare™ and standard care. Semi-structured interviews with mothers from AB-FICare™ (n = 14) and standard care (n = 12) NICUs were analyzed using interpretive description informed by grounded theory methods. We identified a major theme of Journeying to Home with six categories: Recovering from Birth, Adapting to the NICU, Caring for Baby, Coping with Daily Disruption, Seeing Progress, and Supporting Parenting. Mothers in the AB-FICare™ group identified an enhancement to standard care related to building reciprocal trust with healthcare providers that accelerated Journeying to Home.
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Miller L, Richard M, Krmpotic K, Kennedy A, Seabrook J, Slumkoski C, Walls M, Foster J. Parental presence at the bedside of critically ill children in the pediatric intensive care unit: A scoping review. Eur J Pediatr 2022; 181:823-831. [PMID: 34626225 PMCID: PMC8501356 DOI: 10.1007/s00431-021-04279-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Parental presence at the bedside (PPB) of critically ill children in the pediatric intensive care unit (PICU) is necessary for operationalizing family-centred care. Previous evidence syntheses emphasize parent-healthcare provider interactions at rounds and resuscitation; our focus is the parent-child dyad. Prior to embarking on further study, we performed a scoping review to determine the breadth and scope of the literature addressing PPB of critically ill children in the PICU. We searched five online databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and PSYCHINFO) and the grey literature to identify English and French reports from January 1960 to June 2020 addressing physical parental presence with children (birth to 18 years) in intensive care units, without limitation by methodology. Screening, reference selection, and data extraction were performed by two independent reviewers. Data were extracted into a researcher-designed tool. We identified 204 publications (81 quantitative, 68 qualitative, 22 mixed methods, and 9 descriptive case or practice change studies, and a further 24 non-study reports). PPB was directly assessed in 78 (38%) reports, and was the primary objective in 64 (31%). Amount or quality of presence was addressed by 114 reports, barriers and enablers by 152 sources, and impacts and outcomes by 134 sources. While only 6 reports were published in the first two decades of our search (1960-1980), 17 reports were published in 2019 alone. Conclusions: A relatively large body of literature exists addressing PPB of critically ill children. Separate systematic evidence syntheses to assess each element of PPB are warranted. Scoping review protocol registration: Open science framework, protocol nx6v3, registered 9-September-2019. What is Known: • Parental presence at the bedside of critically ill children must be enabled to facilitate family centeredness in care. • Systematic evidence syntheses have focused on parental presence at rounds or resuscitation, rather than with the child throughout the intensive care journey. What is New: • Many reports (n=204) address parental presence at the bedside in the pediatric intensive care unit, though most do as incidental findings • Identifies studies addressing key elements of parental presence in the PICU including barriers and enablers to, amount and quality of, and impact and outcomes of parental presence, and demonstrates trends over time and geography.
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Affiliation(s)
- Lauren Miller
- Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Monique Richard
- Department of Pediatric Critical Care, IWK Health, Halifax, NS Canada
| | - Kristina Krmpotic
- Department of Pediatric Critical Care, IWK Health, Halifax, NS Canada
- Department of Critical Care, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Anne Kennedy
- School of Education, Acadia University, Wolfville, NS Canada
| | - Jamie Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON Canada
- Department of Pediatrics and Department of Epidemiology & Biostatistics, Western University, London, ON Canada
- Children’s Health Research Institute and Lawson Health Research Institute, London, ON Canada
| | - Corey Slumkoski
- Department of Pediatric Critical Care Parent Partner, IWK Health, Halifax, NS Canada
| | - Martha Walls
- Department of Pediatric Critical Care Parent Partner, IWK Health, Halifax, NS Canada
| | - Jennifer Foster
- Department of Pediatric Critical Care, IWK Health, Halifax, NS Canada
- Department of Critical Care, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
- Children’s Health Research Institute and Lawson Health Research Institute, London, ON Canada
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Okhovat F, Abdeyazdan Z, Namnabati M. Follow-up Plan as a Necessity for Nursing Care: A Decrease of Stress in Mothers with their Children in Pediatric Surgical Units. J Caring Sci 2021; 10:191-195. [PMID: 34849364 PMCID: PMC8609124 DOI: 10.34172/jcs.2021.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/21/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction: Children are vulnerable to damage. Health problems in children, especially if necessitate hospitalization, can cause stress in their parents that may persist even long after discharge. This study aimed to investigate the effect of implementing follow-up care plans on stress in mothers of children discharged from pediatric surgical units.
Methods: A quasi-experimental study was conducted on 64 mothers whose children were hospitalized in the surgical wards of two educational hospitals affiliated to Isfahan University of Medical Sciences, Iran. The participants were randomly assigned into two groups of control and experimental. The data collection tools included a demographic data questionnaire and stress response inventory (SRI). The interventions were performed using a four-stage follow-up care plan. The data were analyzed using SPSS software version 13 and descriptive statistics, independent t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) test.
Results: The mean (SD) stress scores of the experimental group were 64.1 (28.8), 20.4 (12.4), and 11.6 (7.5) before, one week, and one month after the intervention, respectively. In the control group, these scores were 61.2 (29.2), 59.9 (25.5), and 46.7 (19.1), respectively. The results showed the mean score was significantly lower than that of the control group at one week and one month after the intervention in the experimental group.
Conclusion: Our results demonstrated that a follow-up care plan can decrease the stress levels of mothers as a continuity of patient care even after discharge.
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Affiliation(s)
- Forogh Okhovat
- Department of Nursing, Shahrekord Branch, Islamic Azad University, Sharekord, Iran
| | - Zahra Abdeyazdan
- Department of Infant and Pediatric. Nursing and Midwifery Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Namnabati
- Department of Infant and Pediatric. Nursing and Midwifery Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Woo D, Yu H, Kim HJ, Choi M, Kim DH. [Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units]. J Korean Acad Nurs 2021; 51:573-584. [PMID: 34737250 DOI: 10.4040/jkan.21143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19. METHODS This study adopted the double diamond process of service design comprising the discovery, defining, and development stages. RESULTS We developed an untact visit service based on an application that considered the child's status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder. CONCLUSION Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child's information in real-time, and provide one-stop service without increasing healthcare providers' work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.
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Affiliation(s)
- Dahae Woo
- Department of Industrial Design, Sungshin Women's University, Seoul, Korea
| | - Hanui Yu
- Department of Industrial Design, Sungshin Women's University, Seoul, Korea
| | - Hyo Jin Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Minyoung Choi
- Department of Services and Design Engineering, Sungshin Women's University, Seoul, Korea
| | - Dong Hee Kim
- College of Nursing, Sungshin Women's University, Seoul, Korea.
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Paraszczuk AM, Feeg VD, Betz CL, Mannino JE. Psychometric Testing of Family Centered Care (FCC) Instrument: A Mixed Methods Analysis of Pediatric Nurses and Their Workplace Perceptions of FCC. J Pediatr Nurs 2021; 61:75-83. [PMID: 33794447 DOI: 10.1016/j.pedn.2021.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE Family-Centered care (FCC) is a model used in pediatric healthcare delivery wherein planning care for children incorporates the family, but questions remain whether there has been effective FCC implementation in practice. The purpose of this study was to examine the importance of FCC to pediatric nurses and their view of their organizations' support of FCC implementation. METHOD A survey with FCC descriptor statements was distributed electronically to the Society of Pediatric Nurses. Direct care nurses (N = 132) responded to demographic questions including their education level and organization size, and 26 items rating the importance of elements of FCC in their care (as it applies to themselves) and in their organizations (as it applies to their hospital or organization) using a 5-point Likert scale. Open ended questions supplemented the survey to yield narrative comments to triangulate the findings. RESULTS The nurses' personal responses and their rating of their organizations were analyzed separately. The Cronbach alphas were 0.867 and 0.938, respectively. Factor analyses revealed the same three factors in the two foci of questions for (a) the nurse's own practice and (b) the organization's support of FCC: Philosophy of FCC, Implementation of FCC and Environment Variations of FCC. A qualitative process of narrative analysis added support to the factors with clarity in thematic triangulation. Additionally, there was a significant difference in the mean scores between nurses' personal responses and the mean scores for their organizations for all three factors (p = .000) and for self-reported FCC by nursing education to validate the utility of the tool. CONCLUSIONS This instrument quantified the importance of FCC to pediatric nurses and their workplace support of FCC and can be used in future studies to evaluate FCC.
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Affiliation(s)
- Ann Marie Paraszczuk
- Molloy College, Barbara H. Hagan School of Nursing and Health Sciences, NY, USA.
| | - Veronica D Feeg
- Molloy College, Barbara H. Hagan School of Nursing and Health Sciences, NY, USA.
| | - Cecily L Betz
- USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, CA, USA.
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Parsons E, Darlington AS. Parents' perspectives on conflict in paediatric healthcare: a scoping review. Arch Dis Child 2021; 106:981-986. [PMID: 33593741 DOI: 10.1136/archdischild-2020-320975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/01/2021] [Accepted: 01/30/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Conflict in paediatric healthcare is becoming increasingly prevalent, in particular relation to paediatric end of life. This is damaging to patients, families, professionals and healthcare resources. Current research has begun to explore perspectives of healthcare professionals (HCPs), but the parental views on conflict are lacking. OBJECTIVES This scoping review explores parental views on conflict during a child's end of life. In addition, parental views are mapped onto HCPs' views. METHODS A search was completed of the databases CINAHL, PubMed, Web of Science, Embase and Medline between 1997 and 2019, focused on parents of children with involvement with palliative or end-of-life care referring to conflict or disagreements. RESULTS The review found 10 papers that included parental views on conflict. Data on conflict were categorised into the following seven themes: communication breakdown, trust, suffering, different understanding of 'best interest', disagreements over treatment, spirituality and types of decision-making. In particular, parental expertise, perspectives on suffering and ways of making decisions were significant themes. A subset of themes mirror those of HCPs. However, parents identified views of conflict unique to their perspective. CONCLUSIONS Parents identified important themes, in particular their perspective of what constitutes suffering and 'best interest'. In addition, parents highlight the importance of being recognised as an expert.
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Affiliation(s)
- Emily Parsons
- Savannah Neurology, Evelina London Children's Hospital, London, UK .,Health Sciences, University of Southampton, Southampton, UK
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Cetintas I, Akgun Kostak M, Semerci R, Kocaaslan EN. The Relationship Between Parents' Perceptions of Family-Centered Care and Their Health Care Satisfaction. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This study was conducted to determine the relationship between the perceptions of parents whose children are hospitalized about family-centered care provided in the hospital and their health care satisfaction and the factors affecting them.
Methods: This descriptive study was conducted with parents (n=169) of children who were hospitalized in a university hospital in Turkey between May and July 2019. Data were collected with "Child and Family Information Form", "Family-Centered Care Scale" and "PedsQL Health Care Satisfaction Scale". Data were analyzed with descriptive statistics, Mann Whitney U, and Spearman correlation tests.
Results: The mean age of the children was 6.86±5.63, 51.5% were male, 56.2% were hospitalized before and 88.2% of parents received information about the care and treatment of their children. There was a positive correlation between the parents’ Family-Centered Care Scale and PedsQL Health Care Satisfaction Scale scores and between the age of the children and age of the mother and the PedsQL Health Care Satisfaction Scale scores, the number of children and Family-Centered Care Scale scores of parents. A statistically significant difference was found between the child's previous hospitalization and median scores of the Family-Centered Care Scale, and between whether parents receive information about the care and treatment of their children and the median scores of the PedsQL Health Care Satisfaction Scale.
Conclusion: In this study, as the family-centered care that parents expect was met, their health care satisfaction increased. As the age of children and mothers increased, parents' health care satisfaction increased. Health care satisfaction of parents who received information about treatment and care was found higher.
Keywords: family-centered care, patient satisfaction, child, parents
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Affiliation(s)
- Ismail Cetintas
- Department of Nursing, Child Health and Diseases Nursing, Trakya University, Faculty of Health Sciences
| | - Melahat Akgun Kostak
- Department of Nursing, Child Health and Diseases Nursing, Trakya University, Faculty of Health Sciences
| | - Remziye Semerci
- Department of Nursing, Child Health and Diseases Nursing, Trakya University, Faculty of Health Sciences
| | - Esra Nur Kocaaslan
- Department of Nursing, Child Health and Diseases Nursing, Trakya University, Faculty of Health Sciences
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Nurse and Provider Pain Management Education Priorities and Barriers. Pain Manag Nurs 2021; 22:579-585. [PMID: 34393038 DOI: 10.1016/j.pmn.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/25/2021] [Accepted: 06/19/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The purpose of this research was to describe health care nurse and providers' pain management education priorities and barriers for pediatric cardio-thoracic surgical (CTS) patients and their caregivers. DESIGN This was a qualitative-descriptive study design using survey methodology. METHODS A convenience sample of 206 (CTS) health care professionals including 172 nurses, 11 advanced practice providers, and 23 physicians were invited to participate in this study. The survey was distributed through a work e-mail within a 145-bed tertiary pediatric hospital and focused on collaborative pain management educational priorities and barriers. RESULTS Of the 206 cardio-thoracic service health care nurses/providers surveyed, 45.6 % (N = 94) responded to the survey. The top pain management education priority for these nurses/providers included immediate postoperative pain management knowledge for the caregiver and pediatric CTS patient. The lowest priority 13.8% (N = 13) included education related to pain management needs after discharge. Of the 94 nurses/providers who responded, 31.9% (n = 30) identified the presence of timing and communication barriers in providing pain management education with caregivers and pediatric CTS patients. AIMS The aim of this research was to describe health care providers pain management education priorities and barriers for cardio-thoracic surgical (CTS) pediatric patients and their caregivers. SETTING 145-bed tertiary pediatric hospital. PARTICIPANTS/SUBJECTS Nurses, advanced practice providers [APP's], and physicians. CONCLUSIONS Nurses and providers prioritize immediate postoperative pain management education; however, there remains a need to focus more on the outcomes of pain management education for caregivers and pediatric CTS patients after discharge.
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Negarandeh R, Hassankhani H, Jabraeili M, Abbaszadeh M, Best A. Health care staff support for mothers in NICU: a focused ethnography study. BMC Pregnancy Childbirth 2021; 21:520. [PMID: 34289802 PMCID: PMC8296702 DOI: 10.1186/s12884-021-03991-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/08/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Mothers of premature newborns in the neonatal intensive care unit (NICU) have complex needs and require a significant amount of support during the NICU admission. However, little is known about mothers' support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers' support needs in the NICU. METHODS A focused ethnographic approach was adopted. Observations and interviews with 21 mothers, 18 nurses, and five physicians were undertaken over a seven months period. Qualitative data analysis was conducted using the Roper and Shapira (2000) five-step framework. RESULT Two main themes of "insufficient provision of the mothers' support needs" (subthemes: inadequate accompany of the mothers in care, assigning monitoring and care to the mothers, inadequate sharing of medical the information) and "supporting the mothers in certain circumstances" (subthemes: reassuring the mothers, supporting the mothers with reduced functional capacity, providing information) were obtained. CONCLUSION The mothers experienced a gap between expected and actual support provided by health care staff. Although, the health care staff believed that mothers' support was a necessity, it was not their main concerns, and they considered workload as a barrier for the mothers support in the NICU.
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Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Jabraeili
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Amy Best
- Campus Teacher, School of Nursing, Massey University Wellington, Wellington, Australia
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Family Experiences with Care for Children with Inherited Metabolic Diseases in Canada: A Cross-Sectional Survey. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 15:171-185. [PMID: 34282509 PMCID: PMC8289623 DOI: 10.1007/s40271-021-00538-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
Background and Objective Children with inherited metabolic diseases often require complex and highly specialized care. Patient and family-centered care can improve health outcomes that are important to families. This study aimed to examine experiences of family caregivers (parents/guardians) of children diagnosed with inherited metabolic diseases with healthcare to inform strategies to improve those experiences. Methods A cross-sectional mailed survey was conducted of family caregivers recruited from an ongoing cohort study. Participants rated their healthcare experiences during their child’s visits to five types of healthcare settings common for inherited metabolic diseases: the metabolic clinic, the emergency department, hospital inpatient units, the blood laboratory, and the pharmacy. Participants provided narrative descriptions of any memorable negative or positive experiences. Results There were 248 respondents (response rate 49%). Caregivers were generally very or somewhat satisfied with the care provided at each care setting. Appropriate treatment, provider knowledge, provider communication, and care coordination were deemed essential aspects of satisfaction with care by the majority of participants across many settings. Memorable negative experiences were reported by 8–22% of participants, varying by setting. Among participants who reported memorable negative experiences, contributing factors included providers’ demeanor, lack of communication, lack of involvement of the family, and disregard of an emergency protocol letter provided by the family. Conclusions While caregivers’ satisfaction with care for children with inherited metabolic diseases was high, we identified gaps in family-centered care and factors contributing to negative experiences that are important to consider in the future development of strategies to improve pediatric care for inherited metabolic diseases. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-021-00538-8.
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Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Sedation, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Engagement/Empowerment Bundle Practices for Critically Ill Children: An International Survey of 161 PICUs in 18 Countries. Crit Care Med 2021; 50:114-125. [PMID: 34259659 DOI: 10.1097/ccm.0000000000005168] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate current international practice in PICUs regarding components of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Sedation, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Engagement/Empowerment" ("ABCDEF") bundle. DESIGN Online surveys conducted between 2017 and 2019. SETTING One-hundred sixty-one PICUs across the United States (n = 82), Canada (n = 14), Brazil (n = 27), and Europe (n = 38) participating in the Prevalence of Acute Rehabilitation for Kids in the PICU study. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of the 161 participating PICUs, 83% were in academic teaching hospitals and 42% were in free-standing children's hospitals. Median size was 16 beds (interquartile range, 10-24 beds). Only 15 PICUs (9%) had incorporated all six ABCDEF bundle components into routine practice. Standardized pain assessment (A) was the most common (91%), followed by family engagement (F, 88%) and routine sedation assessment (C) with validated scales (84%). Protocols for testing extubation readiness or conducting spontaneous breathing trials (B) were reported in 57%, with 34% reporting a ventilator weaning protocol. Routine delirium monitoring with a validated screening tool (D) was reported by 44% of PICUs, and 26% had a guideline, protocol, or policy for early exercise/mobility (E). Practices for spontaneous breathing trials were variable in 29% of Canadian PICUs versus greater than 50% in the other regions. Delirium monitoring was lowest in Brazilian PICUs (18%) versus greater than 40% in other regions, and family engagement was reported in 55% of European PICUs versus greater than 90% in other regions. CONCLUSIONS ABCDEF bundle components have been adopted with substantial variability across regions. Additional research must rigorously evaluate the efficacy of specific elements with a focus on B, D, E, and full ABCDEF bundle implementation. Implementation science is needed to facilitate an understanding of the barriers to ABCDEF implementation and sustainability with a focus on specific cultural and regional differences.
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Brennan M, Uveges MK. Ethical Issues in the Care of Emerging Adults in Pediatric Intensive Care Units. AACN Adv Crit Care 2021; 32:219-226. [PMID: 34161968 DOI: 10.4037/aacnacc2021949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mary Brennan
- Mary Brennan is a Registered Nurse, Boston Children's Hospital, 300 Longwood Avenue Boston, MA 02115
| | - Melissa Kurtz Uveges
- Melissa Kurtz Uveges is Assistant Professor, Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
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Thunberg G, Johnson E, Bornman J, Öhlén J, Nilsson S. Being heard - Supporting person-centred communication in paediatric care using augmentative and alternative communication as universal design: A position paper. Nurs Inq 2021; 29:e12426. [PMID: 34076320 DOI: 10.1111/nin.12426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 12/30/2022]
Abstract
Person-centred care, with its central focus on the patient in partnership with healthcare practitioners, is considered to be the contemporary gold standard of care. This type of care implies effective communication from and by both the patient and the healthcare practitioner. This is often problematic in the case of the paediatric population, because of the many communicative challenges that may arise due to the child's developmental level, illness and distress, linguistic competency and disabilities. The principle of universal design put forth in conventions and legislation means that the design of products and services should be usable by all people, to the greatest extent possible. Augmentative and alternative communication encompasses strategies, for example pictures and apps, that are typically used with people with communication disability. In this position paper, we argue for the universal use of augmentative and alternative communication to support person-centred communication and care for children, regardless of age or potential disability. Clinical examples are shared from three different paediatric care settings where pictorial supports were applied universally. Interviews were conducted with children and adolescents (with and without disabilities), parents and healthcare practitioners, and the principles of universal design were used as a framework to demonstrate how person-centred communication is supported in paediatric care.
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Affiliation(s)
- Gunilla Thunberg
- Dart Centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Speech and Language Pathology Unit, Institute of Neuroscience and Physiology at Sahlgrenska Academy, Gothenburg, Sweden.,Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Joakim Öhlén
- Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Stefan Nilsson
- Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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Barratt M, Bail K, Paterson C. Children living with long-term conditions: A meta-aggregation of parental experiences of partnership nursing. J Clin Nurs 2021; 30:2611-2633. [PMID: 33829591 DOI: 10.1111/jocn.15770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/02/2021] [Accepted: 03/16/2021] [Indexed: 01/30/2023]
Abstract
AIM To explore how parents of children with long-term conditions experience partnership in paediatric and neonatal nursing care and to identify existing partnership barriers and facilitators. BACKGROUND Parent-nurse partnership is fundamental to paediatric and neonatal nursing. Partnership is characterised by five attributes: parental participation, negotiation, mutual trust and respect, shared roles and decision-making, and communication. Little is known about the parental experiences of partnership nursing specific to children living with a long-term condition. DESIGN A qualitative meta-aggregation review following Joanna Briggs Institute meta-aggregation approach. METHODS A comprehensive search was conducted in six electronic databases. Studies were assessed according to the inclusion and exclusion criteria. Qualitative findings with illustrative quotes from included studies were extracted and grouped into categories which informed the synthesised findings. This review has been reported according to the PRISMA guidelines. FINDINGS A total of 4,404 studies were screened, 162 full-text studies were assessed against the inclusion and exclusion criteria, and a total of six studies were included. The meta-aggregation developed three overarching synthesised findings which were as follows: (a) empowering parents to become involved, (b) effective communication to recognise mutual expertise and (c) collaborative nurse-family relationships. CONCLUSION Parents valued collaboration where both parents and nurses are recognised equally for their skills and expertise. A power struggle existed between parents and nurses when expertise was not recognised. Parents appreciated nurses who empowered them to develop new skills and knowledge in the care of their own child. RELEVANCE TO CLINICAL PRACTICE Nurses need to recognise the skills and knowledge that parents have surrounding the care requirements of their own children. Collaboration and negotiation are key to successful partnership between nurses and parents. Nurses need to frequently reflect on how they are successfully partnering with both parents and children and ensure all parties in the nurse/parent/child triad feel supported and empowered.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Canberra, ACT, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Canberra, ACT, Australia.,Prehabilitation, Activity, Cancer, Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia.,Robert Gordon University, Aberdeen, UK
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Farokhzadian J, Forouzi MA, Sheikhbardsiri H. Mothers and nurses' perceptions of the family-centered care barriers in pediatric departments of an educational hospital in Iran. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 34:219-224. [PMID: 33811709 DOI: 10.1111/jcap.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 03/01/2021] [Accepted: 03/13/2021] [Indexed: 02/05/2023]
Abstract
PROBLEM Family-centered care (FCC) is a concept used to describe an approach to caring for children and their families within health services. This study compared mothers and nurses' perceptions of barriers to FCC. METHODS This cross-sectional study was conducted in an educational hospital affiliated to Kerman University of Medical Sciences at the southeast of Iran in 2019. Using a researcher-designed questionnaire, we assessed mothers' and nurses' perceptions of barriers to FCC with a census method (60 nurses and 82 mothers). FINDINGS Mothers (49.8 ± 21.1) and nurses' (49.2 ± 16.4) mean scores of the perception of FCC barriers were at a moderate level. No significant difference was found between mothers' and nurses' perceptions of barriers to FCC. A significant relationship was observed between age, child's admission history, and the perception of FCC barriers in the mothers' group. CONCLUSION Findings suggest that national and regional policies of educational hospitals should assess factors contributing to the FCC barriers, focus on how to reduce these barriers, and provide appropriate collaborative care by nurses and the family of patients.
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Affiliation(s)
- Jamileh Farokhzadian
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansooreh Azizzadeh Forouzi
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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