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Pinero de Plaza MA, Hutchinson C, Beleigoli A, Tieu M, Lawless M, Conroy T, Feo R, Clark RA, Dafny H, McMillan P, Allande-Cussó R, Kitson AA. The Caring Life Course Theory: Opening new frontiers in care-A cardiac rehabilitation example. J Adv Nurs 2024. [PMID: 39011837 DOI: 10.1111/jan.16312] [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: 03/14/2024] [Revised: 05/27/2024] [Accepted: 06/23/2024] [Indexed: 07/17/2024]
Abstract
AIM(S) To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address disparities in rural, low socio-economic areas. METHODS A secondary analysis of data collected from 15 CR programmes to identify CR patterns through the CLCT lens using a mixed-methods approach. All analytical processes were conducted in NVivo, coding qualitative data through thematic analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. RESULTS A strong interconnectedness among constructs: 'care from others', 'capability', 'care network' and 'care provision' (coefficient = 1) highlights their entangled crucial role in CR. However, significant conceptual disparities between 'care biography' and 'fundamental care' (coefficient = 0.4) and between 'self-care' and 'care biography' (coefficient = 0.384615) indicate a need for more aligned and personalized care approaches within CR. CONCLUSION The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement in rural and underserved regions. IMPLICATIONS Integrating CLCT into CR programme designs could effectively address participation challenges, demonstrating the theory's utility in developing targeted, accessible care interventions/solutions. IMPACT Explored the challenge of low CR engagement in rural, low socio-economic settings. Uncovered care provision, transitions and individual care biographies' relevance for CR engagement. Demonstrated the potential of CLCT to inform/transform CR services for underserved populations, impacting practices and outcomes. REPORTING METHOD EQUATOR-MMR-RHS. PATIENT CONTRIBUTION A consumer co-researcher contributed to all study phases.
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Affiliation(s)
- Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, Northwest Territories, Australia
| | - Claire Hutchinson
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Matthew Tieu
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Adelaide Health Simulation, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Lawless
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Tiffany Conroy
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, Northwest Territories, Australia
| | - Rebecca Feo
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Robyn A Clark
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, Northwest Territories, Australia
| | - Hila Dafny
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Penelope McMillan
- Health Consumer Advocate with Lived Experience in Multimorbidity Disease Management, Adelaide, South Australia, Australia
| | - Regina Allande-Cussó
- Nursing Department, Nursing, Physiotherapy and Podiatry School, University of Seville, Seville, Spain
| | - Alison A Kitson
- Caring Futures Institute, College Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Wray J, Ndokera R, Pierce CM, Oldham G. The impact of restrictions to visiting in paediatric intensive care during the COVID-19 pandemic. Nurs Crit Care 2023; 28:818-825. [PMID: 36593739 DOI: 10.1111/nicc.12873] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Restrictions to hospital visiting were mandated during the COVID-19 pandemic, with variability in the degree of restriction imposed. At times, paediatric intensive care units (ICU) restricted visiting to one parent/carer. Views of parents/carers and ICU staff about changes in the visiting policy are not well understood. STUDY DESIGN This is a Service evaluation involving questionnaire survey incorporating rating scales and free-text comments. Inner-city specialist children's hospital. Parents/carers of children on ICU between December 2020-March 2021 and staff who were working on ICU during May-June 2021. Parents and staff on ICU were invited to complete a questionnaire focusing on their experience of being or working on ICU. Quantitative data were analysed descriptively and free-text comments were thematically analysed. RESULTS Completed questionnaires were received from 81/103 (79%) parents/carers and 217/550 (39%) staff. The majority of parents (n = 60;77%) and staff (n = 191;89%) understood the need for the one-parent visiting policy but acknowledged it was a source of considerable stress. More staff than parents agreed it was appropriate other relatives/friends visiting was not permitted (Z = 3.715;p < .001). There was no association between parents' satisfaction with their child's care and views about the visiting policy. However, staff were more likely to report an impact on their ability to deliver family centred care if they disagreed with the policy. CONCLUSION The COVID-19 visiting policy had a clear impact on parents and staff. In the event of any future threat to open-access visiting to children in hospital, the potentially damaging effect on children, parents, and staff must be considered. RELEVANCE TO CLINICAL PRACTICE Visiting policies need to take account of parents being partners in their child's care, rather than purely visitors to the unit where their child is being cared for. Visiting for two carers should always be facilitated, including during a crisis such as a pandemic.
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Affiliation(s)
- Jo Wray
- Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rufaro Ndokera
- Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Christine M Pierce
- Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Geralyn Oldham
- DRIVE, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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