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van Burgsteden L, Lamerichs J, Hoogerwerf A, te Molder H, de Jong M. Formulating parents' feelings: Analyzing parent-nurse conversations in family-integrated neonatal care to develop communication training. PEC INNOVATION 2024; 5:100327. [PMID: 39314545 PMCID: PMC11418159 DOI: 10.1016/j.pecinn.2024.100327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 09/25/2024]
Abstract
Objective The novel concept of Family-Integrated Care (FICare) requires nurses to be parents' partners in neonatal care. We combined analyses of real-life parent-nurse conversations and interviews to elucidate nurses' role in providing psychosocial support to parents. Findings inform the development of communication training on topicalizing parents' feelings. Methods Conversation analysis of 15 audio-recorded parent-nurse conversations, and thematic analysis of interviews with 2 nurses. Results In parent-nurse conversations, nurses showed a "balancing act" in formulating parents' feelings, revealing the complexities of addressing parents' feelings. Overall, parents confirmed nurses' formulations, but also expanded or modified them, or indicated restricted conversational space. In the interviews, nurses discussed four purposes of conversations with parents, emphasizing elaborating on parents' feelings, while discussing associated challenges. Conclusion Our conversation analysis revealed a continuum of nurses' formulations of parents' feelings, and nurses' reflections illuminated how and when the formulations were used to invite parents' "feelings talk". Innovation This study is the first to use conversation analysis to analyze parent-nurse conversations. Additionally, it pioneers combining these analyses with interviews, inviting nurses to reflect on how to incorporate the findings into FICare. This combination strongly informs the development of tailored communication training, drawing from real-life conversations and nurses' articulated needs.
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Affiliation(s)
- Lotte van Burgsteden
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, De Boelelaan 1105 1081, HV, Amsterdam, the Netherlands
| | - Joyce Lamerichs
- Knowledge Center Health and Wellbeing, University of Applied Sciences Windesheim Zwolle, Campus 2, 8017, CA, Zwolle, the Netherlands
| | - Annemarie Hoogerwerf
- Department of Neonatology, Albert Schweitzer Hospital Dordrecht, Albert Schweitzerplaats 25, 3318, AT, Dordrecht, the Netherlands
| | - Hedwig te Molder
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, De Boelelaan 1105 1081, HV, Amsterdam, the Netherlands
| | - Miranda de Jong
- Department of Pediatrics, Albert Schweitzer Hospital Dordrecht, Albert Schweitzerplaats 25, 3318, AT, Dordrecht, the Netherlands
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Albsoul RA, Alshyyab MA, Albayyari RY, Alselaibi DH, Flefil SA, Jardaneh LH, Dababseh SYF, Al Odat BA, Alkubaisi FA, AlKhawaldeh MH, FitzGerald G. Qualitative evaluation of missed nursing care in neonatal intensive care units in a teaching hospital in Jordan. J Pediatr Nurs 2023; 73:e277-e284. [PMID: 37788945 DOI: 10.1016/j.pedn.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Missed nursing care (MNC) is a worldwide patient safety issue. However, little is known about MNC in neonatal intensive care units (NICU). The aim of this paper is to explore the elements and factors influencing the occurrence of MNC in the NICU in a teaching hospital in Amman, Jordan. DESIGN AND METHODS The study used a qualitative descriptive design. Semi-structured interviews were conducted with NICU nurses. Purposeful sampling was used to select the participants and data collection was performed in the period August 2022 to September 2022. Data were analyzed using thematic analysis. RESULTS The participants included 15 female nurses. The majority of the participants held a bachelor's degree in nursing. Five themes emerged from the analysis of data namely: (1) Conceptualizations of MNC (2) Missed care elements in the NICU (3) Reasons behind MNC in the NICU (4) Consequences of MNC and (5) Strategies to reduce the occurrence of MNC. Feeding,changing diapers, monitoring vital signs, and medication administrationwere identified as missed care elements in the NICU. CONCLUSIONS The findings of this research may inform the development of interventions that may reduce missed care incidents in the NICU. PRACTICE IMPLICATIONS Addressing staff shortages and the provision of necessary materials and equipment appear to be the key factors that may reduce the frequency of MNC. Thus, enhancing patient safety and quality healthcare in this challenging healthcare environment.
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Affiliation(s)
- Rania Ali Albsoul
- Healthcare management, Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
| | - Muhammad Ahmed Alshyyab
- Health Services Management, Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | | | | | | | | | | | | | | | | | - Gerard FitzGerald
- Public Health, School of Public Health and Social Work, QUT, Brisbane, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Kim EK, Cho IY, Yun JY, Park B. Factors influencing neonatal intensive care unit nurses' parent partnership development. J Pediatr Nurs 2023; 68:e27-e35. [PMID: 36411178 DOI: 10.1016/j.pedn.2022.10.015] [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: 05/25/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neonatal nurses play an important role in the development of effective partnerships, as they have more consistent interactions with the patients' parents and can encourage parental involvement. This study aimed to identify factors influencing neonatal intensive care unit (NICU) nurses' development of partnerships with parents of high-risk infants in South Korea based on King's interacting systems theory. METHODS We collected data utilizing a structured questionnaire, which included the following variables: developmental supportive nursing competency, empowerment, emotional intelligence, patient-centered communication skills, interpersonal competence, nursing work environment, and nurse-parent partnership. The participants were 140 pediatric nurses with at least one year of NICU experience in South Korea. We used SPSS/WIN 26.0 to analyze the data. FINDINGS Of the factors evaluated, empowerment (β = 0.35, p < 0.001), patient-centered communication skills (β = 0.25, p < 0.01), interpersonal competence (β = -0.27, p = 0.001), emotional intelligence (β = 0.25, p = 0.005), age (β = -0.15, p < 0.01), and gender (β = 0.12, p = 0.03) explained 62.4% of the total variance of the nurse-parent partnership. Our results identify the factors affecting NICU nurses' development of partnerships with parents of high-risk infants. IMPLICATIONS FOR PRACTICE Strategies and efforts to enhance the nurse-parent relationship must consider improving nurse empowerment, intelligence, and interpersonal factors.
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Affiliation(s)
- Eun Kyoung Kim
- Chonnam National University Hospital, Gwang-ju, South Korea
| | - In Young Cho
- College of Nursing, Chonnam National University, South Korea.
| | - Ji Yeong Yun
- Department of Nursing, Jesus University, South Korea
| | - Bobae Park
- Department of Nursing, Seoul National University Hospital, Department of Nursing, College of Nursing, Yonsei University, South Korea
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How to support fathers of preterm infants in early parenthood - An integrative review. J Pediatr Nurs 2022; 67:e38-e47. [PMID: 36335065 DOI: 10.1016/j.pedn.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/04/2022]
Abstract
PROBLEM Preterm birth is a stressful event. Paternal experiences of having a preterm infant indicate a need for tailored support. However, it is unclear which interventions work best. This review presents the evidence on existing healthcare interventions to support fathers of preterm infants in early parenthood, how effective they are and paternal experiences with the interventions. ELIGIBILITY CRITERIA The integrative review process of Whittemore and Knafl was used to guide the study. A structured and comprehensive literature search was conducted in PubMed (MEDLINE), Embase, CINAHL, PsycInfo, Cochrane, Scopus, Web of Science, SweMed+, and Proquest Dissertation & Thesis Global. SAMPLE A total of 18 qualitative and quantitative studies were included in the review. The Mixed Methods Appraisal Tool was used to assess quality. RESULTS Three overall themes were identified in the analysis: 1) Skin-to-skin contact supported interaction between infant and father, 2) information impacted paternal experiences of stress, anxiety, and development of fatherhood, 3) fathers' relationships with the nurses oscillated between conflict and assistance. CONCLUSIONS Our findings show that targeted interventions could support father-infant interaction and reduce stress among fathers of preterm infants. IMPLICATIONS Fathers of preterm infants rely on nurses to support their engagement in early parenthood, while nurses facilitate the interventions that engage the fathers. It is also essential to develop a culture within the neonatal intensive care unit that encourages the presence of fathers and enhances educational nursing strategies for supporting fathers of preterm infants during early parenthood.
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Attitudes Toward Neonatal Palliative Care Among Turkish Nurses and Physicians: A Comparative Cross-sectional Study. J Hosp Palliat Nurs 2022; 24:E185-E196. [PMID: 35470317 DOI: 10.1097/njh.0000000000000875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Few studies have examined and compared neonatal physicians' and nurses' attitudes toward palliative care. This comparative study sought to evaluate attitudes toward neonatal palliative care in neonatal nurses and physicians and identify associated facilitators and barriers. This comparative, cross-sectional study included 173 neonatal intensive care unit staff (149 neonatal nurses and 24 neonatal physicians) in 2 hospitals in Istanbul, Turkey. Data were collected using the Turkish version of the Neonatal Palliative Care Attitude Scale. The results of the study revealed 8 facilitators and 9 barriers to neonatal palliative care. Nurses were significantly more likely than physicians to agree that parents are informed about palliative care options in their unit ( P = .008), that caring for dying infants is traumatic ( P = .007), and that their willingness to provide palliative care is influenced by their personal attitudes toward death ( P = .015). This study demonstrates the importance of parents' active involvement in the palliative care process, the establishment of standard policies and guidelines, and the provision of vocational and in-service education programs to support palliative care. Initiatives to strengthen facilitators and mitigate barriers are needed to optimize the implementation of palliative care in NICUs.
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Zwicky A, Thaqi Q, Hediger H, Naef R. The influence of nurse characteristics on practice skills and attitudes towards working with families in critical care: A regression analysis. Intensive Crit Care Nurs 2022; 72:103261. [PMID: 35672213 DOI: 10.1016/j.iccn.2022.103261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The study aimed to identify nurse characteristics that influence their self-perceived practice skills in working with families and their attitudes towards engaging families in adult and neonatal intensive care units. RESEARCH METHODOLOGY/DESIGN Secondary data analysis using a descriptive, cross-sectional design. SETTING An online survey was completed by 256 nurses from six adult intensive (73% response rate) and two neonatal intensive and one intermediate care unit (27% response rate) in a Swiss, university affiliated hospital. MAIN OUTCOME MEASURES Nurses' self-perceived practice skills in working with families were assessed with the "Family Nursing Practice Scale". Attitudes towards families were measured with the "Families' Importance in Nursing Care - Nurses' Attitudes Scale". Data were analysed with multiple linear regression models. RESULTS Prior education in family nursing significantly influenced nurses' self-perceived practice skills in working with families. Nurses' clinical speciality had a significant influence on their attitudes towards overall, and on the subscale "family as a burden". Neonatal intensive care nurses showed more open attitudes towards families overall, but perceived family more often as a burden than nurses in adult intensive care. Nurses' perceived skills and attitudes in family engagement significantly influenced each other. CONCLUSION The results suggest that nurses' prior education in family nursing and clinical speciality determine their ability to work with and engage families in critical care. Our study suggests that integration of family nursing engagement practices in critical care requires educational implementation strategies combined with culture change efforts.
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Affiliation(s)
- Anja Zwicky
- Cantonal Hospital Winterthur, Department of Medicine, Brauerstrasse 15, 8400 Winterthur, Switzerland.
| | - Qendresa Thaqi
- Centre of Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland.
| | - Hannele Hediger
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland.
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland.
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Mcharo SK, Bally J, Spurr S, Walker K, Peacock S, Holtslander L. Exploring nursing presence as experienced by parents in pediatric oncology. J Pediatr Nurs 2022; 66:86-94. [PMID: 35687929 DOI: 10.1016/j.pedn.2022.05.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nursing presence has been viewed as a valuable way to create therapeutic relationships and has been linked to better health outcomes for patients and families. However, whether nursing presence can be described and how parents in pediatric oncology experience this phenomenon remains unanswered. Therefore, the purpose of this study was to explore how parents of children with cancer describe and experience nursing presence. METHODS This study used Giorgi's phenomenological approach to explore nursing presence as experienced by parents of children with cancer. Ten participants from a pediatric oncology clinic in Canada were interviewed. Giorgi's approach was used to analyze these data. FINDINGS Based upon participants' descriptions, a structure of nursing presence emerged which included six constituent features: An attitude of presence, a source of encouragement, clinical experience and expertise, therapeutic communication, family involvement, and a sense of home away from home. Most notably, nursing presence as experienced by parents was characterized by the 'being' and 'doing' of presence which were equally important. CONCLUSION The experiences described by parents provided rich and nuanced insights into what it meant to experience nursing presence in a pediatric oncology setting. This study provides a structure for this meaning making and expounds on its constituent features, describing what nursing presence resembles when experienced by parents of children with cancer. PRACTICE IMPLICATIONS This study informs nursing practice, policy, and education in ways that are likely to enhance care and the subsequent well-being of pediatric oncology patients and families.
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Affiliation(s)
- Solomon K Mcharo
- University of Saskatchewan, College of Nursing, Saskatoon, SK S7N 5E5, Canada.
| | - Jill Bally
- University of Saskatchewan, College of Nursing, E4348 Health Sciences, Saskatoon, SK, Canada.
| | - Shelley Spurr
- University of Saskatchewan, College of Nursing, E4244 Health Sciences, Saskatoon, SK, Canada.
| | - Keith Walker
- University of Saskatchewan, College of Education, 3063 Education, Saskatoon, SK, Canada.
| | - Shelley Peacock
- University of Saskatchewan, College of Nursing, E4340 Health Sciences, Saskatoon, SK, Canada.
| | - Lorraine Holtslander
- University of Saskatchewan, College of Nursing, E4252 Health Sciences, Saskatoon, SK, Canada.
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Ejlertsen C, Rosenstrøm S, Kristensen IH, Brødsgaard A. Engaging in partnerships is the key to preserving and creating a trustful collaboration with vulnerable families: A focus group study. Midwifery 2022; 114:103440. [DOI: 10.1016/j.midw.2022.103440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/22/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022]
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Factorial Validity of the Pediatric Nurse Parent Partnership Scale—Pediatric Nurses (PNPPS-PN). Healthcare (Basel) 2022; 10:healthcare10060991. [PMID: 35742042 PMCID: PMC9222722 DOI: 10.3390/healthcare10060991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
For the optimal growth and development of high-quality professional nursing care for hospitalized children, a partnership between pediatric nurses and parents within the context of the family is essential. The aim of the present study was to evaluate the factorial validity of the Pediatric Nurse Parent Partnership Scale for hospital pediatric nurses (PNPPS-PN) and to investigate the associations of its components with the Nursing Professional Value Scale and Compassion Competence Scale. This study used survey data from 236 pediatric nurses collected between March and June 2019. The seven-factor structure showed an acceptable to good fit in the confirmatory factor analysis, and the scale correlated as expected with measures of compassion competence and nursing professional values. The Cronbach’s α for the scale was 0.89, indicating good internal consistency reliability. The PNPPS-PN is a psychometrically sound instrument for assessing pediatric nurse-reported partnerships between pediatric nurses and parents in hospital settings.
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Kavati AB, Ramirez F. Nursing commentary to "Surrogate decision-making in crisis". JOURNAL OF MEDICAL ETHICS 2022; 48:293-294. [PMID: 33789949 DOI: 10.1136/medethics-2021-107355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Affiliation(s)
| | - Fritzie Ramirez
- Neonatal Services, University Hospitals of Leicester NHS Trust, Leicester, UK
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Jerofke-Owen TA, McAndrew NS, Gralton KS, Totka JP, Weiss ME, Fial AV, Sawin KJ. Engagement of Families in the Care of Hospitalized Pediatric Patients: A Scoping Review. JOURNAL OF FAMILY NURSING 2022; 28:151-171. [PMID: 34605283 DOI: 10.1177/10748407211048894] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies (N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse-patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.
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Affiliation(s)
| | - Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert Hospital & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Joan P Totka
- Marquette University, Milwaukee, WI, USA
- Children's Wisconsin, Milwaukee, USA
| | | | | | - Kathleen J Sawin
- University of Wisconsin-Milwaukee, USA
- Children's Wisconsin, Milwaukee, USA
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Abstract
INTRODUCTION In 2019, the national average turnover rate of registered nurses in the United States was approximately 17.8%. Each percentage increase in turnover costs a hospital, on average, $270,800. Although burnout is a known contributor to nurses' turnover intention, few studies have examined the relationship between nurse burnout and turnover, and there is little data on this relationship in neonatal intensive care environments. The purpose of this study was to examine the relationship between nurse burnout and turnover among neonatal intensive care unit (NICU) nurses. STUDY DESIGN A secondary analysis of data collected from an observational study involving 136 nurses in a 52-bed NICU from 2013 to 2014. METHODS Multivariate logistic regression models were used to test for associations between measures of burnout and turnover. RESULTS 16.9% of nurses turned over during the 11 months of the original study. Most nurses reported high (46%) to moderate (37%) levels of emotional exhaustion. Final models did not indicate a relationship between burnout and turnover. CLINICAL NURSING IMPLICATIONS Although burnout has been associated with turnover intent among nurses, we did not observe an association between burnout and turnover among NICU nurses. Despite no direct relationship between burnout and turnover in the NICU, burnout may have other negative consequences. Nurse leaders should continue to prioritize reducing burnout among nursing staff to improve the well-being of the NICU nurse workforce.
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Abstract
BACKGROUND/INTRODUCTION One way the goal of establishing a partnership with families is accomplished, specific to the pediatric intensive care units, is 24-hour visitation and presence/participation during medical rounds and procedures. Despite the breadth of literature on the positive effect of parent presence, as well as the nearly nationwide adoption of 24-hour pediatric intensive care unit visitation, there is little to no research about how these changes have affected parents' perception of their role in the pediatric cardiac intensive care unit (PCICU). OBJECTIVES/AIMS The purpose of this study was to explore and better understand the experience of parents in the PCICU within a patient/family-centered care model. METHODS Using a qualitative descriptive approach, interviews were conducted with parents of children currently admitted as inpatients in the PCICU. Participants were asked broad, open-ended questions and probes to attain qualitative descriptions of their experiences and perceptions of their parental role in the PCICU. The research design for this study was based on naturalistic inquiry and was used to describe rather than interpret parental experiences in their own words. RESULTS Eleven parents from 7 families were interviewed; parents described their role in terms of 2 main categories, as one who is an advocate and decision maker and one who provides emotional and physical support. Parents valued the expertise of the PCICU team but also shared the significance of the team recognizing their role as parents. Incorporating parents as an integral member of the health care team is a fundamental component to PCICU care. DISCUSSION/CONCLUSION The role of parents is irreplaceable, particularly in the PCICU. The medical complexity of the intensive care can be a barrier to act as parents resulting in a disruption of family-centered care. Nursing staff avert this disruption through modeling parenting to their child's present circumstances and involvement in normal parenting tasks.
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Gilstrap CM. Organizational Sensegiving in Family-Centered Care: How NICU Nurses Help Families Make Sense of the NICU Experience. HEALTH COMMUNICATION 2021; 36:1623-1633. [PMID: 32643420 DOI: 10.1080/10410236.2020.1785373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As frontline caregivers, nurses play a central role in the coordination and delivery of family-centered care (FCC) in neonatal intensive care units (NICUs). Nurses see first-hand the fear, uncertainty, and anxiety parents experience due to unfamiliar and intimidating elements of neonatal care and the NICU environment. This study examines the sensegiving strategies nurses use to help families make sense of their NICU experience. In-depth, semi-structured interviews were conducted with 14 NICU nurses at a mid-size nonprofit hospital. Findings reveal nurses utilize four sensegiving strategies to influence parents' understanding of, response to, and participation in neonatal care practices: educate parents, personalize information, promote open communication, and encourage meaningful involvement. Overall, nurses rely on communication to align parents' meaning construction with FCC features and goals. Hospital administrators and nurse managers should integrate this study's findings into nurse training and professional development opportunities to teach nurses about parental sensemaking, factors that affect nurse sensegiving efforts, how to create effective sensegiving strategies, and sensegiving challenges they may face. Healthcare leaders should also provide organizational structures, resources, and continuing education programs that help nurses cope with the emotional demands of sensegiving. Moreover, nurses should talk to colleagues or supervisors and participate in self-care activities if sensegiving starts to impact their well-being or ability to provide effective FCC.
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Adcock A, Cram F, Edmonds L, Lawton B. He Tamariki Kokoti Tau: Families of Indigenous Infants Talk about Their Experiences of Preterm Birth and Neonatal Intensive Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9835. [PMID: 34574759 PMCID: PMC8472228 DOI: 10.3390/ijerph18189835] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/04/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022]
Abstract
Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. A cross-sectional interpretative phenomenological analysis of first interviews with 19 whānau participating in a Kaupapa Māori (by, with, for Māori) qualitative longitudinal study of preterm birth identified themes from their experiences and the meanings they attributed to them. Preterm birth was an emotional roller coaster, with the birth imaginary and anticipated roles disrupted as health practitioners took over the care of their infants. Whānau expressed the desire to be close to their infants, holding them, loving them, nurturing them, and emplacing them within whakapapa (genealogy, continual layering of foundations) networks. When health practitioners or hospital policies inhibited this intimacy by isolating, excluding, or discriminating, whānau were frustrated. Being familiar with hospital routines, staff, peers, infant cares, and being wrapped in wider whānau support were key for whānau coping. Whakawhanaungatanga (processes of establishing relationships) create safe spaces for whānau to be themselves. This quietens the 'storm' and returns whānau to a sense of calm, through the reclamation of their environment.
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Affiliation(s)
- Anna Adcock
- (Ngāti Mutunga) Te Tātai Hauora o Hine Centre for Women’s Health Research, Te Herenga Waka Victoria University of Wellington, Wellington 6140, New Zealand
| | - Fiona Cram
- (Ngāti Pāhauwera) Katoa Ltd., Auckland 1143, New Zealand;
| | - Liza Edmonds
- (Ngāpuhi, Ngāti Whātua) Dunedin Hospital, Southern District Health Board, Dunedin 9016, New Zealand;
- Department of Women’s and Children’s Health, University of Otago, Dunedin 9016, New Zealand
| | - Beverley Lawton
- (Te Aitanga-a-Hauiti) Te Tātai Hauora o Hine Centre for Women’s Health Research, Te Herenga Waka Victoria University of Wellington, Wellington 6012, New Zealand;
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Sánchez-Rubio L, Cleveland LM, Durán de Villalobos MM, McGrath JM. Parental Decision-Making in Pediatric Intensive Care: A Concept Analysis. J Pediatr Nurs 2021; 59:115-124. [PMID: 33848782 DOI: 10.1016/j.pedn.2021.03.018] [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: 07/09/2020] [Revised: 02/23/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
The development of nursing knowledge requires a close relationship between theory, research, and practice. The purpose of the analysis of the concept of "parental decision-making in pediatric critical care" is to facilitate nurses' therapeutic care of critically ill children and their families. To construct, structure, and give meaning to the concept, we use our experience in the field, critical reading of the literature, and careful analysis of data that have emerged about parental decision-making in pediatric intensive care. Several factors affect parent's ability to act as decision-makers: the psychosocial and physical disorders they develop, the subordination of their parental roles by the health care team, and the child's critical state of health. While different disciplines, including nursing, have well described the decision-making concept, parental decision-making in the context of pediatric intensive care has not been as well delineated. Nursing science recognizes the importance of decision-making and has incorporated the concept as an essential domain of its philosophical and disciplinary interests. Following the method proposed by Walker and Avant, the concept was analyzed, attributes, background, and consequences described. A model case was presented and discussed. An operational definition emerges, providing knowledge for professional nursing practice and will be the basis for an essential theoretical development around this phenomenon. Parents' recognition, the promotion of family-centered care, and shared decisions are ideal for encouraging parental participation.
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Affiliation(s)
- Lorena Sánchez-Rubio
- Programa de Enfermería, Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
| | - Lisa M Cleveland
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | | | - Jacqueline M McGrath
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
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Xu L, Gong S, Yuan LK, Chen JY, Yang WY, Zhu XC, Yu SY, Huang R, Tian S, Ding HY, He MD, Xiao SJ. Enhanced recovery after surgery for the treatment of congenital duodenal obstruction. J Pediatr Surg 2020; 55:2403-2407. [PMID: 32571537 DOI: 10.1016/j.jpedsurg.2020.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Enhanced recovery after surgery (ERAS) has been widely used in adult surgery. However, ERAS has not been reported in neonatal surgery. The present prospective study explored the application value of ERAS in treating congenital duodenal obstruction (CDO). METHODS A total of 68 cases of CDO were collected from October 1, 2017 to July 31, 2019. We divided patients with a prenatal diagnosis of congenital duodenal obstruction into the ERAS group and those who were diagnosed the disease after birth into the control group. The ERAS group adopted ERAS-related measures, and the control group followed the usual measures. The study compared the differences in the gestational age, birth weight, length of hospital stay (LOS), complications, feeding intolerance, and weight one month after surgery between the two groups. RESULTS A total of 49 patients were included in the analysis, including 23 who were allocated to the ERAS group and 26 to the control group. The LOS was 9.696±1.222 days in the ERAS group and 12.654±1.686 days in the control group, resulting in a significantly shorter LOS in the ERAS group than in the control group (p<0.001). One month after surgery, the neonates in the ERAS group weighted significantly more than those in the control group. No differences were observed in birth weight, gestational age, and the incidence of complications or feeding intolerance between the two groups. CONCLUSION In this single-center study, the implementation of neonate-specific ERAS for CDO surgery was feasible and safe and led to a shorter LOS without increasing the incidence of complications or feeding intolerance. TYPE OF STUDY Treatment Study LEVEL OF EVIDENCE: Level III.
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Affiliation(s)
- Lu Xu
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shu Gong
- Department of Radiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Li-Ke Yuan
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jia-Ying Chen
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wen-Yi Yang
- Reproductive Health and Infertility Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiao-Chun Zhu
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Su-Yan Yu
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Rong Huang
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Song Tian
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Hui-Yang Ding
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China
| | - Mu-Dan He
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shang-Jie Xiao
- Guangdong Women and Children's Hospital, Guangzhou Medical University.
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Neonatal nursing in the COVID-19 pandemic: can we improve the future? JOURNAL OF NEONATAL NURSING : JNN 2020; 26:247-251. [PMID: 32837225 PMCID: PMC7351431 DOI: 10.1016/j.jnn.2020.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/04/2020] [Accepted: 07/04/2020] [Indexed: 12/23/2022]
Abstract
The current 2019 coronavirus disease (COVID-19) is the world's largest and most pervasive public health emergency in more than one hundred years. Although neonatal units have not been at the epicentre of the current health crisis, they have also been forced to adopt contingency plans with the aim of protecting hospitalised neonates, their families, and professionals. Neonatal units have been forced to alter the neonatal care framework based on promoting neurodevelopment and family-centred care. The peak of the pandemic is falling in most countries, but COVID-19 infection is not eradicated and there is uncertainty about new outbreaks. It is time to reflect about better strategies to preserve the rights and excellence of care for newborns and their families. This column will highlight the changes that have occurred in neonatal units, and their impact on neonatal care and families. It is a time for critical reflection on nursing practice.
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Ochandorena-Acha M, Noell-Boix R, Yildirim M, Cazorla-Sánchez M, Iriondo-Sanz M, Troyano-Martos MJ, Casas-Baroy JC. Experiences and coping strategies of preterm infants' parents and parental competences after early physiotherapy intervention: qualitative study. Physiother Theory Pract 2020; 38:1174-1187. [PMID: 32892686 DOI: 10.1080/09593985.2020.1818339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Birth before term is a stressful experience for parents because of the unexpected delivery or admission to the neonatal intensive care unit. OBJECTIVE This research aimed to evaluate the impact of the early PT intervention on preterm infants' parents' experiences, and also to obtain knowledge about parents' experiences and perceived difficulties during preterm infants' care. METHODS This qualitative study is based on the methods of phenomenology. In the first phase, open interviews were developed to allow researchers to immerse themselves in the context of the study and refine the questions for the semi-structured interviews. Data collected from the semi-structured interviews were analyzed through content analysis. RESULTS The results were summarized around three themes: 1) parental competence; 2) difficulties during preterm infants' care; and 3) coping strategies. Each theme was divided into two sub-themes. CONCLUSION Mothers and fathers of preterm infants experienced difficulties when caring for their babies. Parents that received the early physiotherapy intervention felt empowered to take care of their babies and to enhance infants' development. These parents were more capable of developing coping strategies after the intervention. Parents that did not receive the early physiotherapy intervention expressed difficulties when caring for their preterm babies.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Rosa Noell-Boix
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Meltem Yildirim
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Maria Cazorla-Sánchez
- Neonatal Department, Sant Joan De Deu Barcelona Children's Hospital, Barcelona, Spain
| | - Martín Iriondo-Sanz
- Neonatal Department, Sant Joan De Deu Barcelona Children's Hospital, Barcelona, Spain
| | | | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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20
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Parental Understanding of Surgical Care in the Neonatal Intensive Care Unit. J Surg Res 2020; 255:118-123. [PMID: 32543376 DOI: 10.1016/j.jss.2020.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pediatric surgeons are routinely required to discuss complex diagnoses and treatment plans with the parents of their patients. Yet, how well this information is understood by its target audience is unknown. To explore this issue, we asked parents of postoperative neonatal intensive care unit patients to describe their children's care in a variety of domains. Our goal was to assess the degree of parental understanding and to identify factors that influenced comprehension. MATERIALS AND METHODS Parents of neonatal intensive care unit patients who underwent a general surgical procedure were asked to complete a survey of their children's care in six domains of comprehension: name of the primary diagnosis, description of the primary diagnosis, description of the purpose of surgery, identification of surgical risks, identification of surgical benefits, and identification of concerning signs or symptoms to look for after discharge. Parental demographic factors such as age, level of education, and socioeconomic status were recorded, as was the presence of a prenatal diagnosis. RESULTS Overall, 66% of participants described their child's primary surgical condition. Even fewer were able to describe a benefit or risk of the procedure. Parental use of outside resources to gain information was found to significantly relate to parental understanding in all domains. Parental level of education also improved comprehension. CONCLUSIONS Parental understanding of surgical procedures, including the events leading up to and after an operation, is an important component of overall patient care. However, we were able to demonstrate that this understanding may be limited in spite of the best efforts of medical professionals. Further investigations should focus on ways in which information can be delivered more effectively to parents.
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Barnes S, Rio L, de Goumoëns V, Grandjean C, Ramelet AS. Effectiveness and family experiences of interventions promoting partnerships between families and pediatric and neonatal intensive care units: a mixed methods systematic review protocol. JBI Evid Synth 2020; 18:1292-1298. [PMID: 32813377 DOI: 10.11124/jbisrir-d-19-00277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This mixed methods systematic review examines the effectiveness and family experiences of interventions that promote partnerships between parents and the multidisciplinary health care team in pediatric and neonatal intensive care units. INTRODUCTION The hospitalization of a child or infant in an intensive care unit can have considerable negative effects on them and their family. Family members can experience increased stress, anxiety or depression and detrimental impacts on quality of life and family functioning. Interventions that promote families as health care partners may improve negative outcomes arising from intensive care hospitalization. INCLUSION CRITERIA The review will include family members of pediatric or neonatal patients hospitalized in an intensive care unit. It will focus on interventions that promote partnership between families and multidisciplinary health care teams in pediatric and neonatal intensive care units and the family's experiences of these interventions. The outcomes of interest are stress, anxiety, depression, quality of life, family functioning, family empowerment or satisfaction with family-centered care. METHODS The proposed review will follow the JBI methodology for convergent segregated mixed methods systematic reviews. It will search for published and unpublished studies from eight different sources. Studies will be reviewed by title and abstract and potentially eligible studies will have full text retrieved for further review. Studies meeting the inclusion criteria will be assessed on methodological quality and the data will be extracted. Separate quantitative and qualitative analysis and synthesis will be performed and an overall analysis will be presented. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019137834.
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Affiliation(s)
- Shannon Barnes
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Noosaville, Australia
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Laura Rio
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
| | - Véronique de Goumoëns
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
- Department of Nursing, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Chantal Grandjean
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
| | - Anne-Sylvie Ramelet
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a JBI Centre of Excellence
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Naef R, Kläusler-Troxler M, Ernst J, Huber S, Dinten-Schmid B, Karen T, Petry H. Translating family systems care into neonatology practice: A mixed method study of practitioners’ attitudes, practice skills and implementation experience. Int J Nurs Stud 2020; 102:103448. [DOI: 10.1016/j.ijnurstu.2019.103448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
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Koreska M, Petersen M, Andersen BL, Brødsgaard A. Supporting families on their journey towards a normal everyday life - facilitating partnership in an early discharge program for families with premature infants. J SPEC PEDIATR NURS 2020; 25:e12274. [PMID: 31576656 DOI: 10.1111/jspn.12274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE Several Danish neonatal intensive care units (NICUs) offer the possibility of an early discharge program (EDP) for families with premature infants, when the infant reaches the gestational age ≥ 34 weeks and a weight ≥ 1,500 g. The purpose of this study is to explore how the partnership with these families can be facilitated by the nurse based on the principles of the framework of family centered care (FCC). DESIGN AND METHODS The study was conducted as an ethnographic inquiry inspired by Spradley and based on participant observation of 12 contacts between nurse and family, one informal and three formal interviews with nurses in the EDP-unit of a Danish NICU. RESULTS This study illustrates how EDP-nurses facilitate a partnership with the families enrolled in EDP by using a range of complex strategies to adjust their care to the family's changing needs, while acknowledging the family's way of being. The partnership typically develops in three phases: "Settling in EDP," "Thriving in EDP," and "Leaving the EDP nest." The EDP-nurses have a clear understanding of whether a partnership is well functioning or challenging and they play a unique role by facilitating a partnership that supports the family on the journey towards a normal everyday life. PRACTICE IMPLICATIONS The knowledge unraveled in this study may prove helpful for training future EDP-nurses in the neonatal field of FCC, when improving the quality of an existing EDP or developing a new EDP based on the principles of FCC.
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Affiliation(s)
- Mai Koreska
- Unit of Neonatology, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Denmark
| | - Mette Petersen
- Unit of Neonatology, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Denmark
| | - Bente Lund Andersen
- Unit of Neonatology, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Denmark
| | - Anne Brødsgaard
- Unit of Neonatology, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Denmark.,Section for Nursing, Department of Public Health, University of Aarhus, Denmark
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Brødsgaard A, Pedersen JT, Larsen P, Weis J. Parents' and nurses' experiences of partnership in neonatal intensive care units: A qualitative review and meta‐synthesis. J Clin Nurs 2019; 28:3117-3139. [DOI: 10.1111/jocn.14920] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/22/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Brødsgaard
- Department of Pediatrics and Adolecent Medicine Copenhagen University Hospital Hvidovre Copenhagen Denmark
- Department of Public Health, Section for Nursing University of Aarhus Aarhus Denmark
| | | | - Palle Larsen
- Department of Nursing University College Lillebaelt Svendborg Denmark
| | - Janne Weis
- Department of Neonatology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
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25
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Reid S, Bredemeyer S, Chiarella M. Integrative Review of Parents' Perspectives of the Nursing Role in Neonatal Family-Centered Care. J Obstet Gynecol Neonatal Nurs 2019; 48:408-417. [PMID: 31150595 DOI: 10.1016/j.jogn.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify the perceptions of mothers and fathers of newborns admitted to NICUs regarding the role of neonatal nurses in the provision of family-centered care and how neonatal nurses were able to interpret and meet parents' needs. DATA SOURCES We conducted literature searches in the CINAHL, MEDLINE, Embase, PsycINFO, Dissertations and Theses Global, and Maternity and Infant Care databases. STUDY SELECTION Articles on qualitative and quantitative studies were selected if they were published in English from 2009 to 2018; they were set in countries with similar health care resources in Australasia, Canada, Europe, Scandinavia, the United Kingdom, and the United States; and the data were collected from parents. We identified 31 studies for analysis. DATA EXTRACTION We used the thematic analysis method of Braun and Clarke to extract data elements that were grouped and coded into themes and subthemes. DATA SYNTHESIS Through ongoing iterative analysis, we generated six themes from the 18 subthemes that in combination presented the experiences of parents in the context of family-centered care provided by neonatal nurses: Process of Becoming a Parent, Neonatal NursesSupportingParents, Infant Safety, Communication, Barriers to Parenting, and Parenting Inhibited by Neonatal Nurses. CONCLUSION The six themes reflected the contribution made by neonatal nurses to family-centered care in the NICU. The parents' perspectives of nurses were mostly positive, but some negative aspects attributed to nurses identified in earlier studies persisted.
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26
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Journey to mother baby care: Implementation of a combined care/couplet model in a Level 2 neonatal intensive care unit. Birth Defects Res 2019; 111:1060-1072. [DOI: 10.1002/bdr2.1524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/10/2019] [Indexed: 11/07/2022]
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Chugh Sachdeva R, Mondkar J, Shanbhag S, Manuhar M, Khan A, Dasgupta R, Israel-Ballard K. A Qualitative Analysis of the Barriers and Facilitators for Breastfeeding and Kangaroo Mother Care Among Service Providers, Mothers and Influencers of Neonates Admitted in Two Urban Hospitals in India. Breastfeed Med 2019; 14:108-114. [PMID: 30676061 DOI: 10.1089/bfm.2018.0177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Known interventions like breastfeeding and kangaroo mother care (KMC) can avert a large share of infant deaths. Mother Baby Friendly Initiative Plus (MBFI+) is an integrated approach to ensure exclusive human milk diet through promotion of breastfeeding, KMC, and provision of donor human milk (DHM) to vulnerable neonates lacking mothers' own milk. MATERIALS AND METHODS Qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their knowledge, perceptions, and practices on breastfeeding, KMC, DHM, and human milk banks (HMBs) in 2 facilities in India, one with and another without an operational HMB. This article presents the findings on breastfeeding and KMC. RESULTS Nearly all mothers mentioned that antenatal visits lacked information on breastfeeding. Most were unaware of the recommended duration of exclusive breastfeeding. Most parents knew about the benefits of breast milk and colostrum. Limited staff and privacy in facilities resulted in inadequate breastfeeding and milk expression support to mothers, who found feeding of preterm and low-birth-weight babies challenging. Mothers shared challenges in breastfeeding at home, such as low family support and privacy and burden of household chores. Only those mothers who practiced KMC were aware of its benefits. Few service providers and recipients were comfortable with the practice of wet nursing in the absence of breastfeeding. CONCLUSIONS MBFI+ is a promising approach to strengthen breastfeeding and KMC. Quality counseling on breastfeeding and milk expression from antenatal period, increasing awareness and training on KMC for mothers, improving infrastructure, addressing staff shortage, and building capacities of hospital staff on MBFI+ are needed.
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Affiliation(s)
| | - Jayashree Mondkar
- 2 Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India
| | - Sunita Shanbhag
- 3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India
| | - Minu Manuhar
- 3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India
| | - Aisha Khan
- 2 Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India.,3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India
| | - Rajib Dasgupta
- 4 Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Kiersten Israel-Ballard
- 1 Department of Maternal, Newborn, Child Health and Nutrition, PATH, New Delhi, India.,5 Department of Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, Washington
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Månsson C, Sivberg B, Selander B, Lundqvist P. The impact of an individualised neonatal parent support programme on parental stress: a quasi‐experimental study. Scand J Caring Sci 2019; 33:677-687. [DOI: 10.1111/scs.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Catrin Månsson
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
- Department of Neonatology Skåne University Hospital Lund Sweden
| | - Bengt Sivberg
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
| | - Bo Selander
- Department of Pediatrics Central Hospital Kristianstad Sweden
| | - Pia Lundqvist
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
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Gibb ACN, Crosby MA, McDiarmid C, Urban D, Lam JYK, Wales PW, Brockel M, Raval M, Offringa M, Skarsgard ED, Wester T, Wong K, de Beer D, Nelson G, Brindle ME. Creation of an Enhanced Recovery After Surgery (ERAS) Guideline for neonatal intestinal surgery patients: a knowledge synthesis and consensus generation approach and protocol study. BMJ Open 2018; 8:e023651. [PMID: 30530586 PMCID: PMC6303622 DOI: 10.1136/bmjopen-2018-023651] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Enhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identify and attempt to bridge the gaps between current practices and best evidence. Our study is the first paediatric ERAS protocol endorsed by the International ERAS Society. METHODS A research team consisting of international clinical and family stakeholders as well as methodological experts have iteratively defined the scope of the protocol in addition to individual topic areas. A modified Delphi method was used to reach consensus. The second phase will include a series of knowledge syntheses involving a rapid review coupled with expert opinion. Potential protocol elements supported by synthesised evidence will be identified. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to determine strength of recommendations and the quality of evidence. The third phase will involve creation of the protocol using a modified RAND/UCLA Appropriateness Method. Group consensus will be used to rate each element in relation to the quality of evidence supporting the recommendation and the appropriateness for guideline inclusion. This protocol will form the basis of a future implementation study. ETHICS AND DISSEMINATION This study has been registered with the ERAS Society. Human ethics approval (REB 18-0579) is in place to engage patient families within protocol development. This research is to be published in peer-reviewed journals and will form the care standard for neonatal intestinal surgery.
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Affiliation(s)
- Ashleigh C N Gibb
- Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Megan A Crosby
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Caraline McDiarmid
- Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Denisa Urban
- Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Y K Lam
- Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul W Wales
- Department of Pediatric Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Megan Brockel
- Department of Pediatric Anesthesia, University of Colorado, Aurora, Colorado, USA
| | - Mehul Raval
- Department of Pediatric Anesthesia, University of Colorado, Aurora, Colorado, USA
- Department of Pediatric Surgery, Northwestern University, Chicago, Illinois, USA
| | - Martin Offringa
- Department of Neonatology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Erik D Skarsgard
- Department of Pediatric Surgery, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Tomas Wester
- Department of Pediatric Surgery, Karolinska University, Stockholm, Sweden
| | - Kenneth Wong
- Department of Surgery, University of Hong Kong, Li Ka Shing Faculty of Medicine, Hong Kong, China
| | - David de Beer
- Department of Pediatric Anesthesia, Great Ormond Street Hospital, London, UK
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mary E Brindle
- Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Martel S, Ives-Baine L. Nurses' Experiences of End-of-life Photography in NICU Bereavement Support. J Pediatr Nurs 2018; 42:e38-e44. [PMID: 29887165 DOI: 10.1016/j.pedn.2018.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To qualitatively explore neonatal intensive care nurses' experiences with end-of-life photography as part of their bereavement support work with families. DESIGN AND METHODS An Interpretive Phenomenological Analysis with data collected through a focus group (n = 6) and one semi-structured interview (n = 1) with neonatal nurses from a Level 3/4 NICU in a Canadian pediatric hospital. RESULTS Participants' comfort with EOL photography developed over time through exposure to bereavement scenarios and positive experiences with families. Participants' experienced a feeling of pressure to balance the photography with clinical responsibilities and find the right time to introduce photography while being sensitive to family experiences. Participants experienced EOL photography as something tangible to give families and were satisfied knowing the images might play an important role in the family's healing after the NICU. CONCLUSIONS All participants had come to value EOL photography as a positive and meaningful part of their work with bereaved families. Identified challenges related to balancing the practice with the unpredictable flow and demands of critical care and to developing an appreciation for and comfort with the photography as part of their healing and the families' healing. PRACTICAL IMPLICATIONS Findings contribute insight into care-provider experience that can inform best practices, training, and staff support for palliative and bereavement work in neonatal and pediatric settings. The findings suggest a need to support nurses emotionally and clinically in carrying out this photography as part of their care for families.
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Affiliation(s)
- Sara Martel
- Joint Graduate Program in Communication & Culture, York University/Ryerson University, Toronto, Ontario, Canada.
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Jones L, Sheeran N, Lanyon H, Evans K, Martincovic T. Nurses’ perceptions of communicating with minority parents in a neonatal nursery: a communication accommodation theory approach. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1460959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Liz Jones
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Hanna Lanyon
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Karina Evans
- School of Applied Psychology, Griffith University, Brisbane, Australia
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The Need for Support and Not Distress Evoking: A Meta-Synthesis of Experiences of Iranian Parents with Premature Infants. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2017. [DOI: 10.5812/ijpbs.5916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Broom M, Parsons G, Carlisle H, Kecskes Z, Thibeau S. Exploring Parental and Staff Perceptions of the Family-Integrated Care Model: A Qualitative Focus Group Study. Adv Neonatal Care 2017; 17:E12-E19. [PMID: 29083997 DOI: 10.1097/anc.0000000000000443] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU. SUBJECTS AND DESIGN This qualitative study took place in a level 3 NICU with 5 parent participants and 8 staff participants, using a post implementation review design. METHODS Parents and staff perceptions of FICare were explored through focus group methodology. Thematic content analysis was done on focus group transcripts. RESULTS Parents and staff perceived the FICare program to have had a positive impact on parental confidence and role attainment and thought that FICare improved parent-to-parent and parent-to-staff communication. Staff reported that nurses working with families in the program performed less hands-on care and spent more time educating and supporting parents. IMPLICATIONS FOR PRACTICE FICare may change current NICU practice through integrating and accepting parents as active members of the infant's care team. In addition, nurse's roles may transition from bedside carer to care coordinator, educating and supporting parents during their journey through the NICU. IMPLICATIONS FOR RESEARCH Further research is needed to assess the long-term impact of FICare on neonates, parents, and staff.
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Ladani MT, Abdeyazdan Z, Sadeghnia A, Hajiheidari M, Hasanzadeh A. Comparison of Nurses and Parents' Viewpoints Regarding the Needs of Parents of Premature Infants in Neonatal Intensive Care Units. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:367-371. [PMID: 29033991 PMCID: PMC5637145 DOI: 10.4103/1735-9066.215672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The birth of a premature infant and her/his hospitalization can cause the parents to experience a variety of needs. Understanding the needs of parents by nurses can lead to provision of high quality care to premature infants. This study aimed to compare the parents' and nurses' viewpoints regarding parents' needs in the neonatal intensive care units (NICU). MATERIALS AND METHODS In this descriptive cross-sectional study, 63 nurses, 120 mothers, and 120 fathers, who met the inclusion criteria, participated. Nurses were selected through a census method and parents through a simple convenience sampling method. Data were gathered using a researcher-made questionnaire and were analyzed using descriptive-analytic statistical methods in the Statistical Package for the Social Sciences software version 16. RESULTS From the viewpoint of mothers, the need for assurance with a mean score of 87.4 was the most important and the need for support with a mean score of 71.37 was the least important need. From the perspective of fathers, the need for assurance with a mean score of 78.5 was the most important and the need for support with a mean score of 51.20 was the least important need. From the viewpoint of the nurses, the need for assurance with a mean score of 77.6 was the most important and the need for support with a mean score of 59.77 was the least important need. The mean scores of the needs of mothers in all subscales were higher than that of the fathers' and nurses' (P < 0.001). CONCLUSIONS From the viewpoint of nurses, the scores of parents' needs were significantly less than that of the parents' for all subscales. It is suggested that appropriate education programs be provided for nurses regarding how they can understand parents' needs to provide high quality care.
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Affiliation(s)
- Marziyeh Tork Ladani
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Abdeyazdan
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sadeghnia
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnoosh Hajiheidari
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Treherne SC, Feeley N, Charbonneau L, Axelin A. Parents' Perspectives of Closeness and Separation With Their Preterm Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:737-747. [PMID: 28802557 DOI: 10.1016/j.jogn.2017.07.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To discover parents' perceptions of closeness to and separation from their preterm infants in the NICU. DESIGN Qualitative descriptive. SETTING Urban Level III NICU. PARTICIPANTS Twenty parents of preterm infants in the NICU. METHODS After ethics approval, data were collected with a smartphone application created for this study. Parents recorded their descriptions of moments of closeness and separation over a 24-hour period in the NICU. Data were transcribed verbatim and content was analyzed. RESULTS Five themes related to parents' perceptions of closeness and separation were identified: Having a role as a parent: Feeling autonomous and making decisions; Providing for and getting to know the infant: Feeding, holding, and interacting; Support from staff; Reluctantly leaving the infant's bedside; and NICU environment. CONCLUSION Autonomy is a key element of a parent's perception of closeness. Staff in the NICU can facilitate autonomy by involving parents in the care of their preterm infants as much as possible to reinforce the parental role. Parents described leaving their infants' bedsides as very difficult.
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Rossman B, Greene MM, Kratovil AL, Meier PP. Resilience in Mothers of Very-Low-Birth-Weight Infants Hospitalized in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:434-445. [DOI: 10.1016/j.jogn.2016.11.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2016] [Indexed: 10/20/2022] Open
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Martin AE, D’Agostino JA, Passarella M, Lorch SA. Racial differences in parental satisfaction with neonatal intensive care unit nursing care. J Perinatol 2016; 36:1001-1007. [PMID: 27583386 PMCID: PMC5079824 DOI: 10.1038/jp.2016.142] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/25/2016] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Nurses provide parental support and education in the neonatal intensive care unit (NICU), but it is unknown if satisfaction and expectations about nursing care differ between racial groups. STUDY DESIGN A prospective cohort was constructed of families with a premature infant presenting to primary care between 1 January 2010 and 1 January 2013 (N=249, 52% white, 42% black). Responses to questions about satisfaction with the NICU were analyzed in ATLAS.ti using the standard qualitative methodology. RESULTS One hundred and twenty (48%) parents commented on nursing. Fifty-seven percent of the comments were positive, with black parents more negative (58%) compared with white parents (33%). Black parents were most dissatisfied with how nurses supported them, wanting compassionate and respectful communication. White parents were most dissatisfied with inconsistent nursing care and lack of education about their child. CONCLUSIONS Racial differences were found in satisfaction and expectations with neonatal nursing care. Accounting for these differences will improve parental engagement during the NICU stay.
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Affiliation(s)
- Ashley E. Martin
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Jo Ann D’Agostino
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, The Children’s Hospital of Philadelphia
| | - Molly Passarella
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Scott A. Lorch
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, The Children’s Hospital of Philadelphia
- The University of Pennsylvania School of Medicine, Philadelphia, PA
- Senior Scholar, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Brødsgaard A, Larsen P, Weis J, Pedersen PU. The perception of partnership between parents of premature infants and nurses in neonatal intensive care units. ACTA ACUST UNITED AC 2016; 14:40-46. [DOI: 10.11124/jbisrir-2016-003073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Dykes F, Thomson G, Gardner C, Hall Moran V, Flacking R. Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units. Acta Paediatr 2016; 105:1039-46. [PMID: 27059114 PMCID: PMC5074324 DOI: 10.1111/apa.13417] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/04/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
Aim Studies have provided insights into factors that may facilitate or inhibit parent–infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues. Methods Six small group discussions and three‐one‐to‐one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent–infant closeness and implications for policy and practice, and thematic analysis was undertaken. Results Participants highlighted how a humanising care agenda that enabled parent–infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio‐economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents. Conclusion Various factors affected parent–infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units.
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Affiliation(s)
- F Dykes
- Maternal and Infant Nutrition and Nurture Unit (MAINN) University of Central Lancashire Preston UK
- Centre for Reproductive, Infant and Child Health (RICH) School of Education, Health and Social Studies Dalarna University Dalarna Sweden
| | - G Thomson
- Maternal and Infant Nutrition and Nurture Unit (MAINN) University of Central Lancashire Preston UK
| | - C Gardner
- Maternal and Infant Nutrition and Nurture Unit (MAINN) University of Central Lancashire Preston UK
| | - V Hall Moran
- Maternal and Infant Nutrition and Nurture Unit (MAINN) University of Central Lancashire Preston UK
| | - R Flacking
- Centre for Reproductive, Infant and Child Health (RICH) School of Education, Health and Social Studies Dalarna University Dalarna Sweden
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Jones L, Peters K, Rowe J, Sheeran N. The Influence of Neonatal Nursery Design on Mothers' Interactions in the Nursery. J Pediatr Nurs 2016; 31:e301-12. [PMID: 27311300 DOI: 10.1016/j.pedn.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/27/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED This study examined the influence of neonatal nursery design on interactions between nurses and mothers of infants in the nursery. DESIGN AND METHODS We used a natural quasi-experimental design, using semi-structured interviews and a structured measure of mothers' and nurses' perceptions of nursing care, to compare mothers (n=26 and n=40) and nurses (n=22 and n=29) in an open-bay (OB) nursery and a single family room (SFR) nursery. Thematic analysis was used to generate key themes from the interviews. RESULTS Mothers and nurses in both nursery designs talked about Valuing interactions; the importance of interactions between mothers and nurses. Mothers and nurses described SFRs as providing a space, My/their room, which enhanced mothers' sense of control and connection with the infant. SFRs were also associated with Changing the norms of interactions with nurses and other mothers, which created challenges in the desired quantity and quality of interactions for mothers and nurses. Nurses in the SFR nursery also reported Enhanced interactions, including improved confidentiality and personalized communication. Mothers in the OB nursery reported more supportive mothering actions from nurses than mothers in the SFR nursery. Both mothers and nurses in the OB nursery also talked about Our nursery community, which captured the value of having other nurses and mothers in the rooms. CONCLUSION Mothers and nurses perceived that the SFR nursery enhanced privacy and maternal closeness for mothers compared to the OB nursery. However, the SFR nursery design presented challenges to some interactions of value to nurses and mothers.
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Affiliation(s)
- Liz Jones
- Griffith University, Mount Gravatt, Queensland, Australia.
| | - Kathryn Peters
- Griffith University, Mount Gravatt, Queensland, Australia
| | - Jennifer Rowe
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Nicola Sheeran
- Griffith University, Mount Gravatt, Queensland, Australia
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Weis J, Lundqvist P. Parent experiences of communication with healthcare professionals in neonatal intensive care units: a qualitative systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2016; 14:12-18. [PMID: 27635740 DOI: 10.11124/jbisrir-2016-003053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objectives of this review are to explore parents' experiences of communication with healthcare professionals and to identify the meaningfulness of communication to parents in the neonatal intensive care unit (NICU).More specifically, the objectives are to identify.
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Affiliation(s)
- Janne Weis
- 1Neonatal Department, Copenhagen University Hospital, Copenhagen, Denmark 2Danish Centre of Systematic Reviews: a Joanna Briggs Institute Centre of Excellence 3Department of Health Sciences, Lund University, Lund, Sweden
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Factors associated with parents' satisfaction with care provided in a neonatal intensive care unit in Greece. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jnn.2016.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Provenzi L, Barello S, Fumagalli M, Graffigna G, Sirgiovanni I, Savarese M, Montirosso R. A Comparison of Maternal and Paternal Experiences of Becoming Parents of a Very Preterm Infant. J Obstet Gynecol Neonatal Nurs 2016; 45:528-41. [DOI: 10.1016/j.jogn.2016.04.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/25/2022] Open
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Abstract
The philosophy of family-centered care in neonatal intensive care units is intended to facilitate parental involvement, shared decision-making, and improved outcomes for infants and families. To support family-centered care, there are multiple interventions with different components and associated outcomes that have been described in the research literature. This evidence leaves many unanswered questions about how best to implement and evaluate strategies to enhance family-centered care. This article provides a brief overview of interventions designed to support family-centered care in neonatal intensive care units and offers an evidence-informed staff education strategy to enhance family-centered care. The evidence-informed relational communications strategies of circular pattern diagrams, questioning, and commendations are described, along with specific examples of how nurses can use them in in their day-to-day practice in neonatal intensive care units.
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Determining the Psychometric Properties of the Turkish Version of the Nurse-Parent Support Tool and the Stress Levels of Parents of Premature Infants Hospitalized in the Neonatal Intensive Care Unit. CLIN NURSE SPEC 2016; 30:E1-10. [DOI: 10.1097/nur.0000000000000204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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An Integrative Review of Mothers' Experiences of Preeclampsia. J Obstet Gynecol Neonatal Nurs 2016; 45:300-7. [PMID: 27063399 DOI: 10.1016/j.jogn.2016.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe and synthesize the extant research on women's experiences with preeclampsia into the postpartum period, when birth is necessary to save the mother's or infant's life. DATA SOURCES The PubMed, PsycINFO, CINAHL, and ISI Web of Science databases were searched for relevant articles published between 2004 and 2014. STUDY SELECTION Although a comprehensive search was performed, only eight studies were found that answered the research question and were included in the review. DATA EXTRACTION Data were extracted and analyzed from each article that addressed women's experiences of pre-eclampsia: authors, year, country, study purpose, design, sample size, setting, main focus, data collection method, study findings, and limitations. DATA SYNTHESIS The following themes emerged from the synthesis of how women experience severe preeclampsia: (a) From Feeling Fear and Closeness to Death to Feeling Hope, (b) Relationship With the Infant, (c) Separation From Loved Ones, and (d) Communication With Health Professionals. CONCLUSION Fear and feeling close to death characterized the experience of childbirth for many of these women, and the premature birth was a shock for many. Having a newborn in the NICU was experienced as a transition from fear to hope as the newborn's life was sustained outside the womb. Separation of the mother from the newborn when one or both need special care remains a problem. Health care professionals must ensure that women in this situation receive the information and support they need and that the information is understood. This review revealed that more research is necessary regarding this specific mother-infant dyad and their families in the context of Western countries and developing countries.
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Bry K, Bry M, Hentz E, Karlsson HL, Kyllönen H, Lundkvist M, Wigert H. Communication skills training enhances nurses' ability to respond with empathy to parents' emotions in a neonatal intensive care unit. Acta Paediatr 2016; 105:397-406. [PMID: 26648201 PMCID: PMC5066675 DOI: 10.1111/apa.13295] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/08/2015] [Accepted: 11/30/2015] [Indexed: 11/28/2022]
Abstract
Aim We quantitatively analysed the effect of a course in communication on the content of nurse–parent encounters and the ability of nurses to respond to the empathic needs of parents in a level III neonatal intensive care unit. Methods We evaluated 36 and 45 nurse–parent encounters audio recorded before and after 13 neonatal nurses attended a communication course. The number of empathic opportunities, the nurses' responses to these and the ways they involved parents in their infants' care were studied. Results Both before and after the course, the nurses talked more than the parents during the conversations. This nurse‐centredness decreased after the course. The use of empathic or exploring responses to empathic opportunities increased from 19.9 ± 9.0% to 53.8 ± 8.9% (p = 0.027), whereas ignoring the feelings of the parents or giving inadequate advice decreased from 63.0 ± 10.0% to 27.5 ± 8.4% (p = 0.043) after the course. Use of statements expressing caring for the parents and encouragement for parents to participate in the care of their infant increased after the course (p = 0.0034 and p = 0.043, respectively). The nurses felt the course was very useful for their profession. Conclusion A course in communication techniques improved nurses' ability to respond to parents' feelings with empathy.
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Affiliation(s)
- Kristina Bry
- Department of Pediatrics Division of Clinical Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden
- Division of Neonatology The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden
| | - Maija Bry
- The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden
| | - Elisabet Hentz
- Division of Neonatology The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden
| | - Håkan L. Karlsson
- Division of Neonatology The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden
| | - Hanna Kyllönen
- Department of Pediatrics Division of Clinical Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Malin Lundkvist
- Department of Pediatrics Division of Clinical Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Helena Wigert
- Division of Neonatology The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden
- Institute of Health and Care Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden
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Marski BDSL, Custodio N, Abreu FCPD, Melo DFD, Wernet M. Alta hospitalar do recém-nascido prematuro: experiência do pai. Rev Bras Enferm 2016; 69:221-8. [DOI: 10.1590/0034-7167.2016690203i] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/29/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: descrever a experiência do pai frente à alta do filho prematuro da Unidade de Terapia Intensiva Neonatal e apontar intervenções para a promoção dessa experiência. Método: pesquisa qualitativa com oito pais que adotou o Interacionismo Simbólico como referencial teórico e a pesquisa de narrativa temática como referencial metodológico. Resultados: a análise dos dados permitiu descrever a experiência do pai a partir de três unidades temáticas: 'limites para a paternidade', 'alta: responsabilização pelo filho' e 'rede social e apoio'. Conclusão: o pai sente-se inseguro para o cuidado com filho em domicílio em função de incipiências no apoio profissional e no contato com o filho na Unidade de Terapia Intensiva Neonatal.
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Gibbs DP, Boshoff K, Stanley MJ. The acquisition of parenting occupations in neonatal intensive care: A preliminary perspective. The Canadian Journal of Occupational Therapy 2016; 83:91-102. [DOI: 10.1177/0008417415625421] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The birth of a preterm infant represents a major crisis for parents that may impact their performance of parenting occupations. Purpose. The purpose of the study was to explore the experiences that enable parents to participate in occupations associated with the role of parenting in a neonatal intensive care unit (NICU). Method. A paradigmatic analysis of narratives was completed based on interviews conducted with six parents of preterm infants. Findings. Six themes were identified: anticipating occupations versus reality, needing emotional resilience, working to reclaim the parental role, navigating the NICU occupation–environment transactions, building and maintaining relationships with staff, and revisioning the future. Implications. The use of an occupation-based approach moves parents’ involvement in the NICU beyond basic caregiving occupations. It highlights the importance of providing opportunities for nurturing and caring for their infants in ways that are meaningful to their identity as a parent.
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