Factors affecting parents’ satisfaction with pediatric wards

The psychometric properties of the Turkish version of the parents' perception of satisfaction with care from pediatric nurse practitioners instrument

AIM

This study was carried out to adapt a measurement tool that can be used to measure the perceived satisfaction level of parents of pediatric patients hospitalized in a pediatric clinic with care from pediatric nurses and to examine its psychometric properties.

DESIGN AND METHOD

The study was conducted methodologically with 301 parents of children who were hospitalized in the pediatric clinic of a university hospital between September and December 2023. Explanatory and confirmatory factor analyses were performed on the data to establish the validity of the scale, Cronbach's alpha reliability coefficient, split-half, item-total score methods were utilized to test its reliability.

RESULTS

The scale consisted of 26 items and a single dimension. It was determined that the total explained variance ratio was 79.246%. According to the confirmatory factor analysis results, goodness of fit values were determined as RMSEA = 0.077, CFI = 0.96, IFI = 0.97, RFI = 0.92, NFI = 0.93, and TLI = 0.96. Cronbach's alpha coefficient was calculated as α = 0.989 for the total scale.

CONCLUSION

The Parents' Perception of Satisfaction with Care from Pediatric Nurse Practitioners Instrument is a valid and reliable measurement tool that can be used to measure the perceived satisfaction level of parents of pediatric patients hospitalized in a pediatric clinic with nursing care.

IMPLICATIONS FOR PRACTICE

The scale can contribute to determining the perceived satisfaction levels of parents of pediatric patients hospitalized in the pediatric clinic with nursing care and, if there is a problem, to providing regular in-service training for pediatric nurses who are responsible for pediatric patient safety and quality of care.

Parental satisfaction with hospital care for children with non-syndromic craniosynostosis: A mixed-method study

PURPOSE

The study aims to investigate factors influencing parents' satisfaction with hospital care for children with craniosynostosis during hospitalization for surgery.

DESIGN AND METHODS

A mixed-methods study with a convergent, parallel design was used. Ninety-five parents responded to the Swedish Pyramid Questionnaire for Treatment, a 25-item questionnaire with six quality domains. In addition, 20 parents were interviewed about their experiences. Frequencies were calculated, and content analysis was used to analyze free-text comments and transcribed interviews.

RESULTS

Parents' assessment of the overall quality of care was high (mean 87%, range 10-100%). They were most satisfied in the domain staff attitudes and less satisfied with information routines and participation. Content analysis of the interviews gave two overarching themes: Factors that parents experienced as facilitating good quality of care and Factors that parents experienced as impeding good quality of care.

CONCLUSIONS

Parents were generally satisfied with the care provided, and interviews captured parents´ views on important factors. Staff attitudes affected parents' perception of quality of care.

PRACTICAL IMPLICATIONS

Clear information and dialogue as well as making parents feel they are part of their child's team can result in higher satisfaction, and allowing families to stay together in the hospital can ease the hospitalization experience. Using a theoretical model can help in suggesting relevant caring actions based on parents' reported care experiences.

Ambulatory sedation for children under 6 years with CHD in MRI and CT

INTRODUCTION

In infants and young children, good image quality in MRI and CT requires sedation or general anesthesia to prevent motion artefacts. This study aims to determine the safety of ambulatory sedation for children with CHD in an outpatient setting as a feasible alternative to in-hospital management.

METHODS

We recorded 91 consecutive MRI and CT examinations of patients with CHD younger than 6 years with ambulatory sedation. CHD diagnoses, vital signs, applied sedatives, and adverse events during or after ambulatory sedation were investigated.

RESULTS

We analysed 91 patients under 72 months (6 years) of age (median 26.0, range 1-70 months; 36% female). Sixty-eight per cent were classified as ASA IV, 25% as ASA III, and 7% as ASA II (American Society of Anesthesiologists Physical Status Classification). Ambulatory sedation was performed by using midazolam, propofol, and/or S-ketamine. The median sedation time for MRI was 90 minutes (range 35-235 minutes) and 65 minutes for CT (range 40-280 minutes). Two male patients (age 1.5 months, ASA II, and age 17 months, ASA IV) were admitted for in-hospital observation due to unexpected severe airway obstruction. The patients were discharged without sequelae after 1 and 3 days, respectively. All other patients were sent home on the day of examination.

CONCLUSION

In infants and young children with CHD, MRI or CT imaging can be performed under sedation in an outpatient setting by a well-experienced team. In-hospital backup should be available for unexpected events.

The effect of VR headsets used during burn dressing in children on satisfaction and anxiety level of their parents

PURPOSE

The aim of this study was to determine the effect of virtual reality used during burn dressing in children on the satisfaction and anxiety levels of their parents.

METHODS

The study, which was designed as a prospective randomized controlled trial, was carried out with the parents of children aged 5-10 years who visited the only burns unit of a hospital in the northern region of Turkiye between 5 July 2021 and 1 April 2022 for dressing. There were a total of 52 participants in the study, 26 in the control and 26 in the intervention group.

RESULTS

The mean age of the children was 7.31 ± 1.81 years in the intervention group and 7.08 ± 1.72 in the control group. After the dressing was applied to the children, the mean anxiety score of the parents of the children was found to be 0.09 ± 0.28 in the intervention group and 0.64 ± 0.53 in the control group. The mean nursing care satisfaction score of the parents in the intervention group was found to be 4.70 ± 0.50 while it was 2.80 ± 0.26 in the control group.

CONCLUSIONS

In the study, while the anxiety levels of the ones in the intervention group decreased after the dressing, their satisfaction levels with nursing care were found higher than the control group.

PRACTICE IMPLICATIONS

Nursing interventions that would reduce the pain and anxiety experienced by children during medical procedures are also effective in reducing the anxiety of parents, and therefore, they should be included in distraction efforts with their children.

Parental satisfaction with paediatric care with and without the support of an eHealth device: a quasi-experimental study in Sweden

BACKGROUND

The period after a child is discharged from hospital is generally described as challenging for the parents. Their satisfaction with the health services received is an important indicator of the quality of care. eHealth devices are increasingly used in health care to support communication with parents. Differences in levels of parental satisfaction by modality of provided care or by parental background are largely unknown. This study aimed to describe satisfaction with health care between sociodemographic groups of parents, who either received or did not receive an eHealth device for communication between parents and hospital staff as a supplement to routine care after a child's discharge from neonatal or paediatric surgery departments.

METHODS

Data from a quasi-experimental study was collected in the south of Sweden, between 2019 and 2021. The Pediatric Quality of Life Inventory™ (PedsQL) Healthcare Satisfaction Generic Module was used to assess the parents' satisfaction with different dimensions of health care. Seventy parents of children hospitalized in a neonatal or a paediatric surgery department were enrolled in intervention (eHealth device, n = 36) and control (no eHealth device, n = 34) groups.

RESULTS

The parents reported high overall satisfaction with the health care provided and were also highly satisfied within different dimensions of care. Moreover, they reported high satisfaction with using an eHealth device, although having support from the eHealth device was related to neither higher nor lower levels of satisfaction with care. There was a significant difference between fathers and mothers in the multivariate sub-analysis in certain instances regarding satisfaction with communication and the level of inclusion.

CONCLUSIONS

Parents were very satisfied with the health care provided, whether or not they received eHealth. Further research looking at groups with and without the support of an eHealth device is required to further develop future paediatric and neonatal care interventions. Communication and support through eHealth can be a tool to alleviate the distress parents experience after their child's hospital admission, accommodate the family's transfer to home, and increase satisfaction with care, but it needs to be evaluated before being implemented.

TRIAL REGISTRATION

Clinical Trials NCT04150120, first registration 4/11/2019.

The Swedish version of EMPATHIC-30 translation and initial psychometric evaluation

BACKGROUND

One way to measure quality of care is by measuring satisfaction of provided care among patients and their families. EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) is a self-reported questionnaire grounded on the principles of FCC aiming to measure parents' satisfaction with paediatric intensive care. There is lack of Swedish questionnaires measuring satisfaction with paediatric intensive care based on family-centered care principles.

AIM

The aim was to translate the instrument EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) into the Swedish language and evaluate psychometrically the Swedish version in a paediatric intensive care context.

METHODS

The instrument EMPATHIC-30 was translated and adapted to Swedish context, thereafter, assessed by expert panels consisting of nurses (panel one; n = 4; panel two; n = 24) and parents (n = 8) with experience in paediatric intensive care. Construct validity, item characteristics and reliability were tested in a cohort of 97 parents whose child had been treated for at least 48 h at two out of four Paediatric Intensive Care Unit (PICUs) in Sweden. Parents whose child died during hospitalisation were excluded.

RESULTS

The Swedish version of EMPATHIC-30 showed an acceptable internal consistency with Cronbach's alpha coefficient for the total scale 0.925. Cronbach's alpha on the domain level varied between 0.548-0.792 with the lowest coefficient in the domain Organisation. Inter-scale correlation revealed acceptable correlations for both subscales (0.440-0.743) and between total scale and subscales (0.623-0.805), which demonstrated good homogeneity for the instrument in its entirety. One problem regarding the domain Organisation and especially the item "It was easy to contact the pediatric intensive care unit by telephone" was revealed, which indicated that the item needs to be reformulated or that the factor structure needs to be further evaluated.

CONCLUSION

The findings from the current study indicated that the Swedish version of EMPATHIC-30 has acceptable psychometric properties and can be used in Swedish PICUs. Using EMPATHIC-30 in clinical practice can give an indication of the overall quality of family-centered care at the PICU.

Breastfeeding sick children in hospital: Exploring the experiences of mothers in UK paediatric wards

There is a paucity of literature exploring the challenges of breastfeeding sick children in hospital. Previous research has focused on single conditions and hospitals which limits understanding of the challenges in this population. Although evidence suggests that current lactation training in paediatrics is often inadequate, it is unclear where the specific training gaps are. This qualitative interview study of UK mothers aimed to explore the challenges of breastfeeding sick infants and children on a paediatric ward or paediatric intensive care unit. From 504 eligible respondents, a sample of 30 mothers of children aged 2-36 months with various conditions and demographic backgrounds was purposively chosen, and a reflexive thematic analysis undertaken. The study identified previously unreported impacts such as complex fluid needs, iatrogenic withdrawal, neurological irritability and changes to breastfeeding behaviour. Mothers described breastfeeding as emotionally and immunologically meaningful. There were many complex psychological challenges such as guilt, disempowerment, and trauma. Wider struggles such as staff resistance to bedsharing, inaccurate breastfeeding information, lack of food and inadequate breast pump provision made breastfeeding more challenging. There are numerous challenges related to breastfeeding and responsively parenting sick children in paediatrics, and these also impacted maternal mental health. Staff skill and knowledge gaps were widespread, and the clinical environment was not always conducive to supporting breastfeeding. This study highlights strengths in clinical care and provides insight into what measures are perceived as supportive by mothers. It also highlights areas for improvement, which may inform more nuanced paediatric breastfeeding standards and training.

Translation and validation of the PPSC-PNP instrument to measure parental satisfaction with care from pediatric nurses in China

PURPOSE

To modify and translate the Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners instrument into Chinese, culturally adapt and initially test it to assess parental satisfaction with care from all levels of pediatric nurses in a pediatric inpatient care context.

DESIGN AND METHODS

The instrument was translated and culturally adapted following a standardized guideline for the translation and cross-cultural adaptation of self-report measures. Content validity, discriminative validity, internal consistency and test-retest reliability were examined.

RESULTS

Four main issues were identified in the translation and cultural adaptation stage. Modifications were therefore made to the Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument. The item-level content validity indexes for the Chinese instrument ranged between 0.83 and 1.0. The Cronbach's alpha coefficient was 0.95, and the intra-class correlation coefficient for test-retest reliability was 0.44.

CONCLUSION

The Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument has good content validity and internal consistency and can be considered a suitable clinical evaluation tool to measure parental satisfaction with care from pediatric nurses in pediatric inpatient settings in China.

PRACTICE IMPLICATIONS

The instrument is anticipated to be useful in strategic planning for Chinese nurse managers responsible for patient safety and quality of care. Additionally, it has the potential to serve as a tool to enable international comparisons in parental satisfaction with care from pediatric nurses after further testing.

Instruments to evaluate hospitalised children parents' satisfaction with nursing care: a scoping review

AIM

To identify instruments that allow the evaluation of parent's satisfaction regarding nursing care during their child hospitalisation.

METHODS

A review was performed using Preferred Reporting Items for Scoping Reviews. The study was prospectively registered in Open Science Framework. Research was carried out on EBSCOhost, PubMed, SciELO, Web of Science and ScienceDirect platforms as well as grey literature. Additionally, the references of selected articles were also examined.

RESULTS

A sample of 65 articles allowed the identifications of 38 distinctive instruments to evaluate parents' satisfaction in different hospital settings. Most studies were applied in paediatric wards (n=28), followed by neonatal intensive care units (n=21), paediatric intensive care units (n=9) and emergency departments (n=7). Sample size ranged from 13 to 3354 and 3 studies used mixed methods, 20 were methodological studies of instruments construction or validation and 43 were quantitative studies. 21 different instruments previously existent were found. In 3 studies, adapted instruments were used and, in 14 studies, structured instruments were purposively designed for the study. Instruments had between 1 and 13 domains and total number of items ranged between 13 and 92. Most studies assessed overall satisfaction (n=53) and instrument reliability (n=49) and/or validity (n=37).

CONCLUSION

Most instruments consider nursing care as a domain of satisfaction. Only two instruments focused specifically on nursing care. In most of the studies, there was a concern to evaluate instruments psychometric properties. This review clearly shows that there is still a gap in the literature on the range of aspects that influence satisfaction and a lack of consensus on ideal conditions for instrument use and application.

Predictors of parental satisfaction with the pediatric ophthalmology care in a Brazilian hospital

The purpose of this cross-sectional study was to assess the satisfaction of parents of visually impaired children with the pediatric ophthalmology care in a Brazilian hospital and to associate parental satisfaction with predictor variables. The study enrolled children with a binocular and monocular visual impairment aged between 4 and 17 years from a single site in Brazil between June 2019 and May 2020. Parents or legal guardians answered the Brazilian version of the Pediatric Quality of Life Inventory^TM (PedsQL^TM 3.0) Healthcare Satisfaction Generic - Parents. Linear regression analysis was used to investigate the association between the PedsQL scores and predictor variables. The sample included 82 children and their respective parents. The mean PedsQL score was 90.3 ± 6.6 (out of 100). In the univariate model, child female sex (p = 0.056), child older age (p = 0.078), better eye visual acuity (VA; p = 0.016), and worse eye VA (p = 0.008) were significantly associated with higher scores. The multivariate estimates identified the worse eye VA (p = 0.034) as a predictor of parental satisfaction. In summary, parents' satisfaction with this pediatric ophthalmology care was high. Nevertheless, a continuous evaluation is warranted to keep up with parents' expectations and plan for possible improvements in clinical practice.

Effects of Virtual Reality Education on Procedural Pain and Anxiety During Venipuncture in Children: A Randomized Clinical Trial

Background

Venipuncture is one of the most frequent and frightening medical procedures for children. This randomized clinical trial aimed to evaluate whether pre-procedural immersive virtual reality (VR) education could decrease pain and anxiety during venipuncture procedure of children.

Methods

Sixty children scheduled for venipuncture at the phlebotomy unit were randomized into either the control or VR group. Before the procedure, children of the control group received conventional simple verbal instructions, whereas those of the VR group experienced a 4-min VR education regarding venipuncture. The primary outcome was the pain and anxiety of pediatric patients assessed with the children’s hospital of eastern ontario pain scale. Secondary outcomes were parental satisfaction, venipuncture time, repeated procedure and procedural difficulty rated by phlebotomists.

Results

The pain and anxiety score during the procedure was significantly lower in the VR group than in the control group (median [IQR], 6.0 [5.0–7.0] vs. 8.0 [6.0–9.8], P = 0.001). Parental satisfaction about the procedural process were higher in the VR group than in the control group (P = 0.029), and the degree of procedural difficulty was lower in the VR group, compared to the control group (P = 0.026).

Conclusion

The preprocedural VR education significantly reduced pain and anxiety of children and decreased the procedural difficulty of phlebotomists during venipuncture procedure.

Clinical Trial Registration

University hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000042968, date of registration: January 9, 2021, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000049043).

Parent's Stress Predictors during a Child's Hospitalization

A child’s illness and hospitalization are particularly difficult and most often an unpredictable situation in a family’s life cycle. The level of stress of a parent of a hospitalized child depends on many factors, such as the psychological characteristics of the child and the parent, the child’s health condition, and support from the family and medical staff. Our research aimed to search for interactions between the stress experienced by the parent and the temperamental variables of both the child and the parent, and the support received from the family and hospital staff. Using three pencil-paper questionnaires—PSS, EAS-D, EAS-C—and interview questionnaire, we tested 203 parent–child dyads at the time of children hospitalization. It was revealed that the most notable moderator of the relationship between temperamental traits and the characteristics of the hospital-related situation is the child’s age. When analyzing the situation of a family with a hospitalized child, particular attention should be paid to parental emotional distress, which, regardless of the child’s age, predicts a high level of parental stress.

Factors influencing the quality of nursing care as perceived by mothers of hospitalized children in South Korea

PURPOSE

This study aimed to identify the factors affecting the quality of nursing care as perceived by mothers of hospitalized children and provide basic data for the development of nursing care quality improvement programs.

METHODS

The participants consisted of 167 mothers, each of whom had a child hospitalized at a specific children's hospital. Data were collected from June 22 to August 8, 2019.

RESULTS

The factors that affected how mothers perceived the quality of nursing care were the communication ability of nurses (β=.44, p<.001) and the mother-nurse partnership (β=.33, p=.001). The total explanatory power of these factors was 54.1%.

CONCLUSION

To improve the quality of pediatric nursing care, it is necessary to improve the communication abilities of nurses and to promote partnership between nurses and the mothers of hospitalized children.

Parents' Views of Family-Centered Care at a Pediatric Intensive Care Unit-A Qualitative Study

Purpose: To describe parents' views of family-centered care at a pediatric intensive care unit. Design and Methods: A qualitative descriptive study with a deductive and inductive approach was conducted based on the principles of family-centered care. Inclusion criteria were parents of children cared for at a pediatric intensive care unit for at least 48 h. Parents of children who died during the hospital stay were excluded. The sample consisted of spontaneous responses from 70 parents to five open questions in the EMpowerment of PArents in THe Intensive Care questionnaire, which was completed at discharge. The spontaneous responses were analyzed using thematic analysis. Results: The analysis of the parents' statement illuminated that partnership, the essence of family-centered care, appeared incomplete. Partnership was particularly evident regarding parents' experiences of being treated with empathy and respect. It also seemed prominent in situations where the professional team provided support to the child, parents, and family. Based on the parents' statements there was potential for development of the family-centered care approach in aspects such as decision-making concerning care and treatment, as well as improving person-centered communication on order to capture parents' experiences and needs in the highly technological pediatric intensive care unit environment. Conclusions: Although in general parents were satisfied with the care, areas for improvement were identified such as participation in decision-making about care and treatment as well as person-centered communication. The results can contribute to future quality improvement interventions focusing family centered care at pediatric intensive care units.