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Şapulu Alakan Y, Akansel N, Özmen ÖA. Experiences of patients' primary caregivers with tracheostomy suctioning before discharge. Eur J Oncol Nurs 2023; 67:102435. [PMID: 37871416 DOI: 10.1016/j.ejon.2023.102435] [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: 03/02/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE This study aimed to determine the experiences of primary caregivers of patients with tracheostomies on the tracheostomy suctioning procedure. METHODS This is a semi-structured qualitative study of 11 primary caregivers of patients with tracheostomies in one university hospital in a province in northwest Turkey. Data were collected using a semi-structured interview technique with the primary caregivers of the patients and interviews were audio-recorded. The content of the audio recordings obtained during each interview was evaluated by the researchers using the content analysis method. The data were categorized, coded, and analyzed by creating themes and sub-themes. RESULTS The experiences of primary caregivers with tracheostomy suctioning before discharge were classified under three themes and 11 sub-themes. The study's main themes were emotional reactions, information needs, and caring responsibility. Caregivers showed either positive or negative emotions when performed tracheostomy suctioning on their patients. Insufficient information on the patient care and recovery process were mostly emphasized topic by caregivers. Such that they express the knowledge deficiency on tracheostomy suctioning and counseling provided either by nurses/physicians. Thus compete with difficulties ends up with feelings of pressure and avoidance of caring responsibility. CONCLUSION Caregivers lack of knowledge and poor skills on tracheostomy suctioning ends up with fear, anxiety, and obstacles on patient caring. Implementing individualized education, supporting patients and their caregivers on tracheostomy suctioning, and following up on caregivers' abilities are valuable interventions.
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Affiliation(s)
- Yeliz Şapulu Alakan
- Department of Medical Services and Techniques, Bursa Uludag University, Turkey.
| | - Neriman Akansel
- Bursa Uludağ University, Faculty of Health Sciences, Department of Surgical Nursing, Bursa, Turkey.
| | - Ömer Avşin Özmen
- Bursa Uludağ University Medical Faculty, Department of Otolaryngology, Bursa, Turkey.
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Pandian V, Hopkins BS, Yang CJ, Ward E, Sperry ED, Khalil O, Gregson P, Bonakdar L, Messer J, Messer S, Chessels G, Bosworth B, Randall DM, Freeman-Sanderson A, McGrath BA, Brenner MJ. Amplifying patient voices amid pandemic: Perspectives on tracheostomy care, communication, and connection. Am J Otolaryngol 2022; 43:103525. [PMID: 35717856 PMCID: PMC9172276 DOI: 10.1016/j.amjoto.2022.103525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate perspectives of patients, family members, caregivers (PFC), and healthcare professionals (HCP) on tracheostomy care during the COVID-19 pandemic. METHODS The cross-sectional survey investigating barriers and facilitators to tracheostomy care was collaboratively developed by patients, family members, nurses, speech-language pathologists, respiratory care practitioners, physicians, and surgeons. The survey was distributed to the Global Tracheostomy Collaborative's learning community, and responses were analyzed. RESULTS Survey respondents (n = 191) from 17 countries included individuals with a tracheostomy (85 [45 %]), families/caregivers (43 [22 %]), and diverse HCP (63 [33.0 %]). Overall, 94 % of respondents reported concern that patients with tracheostomy were at increased risk of critical illness from SARS-CoV-2 infection and COVID-19; 93 % reported fear or anxiety. With respect to prioritization of care, 38 % of PFC versus 16 % of HCP reported concern that patients with tracheostomies might not be valued or prioritized (p = 0.002). Respondents also differed in fear of contracting COVID-19 (69 % PFC vs. 49 % HCP group, p = 0.009); concern for hospitalization (55.5 % PFC vs. 27 % HCP, p < 0.001); access to medical personnel (34 % PFC vs. 14 % HCP, p = 0.005); and concern about canceled appointments (62 % PFC vs. 41 % HCP, p = 0.01). Respondents from both groups reported severe stress and fatigue, sleep deprivation, lack of breaks, and lack of support (70 % PFC vs. 65 % HCP, p = 0.54). Virtual telecare seldom met perceived needs. CONCLUSION PFC with a tracheostomy perceived most risks more acutely than HCP in this global sample. Broad stakeholder engagement is necessary to achieve creative, patient-driven solutions to maintain connection, communication, and access for patients with a tracheostomy.
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Affiliation(s)
- Vinciya Pandian
- Immersive Learning and Digital Innovation, Johns Hopkins School of Nursing, Baltimore, MD, United States of America; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States of America.
| | - Brandon S Hopkins
- Department of Otolaryngology, Head and Neck Surgery, The Cleveland Clinic, Cleveland, OH, United States of America.
| | - Christina J Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein School of Medicine/Montefiore Medical Center, Bronx, New York, NY, United States of America.
| | - Erin Ward
- Global Tracheostomy Collaborative, Raleigh, NC, United States of America; Family Liaison, Multidisciplinary Tracheostomy Team, Boston Children's Hospital, Boston, MA, United States of America; MTM-CNM Family Connection, Inc., Methuen, MA, United States of America(1)
| | - Ethan D Sperry
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Ovais Khalil
- Johns Hopkins University School of Nursing, Baltimore, MD, United States of America.
| | - Prue Gregson
- Tracheostomy Review and Management Services, Austin Health, Melbourne, VIC, Australia.
| | - Lucy Bonakdar
- Tracheostomy Review and Management Services, Austin Health, Melbourne, VIC, Australia.
| | - Jenny Messer
- Austin Health Tracheostomy Patient & Family Forum
| | - Sally Messer
- Austin Health Tracheostomy Patient & Family Forum
| | - Gabby Chessels
- Austin Health Tracheostomy Patient & Family Forum, Tracheostomy Review and Management Services, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia.
| | | | - Diane M Randall
- Memorial Regional Health System, Fort Lauderdale, FL, United States of America.
| | - Amy Freeman-Sanderson
- Graduate School of Health, University of Technology, Sydney, NSW, Australia; Critical Care Division, The George Institute for Global Health, Sydney, NSW, Australia.
| | - Brendan A McGrath
- Anaesthesia & Intensive Care Medicine, Manchester University Hospital NHS Foundation Trust, Wythenshawe, Manchester, United Kingdom; Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
| | - Michael J Brenner
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI, United States of America; Global Tracheostomy Collaborative, Raleigh, NC, United States of America.
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Gursoy TR, Eyuboglu TS, Aslan AT, Pekcan S, Buyukkaya EZ, Hangul M, Kose M, Budakoglu II, Soysal S. The associations between the clinical course of children with tracheostomy and their mothers' depression, burnout, burden, and self-esteem. J Clin Nurs 2022. [PMID: 35818330 DOI: 10.1111/jocn.16450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to evaluate the clinical features of children with tracheostomy and the predictors of psychological status of their primary caregivers in order to determine the associations between the children's clinical course with their caregivers' psychological status. BACKGROUND The caregivers of children with tracheostomy are responsible for providing basic tracheostomy care at home. All these responsibilities may be associated with significant changes in family members' lifestyles, daily routines and family dynamics. DESIGN This study is a cross sectional study. METHODS Data of the family's socioeconomic status and clinical status of children with tracheostomy were noted in four paediatric pulmonology centers. The Beck Depression Inventory, Maslach Burnout Inventory, Zarit Caregiver Burden Scale, and Rosenberg Self-esteem Scale were used for psychological measurements of the caregivers. The STROBE checklist was used for this study. RESULTS Eighty-five children and their primary caregivers were enrolled in the study. The children's median age was 4.1 years. Thirty-eight of them were dependent on home ventilators. Twenty-one had bacterial colonisation. All children's primary caregivers were their mothers. Beck Depression Inventory scores of mothers of children with colonisation were higher. Number of hospitalizations in previous 6 months was related to mothers' emotional exhaustion and depersonalization scores. Duration of children's hospitalizations in previous 6 months was positively correlated to mothers' emotional exhaustion, depersonalization, and Beck Depression Inventory scores. CONCLUSIONS Mothers of children with tracheostomy may experience psychological conditions, such as high levels of depression, burnout, burden and low levels of self-esteem. Frequent and long-term hospitalizations of children correlated with mother's depression and burnout. Therefore, primary caregivers should be evaluated and supported psychologically. RELEVANCE TO CLINICAL PRACTICE Preventing mothers of children with tracheostomy from experiencing psychological conditions such as depression, burnout, burden and low self-esteem can also increase the quality of care for children.
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Affiliation(s)
- Tugba Ramasli Gursoy
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey.,Department of Pediatric Pulmonology, University of Health Sciences, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | | | - Ayse Tana Aslan
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sevgi Pekcan
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Medicine Faculty, Konya, Turkey
| | - Eda Zeynep Buyukkaya
- Department of Pediatrics, Necmettin Erbakan University Meram Medicine Faculty, Konya, Turkey
| | - Melih Hangul
- Department of Pediatric Pulmonology, Erciyes University Faculty of Medicine, Kayseri, Turkey.,Department of Pediatric Pulmonology, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Turkey
| | - Mehmet Kose
- Department of Pediatric Pulmonology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Isıl Irem Budakoglu
- Department of Medical Education, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sebnem Soysal
- Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
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