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Joren CY, Kars MC, Kremer LCM, van Dijk JC, Habing AM, Tijs AM, Trampe AA, Verhagen AAE, Aris-Meijer JL. The purpose of an individual care plan in pediatric palliative care according to healthcare professionals: a qualitative study. BMC Palliat Care 2024; 23:236. [PMID: 39367385 PMCID: PMC11452972 DOI: 10.1186/s12904-024-01569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/26/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND To ensure high-quality pediatric palliative care (PPC) and enable healthcare professionals (HCPs) to provide person-centered care for the individual child with a life-limiting or life-threatening illness and their family, the Individual Care Plan (ICP) for PPC was developed. However, in practice, the ICP for PPC is not used for all children in need of PPC. Insight into why, for which problem and for which children HCPs wish to use an ICP in PPC is therefore necessary to assure that the ICP can be fully implemented in practice. METHODS Two semi-structured focus group interviews were held with 15 experienced healthcare professionals in PPC. Data were thematically analyzed. RESULTS Participants wish to use an ICP to collaboratively establish a plan with parents for the current and future care and treatment of the child. By doing so, they hope to achieve coordination and continuity of care, to achieve shared decision-making, and to support parents and other healthcare professionals in the care of the child. Participants think the ICP could also be used in the care for children with complex chronic conditions. CONCLUSION The purposes for which healthcare professionals wish to use an ICP in PPC are broader than the purpose for which the ICP for PPC was developed. Future research should focus on whether the use of an ICP in PPC practice can achieve these purposes.
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Affiliation(s)
- C Y Joren
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
| | - M C Kars
- Center of Expertise in Palliative Care Utrecht, Julius Center of Health and Primary Care, UMC Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, the Netherlands
| | - L C M Kremer
- Princess Maxima Centre for Pediatric Oncology, Heidelberglaaan 25, Utrecht, 3584 CS, The Netherlands
| | - J C van Dijk
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - A M Habing
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - A M Tijs
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - A A Trampe
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - A A E Verhagen
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - J L Aris-Meijer
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
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Diment L, Curtin S, Kenney L, Reynolds KJ, Granat MH. Priorities when designing a service-focused delivery model for mobility devices: a systematic review. Disabil Rehabil Assist Technol 2024; 19:2442-2453. [PMID: 38349125 DOI: 10.1080/17483107.2024.2313077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/28/2023] [Accepted: 01/26/2024] [Indexed: 10/03/2024]
Abstract
PURPOSE Throughout the world, mobility devices are usually distributed using product-based business models, where a device is provided to a user, and serviced or replaced when the user returns to the clinic with an issue. Moving to a service-based business model can provide continuous and customised support for the user, and provide the clinicians and manufacturers with better data to base their decisions on. This study reviews papers on assistive technology service-based business models and considerations in designing such a model to optimise economic and social value. It then applies the findings to the mobility device space. METHOD A systematic literature search was undertaken in PubMed, Web of Science, and OVID databases to analyse studies that discuss service delivery models used to provide assistive products. Inductive thematic analysis determined the themes, facilitators and barriers associated with providing a service. Findings were applied to mobility device service provision. RESULTS AND CONCLUSION Themes from the 29 relevant papers were grouped into four categories: Access (affordability/availability/education), Utility (customisability/usability/adaptability), Integrity (quality/sustainability/impact), and Compliance (policy/privacy/security). The most common themes were customisability, affordability, availability, and education. There is a need for service-based delivery models to replace conventional product-based models, and many considerations to optimise their design. No publications discussed the design and implementation of a service-based model for mobility device provision that uses modern sensors, software and other digital technologies to optimise the service. Service-based models that use modern digital technologies are new for the mobility device field, but much can be learnt from other fields.
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Affiliation(s)
- L Diment
- Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, Australia
| | - S Curtin
- School of Health and Society, University of Salford, Salford, UK
| | - L Kenney
- School of Health and Society, University of Salford, Salford, UK
| | - K J Reynolds
- Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, Australia
| | - M H Granat
- School of Health and Society, University of Salford, Salford, UK
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Zaino NL, McKee Z, Caskey CD, Steele KM, Feldner HA. Perceptions and experiences of first mobility aid provision for young children with cerebral palsy in the United States: a mixed-methods study. Disabil Rehabil Assist Technol 2024; 19:2519-2530. [PMID: 38344906 DOI: 10.1080/17483107.2023.2301376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 10/03/2024]
Abstract
PURPOSE The purpose of this study was to establish and understand the provision process and impacts of first mobility aids for children with cerebral palsy (CP) in the United States - specifically orthoses, walkers and gait-trainers. METHODS We performed a mixed-methods study including surveys and semi-structured interviews of caregivers of young children with CP (n = 10) and clinicians who work with young children with CP (n = 29). We used content analysis for the surveys and inductive coding for the interviews. RESULTS Four themes emerged: (1) first mobility aids have mixed impacts and use patterns, (2) there is varied caregiver education and understanding about mobility aids, (3) clinician knowledge, consistency and connection impact care and (4) numerous access barriers exist for families, and there are still opportunities for improvement across all domains. CONCLUSIONS This research provides insights into the lived experiences of clinicians and caregivers of young children with CP regarding the prescription, provision, use and impact of first mobility aids, specifically ankle foot orthoses and walkers/gait trainers. This study not only provides researchers and clinicians with an understanding of the current status of the prescription and provision process in the United States, but also offers suggestions for improvements of the process and mobility aids themselves. These results have implications for future research, mobility aid, design and the provision process of first mobility aids.
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Affiliation(s)
- Nicole L Zaino
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Zahra McKee
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Charlotte D Caskey
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Katherine M Steele
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Heather A Feldner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Yavas Celık M, Kaya L. The Relationship Between Care Burden and Spiritual Well-Being of Mothers of Children with Cerebral Palsy: A Cross-Sectional Study from Türkiye. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02098-1. [PMID: 39153165 DOI: 10.1007/s10943-024-02098-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 08/19/2024]
Abstract
This study was conducted to determine the relationship between care burden and spiritual well-being of mothers of children with cerebral palsy and the topics of support that mothers need. This study, which was conducted as a relationship seeker, was completed in approximately 7 months. Data were collected through interviews with 270 mothers of children with cerebral palsy. A questionnaire, Spiritual Well-Being Scale and Burden Interview Scale was used to collect data. It was found that mothers needed a lot of support, such as requesting an increase in physical therapy hours and the need for financial support. There was a moderate negative relationship between SWBS and BIS (r = - 0.39, p = 0.01). According to the results of this study, we can say that spiritual well-being is related to the care burden of mothers, so nurses caring for these children should understand the burden of the mothers of these children and evaluate spiritual well-being.
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Affiliation(s)
- Melike Yavas Celık
- Department of Midwifery, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey.
| | - Leyla Kaya
- Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, Istanbul, Turkey
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Joren CY, Aris-Meijer JL, Kremer LCM, Hofman SC, Rippen-Wagner H, Slingerland-Blom R, van der Velden C, Schuiling-Otten MA, Verhagen AAE, Kars MC. The Practical Application of the Individual Care Plan for Pediatric Palliative Care: A Mixed-Method Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:967. [PMID: 39201902 PMCID: PMC11352542 DOI: 10.3390/children11080967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVE The Individual Care Plan (ICP) for pediatric palliative care was developed to provide person-centered care for the individual child and family. Currently, a lack of clarity remains regarding the use and function of the ICP in daily practice. To further implement the ICP, it is important to identify how parents and healthcare professionals use the ICP and which obstacles or benefits are experienced. METHODS This mixed-method study used qualitative interviews and quantitative questionnaires in (bereaved) parents and healthcare professionals with experience with the ICP. RESULTS Parents and healthcare professionals used the ICP to establish a joint plan for care and treatment of the child to coordinate care and to achieve child- and family-centered care. This includes both obstacles that complicate achieving care goals and benefits that make it easier. Furthermore, responsibilities for the ICP remained unclear, and there was no set point in the illness trajectory for drawing up the ICP. CONCLUSIONS Parents and healthcare professionals use the ICP as intended. However, uncertainties regarding timing, roles and responsibilities prevent optimal use of the ICP. Agreements on timing and responsibilities are needed for further ICP implementation in daily pediatric palliative care practice.
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Affiliation(s)
- Chantal Y. Joren
- University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Judith L. Aris-Meijer
- University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Leontien C. M. Kremer
- Princess Maxima Centre for Pediatric Oncology, Heidelberglaaan 25, 3584 CS Utrecht, The Netherlands
| | - Suzanne C. Hofman
- University Medical Center Utrecht, Wilhelmina Children’s Hospital, Lundlaan 6, 3584 EA Utrecht, The Netherlands
| | | | - Ria Slingerland-Blom
- Dutch Centre of Expertise in Children’s Palliative Care, Mercatorlaan 1200, 3528 BL Utrecht, The Netherlands
| | - Chantal van der Velden
- Dutch Centre of Expertise in Children’s Palliative Care, Mercatorlaan 1200, 3528 BL Utrecht, The Netherlands
| | - Meggi A. Schuiling-Otten
- Dutch Centre of Expertise in Children’s Palliative Care, Mercatorlaan 1200, 3528 BL Utrecht, The Netherlands
| | - Project Team ICP
- University Medical Center Groningen, Beatrix Children’s Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - A. A. Eduard Verhagen
- University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Marijke C. Kars
- Center of Expertise in Palliative Care Utrecht, Julius Center of Health and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
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Li X, Li M, Qin X, Li Y, Wang Y, Han C, Ni S, Sun X, Dong P, Liu J. Providing holistic care to children with cerebral palsy treated with transnasal neural stem cell transplantation. Front Pediatr 2024; 11:1297563. [PMID: 38250587 PMCID: PMC10796742 DOI: 10.3389/fped.2023.1297563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Objective Holistic care is a key element in nursing care. Aiming at the heterogeneous disease of cerebral palsy, researchers focused on children with cerebral palsy who received transnasal transplantation of neural stem cells as a specific group. Based on establishing a multidisciplinary team, comprehensive care is carried out for this type of patient during the perioperative period to improve the effectiveness and safety of clinical research and increase the comfort of children. Methods Between January 2018 and June 2023, 22 children with cerebral palsy underwent three transnasal transplants of neural stem cells. Results No adverse reactions related to immune rejection were observed in the 22 children during hospitalization and follow-up. All children tolerated the treatment well, and the treatment was superior. One child developed nausea and vomiting after sedation; three had a small amount of bleeding of nasal mucosa after transplantation. Two children had a low fever (≤38.5°C), and one had a change in the type and frequency of complex partial seizures. Moreover, 3 children experienced patch shedding within 4 h of patch implantation into the nasal cavity. Conclusion The project team adopted nasal stem cell transplantation technology. Based on the characteristics of transnasal transplantation of neural stem cells in the treatment of neurological diseases in children, a comprehensive and novel holistic care plan is proposed. It is of great significance to guide caregivers of children to complete proper care, further improve the safety and effectiveness of treatment, and reduce the occurrence of complications.
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Affiliation(s)
- Xiaoyan Li
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
| | - Mengyao Li
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Xixian Qin
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Ying Li
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
| | - Yachen Wang
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
| | - Chao Han
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
| | - Shiwei Ni
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
| | - Xuna Sun
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Peipei Dong
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Jing Liu
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning Province, China
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Geary CR, Hook M, Popejoy L, Smith E, Pasek L, Heermann Langford L, Hewner S. Ambulatory Care Coordination Data Gathering and Use. Comput Inform Nurs 2024; 42:63-70. [PMID: 37748014 PMCID: PMC10841852 DOI: 10.1097/cin.0000000000001069] [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] [Indexed: 09/27/2023]
Abstract
Care coordination is a crucial component of healthcare systems. However, little is known about data needs and uses in ambulatory care coordination practice. Therefore, the purpose of this study was to identify information gathered and used to support care coordination in ambulatory settings. Survey respondents (33) provided their demographics and practice patterns, including use of electronic health records, as well as data gathered and used. Most of the respondents were nurses, and they described varying practice settings and patterns. Although most described at least partial use of electronic health records, two respondents described paper documentation systems. More than 25% of respondents gathered and used most of the 72 data elements, with collection and use often occurring in multiple locations and contexts. This early study demonstrates significant heterogeneity in ambulatory care coordination data usage. Additional research is necessary to identify common data elements to support knowledge development in the context of a learning health system.
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Affiliation(s)
- Carol Reynolds Geary
- Author Affiliations : College of Medicine, University of Nebraska Medical Center, Omaha (Dr Geary); Center for Nursing Research and Practice, Advocate Aurora Health, Downers Grove, IL (Dr Hook); Sinclair School of Nursing, University of Missouri, Columbia (Dr Popejoy); School of Nursing, University at Buffalo, NY (Dr Hewner and Mss Smith and Pasek); Logica, Inc., Salt Lake City, UT (Dr Heerman Langford); and College of Nursing, University of Utah, Salt Lake City (Dr Heerman Langford)
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Joren CY, Kars MC, Kremer LCM, Rippen H, Verhagen AAE, Aris-Meijer JL. Improvement and implementation of a national individual care plan in paediatric palliative care: a study protocol. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001677. [PMID: 36697034 PMCID: PMC9884846 DOI: 10.1136/bmjpo-2022-001677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Paediatric palliative care (PPC) is care for children with life-threatening or life-limiting conditions, and can involve complex high-tech care, which can last for months or years. In 2015, the National Individual Care Plan (ICP) for PPC was developed and has shown to be successful. The ICP can be seen as an instrument to facilitate coordination, quality and continuity of PPC. However, in practice, an ICP is often completed too late and for too few children. We aim to improve the coordination, quality and continuity of care for every child with a life-threatening or life-limiting condition and his/her family by further developing and implementing the ICP in the Netherlands. METHODS AND ANALYSIS To evaluate the original ICP, ICP 1.0, interviews and questionnaires will be held among parents of children who have or have had an ICP 1.0 and healthcare professionals (HCPs) who used ICP 1.0. Based on the results, ICP 1.0 will be further developed. An implementation strategy will be written and the renewed ICP, ICP 2.0, will be nationally tested in an implementation period of approximately 7 months. During the implementation period, ICP 2.0 will be used for all children who are registered with Children's Palliative Care teams. After the implementation period, ICP 2.0 will be evaluated using interviews and questionnaires among parents of children who received ICP 2.0 and HPCs who worked with ICP 2.0. Based on these results, ICP 2.0 will be further optimised into the final version: ICP 3.0. ETHICS AND DISSEMINATION This study received ethical approval. The ICP 3.0 will be disseminated through the Dutch Centre of Expertise in Children's Palliative Care, to ensure wide availability for the general public and HCPs within PPC. Additionally, we aim to publish study results in open-access, peer-reviewed journals and to present results at national and international scientific meetings.
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Affiliation(s)
- Chantal Y Joren
- Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands .,Department of Pediatrics, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Marijke C Kars
- Center of Expertise in Palliative Care Utrecht, Julius Center of Health and Primary Care, UMC Utrecht, Utrecht, The Netherlands
| | | | - Hester Rippen
- Dutch Foundation Child and Hospital, Utrecht, The Netherlands
| | - A A Eduard Verhagen
- Department of Pediatrics, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Judith L Aris-Meijer
- Department of Pediatrics, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
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