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Stelwagen M, Westmaas A, Van Kempen A, Scheele F. In-hospital education of parents of newborns may benefit from competency-based education: A qualitative focus group and interview study among health professionals. J Clin Nurs 2023; 32:1076-1088. [PMID: 35460132 DOI: 10.1111/jocn.16334] [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: 11/09/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
AIMS/OBJECTIVES The aim of this study was to appraise health professionals' self-reported practices in educating parents of hospitalised newborns from the perspective of competency-based education and to identify areas for improvement of parental learning. BACKGROUND Patient education is essential to achieve autonomy in parents of hospitalised newborns. The literature provides descriptions of the use of various components of competency-based education in patient education. This suggests that competency-based education is a valuable concept for patient education. DESIGN A case-based qualitative study. METHODS Three focus group discussions were conducted and 28 semi-structured interviews with 45 health professionals who practice in a hospital setting that is designed to empower parents. The data were analysed with a framework analysis approach, using a framework of competency-based education themes for a combined inductive and deductive content data analysis. The recommendations of the Standards for Reporting Qualitative Research checklist were followed. FINDINGS Two themes of competency-based education emerged as evidently operationalised: (1) 'Learning climate' and (2) 'Role modeling'. Five themes emerged as incompletely operationalised: (1) 'Parent curriculum based on inter-professional consensus'; (2) 'Transparency about the competencies needed'; (3) 'Access to teaching'; (4) 'Assessing and reporting results'; and (5) 'Proficiency statements based on autonomy expectations'. Two themes did not emerge: (1) 'Empowering parents to be active learners' and (2) 'Evaluation and improvement of the education program'. CONCLUSIONS Parent education is at risk of being merely on a master-apprentice model and may be more effective if it is designed on competency-based education principles. Identified areas for improvement are empowering parents to be 'active learners' and by involving them in the evaluation and improvement of the educational program. Parent education in neonatal health care may benefit from an appraisal based on competency-based education themes. RELEVANCE TO CLINICAL PRACTICE Appraising parent education based on competency-based education principles is feasible for improving the learning process towards parent autonomy.
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Affiliation(s)
- Mireille Stelwagen
- Department of Teaching and Department of Pediatrics at OLVG Hospital, Amsterdam, The Netherlands
| | - Alvin Westmaas
- Department of Social Psychology, Maastricht University, Maastricht, The Netherlands.,Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Anne Van Kempen
- Department of Pediatrics at OLVG Hospital, Amsterdam, The Netherlands
| | - Fedde Scheele
- Department of Gynecology and Department Teaching at OLVG Hospital, Health systems innovation and education at the VU University Amsterdam and Amsterdam University Medical Center, Amsterdam, The Netherlands
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Orlando JM, Cunha AB, Alghamdi ZS, Lobo MA. How do parents and early intervention professionals utilize educational resources about infant development and play? Early Hum Dev 2023; 180:105763. [PMID: 37028178 DOI: 10.1016/j.earlhumdev.2023.105763] [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: 02/24/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Parents utilize online sources to learn about health information, however few studies have examined where parents look for information about development or play for young children. AIMS Investigate parents' and early intervention (EI) providers' practices and preferences regarding parent education about infant development and play. STUDY DESIGN Cross-sectional survey design. SUBJECTS 112 parents and 138 EI providers participated. OUTCOME MEASURES One survey probed where parents look for information and preferred methods for receiving information about infant development and play. A second survey identified the parent education sources used and perceived quality of sources available by EI providers. Descriptive and inferential analyses were conducted. RESULTS 112 parents and 138 EI providers participated. A greater proportion of parents sought information about development than play. Overall, parents used internet searches and preferred websites for education about development and play; however, parents of infants at risk for developmental delay preferred receiving developmental information through home visits or classes. Most EI providers have not asked parents where they look for information. A greater proportion of EI providers agreed existing sources about development, rather than about play, are high quality, but identified the need to develop high-quality sources about both topics. CONCLUSIONS There are a variety of methods that parents access and prefer for education about infant development and play. EI providers and other healthcare professionals should discuss the methods with parents to support parents in their quest for information and ensure parents receive high-quality information.
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Affiliation(s)
- Julie M Orlando
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Andrea B Cunha
- University of Nebraska Medical Center, Department of Physical Therapy, Omaha, NE, USA
| | - Zainab S Alghamdi
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Michele A Lobo
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA.
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McNair C, Chirinian N, Uleryk E, Stevens B, McAllister M, Franck LS, Taddio A, Shah V. Effectiveness of parental education about pain in the neonatal period on knowledge, attitudes, and practices: A systematic review and meta-analysis. Paediatr Child Health 2022; 27:454-463. [PMID: 36583071 PMCID: PMC9792286 DOI: 10.1093/pch/pxac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/20/2022] [Indexed: 01/01/2023] Open
Abstract
Background Despite the availability of effective, safe, and feasible pain management strategies, infant pain remains undertreated. Parents can play a key role in advocating for or delivering pain management strategies if they are educated. To date, a quantitative synthesis of the effectiveness of parental education about pain management in the neonatal period has not been performed. Objective To systematically review the effectiveness of parental education during the neonatal period on pain management in infancy. Methods MEDLINE, EMBASE, PsycInfo, CINAHL, and the Cochrane Library were searched for relevant randomized controlled trials (RCTs) and non-randomized trials (NRTs) that evaluated parental education with respect to pain management during the neonatal period in any setting from inception to February 2021. Screening of article titles and abstracts and data extraction were performed in duplicate. The risk of bias was assessed using the Cochrane Risk Bias Tool 2.0 and the Risk of Bias in Non-randomized Studies of Interventions for RCTs and NRTs, respectively. As per the GRADE methodology, critically important and important outcomes were identified. Critically important outcomes included utilization of pain management strategies and infant pain. Important outcomes included parental knowledge about pain mitigation strategies, parental attitudes, compliance with painful procedures, procedure outcomes, and safety. Data were combined and presented as relative risk (RR) or mean or standardized mean difference (MD or SMD) with 95% confidence interval (CI). Results Of the six studies eligible for inclusion, four studies were RCTs and two studies were NRTs. Written information and/or video were used to deliver parental education during the neonatal period in hospital settings in all studies. Four studies (two RCTs and two NRTs) reported on critically important outcomes. The risk of bias was low for the two RCTs and moderate to serious for the two NRTs. Utilization of pain management strategies was assessed for heel lance in the first 48 hours of life in two studies and for vaccine injection at 2 to 6 months of life in two studies. Higher utilization rate for pain management strategies was reported in the pain education group in three studies (RR 1.15, 95% CI 1.04, 1.26; N=2712). There was no difference in the mean number of pain management strategies used in one NRT tracking utilization tracking utilization as continuous data (MD 0.20, 95% CI -0.01, 0.41; N=178). Parent-reported infant pain scores were lower in the pain education group in one RCT (MD -0.16, 95% CI -0.27, -0.06; N=1615). The quality of evidence for the outcome of utilization of pain management strategies was very low while for the outcome of infant pain the quality of evidence was moderate. Five studies (3 RCTs and 2 NRTs) reported on important outcomes. The risk of bias was low for two RCTs and high for one RCT and moderate to serious for the two NRTs. Parental knowledge about pain management strategies (SMD 0.54, 95% CI 0.26, 0.82), parental confidence in their ability to manage pain (SMD 0.24, 95% CI 0.14, 0.34), parental satisfaction with education (MD 1.18, 95% CI 0.84, 1.52) and parental satisfaction with pain management (RR 1.05. 95% CI 1.01, 1.08) were increased in the pain education group. None of the included studies reported on procedural outcomes. No adverse events with the pain education nor the use of pain management interventions were reported in one study. Conclusions Parental education in the neonatal period was effective in increasing utilization of pain management strategies during painful procedures. Reduction of pain in infants is based on one study of moderate quality. Furthermore, parental education increased parental knowledge about pain management strategies, confidence in their ability to manage infant pain, and satisfaction with the education and pain management. Parental pain education should be incorporated into postnatal care.
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Affiliation(s)
- Carol McNair
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Nevart Chirinian
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - Bonnie Stevens
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Mary McAllister
- Nursing Practice, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Linda S Franck
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vibhuti Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
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Feng H, Liu Y, Li J, Jiang H. Breastfeeding-oriented education for parturients separated from their hospitalized infants: a qualitative study of nurses' perspectives in Shanghai, China. BMC Pregnancy Childbirth 2022; 22:888. [PMID: 36456913 PMCID: PMC9713735 DOI: 10.1186/s12884-022-05227-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The benefits of breastfeeding for both mother and baby are well recognized. However, the separation of the mother-newborn dyad leads to a lower breastfeeding rate. These parturients who are separated from their hospitalized infants are sometimes unaware of the importance of breastfeeding, while nurses do know how important health education on breastfeeding is and how it can be improved. This descriptive qualitative study aimed to explore the experiences of nurses regarding health education on breastfeeding and summarize the potential ways to improve it. METHODS A descriptive phenomenological qualitative approach was utilized in this study, and in-depth, semi-structured interviews were conducted with nurses at a tertiary A-grade obstetrics-and gynecology-specialized hospital in Shanghai, China. The purposive and snowball sampling method was used and Colaizzi's seven-step phenomenological analysis was employed. The Consolidated criteria for Reporting Qualitative research (COREQ) was followed to report findings. RESULTS Fifteen nurses participated in the study and shared their suggestions based on their experiences. Four overarching themes emerged from the data: (1) extending the education duration, (2) enriching the educational content, (3) expanding the education subjects, and (4) perfecting the educational process. Each theme included several subthemes. CONCLUSION Health education on breastfeeding should focus on the time, content, subjects, and process as a whole. The nurses' statements provided a reference for nursing or hospital supervisors to take measures to improve education and increase the breastfeeding rate of hospitalized neonates. Further research from the perspectives of parturients and their family members is needed, to find out what the key points are that all of them attach importance to.
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Affiliation(s)
- Haoxue Feng
- grid.24516.340000000123704535Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092 China
| | - Ying Liu
- grid.459512.eObstetrics Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
| | - Junying Li
- grid.459512.eGynecology Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
| | - Hui Jiang
- grid.459512.eNursing Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
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Wyles C, Gephart SM, Nunez F. Engaging Parents of Fragile Infants in the Design and Appraisal of Health Literature: An Español Toolkit for Necrotizing Enterocolitis. J Perinat Neonatal Nurs 2022; 36:198-208. [PMID: 35476774 DOI: 10.1097/jpn.0000000000000644] [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: 11/26/2022]
Abstract
WHAT WAS OBSERVED OR INVESTIGATED The increased morbidity of diverse infants is unacceptable, and methods to reduce necrotizing enterocolitis (NEC) in their communities are needed. This article discusses the importance of the Español toolkit; provides a backstory of how the Español toolkit came about and how it was verified and validated; and concludes with impressions from involving parents in the research process. SUBJECTS AND METHODS After research evidence was translated from English into Spanish, a cross-sectional exploratory, descriptive, mixed-methods study was conducted, guided by the knowledge translation into practice (Translating Research Into Practice [TRIP]) framework. Twenty bilingual English-Spanish parents of fragile infants evaluated the NEC-Zero Español toolkit from a single neonatal intensive care unit. RESULTS AND CONCLUSIONS The NEC-Zero Español toolkit was found to be easy-to-use and useful and provided information that can be used to augment information sharing. Having access to health information offers a meaningful way to start a conversation and may even impact positive behaviors such as breastfeeding promotion. To lessen Spanish speakers' linguistic barriers, providing materials in Spanish can help meet their information needs and initiate conversations with healthcare providers. This is particularly important because Hispanic infants are at high risk for NEC.
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McCulloch H, Campbell-Yeo M, Richardson B, Dol J, Hundert A, Dorling J, Whitehead L, MacRae G, Bishop T, Afifi J, Earle R, Rose AE, Foye S, Inglis D, Kim T, Leighton C, Melanson A, Simpson DC, Smit M. The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:49-62. [PMID: 34931565 PMCID: PMC9072949 DOI: 10.1177/19375867211065178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.
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Affiliation(s)
| | - Marsha Campbell-Yeo
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brianna Richardson
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | | | | | | | - Sarah Foye
- IWK Health, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Mike Smit
- School of Information Management, Dalhousie University, Halifax, Nova Scotia, Canada
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Givrad S, Hartzell G, Scala M. Promoting infant mental health in the neonatal intensive care unit (NICU): A review of nurturing factors and interventions for NICU infant-parent relationships. Early Hum Dev 2021; 154:105281. [PMID: 33229068 DOI: 10.1016/j.earlhumdev.2020.105281] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Premature and medically vulnerable infants experience early and sometimes prolonged separation from their parents, intrusive and unnatural environments, painful and distressing procedures, difficulties with physiological regulation, increased biological and neurological vulnerabilities, and grow up to have higher rates of neurocognitive and psychosocial difficulties. Parents of infants born prematurely or with medical vulnerabilities, in turn, experience significant distress and are a psychiatrically vulnerable population, with very high rates of depression, anxiety, and posttraumatic stress disorder. The combination of these factors cause significant challenges for some of these infants and parents in developing an early optimal relationship and connection. Given the critical importance of early relationships with main caregivers for infant mental health and long-term developmental outcomes, we review various targets of intervention to promote healthy infant and parent mental health and bonding thereby facilitating an optimal infant-parent relationship in the NICU population.
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Affiliation(s)
- Soudabeh Givrad
- Weill Cornell Medicine, 525 East 68th street, box 140, New York, NY 10065, United States of America.
| | - Georgina Hartzell
- Weill Cornell Medicine, 525 East 68th street, box 140, New York, NY 10065, United States of America.
| | - Melissa Scala
- Stanford University School of Medicine, 750 Welch Rd, Suite 315, Palo Alto, CA 94304, United States of America.
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Improving the Efficiency and Effectiveness of Parent Education in the Neonatal Intensive Care Unit: Erratum. Adv Neonatal Care 2020; 20:150. [PMID: 32221139 PMCID: PMC7497467 DOI: 10.1097/anc.0000000000000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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