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Al-Motlaq M, Foster M, Zgambo M, Neill S. Assessing the maturity of the "Family Centered Care" concept: A review of concept analyses studies. J Pediatr Nurs 2024; 79:150-156. [PMID: 39265244 DOI: 10.1016/j.pedn.2024.09.004] [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: 07/08/2024] [Revised: 09/04/2024] [Accepted: 09/04/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Concept analysis studies play major role in clarifying and operationalizing concepts. This approach has been used to clarify and advance knowledge about the concept of Family Centred Care (FCC). The concept of FCC has been studied by many nursing scholars using different methods. AIM This review aimed to combine outcomes of concept analysis studies to assess the level of maturity of the concept of Family Centred Care. METHODS Formal electronic databases (MEDLINE and CINAHL) and informal (Google Scholar) were searched using the terms "Family Centred Care" and "concept analysis". The Morse concept maturity evaluation approach was used to appraise the retrieved studies. RESULTS 35studies were identified of which12 met the inclusion criteria and were included in the analysis. Three studies used Walker and Avant concept analysis methodology, three applied the Rodgers evolutionary model while six applied modified mixed/hybrid approaches. While a few provided a definition of FCC, none have been able to confirm the maturity of the concept. This review summarized the different trials to analyze the concept of FCC supporting the rethinking of the model and emergence of new models such as Child and Family Centred Care (CFCC). IMPLICATIONS Concept analyses should be done periodically to assess the maturity of emerging concepts. Previously published FCC concept analyses manuscripts show the concept has evolved and gained significant recognition and acceptance over time. A clearer definition of FCC supports its positive impact on patient outcomes. A comprehensive FCC tool that can evaluate the effective delivery of FCC is needed.
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Affiliation(s)
- Mohammad Al-Motlaq
- Department of Maternal Child and Family Health, Faculty of Nursing, The Hashemite University, Zarqa, Jordan.
| | - Mandie Foster
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Edith Cowan University, School of Nursing and Midwifery, Joondalup, Western Australia, Australia.
| | - Maggie Zgambo
- Edith Cowan University, School of Nursing and Midwifery, Joondalup, Western Australia, Australia.
| | - Sarah Neill
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK.
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Carter B, Young S, Ford K, Campbell S. The Concept of Child-Centred Care in Healthcare: A Scoping Review. Pediatr Rep 2024; 16:114-134. [PMID: 38391000 PMCID: PMC10885088 DOI: 10.3390/pediatric16010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system.
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Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK
| | - Sarah Young
- Launceston Clinical School, Tasmanian School of Medicine, College of Health & Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Karen Ford
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Steven Campbell
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
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Cai Q, Wang H, Chen D, Xu W, Yang R, Xu X. Effect of family-centred care on parental mental health and parent-infant interactions for preterm infants: a systematic review protocol. BMJ Open 2022; 12:e062004. [PMID: 36198456 PMCID: PMC9535193 DOI: 10.1136/bmjopen-2022-062004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Unexpected premature delivery and separation from preterm infants are common problems that parents of preterm infants must handle with. Parents of preterm infants may suffer from severe psychological distress. Family-centred care (FCC) can effectively ease parents' psychological distress and strengthen connections between parents and their preterm infants. The purpose of this systematic review will be to systematically review and evaluate the impacts of FCC interventions on the mental health of parents of preterm infants and the parent-infant relationship. METHODS AND ANALYSIS This protocol for this systematic review will be conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. We will search databases including PubMed, Embase, The Cochrane Library, CINAHL, Web of Science, PsycINFO, Scopus and ProQuest, CNKI, SinoMed and Wanfang Data from 1 July 2012 to 1 July 2022. An additional search of OpenGrey will be conducted to identify grey literature. Randomised controlled trials related to FCC inventions for preterm infants≤37 weeks' gestational age and their parents will be included, and the outcome measures will be parental mental health and parent-infant interaction. Two reviewers will independently conduct title and abstract screening, full-text screening, data extraction and study quality assessment. Risk of bias for the studies will be evaluated using the Cochrane Collaboration Risk of Bias V.2.0. Any disagreements will be solved by a third reviewer to reach a consensus. If appropriate, a meta-analysis will be conducted to assess the effect of FCC on parental mental health and parent-infant relationship. ETHICS AND DISSEMINATION Research ethics approval will not be required for this review since it will not involve the collection of primary data and will only use published literature. The results will be disseminated in a peer-reviewed journal through publication or by presentation at relevant academic conference. PROSPERO REGISTRATION NUMBER CRD42022299203.
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Affiliation(s)
- Qian Cai
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Hua Wang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Danqi Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenli Xu
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
| | - Rui Yang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinfen Xu
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
- Obstetrics Department, Haining Maternal and Child Health Hospital, Branch of Women's Hospital School of Medicine Zhejiang University, Haining, Zhejiang, China
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McInally W, Campbell K. Healthcare Professional and Service User Perspectives on Formal Educational Programmes for Children and Young People with Cancer in the UK. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:608-614. [PMID: 33033951 PMCID: PMC9205799 DOI: 10.1007/s13187-020-01854-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Caring for children and young people with cancer requires specific knowledge, skills and experience to deliver the complex care regimes both within the hospital or community environment. This study explored the educational gaps in caring for children and young people with cancer. To address this, a mixed methodology approach was adopted in two phases. Phase one was a questionnaire circulated to healthcare professional members (n = 850) of the Children's Cancer and Leukaemia Group and Managed Service Network, Scotland. Response rate (n = 121) (14%) was achieved. In phase two of the study, a focus groups (n = 4) was conducted with young people in Scotland through the Managed Service Network. This was to gain a critical understanding from service user perspective and what they deemed as important to their overall care delivery. Phase one: healthcare professional results reported that 76% (n = 93) were aware of education; 69% (n = 84) found that knowledge supported practice development, but only 45% (n = 55) finding current education provision useful. The top education topics identified to be lacking in educational availability were communication, psychological support, dealing with young people, supportive care, diagnosis and treatment and challenges to learning. Several participants 64% (n = 78) suggested that funding and time was a barrier, and that there was a lack of provision. Phase two: Findings from the focus group (n = 4) thematic analysis identified five key themes. Service users expected professionals to be knowledgeable and trained, but when talking about experiencing care, gave insights into the gaps in their care. Findings suggest that formal cancer education is required.
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Affiliation(s)
- Wendy McInally
- Faculty of Wellbeing, Education and Language Studies, The Open University, 10 Drumsheugh Gardens, EH3 7QJ Edinburgh, Scotland
| | - Karen Campbell
- Macmillan Cancer Support, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8EG Scotland
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Sturgiss EA, Peart A, Richard L, Ball L, Hunik L, Chai TL, Lau S, Vadasz D, Russell G, Stewart M. Who is at the centre of what? A scoping review of the conceptualisation of 'centredness' in healthcare. BMJ Open 2022; 12:e059400. [PMID: 35501096 PMCID: PMC9062794 DOI: 10.1136/bmjopen-2021-059400] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We aimed to identify the core elements of centredness in healthcare literature. Our overall research question is: How has centredness been represented within the health literature published between 1990 and 2019? METHODS A scoping review across five databases (Medline (Ovid), PsycINFO, CINAHL, Embase (Ovid) and Scopus; August 2019) to identify all peer-reviewed literature published since 1990 that focused on the concept of centredness in any healthcare discipline or setting. Screening occurred in duplicate by a multidisciplinary, multinational team. The team met regularly to iteratively develop and refine a coding template that was used in analysis and discuss the interpretations of centredness reported in the literature. RESULTS A total of 23 006 title and abstracts, and 499 full-text articles were screened. A total of 159 articles were included in the review. Most articles were from the USA, and nursing was the disciplinary perspective most represented. We identified nine elements of centredness: Sharing power; Sharing responsibility; Therapeutic relationship/bond/alliance; Patient as a person; Biopsychosocial; Provider as a person; Co-ordinated care; Access; Continuity of care. There was little variation in the concept of centredness no matter the preceding word (eg, patient-/person-/client-), healthcare setting or disciplinary lens. Improving health outcomes was the most common justification for pursuing centredness as a concept, and respect was the predominant driving value of the research efforts. The patient perspective was rarely included in the papers (15% of papers). CONCLUSIONS Centredness is consistently conceptualised, regardless of the preceding word, disciplinary lens or nation of origin. Further research should focus on centring the patient perspective and prioritise research that considers more diverse cultural perspectives.
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Affiliation(s)
- Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Annette Peart
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lauralie Richard
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Lauren Ball
- Menzies Health Institute Queensland, Griffith University,School of Public Health, Southport, Queensland, Australia
| | - Liesbeth Hunik
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tze Lin Chai
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Steven Lau
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | - Grant Russell
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Moira Stewart
- Department of Family Medicine, Centre for Studies in Family Medicine, Western University, London, Ontario, Canada
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Exploring Parent Support Needs during the Newborn Hearing Diagnosis Pathway. J Clin Med 2022; 11:jcm11051389. [PMID: 35268480 PMCID: PMC8911342 DOI: 10.3390/jcm11051389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022] Open
Abstract
Universal newborn hearing screening (UNHS) facilitates early detection of permanent congenital hearing loss in newborns. In recognition of specific needs among parents, support services have been established within some UNHS programs, including the Victorian Infant Hearing Screening Program (VIHSP). Despite this, there is limited research about how to best support parents in the context of well-established UNHS programs. This project aims to retrospectively explore parental support needs between the newborn hearing screen and enrolment into early intervention services. We used semi-structured interviews with parents three- to- six-months post confirmation of their newborn’s diagnosis of bilateral moderate-profound sensorineural hearing loss. Data were analysed using inductive content analysis. Thirteen parents of ten children were interviewed. Parents described high satisfaction with the support they received. Some parents felt unprepared for a diagnosis of hearing loss, having been reassured that transient causes such as middle ear fluid caused the hearing screen result. Parents reported mixed responses regarding the value of parent-mentor support along the pathway and some parents described needing additional psychological input to adjust to their child’s diagnosis. These findings provide insights into how a well-established UNHS program, VIHSP, supports parents along the hearing diagnosis pathway and how support can be further enriched.
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Attard C, Elliot M, Grech P, McCormack B. Adopting the Concept of ‘Ba' and the ‘SECI' Model in Developing Person-Centered Practices in Child and Adolescent Mental Health Services. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:744146. [PMID: 36188764 PMCID: PMC9397818 DOI: 10.3389/fresc.2021.744146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022]
Abstract
The concept of knowledge is divided into explicit and tacit knowledge; explicit knowledge refers to the knowledge that can be articulated, written and stored, while tacit knowledge refers to personal experiences, values, beliefs and emotions of an individual. By Nonaka's theory, explicit and tacit knowledge do not lie separately but interact together by interactions and relationships between human beings. Thus, the SECI model is based on the assumption that knowledge is created through the social interaction of tacit and explicit knowledge; known as knowledge conversion. The SECI model is based upon four modes of knowledge conversion; socialization, externalization, combination and internalization. 'Ba' is considered to be a shared platform for knowledge creation. 'Ba' is a shared space, be it physical, mental or a combination of both that serves as a foundation of knowledge creation. Ba involves sharing of tacit knowledge i.e. emotions, feelings, experiences and mental images. It also involves the formation of a collective relationship which is open to the sharing of practices, values, processes and culture. This concept focuses mainly on the individual as a person who holds the knowledge rather than just on the knowledge itself. It aims to create a common space to bring people together where they can dialogue to share and create knowledge. As in the relationships formed in person-centered practices, relationships formed in Ba are based on not just the sharing of objective knowledge but also on sharing values, beliefs, and emotions. It also reflects the formation of a person-centered environment as a basis for person-centered research where healthful relationships with the participants are formed. Furthermore, Ba will aid in creating a sense of connectiveness and dialogue, thus focusing on the idea that the development of new practices is done with others rather than to others. In this article we will discuss how these Eastern concepts can be adapted and used to develop person-centered practices within child and adolescent mental health services, specifically related to rehabilitation and recovery. The concepts of personhood will be discussed, followed by a reflection on current practices adopted when working with children and adolescents.
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Affiliation(s)
- Christie Attard
- Division of Nursing, Queen Margaret University, Musselburgh, United Kingdom
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Msida, Malta
- *Correspondence: Christie Attard
| | - Michelle Elliot
- Division of Occupational and Art Therapies, Queen Margaret University, Musselburgh, United Kingdom
| | - Paulann Grech
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Brendan McCormack
- Division of Nursing, Queen Margaret University, Musselburgh, United Kingdom
- Division of Occupational and Art Therapies, Queen Margaret University, Musselburgh, United Kingdom
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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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Fraser LK, Murtagh FE, Aldridge J, Sheldon T, Gilbody S, Hewitt C. Health of mothers of children with a life-limiting condition: a comparative cohort study. Arch Dis Child 2021; 106:987-993. [PMID: 33653713 PMCID: PMC8461446 DOI: 10.1136/archdischild-2020-320655] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/17/2021] [Accepted: 01/31/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition. METHODS Comparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal-child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk. RESULTS A total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18). CONCLUSION This study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.
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Affiliation(s)
| | - Fliss Em Murtagh
- Hull York Medical School, University of Hull, Hull, Kingston upon Hull, UK
| | - Jan Aldridge
- Clinical Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Trevor Sheldon
- School of Medicine, Queen Mary University of London, London, UK
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Brugnaro BH, Lima CRG, Campos ACD, Rocha NACF. Translation of the “F-Words Tools” into Brazilian Portuguese. FISIOTERAPIA EM MOVIMENTO 2021. [DOI: 10.1590/fm.2021.34110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The International Classification of Functionality, Disability and Health (ICF) determines that for any health condition, functionality is the result of the multidirectional relationship between the positive aspects of the components of body structures and functions, activities, participation and contextual factors, encompassing personal and environmental factors. Objective: To translate and culturally adapt the “F-Words Tools” into Brazilian Portuguese. Methods: Permission to translate was granted by the authors. After reading and understanding the instruments, a researcher performed a non-certified translation into Brazilian Portuguese. Next, the back translation into English was done by a specialist in both languages without prior knowledge of the original versions. The result of the back translation was sent to the authors of the instrument for verification of semantics and content. Based on the authors' recommendations and the results of translation analyses, there was no need for cultural adaptation. Results: The back translation was approved by the authors, indicating that the Brazilian Portuguese version of all instruments was adequate. The translated titles are: Termo de Compromisso (Agreement), Colagem (Collage), Perfil (Profile) and Folha de Metas (Goal Sheet). The ICF framework was entitled: “The ICF model and My Favorite Words”. The material is available free of charge at the CanChild website. Conclusion: The translation into Brazilian Portuguese allows materials to be used in Brazil to disseminate the concepts of the ICF and the “F-words” in clinical and family settings.
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Predieri B, Bruzzi P, Bigi E, Boncompagni A, Bocchi F, Cenciarelli V, Madeo SF, Poluzzi S, Pugliese M, Toffoli C, Lucaccioni L, Iughetti L. Health-related quality of life and metabolic control in immigrant and Italian children and adolescents with type 1 diabetes and in their parents. Pediatr Diabetes 2020; 21:1031-1042. [PMID: 32418308 DOI: 10.1111/pedi.13042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/23/2020] [Accepted: 05/08/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To determine if the diabetes-specific health-related quality of life (D-HRQOL) of young people with type 1 diabetes (T1D) and their parents is influenced by migrant status. SUBJECTS AND METHODS One hundred and twenty-five patients (12.4 ± 3.55 years, males 53.6%) with T1D and their parents (102 mothers, 37 fathers) were enrolled and categorized into: group A (both foreign parents) and group B (both native Italian parents). The Pediatric Quality of Life Inventory™ 3.0 Diabetes Module (PedsQL™ 3.0 DM) was used to evaluate the D-HRQOL. Data on diabetic ketoacidosis (DKA) at T1D onset, insulin therapy, and glycosylate hemoglobin (HbA1c) were also collected. RESULTS Group A (n = 40), compared to group B (n = 85), had higher frequency of DKA at T1D onset (P < .001) and a lower use of sensor augmented insulin pump (P = .015). HbA1c values were higher in group A than in group B (P < .001). Patients' "Diabetes symptoms" (P = .004), "Treatment barriers" (P = .001), and "Worry" (P = .009) scales scores were lower in group A than in group B. Mothers of group A had lower scores in "Diabetes symptoms" (P = .030), "Treatment barriers" (P < .001), "Treatment adherence" (P = .018), "Communication" (P = .009) scales, and total score (P = .011) compared to the group B ones. High PedsQL™ 3.0 DM was significantly associated with being Italian, being prepubertal, and having lower HbA1c mean levels. CONCLUSIONS Being a migrant confers disadvantages in terms of D-HRQOL and metabolic control in children and adolescents with T1D. Specific educational interventions should be considered in the clinical care of patients with migration background, to improve D-HRQOL and health status.
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Affiliation(s)
- Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy.,Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Patrizia Bruzzi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bigi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Boncompagni
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Bocchi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Cenciarelli
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona F Madeo
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Poluzzi
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Marisa Pugliese
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Carlotta Toffoli
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Lucaccioni
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy.,Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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12
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Raatz M, Ward EC, Marshall J, Afoakwah C, Byrnes J. "It Takes a Whole Day, Even Though It's a One-Hour Appointment!" Factors Impacting Access to Pediatric Feeding Services. Dysphagia 2020; 36:419-429. [PMID: 32617894 DOI: 10.1007/s00455-020-10152-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/23/2020] [Indexed: 01/18/2023]
Abstract
Feeding disorders can have a significant impact on children and their families. Access to supportive multidisciplinary care is central to improving outcomes; however, there are numerous factors that can impact service access. Using a mixed methods design, the current study examined parents' experiences and satisfaction with accessing a state-wide government-funded tertiary pediatric feeding clinic in Australia. Parents of 37 children (aged 7 weeks to 17 years) participated in the study, residing 6-1435 km from the service. Each completed questionnaires regarding satisfaction (Client Satisfaction Questionnaire-8 Child Services) and costs, and participated in a semi-structured interview. Costs were measured as both direct (e.g., accommodation) and indirect (measured as lost productivity) associated with accessing their feeding appointment. Results revealed parents were highly satisfied with their child's feeding services, but considerable impacts were reported in accessing the service with 85% of the group noting that attending their child's appointment took at least half a day. The total cost per appointment ranged between $53 and $508 Australian dollars. Interviews identified three main barrier themes: distance and travel, impact on daily activities (e.g., work, school), and parent perception of inaccurate representation of their child's feeding skills within the clinic environment. The issues raised were also tempered by an overarching theme of parental willingness to do "whatever was needed" to meet their child's needs, regardless of these barriers. Service providers should be cognizant of the factors that impact access for families and consider alternative service-delivery models where appropriate to help reduce family burden associated with accessing necessary care.
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Affiliation(s)
- Madeline Raatz
- Speech Pathology Department, Queensland Children's Hospital, PO Box 3474, Brisbane, QLD, 4101, Australia. .,School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Elizabeth C Ward
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.,Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, QLD, Australia
| | - Jeanne Marshall
- Speech Pathology Department, Queensland Children's Hospital, PO Box 3474, Brisbane, QLD, 4101, Australia.,School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Clifford Afoakwah
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, QLD, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, QLD, Australia
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Mark K. Family presence during paediatric resuscitation and invasive procedures: the parental experience: An integrative review: An integrative review. Scand J Caring Sci 2020; 35:20-36. [PMID: 32200563 DOI: 10.1111/scs.12829] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/08/2020] [Accepted: 02/02/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The evolvement of family-centred care has been an ongoing process since the Platt Report 1959. Family-centred care has become the modern working model in paediatrics and obstetrics. Parental participation is central to family-centred care. Whether it is applied consistently remains to be concluded. AIM The aim of the study was to describe the family experiences of being present during paediatric resuscitation and invasive procedures. METHOD The design used in this study is an integrative review by Whittemore & Knafl. Databases PubMed and CINAHL were searched for primary research concerning the parental experiences of participating in paediatric resuscitation and invasive procedures. Eighteen studies were included in the study. A quality assessment tool was applied. FINDINGS A pro-parental presence was the results of 17 of the 18 included studies. Six common themes were found: 'Being there', 'Calming child', 'Calming parent', 'Having the right', 'Do it again' and 'Seeing is believing'. CONCLUSION Including family in resuscitation and invasive procedures requires openness as a working model and demands organisational changes and the updating of guidelines. The inseparability of parent-child is attachment theory practised, an innate quality of being a child as well as a parent. Recommendations are to have a facilitator present during resuscitation and invasive procedures to alleviate stress on everyone's part, enabling family participation.
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Affiliation(s)
- Katarina Mark
- Department of Neurobiology Care Science and Society, Karolinska Institute, Huddinge, Sweden
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14
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Hao Z, Ruggiano N. Family-centeredness in dementia care: what is the evidence? SOCIAL WORK IN HEALTH CARE 2020; 59:1-19. [PMID: 31900066 DOI: 10.1080/00981389.2019.1690089] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 10/05/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
Over the last decade, person-centered practices in care for adults with Alzheimer's disease and related dementias (AD/RD) has received significant attention from the health care and social service literature, though less attention has been paid to family-centered care (FCC). Initially conceptualized for application in pediatric care, FCC is an approach where clinicians develop partnerships with care recipients' family members and views family members as having expertise to contribute to the clinical team. More recently, FCC has been extended to the literature on AD/RD care, though little is known about the extent to which family-centered interventions have been developed for use in AD/RD clinical practice, or the effectiveness of family-centered care for this population. To contribute to gaps in scholarship, this systematic review identified and evaluated intervention studies examining FCC in AD/RD clinical care. Implications for research and practice are discussed.
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Affiliation(s)
- Zhichao Hao
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Nicole Ruggiano
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
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15
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O'Connor S, Brenner M, Coyne I. Family‐centred care of children and young people in the acute hospital setting: A concept analysis. J Clin Nurs 2019; 28:3353-3367. [DOI: 10.1111/jocn.14913] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/07/2019] [Accepted: 03/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Siobhán O'Connor
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
| | - Maria Brenner
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
| | - Imelda Coyne
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
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16
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van Oort PJS, Maaskant JM, Smeulers M, van Oostrum N, Vermeulen E, van Goudoever JB. Participation of Parents of Hospitalized Children in Medical Rounds: A Qualitative Study on Contributory Factors. J Pediatr Nurs 2019; 46:e44-e51. [PMID: 30904344 DOI: 10.1016/j.pedn.2019.02.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Factors that promote parents' participation during medical rounds on their hospitalized child have not been fully addressed. The aim of this study was to identify factors that promote the participation of family members during medical rounds. DESIGN AND METHODS This was a descriptive qualitative study using elements of analysis from the grounded theory method. Semi-structured interviews and non-participant observations were performed from December 2015 until June 2016 and took place on a general academic pediatric ward where the age of children did not exceed 12 months. RESULTS In total 20 participants were interviewed: 10 pediatric nurses, 4 pediatricians and 6 parents. In addition, five medical rounds were videotaped. Five themes emerged from the analyses of the interviews and videotapes: "conditions", "structure of medical rounds", "cast", "adaptive professionals" and "parents' participation as a process". CONCLUSION Contextual factors, such as the room and seating arrangement, as well as the willingness of healthcare professionals to work together with the parents are important in enabling parents' participation. To promote active participation, professionals have to communicate in layman's terms and information given by parents has to be taken seriously. Support and coaching of parents during the medical rounds and evaluating the rounds are meaningful factors. PRACTICE IMPLICATIONS These findings help healthcare professionals to restructure the traditional medical rounds to enable parents' participation. The identified communication skills and attitudes can enhance the competencies of nurses and doctors as communicators and collaborators. This urge the need for more specific education for professionals to promote parents' participation.
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Affiliation(s)
- Peter J S van Oort
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands; ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
| | - Jolanda M Maaskant
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands; ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Marian Smeulers
- Outpatients' Department, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Nicky van Oostrum
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands; ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Eric Vermeulen
- Dutch Patient Alliance for Rare and Genetic Diseases, Soest, the Netherlands
| | - Johannes B van Goudoever
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Department of Pediatrics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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17
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Gill SD, Fuscaldo G, Page RS. Patient-centred care through a broader lens: Supporting patient autonomy alongside moral deliberation. Emerg Med Australas 2019; 31:680-682. [PMID: 30924236 DOI: 10.1111/1742-6723.13287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/24/2019] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
Patient-centred care (PCC) is an essential component of high-quality healthcare and shared decision-making is its cornerstone. Yet, integrating the principles of PCC into healthcare practice is not always straightforward and shared decision-making can be complicated and ethically demanding. While ethicists and academics routinely debate moral aspects of clinical care, such discussion among clinicians is less overt. In this paper, we use Emmanuel et al.'s deliberative model to provide a practical framework for considering ethical aspects of PCC and shared decision-making. The model encourages us to appreciate PCC through a broader lens and consider patient autonomy alongside other moral obligations such as justice and the equitable distribution of finite resources. The model can be used by healthcare providers, patients and caregivers to facilitate dialogue and moral deliberation regarding the merit of their preferences and values; in this way, individualised care can be delivered without compromising other important ethical obligations.
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Affiliation(s)
- Stephen D Gill
- Barwon Centre for Orthopaedic Research and Education (B-CORE), St John of God Hospital, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | | | - Richard S Page
- Barwon Centre for Orthopaedic Research and Education (B-CORE), St John of God Hospital, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
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18
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Lyu QY, Wong FKY, You LM, Zhou XZ. Unmet Family Needs Concerning Healthcare Services in the Setting of Childhood Hospitalization for Cancer Treatment in Mainland China: A Qualitative Study. J Pediatr Nurs 2019; 44:e66-e71. [PMID: 30503155 DOI: 10.1016/j.pedn.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE The focus of this paper is to identify the unmet family needs during children's hospitalization for cancer treatment. DESIGN AND METHODS Qualitative interviews were carried out with five fathers and fourteen mothers purposively sampled from four pediatric oncology departments in Mainland China from September 2013 to March 2014. Audiotaped interviews were transcribed verbatim, and data in transcripts were coded and analyzed by qualitative content analysis. RESULTS The identified unmet family needs pertaining to healthcare service during a child's hospitalization for cancer treatment were unmet need for warm and supportive attitudes; competent care; adequate information; a comfortable environment; and catering support. CONCLUSIONS The results showed that families with children hospitalized for cancer treatment have a variety of unmet needs related to healthcare service. These identified unmet family needs have already shed light on areas for healthcare service improvement. PRACTICE IMPLICATIONS This study have reminded nurses' to become more concerned about unmet family needs instead of only focusing on the hospitalized child in clinical settings. Healthcare professionals can assist in promoting family adaptation to children's hospitalization by satisfying their unmet family needs.
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Affiliation(s)
- Qi-Yuan Lyu
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | | | - Li-Ming You
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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19
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Parent's experiences of their child's withdrawal syndrome: a driver for reciprocal nurse-parent partnership in withdrawal assessment. Intensive Crit Care Nurs 2018; 50:71-78. [PMID: 30224222 DOI: 10.1016/j.iccn.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/29/2018] [Accepted: 09/04/2018] [Indexed: 11/20/2022]
Abstract
Withdrawal assessment in critically ill children is complicated by the reliance on non-specific behaviours and compounded when the child's typical behaviours are unknown. The existing approach to withdrawal assessment assumes that nurses elicit the parents' view of the child's behaviours. OBJECTIVE AND RESEARCH METHODOLOGY This qualitative study explored parents' perspectives of their child's withdrawal and preferences for involvement and participation in withdrawal assessment. Parents of eleven children were interviewed after their child had completed sedation weaning during recovery from critical illness. Data were analysed using thematic analysis. SETTING A large children's hospital in the Northwest of England. FINDINGS Parents experienced varying degrees of partnership in the context of withdrawal assessment and identified information deficits which contributed to their distress of parenting a child with withdrawal syndrome. Most parents were eager to participate in withdrawal assessment and reported instances where their knowledge enabled a personalised interpretation of their child's behaviours. Reflecting on the reciprocal nature of the information deficits resulted in the development of a model for nurse-parent collaboration in withdrawal assessment. CONCLUSION Facilitating nurse-parent collaboration in withdrawal assessment may have reciprocal benefits by moderating parental stress and aiding the assessment and management of withdrawal syndrome.
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20
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Ford K, Campbell S, Carter B, Earwaker L. The concept of child-centered care in healthcare. ACTA ACUST UNITED AC 2018; 16:845-851. [DOI: 10.11124/jbisrir-2017-003464] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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21
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Boland L, Kryworuchko J, Saarimaki A, Lawson ML. Parental decision making involvement and decisional conflict: a descriptive study. BMC Pediatr 2017; 17:146. [PMID: 28610580 PMCID: PMC5470309 DOI: 10.1186/s12887-017-0899-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 06/05/2017] [Indexed: 01/03/2023] Open
Abstract
Background Decisional conflict is a state of uncertainty about the best treatment option among competing alternatives and is common among adult patients who are inadequately involved in the health decision making process. In pediatrics, research shows that many parents are insufficiently involved in decisions about their child’s health. However, little is known about parents’ experience of decisional conflict. We explored parents’ perceived decision making involvement and its association with parents’ decisional conflict. Method We conducted a descriptive survey study in a pediatric tertiary care hospital. Our survey was guided by validated decisional conflict screening items (i.e., the SURE test). We administered the survey to eligible parents after an ambulatory care or emergency department consultation for their child. Results Four hundred twenty-nine respondents were included in the analysis. Forty-eight percent of parents reported not being offered treatment options and 23% screened positive for decisional conflict. Parents who reported being offered options experienced less decisional conflict than parents who reported not being offered options (5% vs. 42%, p < 0.001). Further, parents with options were more likely to: feel sure about the decision (RR 1.08, 95% CI 1.02–1.15); understand the information (RR 1.92, 95% CI 1.63–2.28); be clear about the risks and benefits (RR 1.12, 95% CI 1.05–1.20); and, have sufficient support and advice to make a choice (RR 1.07, 95% CI 1.03–1.11). Conclusion Many parents in our sample experienced decisional conflict after their clinical consultation. Involving parents in the decision making process might reduce their risk of decisional conflict. Evidence based interventions that support parent decision making involvement, such as shared decision making, should be evaluated and implemented in pediatrics as a strategy to reduce parents’ decisional conflict. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0899-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Boland
- University of Ottawa, Faculty of Health Sciences, Population Health, 125 University Street, room 232, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer Kryworuchko
- University of Saskatchewan College of Nursing Health Sciences, E-4220, 104 Clinic Place, Saskatoon, S7N 5E5, SK, Canada.,Present address: School of Nursing, University of British Columbia, Vancouver, Canada
| | - Anton Saarimaki
- Ottawa Hospital Research Institute & University of Ottawa, 501 Smyth Road, Box 711, Ottawa, ON, K2G 0Y1, Canada
| | - Margaret L Lawson
- Family Decision Services, CHEO Research Institute, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
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Dennis C, Baxter P, Ploeg J, Blatz S. Models of partnership within family-centred care in the acute paediatric setting: a discussion paper. J Adv Nurs 2016; 73:361-374. [PMID: 27706840 DOI: 10.1111/jan.13178] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 12/16/2022]
Abstract
AIMS A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships. A rigorous examination of concepts embedded in family-centred care such as partnership may provide a better understanding of how to implement the broader concept and support exemplary care in today's clinical practice environment. DESIGN Discussion paper. DATA SOURCES Electronic search (January 2000 - December 2014) performed on CINAHL, Medline, EMBASE, Sociological Abstracts and PsychINFO using keywords partnership, family-centred care and conceptual framework. Eligible references were drawn from the databases, reference lists and expert sources. Eight models met inclusion criteria and had currency and relevance to the acute paediatric setting. IMPLICATIONS FOR NURSING Nurses should continue exploring partnership in various paediatric contexts given the wide-ranging definitions, lack of operational indicators and need for stronger relational statements in current models. An examination of key strategies, barriers and facilitators of partnership is recommended. CONCLUSION One partnership model had both high overall maturity and best fit with family-centred care principles. All models originate from Western and developed countries, indicating that future partnership models should be more geographically, culturally and economically diverse.
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Affiliation(s)
- Christine Dennis
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Pamela Baxter
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Susan Blatz
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
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23
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Knox V, Menzies S. Using the Measure of Processes of Care to Assess Parents' Views of a Paediatric Therapy Service. Br J Occup Ther 2016. [DOI: 10.1177/030802260506800303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bobath Scotland is a tertiary referral centre providing therapy for children with cerebral palsy. The staff wanted to find a standardised tool that could assess parents' views regarding the care that their children had received. The aim of this study was to conduct a trial using a recently developed tool, the Measure of Processes of Care (MPOC) (King et al 1995), to investigate families' perceptions of the care received at Bobath Scotland and the extent to which they considered it ‘family friendly’. The MPOC questionnaire was sent to the families who attended Bobath Scotland during a 12-month period. The MPOC consists of five scales: enabling and partnership; general information; specific information; coordinated and comprehensive care; and respectful and supportive care. Items are scored on a 7-point scale, from the behaviour ‘never’ occurs (1) to ‘occurs to a great extent’ (7). Mean scores are calculated for each scale. Questionnaires were sent to 114 families and 72 were returned completed (63%). The mean scale scores were as follows: enabling and partnership, 6.3 (SD 0.64); general information, 4.3 (SD 1.69); specific information, 6.5 (SD 0.75); coordinated and comprehensive care, 6.3 (SD 0.75); and respectful and supportive care, 6.5 (SD 0.60). The overall mean scale scores were high, demonstrating that families were satisfied with their care. The MPOC proved an appropriate tool to investigate the perceptions of care of families attending a paediatric centre.
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24
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Experiences of neonatal nurses and parents working collaboratively to enhance family centred care: The destiny phase of an appreciative inquiry project. Collegian 2016. [DOI: 10.1016/j.colegn.2015.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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25
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Nijhuis BJG, Reinders-Messelink HA, de Blécourt ACE, Olijve WG, Groothoff JW, Nakken H, Postema K. A review of salient elements defining team collaboration in paediatric rehabilitation. Clin Rehabil 2016; 21:195-211. [PMID: 17329277 DOI: 10.1177/0269215506070674] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To explicate the complex process of team collaboration and identify salient elements of team collaboration in paediatric rehabilitation. Data sources: After an initial search to define key features of team collaboration a systematic search on team collaboration and the key features was executed to identify salient elements. The systematic search was carried out in Index Medicus (MEDLINE), Educational Resource Information Clearinghouse (ERIC) and American Psychological Association (Psyc INFO) covering the period from January 1993 to December 2004. Review methods: Based on title and abstract relevant publications were identified and qualitatively assessed by two reviewers. To facilitate the interpretation of the salient elements, the articles were also classified according to the criteria ‘participants and setting’ and ‘research method’. Results: Of the total of 930 identified publications 28 studies proved eligible and were subsequently assessed. The evaluation yielded 29 salient elements defining five key features of team collaboration (i.e. communication, decision making, goal setting, organization and team process). Parent involvement proved to play a dominant role and was mentioned in relation to all five features. Conclusions: Based on the results, rather than an underlying element, it is proposed to consider parent involvement as the sixth feature of team collaboration. The 29 distinctive elements of teamwork could be useful as a guideline and checklist for empirical studies and may help enhance multidisciplinary collaboration in paediatric care. However, additional exploratory research focusing on the way these elements interact with each other and the key features and whether they facilitate or restrict team collaboration is warranted.
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Affiliation(s)
- B J G Nijhuis
- Center for Rehabilitation and Northern Center for Health Care Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Abstract
Introduction: This systematic review seeks to identify the intended
components of the role of care coordinator for children with complex care needs
and the factors that determine its composition in practice. Theory and methods: The initial search identified 1,157 articles, of
which 37 met the inclusion criteria. They were quality assessed using the SIGN
hierarchy of evidence structure. Results: Core components of the role include: coordination of care
needs, planning and assessment, specialist support, emotional support,
administration and logistics and continuing professional development.
Influencing factors on the role include the external environment (political and
socio-economic), the internal environment (organisational structure and funding
protocols), the skills, qualifications and experience of the coordinator, the
family circumstances and the nature of the interaction between the care
coordinator and the family. Discussion: The lack of consistent terminology creates challenges
and there is a need for greater consensus on this issue. Organisations and
healthcare professionals need to recognise the extent to which contextual
factors influence the role of a care coordinator in practice and plan
accordingly. Despite evidence that suggests that the role is pivotal in ensuring
that care needs are sustained, there remains great variability in the
understanding of the role of a care coordinator for this population. Conclusions: As the provision of care increasingly moves closer to
home there is a need for greater understanding of the nature and composition of
the interaction between care coordinators and families to determine the extent
to which appropriate services are being provided. Further work in this area
should take into consideration any potential variance in service provision, for
example any potential inequity arising due to geographic location. It is also
imperative, where appropriate, to seek the views of children with complex care
needs and their siblings about their experiences.
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Rossignol L. Relationship between Participation in Patient- and Family-Centered Care Training and Communication Adaptability among Medical Students: Changing Hearts, Changing Minds. Perm J 2016; 19:54-8. [PMID: 26176569 DOI: 10.7812/tpp/14-110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A census of 43 third-year medical students at the University of New Mexico School of Medicine participated in Parents Reaching Out: Families as Faculty program during their pediatric rotation. Analysis of variance revealed statistical significance for the factor "appropriate disclosure" (meaning students have become more sensitive to the level of intimacy that the other person is seeking and the student is willing to offer more information). There was a positive correlation between pretest and posttests in social experience, wit, and social confirmation.
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Affiliation(s)
- Lisa Rossignol
- Current Fellow at the Georgetown Leadership Academy in Cultural Competence and Cultural and Linguistic Diversity in Santa Fe, NM. She served for two years on the Patient Centered Outcomes Research Initiative Improving Healthcare Systems Advisory Board, and is now serving as Parent Liaison to the American Academy of Pediatrics' Council on Quality Improvement and Patient Safety. NM.
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28
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Arcuri GG, McMullan AE, Murray AE, Silver LK, Bergthorson M, Dahan-Oliel N, Coutinho F. Perceptions of family-centred services in a paediatric rehabilitation programme: strengths and complexities from multiple stakeholders. Child Care Health Dev 2016; 42:195-202. [PMID: 26647743 DOI: 10.1111/cch.12308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 08/24/2015] [Accepted: 10/21/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Family-centred services (FCS) are best practice in paediatric rehabilitation and describe philosophies and approaches to medical care that emphasize the partnership and involvement of parents. While evidence supports FCS, there are complexities to its successful implementation. This mixed-methods study aimed to measure the extent to which parents and the healthcare provider (HCP) perceive service provision as being family centred, and to describe barriers and facilitators to the delivery of FCS. METHODS Parents of children participating in a rehabilitation programme and HCPs providing services participated in this study. Parents completed the measure of processes of care-20 and participated in interviews, while HCPs completed the measure of processes of care-service providers and participated in a focus group. RESULTS Quantitative analysis revealed that parents were mostly satisfied with features of FCS, which included communication and support between parents and HCPs, respect of diversity and parental collaboration and participation. Parents identified communication methods and psychosocial needs as areas that facilitated but sometimes detracted from FCS. Institutional barriers led to the identification of areas for improvement identified by multiple stakeholders. HCPs identified more areas for improvement than parents. CONCLUSION When considering these barriers, it is evident that implementation is a complex process, impacted by institutional barriers. FCS needs to be investigated further, and systemic interventions should be used to facilitate its implementation.
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Affiliation(s)
- G G Arcuri
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - A E McMullan
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - A E Murray
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Motor Developmental Disorders Program, MAB Mackay Rehabilitation Centre, Montreal, QC, Canada
| | - L K Silver
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - M Bergthorson
- Motor Developmental Disorders Program, MAB Mackay Rehabilitation Centre, Montreal, QC, Canada
| | - N Dahan-Oliel
- Shriners Hospital for Children, Montreal, QC, Canada
| | - F Coutinho
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
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Foster M, Whitehead L, Maybee P. The Parents', Hospitalized Child's, and Health Care Providers' Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research. JOURNAL OF FAMILY NURSING 2016; 22:6-73. [PMID: 26706128 DOI: 10.1177/1074840715618193] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Family-centered care (FCC) purports that unlimited presence and involvement of the family in the care of the hospitalized child will optimize the best outcome for the child, family, and institution. A systematic appraisal was conducted of peer-reviewed, English-language, primary quantitative research conducted within a pediatric critical care setting reported from 1998 to 2014. The aim of this review was to explore the parents', hospitalized child's, and health care providers' perception of FCC within pediatric critical care. Fifty-nine articles met the criteria that generated themes of stress, communication, and parents' and children's needs. This review highlighted that communication tailored to meet the parents' and child's needs is the key to facilitating FCC and positive health outcomes. Health care providers need to be available to provide clinical expertise and support throughout the health care journey. Future initiatives, education, and research are needed to evaluate the benefits of parent- and child-led FCC practice.
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Affiliation(s)
- Mandie Foster
- 1 University of Otago, Christchurch, New Zealand
- 2 Christchurch Hospital, New Zealand
| | - Lisa Whitehead
- 3 Edith Cowan University, Joondalup, Western Australia, Australia
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Stefánsdóttir S, Thóra Egilson S. Diverging perspectives on children’s rehabilitation services: a mixed-methods study. Scand J Occup Ther 2015; 23:374-82. [DOI: 10.3109/11038128.2015.1105292] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Tierney S, Blackhurst M, Scahill R, Callery P. Loss and rebuilding: A qualitative study of late diagnosis of cleft palate. J SPEC PEDIATR NURS 2015; 20:280-9. [PMID: 26149202 DOI: 10.1111/jspn.12125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 05/26/2015] [Accepted: 05/29/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To explore the experiences of parents whose child received a late diagnosis of cleft palate (>24 hr after birth). DESIGN AND METHODS Parents of 17 children and three nurses specialised in cleft care (specialist nurses) took part in a qualitative, semi-structured interview. Framework analysis was applied to data. RESULTS Loss and rebuilding was an overarching concept-from the crescendo leading up to the bombshell of diagnosis, followed by the aftermath of dealing with the child's long-term condition. PRACTICE IMPLICATIONS Specialist nurses can help parents to trust healthcare professionals and to feel confident in their ability to nurture by listening, informing, and supporting.
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Affiliation(s)
- Stephanie Tierney
- Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Peter Callery
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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Stremler R, Adams S, Dryden-Palmer K. Nurses' views of factors affecting sleep for hospitalized children and their families: A focus group study. Res Nurs Health 2015; 38:311-22. [PMID: 25970699 DOI: 10.1002/nur.21664] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 11/09/2022]
Abstract
Light, noise, and interruptions from hospital staff lead to frequent awakenings and detrimental changes to sleep quantity and quality for children who are hospitalized and their parents who stay with them overnight. An understanding of nurses' views on how care affects sleep for the hospitalized child and parent is crucial to the development of strategies to decrease sleep disturbance in hospital. The purpose of this descriptive qualitative study was to gain an understanding of nurses' views on their role in and influence on sleep for families; perceived barriers and facilitators of patient and parent sleep at night; strategies nurses use to preserve sleep; the distribution, between parent and nurse, of care for the child at night; views of the parent as a recipient of nursing care at night; and the nature of interactions between nurses and families at night. Thirty registered nurses from general pediatric and critical care units participated in one of four semi-structured focus groups. Four main influences on sleep were identified: child factors; environmental factors; nurse-parent interaction factors; and nursing care factors. Some of these restricted nurses' ability to optimize sleep, but many factors were amenable to intervention. Balancing strategies to preserve sleep with the provision of nursing assessment and intervention was challenging and complicated by the difficult nature of work outside of usual waking hours. Nurses highlighted the need for formal policy and mentoring related to provision of nursing care at night in pediatric settings.
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Affiliation(s)
- Robyn Stremler
- Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Room 288, 155 College Street, Toronto, Ontario, Canada, M5T 1P8.,Adjunct Scientist, The Hospital for Sick Children, Toronto, Canada
| | - Sherri Adams
- Nurse Practitioner, Paediatric Medicine Complex Care Program, The Hospital for Sick Children, Toronto, Canada
| | - Karen Dryden-Palmer
- Clinical Nurse Specialist, Bereavement Coordinator, Critical Care, The Hospital for Sick Children, Toronto, Canada
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Majamanda MD, Munkhondya TEM, Simbota M, Chikalipo M. Family Centered Care versus Child Centered Care: The Malawi Context. Health (London) 2015. [DOI: 10.4236/health.2015.76088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Involving parents in managing their child's long-term condition-a concept synthesis of family-centered care and partnership-in-care. J Pediatr Nurs 2015; 30:143-59. [PMID: 25458112 DOI: 10.1016/j.pedn.2014.10.014] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 10/16/2014] [Accepted: 10/19/2014] [Indexed: 11/23/2022]
Abstract
UNLABELLED BACKGROUNG: Fostering effective engagement, collaboration and empowerment are central to supporting parents caring for children with long-term conditions. METHODS A concept synthesis was undertaken to identify the shared antecedents and attributes underpinning models of family-centered care and partnership-in-care. RESULTS Thirty studies were reviewed; antecedents of models related to unclear roles, entrenched professional practices, and lack of guidelines supporting their implementation; with central attributes being building trust, listening to parent concerns and valuing parents' knowledge of their child. CONCLUSION The key attributes are outlined in a practical framework of involvement which may promote parent-professional collaboration for families of children with long-term conditions.
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Nightingale R, Sinha MD, Swallow V. Using focused ethnography in paediatric settings to explore professionals' and parents' attitudes towards expertise in managing chronic kidney disease stage 3-5. BMC Health Serv Res 2014; 14:403. [PMID: 25234741 PMCID: PMC4176584 DOI: 10.1186/1472-6963-14-403] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 09/15/2014] [Indexed: 11/26/2022] Open
Abstract
Background Interactions between parents and healthcare professionals are essential when parents of children with chronic conditions are learning to share expertise about clinical care, but limited evidence exists on how they actually interact. This paper discusses the use of focused ethnography in paediatric settings as an effective means of exploring attitudes towards expertise. Methods The paper draws on repeated observations, interviews and field-notes involving the parents of six children with chronic kidney disease, and 28 healthcare professionals at two, tertiary, children’s hospital-based units. Data were analysed using the Framework approach and the concepts of expertise and self-management. Results Our study highlighted rewards and challenges associated with focused ethnography in this context. Rewards included the ability to gain a richer understanding of the complex phenomena of mutual acknowledgement of expertise that occurs during parent/ healthcare professional interactions. Challenges related to gaining informed consent and ensuring potential participants had an adequate understanding of the purpose of the study. Two dimensions of parental expertise around their child (personal and clinical) were evident in our data. Parents’ and professionals’ expertise about the child and their condition was acknowledged and exchanged as parents learnt to share clinical-care with the multi-disciplinary team. Healthcare professionals acknowledged parents’ need to understand aspects of each of the eight disciplinary knowledge bases relating to their child’s management and recognised parents’ expert knowledge of their child, found ways to mobilise this knowledge, and wove parents’ expertise into the management plan. Parents spoke of the degree to which their own expert knowledge of their child complemented healthcare professionals’ clinical knowledge. However, ambivalence around expertise was evident as both parents and healthcare professionals questioned what the expertise was, and who the expert was. Our discussion focuses on the ways healthcare professionals and parents share expertise around the child’s condition as parents take on responsibility for home-based clinical care. Conclusions Our findings point to focused ethnography being an effective way of capturing new insights into parent and professional interactions in a paediatric setting and mutual acknowledgement of expertise; these insights may help redress the reported limitations of previous, retrospective studies.
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Affiliation(s)
- Ruth Nightingale
- NIHR Clinical Research Network: North Thames, c/o Somers Clinical Research Facility, Frontage Building, Level 1, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
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King G, Chiarello L. Family-centered care for children with cerebral palsy: conceptual and practical considerations to advance care and practice. J Child Neurol 2014; 29:1046-54. [PMID: 24810084 DOI: 10.1177/0883073814533009] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/16/2022]
Abstract
This article focuses on conceptual and practical considerations in family-centered care for children with cerebral palsy and their families. In the last 5 years, there have been important advances in our understanding of the components of family-centered care, and initial attempts to understand the client change processes at play. Recent research elaborates on family-centered care by delving into aspects of family-provider partnership, and applying family-centered principles to organizational service delivery to bring about organizational cultures of family-centered care. Recent research has also begun to consider mediators of client change, and new practice models have been proposed that embrace family-centered principles and illustrate the "art" of practice. Future research directions are discussed, including explorations of causal relationships between family-centered care principles, elements of caregiving practice, client change processes, and child and family outcomes. The meaning of the recent literature for pediatric neurology practice is considered.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute and University of Toronto, Toronto, Ontario, Canada
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Moreau KA, Cousins JB. A survey of program evaluation practices in family-centered pediatric rehabilitation settings. EVALUATION AND PROGRAM PLANNING 2014; 43:1-8. [PMID: 24239867 DOI: 10.1016/j.evalprogplan.2013.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 10/01/2013] [Accepted: 10/10/2013] [Indexed: 06/02/2023]
Abstract
Program evaluation is becoming increasingly important in pediatric rehabilitation settings that adhere to the family-centered service (FCS) philosophy. However, researchers know little about the specific evaluation activities occurring in these settings or the extent to which evaluators/service providers uphold FCS in their program evaluation activities. Through a questionnaire survey, this study aimed to document evaluators/service providers' perceptions of the level of program evaluation occurring in their Canadian pediatric rehabilitation centers. It also investigated the extent to which evaluators/service providers perceive program evaluation practices at their centers to be consistent with the FCS context of Canadian pediatric rehabilitation settings. The findings suggested that the amount of evaluation activities occurring within the respondents' centers is variable; that the majority of individuals working in program evaluation do not have formal training in it; and that the respondents' centers have limited resources for evaluation. The study also showed that staff members believe their centers' evaluation activities are somewhat consistent with FCS philosophy, but that improvements are needed.
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Affiliation(s)
- Katherine A Moreau
- University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier Road, Ottawa, ON K1N 6N5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada.
| | - J Bradley Cousins
- University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier Road, Ottawa, ON K1N 6N5, Canada
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38
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LeGrow K, Hodnett E, Stremler R, McKeever P, Cohen E. Bourdieu at the bedside: briefing parents in a pediatric hospital. Nurs Inq 2014; 21:327-335. [PMID: 24467272 DOI: 10.1111/nin.12063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2013] [Indexed: 11/30/2022]
Abstract
The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting.
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Affiliation(s)
- Karen LeGrow
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, ON, Canada; The Hospital for Sick Children, Toronto, ON, Canada
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Coyne I, Murphy M, Costello T, O'Neill C, Donnellan C. A survey of nurses' practices and perceptions of family-centered care in Ireland. JOURNAL OF FAMILY NURSING 2013; 19:469-488. [PMID: 24108266 DOI: 10.1177/1074840713508224] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Family-centered care (FCC) is a philosophy of care that recognizes the family's central role in the child's life and in the delivery of care. We used a survey design to investigate the practices and perceptions of nurses toward FCC in Ireland. Data were obtained from 250 nurses in seven hospitals using the Family-Centered Care Questionnaire-Revised (FCCQ-R). Findings indicated that nurses' practices were significantly different from their perceptions of FCC. Nurses with dual registration (children and adult) had significantly lower mean scores on the total current (practice) scale than the other registration subgroups. Nurses with a baccalaureate or a higher academic qualification had higher mean scores than nurses who held a certificate-level qualification on the total necessary (perception) scale, which assessed the activities perceived to be necessary for FCC. Findings showed that nurses support FCC but perceive the design of the health care system and parent-professional collaboration as barriers to FCC practice.
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40
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Shanley L, Mittal V, Flores G. Preventing dehydration-related hospitalizations: a mixed-methods study of parents, inpatient attendings, and primary care physicians. Hosp Pediatr 2013; 3:204-211. [PMID: 24313088 DOI: 10.1542/hpeds.2012-0094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The goal of this study was to identify the proportion of dehydration-related ambulatory care-sensitive condition hospitalizations, the reasons why these hospitalizations were preventable, and factors associated with preventability. METHODS A cross-sectional survey of primary care providers (PCPs), inpatient attending physicians, and parents was conducted in a consecutive series of children with ambulatory care-sensitive conditions admitted to an urban hospital over 14 months. RESULTS Eighty-five children were diagnosed with dehydration. Their mean age was 1.6 years; most had public (74%) or no (17%) insurance, and were nonwhite (91%). The proportion of hospitalizations assessed as preventable varied from 12% for agreement among all 3 sources to 45% for any source. Parents identified inadequate prevention (50%), poor self-education (34%), and poor quality of care (38%) as key factors. PCPs identified parents providing insufficient home rehydration (33%), not visiting the clinic (25%), and not calling earlier (16%) as reasons. Inpatient attending physicians cited home rehydration (40%), delays in seeking care (40%), and lacking a PCP (20%) as contributors. Physicians (PCPs and inpatient attending physicians) were more likely than parents to describe the admission as inappropriate (75% vs 67% vs 0%; P < .01). Parental dissatisfaction with their child's PCP and a history of avoiding primary care due to costs or insurance problems were associated with significantly higher odds of preventable hospitalization. CONCLUSIONS Up to 45% of dehydration-related hospitalizations may be preventable. Inadequate parental education by physicians, insufficient home rehydration, deferring clinic visits, insurance and cost barriers, inappropriate admissions, poor quality of care, and parental dissatisfaction with PCPs are the reasons that these hospitalizations might have been prevented.
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Affiliation(s)
- Leticia Shanley
- Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
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Watt L, Dix D, Gulati S, Sung L, Klaassen RJ, Shaw NT, Klassen AF. Family-centred care: a qualitative study of Chinese and South Asian immigrant parents' experiences of care in paediatric oncology. Child Care Health Dev 2013; 39:185-93. [PMID: 22066491 DOI: 10.1111/j.1365-2214.2011.01342.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. METHODS This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. RESULTS Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. CONCLUSIONS In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit.
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Affiliation(s)
- L Watt
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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42
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Ringnér A, Öster I, Björk M, Graneheim UH. Talking via the child: discursively created interaction between parents and health care professionals in a pediatric oncology ward. JOURNAL OF FAMILY NURSING 2013; 19:29-52. [PMID: 23076622 DOI: 10.1177/1074840712462136] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of this study was to describe discursively constructed interactions between parents and health care professionals (HCPs) in a pediatric oncology ward. Field notes from 70 focused participant observations and 16 informal interviews with 25 HCPs interacting with 25 parents of children with cancer were analyzed using discursive psychology. Six dominant interpretative repertoires (flexible parts of discourses used in everyday interaction) were found. Repertoires used by the HCPs were child, parent, or family oriented, mirroring the primary focus of the interaction. Parents used a spokesperson repertoire to use their own expertise to talk on behalf of the child; an observer repertoire, in which they kept in the background and interfered only when needed; or a family member repertoire to position themselves on a level equal to the ill child. The results are discussed in relation to philosophies influencing pediatric nursing, such as family-centered nursing and child-centered nursing.
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Livesley J, Long T. Children's experiences as hospital in-patients: voice, competence and work. Messages for nursing from a critical ethnographic study. Int J Nurs Stud 2013; 50:1292-303. [PMID: 23332686 DOI: 10.1016/j.ijnurstu.2012.12.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 11/30/2012] [Accepted: 12/06/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is growing evidence that children's subjective interpretations of events may differ significantly from those of adults; yet children's and young people's voices and children's knowledge regarding hospital care remain relatively unexplored. OBJECTIVE To develop insight into children's subjective interpretations and knowledge of being hospital in-patients. DESIGN Critical ethnography. SETTING A nephro-urology ward in a tertiary referral children's hospital in the north of England. PARTICIPANTS A purposive sample was employed of 15 children over 2 phases: six (9-15 years) at home in a reconnaissance first phase, and nine (5-14 years) in hospital in phase 2. METHODS A raft of child-friendly, age-appropriate strategies was used to engage children in phase 1. Phase 2 involved over 100 h of field-work with hospitalised children over 6 months, with observation, interview, play and craft activities as prominent methods. Data were analysed using constant comparative methods. RESULTS The study ward was a place in which children struggled to find a space for their competence to be recognised and their voice heard. Children's voice became manifest in what they said but also through the non-verbal mechanisms of resisting, turning away and being silent. While all the children shared the experience of being in trouble, recognition of their competence was fluid and contingent on their relationships with the nurses alongside other structural and material factors. The children worked hard to maintain their position as knowledgeable individuals. When they could not do so they relied on supportive adults, and in the absence of supportive adults they became marooned and received bare minimum care. CONCLUSION The hospital ward was a place for children in which there was little space for children's voices. When their voices were heard, they were often seen as a challenge. Quiet, sick and shy children who were alone were the most likely to have their needs overlooked and become subject to standardised nursing care. A more inclusive and participatory model of nursing practice with children is urgently needed.
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Affiliation(s)
- Joan Livesley
- School of Nursing, Midwifery and Social Work, College of Health and Social Care, University of Salford, United Kingdom.
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Trajkovski S, Schmied V, Vickers M, Jackson D. Neonatal nurses' perspectives of family-centred care: a qualitative study. J Clin Nurs 2012; 21:2477-87. [PMID: 22889445 DOI: 10.1111/j.1365-2702.2012.04138.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to explore neonatal nurses' perspectives of their role in facilitating family centred care in the neonatal intensive care unit. BACKGROUND The philosophy of family centred care focuses on the health and wellbeing of the newborn and their family, through the development of a respectful partnership between the health care professional and the infant's parents. Many studies report family centred care in the context of paediatric care; however, few studies explore neonatal nurses' perspective of family centred care in the context of neonatal care. DESIGN Qualitative interpretative approach. METHODS Four focus groups and five individual face-to-face interviews were conducted with neonatal intensive care nurses (total n=33) currently practicing in a tertiary Neonatal Intensive Care Unit in Australia. Each focus group and face to face interview was audio-taped and transcribed. Data was analysed using thematic analysis. RESULTS Four dominant themes emerged from the data: (1) Getting to know parents and their wishes (2) Involving family in the day to day care (3) Finding a 'happy' medium (4) Transitioning support across the continuum. CONCLUSION These findings revealed a general understanding of family centred care principles. Nurses reported the potential benefits and challenges of adopting a family centred care approach to deliver optimal care for neonates and their families. The study highlighted that nurses need ongoing organisation support, guidance and further education to assist them in delivering family centred care effectively. RELEVANCE TO CLINICAL PRACTICE Family centred care is a central tenet underpinning neonatal care. Understanding neonatal nurses' perspectives will be useful when developing strategies to strengthen family centred care in the neonatal intensive care unit, and potentially improve neonatal care and family outcomes.
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Affiliation(s)
- Suza Trajkovski
- Family and Community Health Research Group (FaCH), School of Nursing & Midwifery, College of Health Science, University of Western Sydney, Sydney, Australia.
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Kelly P, Kelly D. Childhood cancer-parenting work for British Bangladeshi families during treatment: an ethnographic study. Int J Nurs Stud 2012; 50:933-44. [PMID: 23218019 DOI: 10.1016/j.ijnurstu.2012.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 10/30/2012] [Accepted: 11/06/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To detail the day to day management experiences of a specific group of parents from a minority ethnic group who lack representation in many studies. BACKGROUND Studies of parental experiences during their child's treatment for cancer have revealed a considerable burden of care related to intensive treatment regimens and the uncertainty of prognosis. In the context of UK paediatric cancer services there is limited research on how parents manage their daily lives and no published studies detailing the experiences of parents from minority ethnic groups. DESIGN, SETTING AND PARTICIPANTS This ethnographic study used participant observation in the home, community and clinical settings, to follow eight families of British Bangladeshi children undergoing cancer treatment over an extended time period (22 months). Focused interviews with parents (7) were conducted. Data were analysed concurrently during fieldwork with themes identified, defined and refined, maintaining context whilst comparing within and across data sets. RESULTS Parental roles and responsibilities are reconceptualised in this study as a form of 'work' that parents (and children) undertook to achieve and manage cancer treatment. Five themes describing parental work were identified: Managing Competing Knowledge, Vigilance, Advocacy, Balancing Parental Work and the Burdens of Treatment. Analysis revealed that cancer-specific knowledge was more highly valued by professionals than child-specific knowledge. A good deal of their 'work' related to being vigilant about their child's condition and care and treatment, including acting as advocates. Whilst undertaking caring work for their child, parents had to balance this with a range of other responsibilities. The range of responsibilities placed on parents throughout treatment were acknowledged only rarely by professionals and as a result, parents experienced their input as a burden that lacked recognition and increased a vulnerability, already present through minority ethnic status. CONCLUSIONS The taken for granted and often unseen aspects of parenting during childhood cancer treatment constituted a considerable workload for this group of parents. The relentless nature of treatment was also a burden, since this took place in the context of on-going uncertainty about their child's recovery. Clinical staff should consider the impact of service organisation and treatments on specific groups of parents including minority ethnic groups in order to recognise and mitigate against burdensome work.
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Affiliation(s)
- Paula Kelly
- Louis Dundas Centre for Children's Palliative Care, University College London, United Kingdom.
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Skene C, Franck L, Curtis P, Gerrish K. Parental Involvement in Neonatal Comfort Care. J Obstet Gynecol Neonatal Nurs 2012; 41:786-97. [DOI: 10.1111/j.1552-6909.2012.01393.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Aarthun A, Akerjordet K. Parent participation in decision-making in health-care services for children: an integrative review. J Nurs Manag 2012; 22:177-91. [PMID: 23406447 DOI: 10.1111/j.1365-2834.2012.01457.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2012] [Indexed: 01/08/2023]
Abstract
AIM To describe and synthesize previous research on parents' perceptions of their participation in decision making in child health-care services. BACKGROUND Health policy in the area of user involvement emphasizes parent participation in decision-making (DM), thus ensuring that services are provided in accordance with their child's needs and enhancing parents' control over their child's health-care services. METHOD A systematic literature search, covering the period January 2000 to February 2011, found 18 studies that met the inclusion criteria. The analysis process involved data extraction, reduction, comparison and synthesizing. FINDINGS Three themes emerged: (1) relational factors and interdependence, (2) personal factors and attitudes and (3) organisational factors. CONCLUSIONS Parents highlighted the importance of the parent-health professional relationship, professionals' competence and the possibility of varying the degree of participation in decision making. Challenges involved asymmetry in authority and power, professionals' attitudes and competence and organisational shortcomings in health-care services. Health professionals need to become more aware of their critical role and responsibility in involving parents in DM. IMPLICATIONS FOR NURSING MANAGEMENT Health professionals' attitudes and competence can be improved by knowledge of user involvement and research and facilitating the inclusion of parents in decision making by influencing the culture, routines and resources in the health service.
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Affiliation(s)
- Antje Aarthun
- Department of Therapy, Stavanger University Hospital, Stavanger, Norway
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Higham S, Davies R. Protecting, providing, and participating: fathers' roles during their child's unplanned hospital stay, an ethnographic study. J Adv Nurs 2012; 69:1390-9. [DOI: 10.1111/j.1365-2648.2012.06131.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Sue Higham
- Faculty of Health and Social Care; Open University; Milton Keynes; UK
| | - Ruth Davies
- College of Human and Health Sciences; Swansea University; Wales; UK
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Nelson PA, Kirk SA, Caress AL, Glenny AM. Parents' emotional and social experiences of caring for a child through cleft treatment. QUALITATIVE HEALTH RESEARCH 2012; 22:346-359. [PMID: 21890716 DOI: 10.1177/1049732311421178] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Little is known about the experiences of parents caring for a child through long-term treatment for cleft lip and/or cleft palate. We conducted in-depth interviews with 35 parents with children between the ages of 20 weeks and 21 years to explore experiences across the treatment program. We analyzed the data using a constructivist grounded theory approach and present in detail in this article one subcategory from the analysis: managing emotions. Throughout childhood and adolescence, parents experienced conflicting emotions about their child's impairment, uncertainty about cleft treatment, and stigmatizing attitudes. Although parents attempted to manage emotional tensions by pursuing cleft treatments, the interventions could themselves be a source of conflict for them. We suggest that routine assessment of parents' emotional and social well-being should be included in cleft treatment programs, and access to psychosocial support made available.
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