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MacKay LJ, Chang U, Kreiter E, Nickel E, Kamke J, Bahia R, Shantz S, Meyerhoff H. Exploration of trust between pediatric nurses and children with a medical diagnosis and their caregivers on inpatient care units: A scoping review. J Pediatr Nurs 2024; 78:e1-e30. [PMID: 39085007 DOI: 10.1016/j.pedn.2024.05.030] [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: 02/02/2024] [Revised: 05/26/2024] [Accepted: 05/26/2024] [Indexed: 08/02/2024]
Abstract
PROBLEM Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units. ELIGIBILITY CRITERIA Using the Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews, CINAHL, MEDLINE, PsycINFO, Cochrane DSR, Cochrane Central, and JBI EBP were searched for qualitative, quantitative, mixed methods, and review studies with no time limits published in English. Included studies presented findings on the experiences of developing trust between pediatric nurses and children under 18 years of age and their caregivers within inpatient care units. RESULTS A total of 12,269 titles and abstracts were reviewed independently by two reviewers. 366 full-text articles were retrieved, a final of 81 studies were included in the review. CONCLUSIONS Trust was bi-directional between nurses and children/caregivers, developed over time during multiple interactions, and foundational to the development of relationships. Distinct facilitators and barriers to the development of trust between nurses and children/caregivers were identified. The development of trust was rewarding and enriching for both nurses and children/caregivers and was the fundamental to the provision of safe and high-quality nursing care. IMPLICATIONS Findings provide nurses with direction and strategies on how to develop and maintain trust with children/caregivers on inpatient care units. The development of training programs and interventions geared at equipping nurses with the skills to develop trust with children/caregivers is needed.
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Affiliation(s)
- Lyndsay Jerusha MacKay
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Una Chang
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Elizabeth Kreiter
- Norma Marion Alloway Library, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Emma Nickel
- Alberta Children's Hospital, 28 Oki Drive, Calgary, Alberta T3B 6A8, Canada.
| | - Janice Kamke
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Rubinder Bahia
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Sarah Shantz
- Alberta Children's Hospital, 28 Oki Drive, Calgary, Alberta T3B 6A8, Canada.
| | - Heather Meyerhoff
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
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Carew M, Redley B, Bloomer MJ. Competing Tensions: Nurse Perceptions of Family-Centered Care and Parents' Needs in Neonatal Care. Adv Neonatal Care 2024; 24:35-42. [PMID: 38193725 DOI: 10.1097/anc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Family-centered care is founded upon collaboration between parents and healthcare professionals, caring for a child and parents as one entity. The unfamiliar neonatal environment and complexity of care can make family-centered care challenging. PURPOSE To explore neonatal nurses' perceptions of family-centered care and parents' cultural needs. METHODS This was a qualitative descriptive study using interviews to gather data from registered nurses, and analyzed using inductive content analysis. RESULTS Ten neonatal nurses participated in online interviews, lasting an average of 25 minutes. Parents' cultural needs were poorly understood and assumed synonymous with family-centered care. While all acknowledged the importance of family-centered care, most described tasks to parent-infant bonding, rather than a broader embodiment of family-centered care. In time of uncertainty, emergent clinical priorities took priority over a family-centered approach to care. Cultural care was poorly understood, and care tasks associated with supporting parent-infant bonding suggest further work is necessary to promote embodiment of family-centered care beyond individual tasks. While emergent clinical priorities and neonate well-being will always be the priority, finding a way to respond that concords with the ethos of family-centered care is also essential. IMPLICATIONS FOR PRACTICE AND RESEARCH Clear and consistent leadership is needed to demonstrate greater embodiment of family-centered care, which includes cultural care for parents. Strong leadership and targeted education are key to supporting this change. Further research is warranted to examine and observe practice, in particular how parents' cultural needs are assessed and integrated into family-centered care in neonatal settings.
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Affiliation(s)
- Maddison Carew
- Maternity Unit, Bass Coast Health, Wonthaggi, Victoria, Australia (Ms Carew); School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia (Ms Carew and Prof Redley); Health Complaints Commissioner, Melbourne, Victoria, 3000, Australia (Prof Redley); and School of Nursing and Midwifery, Griffith University, Nathan, Queensland, and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, and Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia (Prof Bloomer)
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DiBiasio PA, Vallabhajosula S, Eigsti HJ. A multisite cross-sectional study of intercultural competencies in doctor of physical therapy students. BMC MEDICAL EDUCATION 2023; 23:741. [PMID: 37803389 PMCID: PMC10559602 DOI: 10.1186/s12909-023-04699-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Physical therapists (PTs) work in diverse communities with individuals whose identities and beliefs may differ significantly from their own. Academic institutions must include intentional curriculum aimed at graduating PTs who can skillfully navigate intercultural encounters. Being prepared to engage with difference and demonstrate skills related to intercultural competencies (ICC) will prepare entry-level PTs to provide individualized, high-quality care. Intercultural competencies are essential skills that can reduce healthcare disparities, and promote equitable and inclusive healthcare delivery. This study examined the impact of PT curricula, student demographics, and participation in intercultural learning experiences (ILEs) on students' development of ICC. METHODS A cross-sectional study of 8 Doctor of Physical Therapy (DPT) programs in the United States (US) compared ICC in first-year (F) and third-year students (T), and T who participated in an ILE (T + ILE) to those who did not (T-only). Subjects included 1,038 students. Outcome measures included The Inventory for Assessing the Process of Cultural Competence-among healthcare professionals-Student Version© (IAPCC-SV), and a demographic survey. RESULTS Independent t-tests showed that group T (mean = 64.34 ± 5.95, 95% CI: 63.78-64.90) had significantly higher IAPCC-SV total scores than group F (mean = 60.8 ± 5.54, 95% CI = 60.33-61.27, p < 0.05). Group T + ILE (mean = 65.81 ± 5.71, 95% CI = 64.91-66.71) demonstrated significantly higher IAPCC-SV total scores than group T-only (mean = 63.35 ± 5.8, 95% CI = 62.6-64.1, p = 0.039). A one-way ANOVA and post hoc comparisons showed that the 25 to 34-year age group (mean = 63.80 ± 6.04, 95% CI = 63.25-64.35, p < 0.001) and the ≥ 35-year age group (mean = 64.21 ± 5.88, 95% CI = 62.20-66.22, p < .024) had significantly higher IAPCC-SV total scores, than the 18 to 24-year age group (mean = 60.60 ± 5.41, 95% CI = 60.09-61.11). Students who identified in US census minority ethnic or racial categories (US-Mn) (mean = 63.55 ± 5.78, 95% CI = 62.75-64.35) had significantly higher IAPCC-SV total scores than students who identified in US majority ethnic or racial categories (US-Mj) (mean = 61.98 ± 5.97, 95% CI = 61.55-62.413, p = .0001). CONCLUSIONS Results of the study support the hypothesis that DPT programs can promote the development of intercultural skills in students. The ultimate objective of this academic preparation is to improve the student's ability to deliver equitable, person-centered healthcare upon entry into practice. Specific ICC for entry-level DPT students are not clearly defined by US physical therapy professional organizations, academic institutions, or accrediting body. Students who participated in an ILE exhibited higher levels of ICC when compared to those who did not. Findings from this study can guide curriculum development, utilization of resources, and outcomes assessment. More research is needed to examine characteristics of an ILE that could inform best practice.
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Affiliation(s)
- Paula A DiBiasio
- Department of Physical Therapy Education, Elon University, Campus Box 2085, Elon, NC, 27244, USA.
| | - Srikant Vallabhajosula
- Department of Physical Therapy Education, Elon University, Campus Box 2085, Elon, NC, 27244, USA
| | - Heidi J Eigsti
- School of Physical Therapy, Regis University, 3333 Regis Blvd, Denver, CO, 80221, USA
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Mazaheri E, Ghahramanian A, Valizadeh L, Zamanzadeh V, Onyeka TC. Disrupted mothering in Iranian mothers with breast cancer: a hybrid concept analysis. BMC WOMENS HEALTH 2021; 21:234. [PMID: 34090407 PMCID: PMC8178819 DOI: 10.1186/s12905-021-01346-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Abstract
Background Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model. Methods The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed. Results In the theoretical phase, the following attributes were determined: “disturbance in maternal identity and roles”, “maternal insensitivity and unresponsiveness: disconnection physically and psychologically”, “the career disruption process” and “biographical disruption”. The fieldwork phase explored three themes including “the unbalance between multiple roles”, “role failure”, and “reduced maternal sensitivity”. The final synthesis yielded that the main integrated elements of mothering disruption are “disease as threating maternal role and identity”, “inability to interpret and respond to child behaviors and needs”, and “support for transitioning from being patient toward maternal competency”. Conclusion With a deeper understanding of the term ‘disrupted mothering’ or ‘mothering disruption’, healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01346-w.
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Affiliation(s)
- Effat Mazaheri
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Shariati Jonubi Avenue, PO Box 5138947977, Tabriz, Iran.
| | - Leila Valizadeh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tonia C Onyeka
- Pain Physician, Palliative Medicine Physician, Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria
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Vo T. Cultural alienation: A concept analysis. Nurs Forum 2020; 56:160-171. [PMID: 32976659 DOI: 10.1111/nuf.12512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/30/2022]
Abstract
AIM To analyze the concept of cultural alienation BACKGROUND: Culturally diverse populations are increasing nationwide. However, many culturally diverse clients have experienced cultural alienation. DESIGN Rodgerian's method of concept analysis DATA SOURCE: Literature in CINAHL, PubMed, PsycINFO, JSTOR, Scopus, LGBT Life, and Oxford Bibliographic databases were searched. Inclusion criteria were full text, peer-reviewed, English language, and published within 5 years. REVIEW METHODS Articles were read in their entirety and reread to determine more contextual data. Antecedents, attributes, and consequences were extracted. RESULTS Fifteen studies were included. Antecedents included: identification with racial, ethnic, sexual minority, disability, chronic illness, and threat to way of life. Attributes were traditional, different, negotiator, preserving, and sustaining. Consequences resulted in sociocultural deprivation, resistance, mistrust, distrust, loss of identity, and racism. CONCLUSIONS Nurses, health care providers, and communities can better support and engage their clients by working together to create an inclusive environment, in which exists a safe space to work, play, and heal. Findings highlight the need to examine one's own assumptions, inquire about the client's cultural care needs, tailor communication at the client's level, acknowledge individual strengths, provide empathetic support, and promote autonomy.
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Affiliation(s)
- Timothea Vo
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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