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van Oort P, Maaskant J, Luttik ML, Eskes A. Impact of a patient and family participation education program on hospital nurses' attitudes and competencies: A controlled before-after study. PEC INNOVATION 2024; 4:100249. [PMID: 38225931 PMCID: PMC10788253 DOI: 10.1016/j.pecinn.2023.100249] [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: 07/12/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024]
Abstract
Objective We designed a Patient and Family Participation Education Program (PFEP) with the aim of fostering a positive attitude and enhancing the competencies of hospital nurses required for effective patient and family participation in care. Methods In a Dutch university hospital, we conducted a before-after study. The PFEP comprising three courses: family conversation, supporting shared decision-making, and health literacy. We assessed nursing attitudes using the FINC-NA questionnaire and competencies with a separate questionnaire before and three months after the program. Changes in attitudes and competencies were analyzed using regression analysis. Results Twenty-two nurses participated in the education group, and 58 participated as controls.After three months, the change scores for the education group were statistically significantly higher on the total attitude score (FINC-NA) compared to the control group. Moreover, in six out of twelve competencies, the education group demonstrated significantly higher scores than the control group. Conclusion The educational program appeared effective in promoting nurses' attitudes and feelings of competencies towards patient and family-centered care. Innovation A blended education program focusing on patient and family has potential value for implementation in hospital care settings, especially for hospitals aiming to cultivate a more patient- and family-centered environment.
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Affiliation(s)
- Peter van Oort
- Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
- Amsterdam University of Applied Sciences, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands
| | - Jolanda Maaskant
- Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Internal Medicine, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Public Health, Amsterdam, the Netherlands
| | - Marie Louise Luttik
- Hanze University of Applied Sciences, Research Group Nursing Diagnostics, Professorship Family Care, Groningen, the Netherlands
| | - Anne Eskes
- Amsterdam University of Applied Sciences, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Public Health, Amsterdam, the Netherlands
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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Alqarawi N, Alhalal E. Factors affecting family-centered care practice by nurses: A systematic review. J Pediatr Nurs 2024; 78:158-171. [PMID: 38944912 DOI: 10.1016/j.pedn.2024.06.008] [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: 04/08/2024] [Revised: 05/26/2024] [Accepted: 06/10/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE This study presents a systematic review of the obstacles to and enablers of family-centered care (FCC) implementation by nurses. FCC, which has demonstrated beneficial outcomes, is regarded as a crucial quality measure in certain pediatric units. However, not all nurses incorporate FCC into their practice. DESIGN AND METHODS A systematic review was conducted from January to June 2023, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various medical subject heading keywords and terms were used to search electronic databases, with the aim of synthesizing and evaluating the results. RESULTS Twenty-three articles were identified for review. Most of these studies were carried out in Western countries. They revealed several facilitators and obstacles to FCC implementation by nurses when caring for sick children. Some of these factors are linked to the personal attributes of the nurses, while others are associated with the characteristics of the families and the healthcare system itself. CONCLUSION Nurses face multi-level barriers that hinder their ability to implement FCC practice. This systematic review identifies the need to leverage nurses' attributes, foster effective nurse-client relationships, and promote organizational changes. PRACTICE IMPLICATIONS Nurses need to comprehend and work toward altering the factors that influence the delivery of FCC. The findings of this review can be used by healthcare organization leaders and policymakers to customize interventions and allocate resources to promote FCC practice. Further research in diverse cultural contexts is needed to examine the cause-and-effect relationship concerning the influence of the identified barriers and facilitators on FCC practice. In addition, experimental studies are required to evaluate the effectiveness of evidence-based interventions on FCC practice by nurses.
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Affiliation(s)
- Nada Alqarawi
- Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Buraydah, Saudi Arabia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Eman Alhalal
- Community and mental health nursing, Nursing college, King Saud University Riyadh, Saudi Arabia.
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Azcárate-Cenoz N, Canga-Armayor A, Alfaro-Díaz C, Canga-Armayor N, Pueyo-Garrigues M, Esandi N. Family-Oriented Therapeutic Conversations: A Systematic Scoping Review. JOURNAL OF FAMILY NURSING 2024; 30:145-173. [PMID: 38529615 DOI: 10.1177/10748407241235141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
There is increasing evidence that highlights the benefits of Family-oriented Therapeutic Conversations (FAM-TC) for the patient and the family; however, studies show variability regarding the content and the way these interventions are offered. This may hamper its further development in clinical practice. This review systematically maps the available literature on nurse-led FAM-TC and offers a solid synthesis of the characteristic, effectiveness, and feasibility of these interventions. A systematic search in PubMed, CINAHL, Cochrane, Web of Science, PsycINFO, Trip (Turning Research Into Practice), BASE (Bielefeld Academic Search Engine), OATD (Open Access Theses and Dissertations), and ProQuest databases identified 37 studies. The interventions varied in interventionist nurses' profile, the intervention content, or the duration of the sessions offered. Most of the interventions showed beneficial effects on perceived family support and family functioning. This review offers suggestions for future studies, such as the inclusion of specific theoretical frameworks for intervention design, targeting both the patient and the family and offered by nurses with family nursing competency.
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Affiliation(s)
- Nerea Azcárate-Cenoz
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Ana Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Cristina Alfaro-Díaz
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Navidad Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - María Pueyo-Garrigues
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Nuria Esandi
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
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Kiwanuka F, Nanyonga RC, Sak-Dankosky N, Kvist T. Influence of perceived benefits, barriers and activities of family engagement in care on family nursing practice: A cross-sectional correlational study. J Adv Nurs 2023; 79:3487-3497. [PMID: 37066738 DOI: 10.1111/jan.15677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/08/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Abstract
AIMS To describe nurses' perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice. DESIGN A cross-sectional correlational study. METHODS In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t-test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data. RESULTS Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family-related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice. CONCLUSION The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice. IMPACT Probabilistic factor-specific predictions of nursing practice with families are provided in this study - this addresses a gap in the evidence regarding the elements that should be optimized when designing well-informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study's findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care. REPORTING METHOD The study adheres to the STROBE reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study.
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Affiliation(s)
- Frank Kiwanuka
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | | | | | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Spiritual lives of children with cancer: A qualitative descriptive study in Lithuania. J Pediatr Nurs 2023; 68:e79-e86. [PMID: 36404190 DOI: 10.1016/j.pedn.2022.11.013] [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: 05/05/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To explore the experience and perception of spiritual lives of children with cancer. DESIGN AND METHODS A qualitative descriptive study included the collection of narratives on spiritual lives of children drawn from two university hospitals in Lithuania in the form of a semi-structured face-to-face interviews. Purposive sample of twenty-seven hospitalized children (5-12 y.) with non-terminal stage of cancer participated in the study. RESULTS The final four themes emerged from across all the questions as: being normal, community, comfort and connections with God. CONCLUSIONS Children with cancer needed to maintain as normal a life as posssible, despite being ill and undergoing treatment. Connections with family and friends were echoed in all the themes that emerged in the study. Children seemed to own their views about needing to pray or not; their needs revolved around asking for health and remission of their illness. Children diagnosed with cancer have a unique understanding of spirituality that is linked to their age, gender, and family composition. These ideas change as children develop and mature. PRACTICAL IMPLICATIONS The need to explore the spiritual lives of children with life threatening illnesses from an early age is evident. Health professionals need to recognize that a child is the product of their family, their community, their culture and their spirituality. Conversations with children about what God means to them and how prayer supports them, is essential. The opinion that spirituality topic might be hardly understood or too sensitive to children is rejected by the researchers.
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McKenna L, Shimoinaba K, Copnell B. Family-centered care and pediatric death in the emergency department: A qualitative study using framework analysis. J Pediatr Nurs 2022; 64:18-23. [PMID: 35131715 DOI: 10.1016/j.pedn.2022.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/15/2021] [Accepted: 01/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Family-centered care is an important concept underpinning care of children. Although much researched in some settings, little research has explored specialist settings, or areas where both children and adults are cared for, such as the emergency department. METHODS This study sought to explore how nurses employ family-centered care in delivering care to children and families when a child dies in the emergency department. Using a descriptive, qualitative approach, semi-structured interviews were conducted with 24 emergency nurses from six Australian states. Interviews were audio-recorded and transcribed verbatim. Framework analysis was applied to examine alignment with family-centered care principles. FINDINGS Nurses described providing support and education, and encouraged families to engage in care decisions, including about ceasing resuscitation efforts. Commonly, senior staff members were allocated during emergencies to support parents. DISCUSSION Emergency nurses should be offered education on family-centered care, and research undertaken to explore families' experiences of their child dying in the emergency department. PRACTICE IMPLICATION Family-centered care should be a focus for the care of children and their families in the emergency department, regardless of the pressure from rapidly occurring events.
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Affiliation(s)
- Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Australia.
| | | | - Beverley Copnell
- School of Nursing and Midwifery, La Trobe University, Australia.
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Cha E, Shin MH, Smart M, Jang H, Lee J, Joung KH, Kim HJ, Faulkner MS. Q-Methodology and Psychological Phenotyping to Design Patient-Centered Diabetes Education for Persons With Type 2 Diabetes on Insulin Therapy. Sci Diabetes Self Manag Care 2022; 48:98-110. [PMID: 35118919 DOI: 10.1177/26350106221076035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this study was to identify the psychological phenotypes of persons with type 2 diabetes (T2D) on insulin therapy to better inform personalized diabetes education strategies to improve self-management behaviors. METHODS Q-methodology, a research approach combining the quantitative rigor of statistical analysis with qualitative data on perception of diabetes self-management by persons with T2D on insulin therapy, was used. The Summary of Diabetes Self-Care Activity measure and A1C in the past 6 months were used to further describe self-management behaviors of each P-sample, Q-sorter. Of 160 statements, 33 Q-sample statements were selected as Q-set. Then, 37 P-samples (24 men; 13 women) were recruited from a university-affiliated diabetes clinic in South Korea. Data obtained from each P-sample with a Q-set and a Q-sorting table, a forced-choice normal distribution table, were analyzed using varimax rotation. RESULTS Forty-one percent of the variance was explained with 5 factors represented by 27 Q-sorters, explaining variance ranging from 5% to 17% for each factor: Factor A (n = 6): those showing self-management education need but possessing inadequate health literacy; Factor B (n = 4): those valuing lifestyle modification to control diabetes; Factor C (n = 5): those valuing antidiabetic medication to control diabetes; Factor D (n = 6): carpe diem, accepting diabetes as destiny; and Factor E (n = 6): those overestimating their competencies to control diabetes. Ten Q-sorters fell into either confounded or nonsignificant. CONCLUSIONS Tailoring messages and educational approaches based on patients' psychological phenotypes are necessary to promote optimal self-management behaviors.
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Affiliation(s)
- EunSeok Cha
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Myoung Hwan Shin
- School of Communication and Media, Sookmyung Women's University, Seoul, South Korea
| | - Michael Smart
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Hyesun Jang
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Jooseon Lee
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Kyong Hye Joung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Hyun Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Melissa Spezia Faulkner
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.,Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
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Hengeveld B, Maaskant JM, Lindeboom R, Marshall AP, Vermeulen H, Eskes AM. Nursing competencies for family-centred care in the hospital setting: A multinational Q-methodology study. J Adv Nurs 2021; 77:1783-1799. [PMID: 33314342 PMCID: PMC8048472 DOI: 10.1111/jan.14719] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
AIM to identify: (1) nursing competencies for FCC in a hospital setting; and (2) to explore perspectives on these competencies among Dutch and Australian professionals including lecturers, researchers, Registered Nurses and policy makers. DESIGN A multinational cross-sectional study using Q-methodology. METHODS First, an integrative review was carried out to identify known competencies regarding FCC and to develop the Q-set (search up to July 2018). Second, purposive sampling was used to ensure stakeholder involvement. Third, participants sorted the Q-set using a web-based system between May and August 2019. Lastly, the data were analysed using a by-person factor analysis. The commentaries on the five highest and lowest ranked competencies were thematically analysed. RESULTS The integrative review identified 43 articles from which 72 competencies were identified. In total 69 participants completed the Q-sorting. We extracted two factors with an explained variance of 24%. The low explained variance hampered labelling. Based on a post-hoc qualitative analysis, four themes emerged from the competencies that were considered most important, namely: (a) believed preconditions for FCC; (b) promote a partnership between nurses, patients and families; (c) be a basic element of nursing; and (d) represent a necessary positive attitude and strong beliefs of the added value of FCC. Three themes appeared from the competencies that were considered least important because they: (a) were not considered a specific nursing competency; (b) demand a multidisciplinary approach; or (c) require that patients and families take own responsibility. CONCLUSIONS Among healthcare professionals, there is substantial disagreement on which nursing competencies are deemed most important for FCC. IMPACT Our set of competencies can be used to guide education and evaluate practicing nurses in hospitals. These findings are valuable to consider different views on FCC before implementation of new FCC interventions into nursing practice.
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Affiliation(s)
- Bram Hengeveld
- LivioEnschedethe Netherlands
- VilansUtrechtthe Netherlands
| | - Jolanda M. Maaskant
- Emma Children’s HospitalAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Robert Lindeboom
- Department of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Andrea P. Marshall
- Menzies Health Institute QueenslandSchool of Nursing and MidwiferyGriffith UniversitySouthportQueenslandAustralia
- Gold Coast HealthSouthportQueenslandAustralia
| | - Hester Vermeulen
- Scientific Center for Quality of Healthcare (IQ healthcare)Radboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
- Faculty of Health and Social StudiesHAN University of Applied SciencesNijmegenThe Netherlands
| | - Anne M. Eskes
- Menzies Health Institute QueenslandSchool of Nursing and MidwiferyGriffith UniversitySouthportQueenslandAustralia
- Department of SurgeryAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
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