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Kongsuwan W, Galvez B, Betriana F. Aesthetics in Nursing Practice as Experienced by Children During Hospitalization in Philippines: A Phenomenological Study. ANS Adv Nurs Sci 2024; 47:248-262. [PMID: 39093934 DOI: 10.1097/ans.0000000000000532] [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: 08/04/2024]
Abstract
This study aimed to describe the meaning of aesthetics in nursing practice as experienced by children during hospitalization. A hermeneutic phenomenological approach was used. Fifteen children who met the inclusion criteria participated in the study conducted from June to August 2021. Data were collected by drawing and interviewing. Kongsuwan's approach was used to analyze the data. Six thematic categories that revealed aesthetics in nursing practice were identified, namely, Enjoyment; Kindness; Creating impressive care; Appreciation of safeness; Intention to know children; and Connecting to others. The study findings present useful knowledge to inform nurses regarding special approaches to implementing aesthetic nursing care for children.
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Affiliation(s)
- Waraporn Kongsuwan
- Author Affiliations: Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand (Drs Kongsuwan and Betriana); and College of Nursing, Silliman University, Dumaguete City, Philippines (Dr Galvez)
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Ay A, Semerci R, Erkul M. Prediction of family-centered care on the unmet care needs of parents of pediatric oncology patients and their psychosocial problems. Pediatr Blood Cancer 2024; 71:e30795. [PMID: 38038401 DOI: 10.1002/pbc.30795] [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: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND/OBJECTIVES It was aimed to determine the predictive power of family-centered care of parents of children with cancer on their unmet care needs and psychosocial problems (anxiety, depression, stress). This study was conducted as a descriptive, correlational, and cross-sectional study. DESIGN/METHODS The study was conducted on 136 parents at a university hospital between January and September 2023, involving parents of children receiving care at the pediatric oncology clinic. Data collection instruments included an Information Form, Family Inventory of Needs Pediatric II (FINPED-II), Family-Centered Care Scale (FCCS), and Depression Anxiety Stress Scale (DASS-21). Data were analyzed using IBM SPSS 28, employing Pearson correlation analysis and linear regression to assess the relationships between variables. RESULTS The study revealed significant positive correlations between Family-Centered Care and Met Needs (r = .676, p < .001) and significant negative correlations between Met Needs and Stress scores (r = -.256, p < .001). Additionally, there were positive correlations between Anxiety and Depression scores (r = .700, p < .001), Anxiety and Stress scores (r = .768, p < .001), and Depression and Stress scores (r = .835, p < .001). Family-centered care significantly predicted Met Needs (p < .001) and accounted for 47% of the variation in Anxiety, Depression, Stress, and Family Inventory of Needs scores. CONCLUSION The findings highlight that family-centered care significantly predicts Met Needs, emphasizing its pivotal role in supporting parents of children with cancer. These findings underscore the importance of family-centered care in pediatric oncology, but also point to the need for further studies to address identified limitations and provide a comprehensive understanding of this complex healthcare dynamic.
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Affiliation(s)
- Ayşe Ay
- Nursing Department, Faculty of Health Sciences, Başkent University, Ankara, Turkey
| | - Remziye Semerci
- Child and Disease Nursing Department, Nursing Faculty, Koç University, İstanbul, Turkey
| | - Münevver Erkul
- Nursing Department, Faculty of Health Sciences, Antalya Science University, Antalya, Turkey
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Marino LV, Collaḉo N, Coyne S, Leppan M, Ridgeway S, Bharucha T, Cochrane C, Fandinga C, Palframan K, Rees L, Osman A, Johnson MJ, Hurley-Wallace A, Darlington ASE. The Development of a Communication Tool to Aid Parent-Centered Communication between Parents and Healthcare Professionals: A Quality Improvement Project. Healthcare (Basel) 2023; 11:2706. [PMID: 37893780 PMCID: PMC10606263 DOI: 10.3390/healthcare11202706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/05/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Good communication is central to good healthcare. As a result of poor communication between parents and healthcare professionals (HCPs) in clinical settings, this study aimed to address this problem by developing a communication tool to empower parents and act as a prompt for HCPs to talk about the child's care and gather information at the point of admission to hospital about what is important to families, therefore supporting patient-centered communication. A design thinking process was used to develop a physical copy of Chloe's card and evaluate its use. Design thinking is a problem-solving approach, which uses an empathetic lens to integrate viewpoints of different stakeholders throughout the process of creating solutions. Design thinking involves five processes: (1) empathise-including a literature review and data synthesis, (2) define-by completing semi-structured interviews with parents about their experience of communication and HCPs perceptions of parent's experience of communication, (3) ideate-iterate the design of Chloe's card with parents and HCPs, (4) prototype-develop the design of Chloe's card, and (5) test-pilot test in clinical practice. Results from this initial study suggest that a small hand-held card, with emoticons and a place to write concerns, was acceptable to parents and feasible to use in clinical practice. Parents do not always feel heard by HCPs and a tool such as Chloe's card may help facilitate sharing of information about matters important to them and their child. However, some HCPs felt the need for a communication tool undermined their clinical skills. Feedback from HCP participants suggests that the idea of Chloe's card was acceptable and perceived as potentially being useful in clinical practice. Further work is required, as part of a larger study, to further refine this communication tool, identify those parents who would benefit most from Chloe's card, as well as to further refine the HCP process prior to implementing it into clinical settings. It was noted future iterations would benefit from a digital version linked with a child's electronic record, as well as multi-language versions and information for parents.
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Affiliation(s)
- Luise V Marino
- Paediatric Intensive Care, Southampton Children's Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Nicole Collaḉo
- School of Health Sciences, Southampton University, Southampton SO17 1BJ, UK
| | | | | | | | - Tara Bharucha
- Paediatric Cardiology, Southampton Children's Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Colette Cochrane
- Paediatric Cardiology, Southampton Children's Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Catarina Fandinga
- Department of Dietetics/Speech Language Therapy, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Karla Palframan
- Department of Dietetics/Speech Language Therapy, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Leanne Rees
- Department of Dietetics/Speech Language Therapy, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Ahmed Osman
- Paediatric Intensive Care, Southampton Children's Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Mark J Johnson
- Neonatal Medicine, Princess Anne Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK
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Wong CL, Phiri PGMC, Chan CWH, Tse M. Nurses' and Families' perceptions and practices and factors influencing the implementation of family-centred care for hospitalised children and their families. J Clin Nurs 2023; 32:6662-6676. [PMID: 37097007 DOI: 10.1111/jocn.16740] [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: 11/12/2022] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/26/2023]
Abstract
AIMS AND OBJECTIVES To explore the perceptions of family-centred care among nurses and the family members of hospitalised children and investigate the facilitators of and barriers to the implementation of family-centred care in Malawi. BACKGROUND In Malawi, approximately 34% of children have long-term illnesses that require hospitalisation. Family-centred care ensures that the delivery of healthcare is grounded in partnerships between healthcare providers, patients and their families, which can improve the psychological well-being of families. However, there is lack a good understanding of how families and nurses perceive this concept, its facilitators and the barriers. DESIGN This was an exploratory qualitative study. Data were analysed deductively and inductively using the five-step qualitative content analysis method. METHODS Twenty-nine nurses and 31 families were recruited. Data were collected through in-depth, semi-structured and face-to-face individual interviews. The study was reported using the COREQ checklist. RESULTS Both nurses and families of hospitalised children recognised the importance of nurse-family partnerships in family-centred care. Four themes emerged as follows: Perceptions of family-centred care, elements of family-centred care, facilitators of family-centred care and barriers to family-centred care. Specific information to families and the religious beliefs of families were identified as important facilitator and barrier to family-centred care, respectively. CONCLUSION The implementation of family-centred care is promising in Malawi, as it is positively perceived by nurses and families, and its implementation is consistent with the Institute for Patient and Family-Centred Care Framework. RELEVANCE TO CLINICAL PRACTICE Our findings present the best practices, gaps and challenges in the context of a low-income country regrading implementation of family-centred care. Education programmes on family-centred care are crucial for sustaining the current gains.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Applied Technoly, Fatima College of Health Sciences, Al Ain, Abu Dhabi, United Arab Emirates
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mankei Tse
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Tuck M, Wittkowski A, Gregg L. A Balancing Act: A Systematic Review and Metasynthesis of Family-Focused Practice in Adult Mental Health Services. Clin Child Fam Psychol Rev 2023; 26:190-211. [PMID: 36318397 PMCID: PMC9879847 DOI: 10.1007/s10567-022-00418-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 01/28/2023]
Abstract
Parental mental illness is a major international public health concern given its implications for whole families, including children. Family-focused practice (FFP), an approach that emphasises a "whole-family" approach to care, provides an opportunity to mitigate the significant risks associated with parental mental health difficulties. The positive benefits associated with FFP have led to a shift in policy and practice towards prioritising FFP within adult mental health services. However, evidence suggests that FFP remains scarce and is not routine. Research has identified the important role of practitioners in facilitating FFP. The current review identified, synthesised and appraised the international qualitative literature examining adult mental health practitioners' implementation experiences of FFP. It aimed to provide an evidence-informed account of practitioner experiences of FFP delivery and to identify key recommendations to enhance future FFP outcomes in AMHS. Ovid Medline, PsycInfo, CINAHL plus, EMBASE and Web of Science Core Collection were searched systematically, in line with PRISMA guidance, up to January 2022. The Critical Appraisal Skills Programme (CASP) was used to undertake the quality appraisal prior to a thematic synthesis being conducted. The review was registered on PROSPERO. Nineteen papers, spanning 17 years of research with 469 practitioners, were included. Three main themes and 14 subthemes were developed, representing different aspects of practitioner experiences of FFP delivery. Practitioners' approach to FFP was variable and influenced by their beliefs about FFP, perceived roles and responsibilities, competence, service setting, and personal parenting status. Practitioners engaged in a balancing act to maintain a dual focus on their service-users and their children, to navigate powerful emotions, and consider multiple perspectives in a biomedical organisational structure that advocates individualised treatment. Although working together unified teams, a greater need for external interagency collaboration was identified. The use of strength-based approaches with clients and dedicated staff resources, within clear guidelines and frameworks, was reported to be necessary to maximise FFP delivery. This review proposes a complex FFP dynamic whereby practitioners engage in a constant balancing act between FFP stakeholders to achieve meaningful FFP outcomes for service-users and their families. Service recommendations are provided.
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Affiliation(s)
- M Tuck
- School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - A Wittkowski
- School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - L Gregg
- School of Health Sciences, The University of Manchester, Manchester, UK.
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.
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Demers LA, Wright NM, Kopstick AJ, Niehaus CE, Hall TA, Williams CN, Riley AR. Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101575. [PMID: 36291511 PMCID: PMC9600460 DOI: 10.3390/children9101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022]
Abstract
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included.
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Affiliation(s)
- Lauren A. Demers
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Naomi M. Wright
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Psychology, University of Denver, Denver, CO 80208, USA
| | - Avi J. Kopstick
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Tech University Health Science Center El Paso, El Paso, TX 97705, USA
| | - Claire E. Niehaus
- Division of Psychology and Psychiatry, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Trevor A. Hall
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-503-418-2134
| | - Cydni N. Williams
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew R. Riley
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
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Hughes ML, Constance J, Millner AJ, Young GI. Caregiver Engagement During Pediatric Post-Acute Care Hospitalization. Hosp Pediatr 2022; 12:952-959. [PMID: 36217894 DOI: 10.1542/hpeds.2021-006118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Caregiver engagement during acute inpatient hospitalizations has been demonstrated to provide developmental and behavioral benefits for children, decrease readmissions and length of stay, and improve caregiver confidence. Caregiver engagement has been examined in acute care settings; however, there is a gap in information regarding caregiver engagement in a pediatric post-acute care hospital (pPACH). The objective of this study was to explore caregiver engagement in a pPACH. PATIENTS AND METHODS All patients, birth to 23 years of age, in the medical service of an independent pPACH in the Northeastern United States, January 1, 2013, through December 31, 2017, were identified. Retrospective review of electronic health records for patient demographics and caregiver engagement, identified as visit(s) and telephone call(s), was conducted. Descriptive statistics and logistic regression were used to distinguish differences and measure associations of caregiver visits and calls between demographic groups. RESULTS The primary mode of caregiver engagement for pPACH patients (n = 614) was by visits, whereas caregiver calls were less frequent. Multivariable logistic regression analysis identified significantly greater odds of caregiver visits among patients ages 1 to 17 years, with private payer, and having a single admission, whereas lower odds of visits were identified among those <1 year or ≥18 years, with ≥2 pPACH admissions, public insurance, Child Protective Services (CPS) involvement, and African American/Black, other, and unknown race/ethnicities. CONCLUSIONS Patients who were infants, had ≥2 admissions, had CPS involvement, and were covered under public payer experienced lower caregiver visit rates. Strategies are needed to further identify and address barriers to caregiver engagement.
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Affiliation(s)
| | - Jordan Constance
- bChildren's Health, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alexander J Millner
- Franciscan Children's, Boston, Massachusetts.,dDepartment of Psychology, Harvard University, Cambridge, Massachusetts
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Dall’Oglio I, Mascolo R, Portanova A, Ragni A, Amadio P, Fiori M, Tofani M, Gawronski O, Piga S, Rocco G, Tiozzo E, Latour JM. Staff Perceptions of Family-Centered Care in Italian Neonatal Intensive Care Units: A Multicenter Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091401. [PMID: 36138710 PMCID: PMC9498145 DOI: 10.3390/children9091401] [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: 08/09/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022]
Abstract
Family Centered Care (FCC) in Neonatal Intensive Care Units (NICUs) included family involvement in the care process of newborns and infants. Staff perceptions of FCC may influence clinical practice and management strategies in NICUs, with an impact on quality and humanization of the care. The Family-Centred Care Questionnaire-Revised (FCCQ-R) was adapted for the NICU setting, therefore the FCCQ-R@it-NICU was developed and used for the present study in 32 Italian NICUs. We calculated internal consistency using Cronbach’s alpha correlation between Current and Necessary dimensions of the scale using the Pearson correlation coefficient. Furthermore, we investigated which characteristics could influence staff perceptions of FCC in NICUs. 921 NICU professionals participated in the study. The FCCQ-R@it-NICU revealed good internal consistency (0.96) and good correlation between dimensions (p < 0.05). Statistical and significant differences in Current and Necessary dimensions were found and some demographic characteristics were found predictable on FCC practice. The FCCQ-R@it-NICU is a valid tool to investigate staff perceptions about FCC in NICU settings. Profession, education level and work experience seem to positively influence the perception of what is required for FCC practice within NICUs.
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Affiliation(s)
- Immacolata Dall’Oglio
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
- Correspondence:
| | - Rachele Mascolo
- Semi-Intensive Care Area/Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Anna Portanova
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Angela Ragni
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Patrizia Amadio
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Martina Fiori
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Marco Tofani
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Simone Piga
- Unit of Epidemiology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship of Nursing Professional Order, Rome Nursing College, 00146 Rome, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Jos M. Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, WA 6102 Perth, Australia
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Barratt M, Bail K, Paterson C. Children living with long-term conditions and their experiences of partnership in nursing care: An integrative systematic review. J Clin Nurs 2022. [PMID: 35768938 DOI: 10.1111/jocn.16429] [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: 01/05/2022] [Revised: 05/01/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE To describe the experiences of nursing care and partnership nursing as expressed by children living with long-term conditions. BACKGROUND Children with long-term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care DESIGN: An integrative review following Joanna Briggs Institute protocols for systematic reviews. METHOD An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full-text publications reviewed. A total of 21 studies were included, three mixed-method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Four integrated findings were identified: "Children are aware of their surroundings and needs," "Children value positive communication," "Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;" and "Children seek a shared decision-making process." DISCUSSION Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long-term condition. RELEVANCE TO CLINICAL PRACTICE Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision-making process if the child wishes to be involved.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia.,Prehabilitation, Activity, Cancer Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia.,Robert Gordon University, Aberdeen, UK
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Yehene E, Goldzweig G, Simana H, Brezner A. "Mind the gap": Exploring pediatric nurses` perceptions of the theory and practice of caring for children and families. J Pediatr Nurs 2022; 64:e84-e94. [PMID: 35016799 DOI: 10.1016/j.pedn.2021.12.024] [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: 07/30/2021] [Revised: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate how pediatric nurses interpret and conceptualize theoretical underpinnings and daily practice scenarios pertaining to their role in pediatric care. DESIGN AND METHODS 139 pediatric nurses completed a survey in which they were asked to endorse to what extent practices related to pediatric concepts are expected from their role ("Expected") or are actually implemented in their clinical work ("Actual"). Survey items were derived from a nursing textbook that outlines the theoretical tenets of the "art of pediatric nursing", along with scenarios and conflicts encountered in everyday practice, covering family-child centered care, child growth and development, and emotional boundaries. RESULTS In both Expected and Actual practices, the highest level of endorsement was for items focused on core elements of family-centered care (80-96%), and moderate-low endorsement levels were observed for items related to therapeutic relationship management and emotional boundaries. A factor analysis yielded 12 factors representing themes related to pediatric nursing. However, the division of items per factor indicated diffusion between key concepts and a discrepancy between theory and practice, especially in regard to maintaining emotional separateness and objectivity, advocacy, managing conflicts within the nurse-child-family triad, and navigating oneself boundaries. CONCLUSIONS Nurses' ability to manage and contain various types of unclear boundaries is crucial for optimal care provision when working with children and families. PRACTICE IMPLICATION Variability in nurses' theoretical role-perception and practical care provision is largely attributed to the way they navigate various ambiguous boundaries in practice and this could be a focal point in educational programs and on-the-job training.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, the Academic College of Tel Aviv, Yaffo, Israel; Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.
| | - Gil Goldzweig
- School of Behavioral Sciences, the Academic College of Tel Aviv, Yaffo, Israel
| | - Hadar Simana
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Amichai Brezner
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
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Hughes B, O’Brien M, Flynn A, Knighting K. Views and experiences of young people, their parents/carers and healthcare professionals of the advance care planning process: A summary of the findings from a qualitative study. Palliat Med 2022; 36:841-854. [PMID: 35360999 PMCID: PMC9087310 DOI: 10.1177/02692163221083447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Advance care planning for young people is relatively new in the UK. There is a lack of understanding about the engagement of young people in their own planning process, optimal timing of discussions and the facilitators and barriers to the engagement of young people. AIM To explore the views and experiences of young people, their parents/carers and HCPs of the advance care planning process. DESIGN A qualitative study, using semi-structured interviews with young people, their parents/carers and healthcare professionals across four case series. Data were analysed using thematic analysis. PARTICIPANTS Fifteen participants were interviewed: young people (n = 2), parents/carers (n = 5) and healthcare professionals (n = 8). RESULTS Three themes were identified from the findings. Key findings related to barriers and facilitators of engaging young people in their own care planning were apparent in the following areas: misperception of terms; hierarchies of power in relationships; and a flexible and innovative organisational structure and culture. CONCLUSION Participants expressed a variety of views and experiences of advance care planning. Advance care planning was thought to be best initiated by a consultant when the young person is in their mid-teens, their condition is stable, and before they transition to adult care. Engagement was also considered to be facilitated by appropriate communication, developing relationships prior to initiating advance care planning, and written support for everyone involved in the process. These factors were supported by training and education for healthcare professionals and a flexible and innovative structure and cultures of organisations.
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Affiliation(s)
| | | | - Anita Flynn
- Edge Hill University, Ormskirk,
Lancashire, UK
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Foster M, Quaye AA, Whitehead L, Hallström IK. Children's voices on their participation and best interests during a hospital stay in Australia. J Pediatr Nurs 2022; 63:64-71. [PMID: 35074701 DOI: 10.1016/j.pedn.2022.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore school-aged children's experiences about their best interests and participation in care during a hospital admission. DESIGN AND METHODS A descriptive qualitative design involving in-depth, iterative inductive review of child responses to generate key words that led to identification of categories and themes. The study was guided by the United Nations Convention on the Rights of the Child's definition of the best interests of the child, Bronfenbrenner's bioecological model and a child centred care approach. RESULTS Nine school-aged children (5-15 years old) from one children's ward in Australia participated. Analysis yielded thirteen categories, six sub-themes, and three themes: 1) Relationships with parents were positive when they met their children's physical and emotional needs and advocated for them; 2) Relationships with staff were positive when staff created opportunities for children to have a say in their healthcare, and checked in on the children and 3) Seeking familiarity away from home was facilitated when the environment children found themselves in provided them their own space and various forms of entertainment. CONCLUSION School-aged children were able to verbalize what their best interests were and how participation in care could be facilitated in the hospital setting. The inter-relationships of the children with their parents, healthcare professionals, and the immediate environment reflected interactions both within, and between systems. RESEARCH AND PRACTICE IMPLICATIONS Children in hospital need to be provided with age-appropriate opportunities to participate in shared decision making to support their best interests. Studies that model and evaluate such opportunities are needed.
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Affiliation(s)
- Mandie Foster
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Edith Cowan University, School of Nursing and Midwifery, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia.
| | - Angela Afua Quaye
- Department of Health Science, Faculty of Medicine, Lund University, Box 188, 221 00 Lund, Sweden.
| | - Lisa Whitehead
- Edith Cowan University, School of Nursing and Midwifery, Perth, Western Australia, Australia; Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
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13
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Phiri PGMC, Chan CWH, Wong CL, Choi KC, Ng MSN. Discrepancies between nurses' current and perceived necessary practices of family-centred care for hospitalised children and their families: A cross-sectional study. J Pediatr Nurs 2022; 62:e25-e31. [PMID: 34229915 DOI: 10.1016/j.pedn.2021.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/04/2021] [Accepted: 06/27/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE This study investigated (1) the discrepancies between the nurses' current and perceived necessary practices of family-centred care (FCC), and (2) the nurses' demographic characteristics associated with current and perceived necessary practices of FCC for hospitalised children and their families in Malawi. DESIGN AND METHODS A cross-sectional study involving 444 nurses was conducted. The Family-Centred Care Questionnaire-Revised was used to examine the discrepancies between the nurses' current and perceived necessary practices of FCC. Univariate and multivariate statistical analyses were performed to identify the nurses' demographic characteristics associated with current and perceived necessary practices of FCC. RESULTS The total mean score of the nurses' current practices of FCC (M = 34.78, SD = 7.06) was significantly lower than that of the nurses' practices of FCC that were perceived as necessary (M = 38.63, SD = 5.60, p < 0.001). The nurses who were over 40 years of age (regression coefficient, β = 9.162, p = 0.014), had a postgraduate qualification (β = 23.314, p < 0.001), were separated or widowed (β = 9.661, p = 0.029), had a Tumbuka cultural background (β = 12.984, p < 0.001), were Seventh-day Adventist members (β = 8.863, p = 0.026), and worked in mission hospitals (β = 16.401, p = 0.021) were more likely to implement current practices of FCC. Conversely, the nurses who were members of the Moslem, Buddhist, or Hindi religious denomination (β = 6.587, p = 0.040), had a Tonga or Ngonde cultural background (β = 6.625, p = 0.046), and were nurse midwife technicians (β = -23.528, p = 0.012) were more likely to implement practices of FCC that they perceived as necessary. CONCLUSION Significant differences between the nurses' current and perceived necessary practices of FCC suggested that there were barriers to implementing necessary practices of FCC. The nurses' cultural and religious backgrounds were predictors of current practices of FCC, and this finding could direct the future development and testing of FCC interventions in Malawi. PRACTICE IMPLICATIONS Continued educational activities and research on the factors that contributed to the discrepancies between the nurses' current and perceived necessary practices of FCC and their impact on FCC in Malawi are critical.
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Affiliation(s)
- Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Marques S N Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
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14
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Farokhzadian J, Forouzi MA, Sheikhbardsiri H. Mothers and nurses' perceptions of the family-centered care barriers in pediatric departments of an educational hospital in Iran. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 34:219-224. [PMID: 33811709 DOI: 10.1111/jcap.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 03/01/2021] [Accepted: 03/13/2021] [Indexed: 02/05/2023]
Abstract
PROBLEM Family-centered care (FCC) is a concept used to describe an approach to caring for children and their families within health services. This study compared mothers and nurses' perceptions of barriers to FCC. METHODS This cross-sectional study was conducted in an educational hospital affiliated to Kerman University of Medical Sciences at the southeast of Iran in 2019. Using a researcher-designed questionnaire, we assessed mothers' and nurses' perceptions of barriers to FCC with a census method (60 nurses and 82 mothers). FINDINGS Mothers (49.8 ± 21.1) and nurses' (49.2 ± 16.4) mean scores of the perception of FCC barriers were at a moderate level. No significant difference was found between mothers' and nurses' perceptions of barriers to FCC. A significant relationship was observed between age, child's admission history, and the perception of FCC barriers in the mothers' group. CONCLUSION Findings suggest that national and regional policies of educational hospitals should assess factors contributing to the FCC barriers, focus on how to reduce these barriers, and provide appropriate collaborative care by nurses and the family of patients.
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Affiliation(s)
- Jamileh Farokhzadian
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansooreh Azizzadeh Forouzi
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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15
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McKinney A, Fitzsimons D, Blackwood B, McGaughey J. Patient and family involvement in escalating concerns about clinical deterioration in acute adult wards: A qualitative systematic review. Nurs Crit Care 2020; 26:352-362. [PMID: 33345386 DOI: 10.1111/nicc.12582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite international standards for recognition and response to deterioration, warning signs are not always identified by staff on acute hospital wards. Patient and family-initiated escalation of care schemes have shown some benefit in assisting early recognition, but are not widely used in many clinical practice areas. OBJECTIVES To explore (a) patients' and relatives' experiences of acute deterioration and (b) patients', relatives' and healthcare professionals' perceptions of the barriers or facilitators to patient and family-initiated escalation of care in acute adult hospital wards. METHODS We conducted a qualitative review using Cochrane methodology. Two reviewers independently screened studies, extracted data, and appraised the quality using a qualitative critical appraisal tool. Findings were analysed using thematic synthesis and confidence in findings was assessed using GRADE-CERQual. SEARCH STRATEGY MEDLINE, CINAHL, EMBASE, PsychINFO databases and grey literature from 2005 to August 2019. INCLUSION CRITERIA Any research design that had a qualitative element and focused on adult patients' and relatives' experiences of deterioration and perceptions of escalating care. RESULTS We included five studies representing 120 participants and assessed the certainty of evidence as moderate using GRADE-CERQual. Findings indicated that a number of patients/relatives have the ability to detect acute deterioration, however, various factors act as both barriers and facilitators to being heard. These include personal factors, perceptions of role, quality of relationships with healthcare staff, and organisational factors. Theoretical understanding suggests that patient and relative involvement in escalation is dependent on both inherent capabilities and the factors that influence empowerment. CONCLUSION This review highlights that patient and family escalation of care interventions need to be designed with the aim of improving patient/relative-clinician collaboration and the sharing of responsibility. RELEVANCE TO PRACTICE These factors need to be addressed to promote more active partnerships when designing and implementing patient and family-initiated escalation of care interventions.
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Affiliation(s)
- Aidín McKinney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Bronagh Blackwood
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Jennifer McGaughey
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Mörelius E, Foster M, Gill FJ. A Scoping Review of Nursing Research Priorities in Pediatric Care. J Pediatr Nurs 2020; 52:e57-e69. [PMID: 32008833 DOI: 10.1016/j.pedn.2020.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 02/07/2023]
Abstract
PROBLEM Priority setting for pediatric nursing is important to plan, coordinate and direct future research. The aim of this scoping review was to systematically identify and synthesise the nature, range and extent of published pediatric nursing research priorities. ELIGIBILITY CRITERIA English language full text publications focusing generic nursing research priorities for the child or adolescent, indexed in CINAHL, EMBASE, The Cochrane Database of Systematic Reviews, AMED, MEDLINE and PsycINFO and published from 2008 to 2019. SAMPLE A total of 789 citations were identified, 44 full text articles were retrieved and assessed for eligibility and eight studies were finally reviewed, quality assessed (CREDES) and synthesised. RESULTS All eight studies used a consensus building method to identify research priorities reported by nurses. Six used Delphi technique, one Nominal Group Technique (NGT) and one consensus workshop. CREDES score range was 10-14 of a possible 16. Synthesis of the 234 nursing research priorities generated four themes; evidenced-based practice, pediatric context, child and family-centered care; pediatric nursing, with 14 subthemes. CONCLUSION The nursing research priorities reported appear to be still current and important to nurses. There was a focus on acute care, with fewer priorities reflecting areas of child-, school-, or mental- health. Consumer and community priorities have not been reported. IMPLICATIONS These nursing research priorities can be used to inform the national or local research agenda, although there is a need to establish priorities from the perspective of all stakeholders and in particular, identify what is important to consumers.
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Affiliation(s)
- Evalotte Mörelius
- Perth Children's Hospital, Nedlands, WA, Australia; School of Nursing and Midwifery, Edith Cowan University, WA, Australia.
| | - Mandie Foster
- School of Nursing and Midwifery, Edith Cowan University, WA, Australia
| | - Fenella J Gill
- Perth Children's Hospital, Nedlands, WA, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, WA, Australia
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17
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Smith J, Ali P, Birks Y, Curtis P, Fairbrother H, Kirk S, Saltiel D, Thompson J, Swallow V. Umbrella review of family‐focused care interventions supporting families where a family member has a long‐term condition. J Adv Nurs 2020. [DOI: 10.1111/jan.14367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/23/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Joanna Smith
- School of Healthcare University of Leeds Leeds UK
| | | | - Yvonne Birks
- Social Policy Research Unit University of York York UK
| | - Penny Curtis
- School of Nursing & Midwifery University of Sheffield Sheffield UK
| | | | - Susan Kirk
- School of Health Sciences University of Manchester Manchester UK
| | | | - Jill Thompson
- School of Nursing & Midwifery University of Sheffield Sheffield UK
| | - Veronica Swallow
- College of Health Wellbeing and Life SciencesSheffield Hallan University Sheffield UK
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18
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Foster M, Whitehead L, Arabiat D. Development and validation of the needs of children questionnaire: An instrument to measure children's self-reported needs in hospital. J Adv Nurs 2019; 75:2246-2258. [PMID: 31197863 PMCID: PMC6852052 DOI: 10.1111/jan.14099] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 03/17/2019] [Accepted: 04/02/2019] [Indexed: 12/26/2022]
Abstract
Aim To develop and psychometrically test the needs of children questionnaire (NCQ), a new instrument to measure school‐aged children's self‐reported psychosocial physical and emotional needs in paediatric wards. Design This is an instrument development study based on recommendations for developing a reliable and valid questionnaire. Method The NCQ was developed over three phases between February 2013–April 2017 and included item generation; content adequacy assessment; questionnaire administration; factor analysis; internal consistency assessment and construct validity. Psychometric properties were assessed after 193 school‐aged children completed the needs of children's questionnaire in four paediatric areas in Australia and New Zealand. Results The development and validation of the NCQ over two countries resulted in a 16‐item, four‐category tool to measure the self‐reported importance and fulfilment of school‐aged children's needs in hospital. Cronbach's alpha for the combined samples was 0.93. Conclusion The NCQ bridges a gap to measure the level of importance and fulfilment of school‐aged children's self‐reported needs in hospital. Future testing and validation is needed in other paediatric areas and countries. Impact The 16‐item NCQ is a valid measure to evaluate if the quality of care delivered and received in hospital is in line with what children self‐report as important and required and to date indicates good usability and utility. Child self‐reports are essential to inform healthcare delivery, policy, research and theory development from a child and family‐centred care lens that honours the United Nations Convention on the Rights of the Child and the best interests of the child.
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Affiliation(s)
- Mandie Foster
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia.,Postgraduate Centre for Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia.,The University of Jordan, School of Nursing, Amman, Jordan
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19
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Iwata M, Han S, Hays R, Doorenbos AZ. Predictors of Depression and Anxiety in Family Members 3 Months After Child's Admission to a Pediatric ICU. Am J Hosp Palliat Care 2019; 36:841-850. [PMID: 31256606 DOI: 10.1177/1049909119859517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Family members of children admitted to intensive care units (ICUs) suffer from severe stress, which sometimes results in long-term psychological problems. We aimed to identify associations between demographic and psychosocial variables at early stages of a child's admission to the ICU and depression and anxiety in family members at approximately 3 months after admission. We also explored predictive models for depression and anxiety at 3 months after admission. METHODS This study is a secondary analysis of data from a previous clinical trial of palliative care for family members in ICUs, in which 380 family members of 220 children reported demographic and psychosocial status at approximately 1 week after ICU admission (baseline), at discharge from the ICUs, and at 3 months after the child's admission to the ICU. Clinical data were extracted from the children's medical records. We used linear regression models and stepwise linear regression for the analyses. RESULTS After controlling for significant confounders of gender (female) and child mortality, worse psychological status at baseline, represented by reported depression, anxiety, and acute stress symptoms, was associated with more severe depression and anxiety at 3 months. Also, a better family relationship at baseline was associated with lower depression and anxiety at 3 months. CONCLUSION We suggest a need to screen family members of children admitted to the ICU with validated scales and intervening with those at high risk of depression and anxiety. CLINICAL TRIALS Registry number NCT02144779 on ClinicalTrials.gov . https://clinicaltrials.gov/ct2/show/NCT02144779?term=NCT02144779&rank=1 .
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Affiliation(s)
- Masayuki Iwata
- 1 Graduate School of Health Management, Keio University, Shinjuku, Japan.,2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Soojeong Han
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Ross Hays
- 3 Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.,4 Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Ardith Z Doorenbos
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA.,5 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
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20
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Foster M, Whitehead L. Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit. J Child Health Care 2019; 23:102-117. [PMID: 29807461 DOI: 10.1177/1367493518778389] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.
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Affiliation(s)
- Mandie Foster
- 1 Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
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21
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Butler AE, Copnell B, Hall H. The impact of the social and physical environments on parent–healthcare provider relationships when a child dies in PICU: Findings from a grounded theory study. Intensive Crit Care Nurs 2019; 50:28-35. [DOI: 10.1016/j.iccn.2017.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/30/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
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22
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Botelho LRM, Anísio NDF, Cruz AC, Santos NC, Angelo M. Self-assessment of family inclusion in institutional policies and practices: nursing team perspective. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2018-0207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To compare the evaluation carried out by the nursing teams of pediatric and maternal-infant with adult patient wards on the inclusion of families in institutional policies and practices. Method: A cross-sectional and descriptive study carried out in a university hospital with 148 professionals from the nursing team of the maternal and pediatric units and 43 from adult units. The data were analyzed by the program Statistical Package for the Social Sciences 22, using the chi-square test and Fisher's exact test. Results: The groups presented distinct perceptions about the differentiation between families and visitors in policies and practices; similar perceptions related to the policies and practices are not favorable to the presence of siblings and children, and to the non-inclusion of the families in aspects related to daily care. Conclusion and Implications for Practice: The perception of nursing teams indicates that families are not included in institutional policies and practices. The results of an organizational self-assessment about families' inclusion subsidize a way to improve organizational policies and practices, making it possible to draw up an action plan to implementing Patient and Family Centered Care at the institutional level.
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Nygård C, Clancy A. Unsung heroes, flying blind-A metasynthesis of parents' experiences of caring for children with special health-care needs at home. J Clin Nurs 2018; 27:3179-3196. [PMID: 29754433 DOI: 10.1111/jocn.14512] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To aggregate, synthesise and interpret qualitative research studies of parents' experiences of caring for a child with special health-care needs at home. BACKGROUND Advances in the field of medical and nursing science have ensured better survival rates for children with chronic illnesses. Many of these children have significant special health-care needs. Today parents assume a caregiver role, undertaking tasks previously provided by nurses in hospitals. As the complexity of care delivered by parents continues to develop, synthesised knowledge can provide an evidence base that will support and guide nurses when caring for these families. DESIGN Metasynthesis. METHODS Based upon a systematic search protocol, a structured literature search, covering the years 2003-2016, was conducted in five electronic databases. Ten studies were included and appraised using the Critical Appraisal Skills Program assessment tool. A metasummary and a metasynthesis were undertaken guided by the metasynthesis methodology as described by Sandelowski and Barroso (Handbook for synthesizing qualitative research. New York, NY: Springer, 2007). RESULTS The results were interpreted and integrated under the overarching theme "unsung heroes, flying blind," supported by eight elucidating categories that illustrate aspects of the parents' life world. CONCLUSIONS The enormous burden of care can weaken the parents' will to carry on and result in a decreased ability to provide care. This can have an impact on the parents' health, family functioning and the sick child's potential health outcomes. Nurses are in a unique position to help these families and should be better prepared for the role. RELEVANCE TO CLINICAL PRACTICE Knowledge of how parents of children with special health-care needs experience their daily lives can promote trust in nurses and guide them in their efforts to support families with children living with chronic illness.
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Affiliation(s)
- Carina Nygård
- Faculty of Health Sciences, UiT The Arctic University of Norway, Harstad, Norway
| | - Anne Clancy
- Faculty of Health Sciences, UiT The Arctic University of Norway, Harstad, Norway
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24
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Foster M, Whitehead L, Arabiat D, Frost L. Parents' and Staff Perceptions of Parental Needs During a Child's Hospital Admission: An Australian Study. J Pediatr Nurs 2018; 43:e2-e9. [PMID: 30041836 DOI: 10.1016/j.pedn.2018.06.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aimed to identify parents' and staff perceptions of parents' needs during a hospital admission and relationships between needs, socio-demographic and clinical variables. DESIGN AND METHODS A cross-sectional descriptive design. Forty-six parents whose child received care and 17 staff who worked within a paediatric ward at a secondary hospital in Western Australia completed the Needs of Parents' Questionnaire in 2016. RESULTS Parent and staff perceptions of the importance of needs were congruent but differences arose between parents and staff on whether these needs were met and needed. Parents were more likely to rate needs as less important, more met and more needed than staff members. Demographic characteristics significantly influenced parents' and staff perceptions of parents' needs in hospital. CONCLUSIONS Staff need to acknowledge that the parent and child's hospital trajectory and demographical characteristics can influence the parent and child's needs in hospital. For family centred healthcare delivery to be effective, care delivery needs to be aligned to what parents and children state their needs are at that time. PRACTICE IMPLICATIONS This study has highlighted that future international collaborative research networks are needed to critique the concepts and clinical implications of FCC from a broader lens and recipients, deliverers and providers of healthcare need to be cognisance of contemporary FCC literature.
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Affiliation(s)
- Mandie Foster
- Edith Cowan University, School of Nursing and Midwifery, Perth, WA, Australia.
| | - Lisa Whitehead
- Edith Cowan University, School of Nursing and Midwifery, Perth, WA, Australia; University of Otago, Postgraduate Centre for Nursing Studies, Christchurch, New Zealand.
| | - Diana Arabiat
- Edith Cowan University, School of Nursing and Midwifery, Perth, WA, Australia; The University of Jordan, Amman, Jordan.
| | - Linda Frost
- Joondalup Health Campus, Paediatric Department, Perth, WA, Australia.
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25
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Dall'Oglio I, Di Furia M, Tiozzo E, Gawronski O, Biagioli V, Di Ciommo VM, Paoletti S, Bianchi N, Celesti L, Raponi M, Antonielli G, Baronio B, Bergami A, Cianchi D, Ciliento G, Vittoria Di Toppa M, Fabbiani A, Fagioli D, Frillici C, Guerrieri S, Lazo J, Madeddu R, Molinari F, Niccolò R, Padrini S, Paolucci F, Pomponi M, Ragni A, Tramutola P, Ventura M. Practices and Perceptions of Family Centered Care among Healthcare Providers: A Cross-sectional Study in a Pediatric Hospital. J Pediatr Nurs 2018; 43:e18-e25. [PMID: 30139704 DOI: 10.1016/j.pedn.2018.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/26/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study aimed to: (1) investigate the extent to which Family Centered Care (FCC) principles are currently applied in clinical practice by healthcare providers working in inpatient units; (2) evaluate the extent to which FCC principles are perceived as necessary; and (3) examine the associations between FCC principles and socio-demographic and job characteristics of participants. Design and Methods A cross-sectional study was conducted at a large pediatric hospital using the Italian version of the FCC Questionnaire Revised (FCCQ-R). Univariate and multivariate analyses were performed. RESULTS Data from 469 healthcare providers were used for analysis. Scores for the FCC daily practices (Current activities) were significantly lower than those for their perceived necessity (Necessary activities) (p < .001). Participants who were male, younger, with work experience >20 years and working in rehabilitation reported a significantly higher perception of Current activities of FCC than others. The older and the more educated the participants, the greater was the perceived necessity of FCC activities. Female, older, and less experienced participants employed by the hospital but not working in the rehabilitation setting perceived a greater gap between Necessary and Current activities of FCC. CONCLUSIONS Scores for the Current and Necessary activities of FCC were lower than those reported in other studies. The lower scores in the Current activities and the significant gap can be due to organizational barriers or lack of skills, but the lower scores in the Necessary activities should be interpreted as a deficit of knowledge about FCC. PRACTICE IMPLICATIONS There is a need for further education about FCC in order to increase its perceived relevance in clinical practice.
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Affiliation(s)
- Immacolata Dall'Oglio
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Michela Di Furia
- Department of Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Emanuela Tiozzo
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Orsola Gawronski
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Valentina Biagioli
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Vincenzo M Di Ciommo
- Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Silvia Paoletti
- Department of Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Natalia Bianchi
- Nursing and health allied professionals Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Lucia Celesti
- Hospitality and Family Services, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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Refinement of an Instrument to Measure the Needs of Parents of Sick Children in the Context of Family Centered Care. J Pediatr Nurs 2018; 43:77-87. [PMID: 30473160 DOI: 10.1016/j.pedn.2018.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/21/2018] [Accepted: 08/26/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to refine an instrument to capture the perceived needs of parents whose children are seriously ill. This article describes the psychometric properties of the Parents' Needs Scale (PNS), a translated, revised 22-item short form from an original instrument that was developed and tested on parents of children with cancer in Hong Kong. METHODS The study was done in three stages that included (a) factor analysis of two samples recruited from clinics in Northern Virginia of parents of children with cancer (n = 74) and end stage renal disease (ESRD) (n = 30); (b) known groups validity testing with two groups of parents recruited in a parallel study on children with special needs (n = 15) and a control group of well children (n = 23); and (c) concurrent validity testing on the subsample of parents of children with special needs using the known measure of Impact on the Family Scale (IFS). Data collection for the stages included mailed questionnaires and follow-up telephone interviews. RESULTS Exploratory factor analysis using the common factor approach identified two domains: (1) needs related to my child's illness and (2) needs unrelated to my child's illness. The factorial structure was followed by item scaling tests to determine item-level convergence and discriminative validity, as well as scale reliability for the two domains (Cronbach's alpha = 0.93 and 0.90). Domain-level discriminant validity tests yielded significant differences on several expected characteristics of the child and/or family based on the literature. The final 22-item scale was reworded and used to establish known groups validity by comparing the two groups of children with acute illnesses from the previous study with two control groups of parents of children who were well or children with special needs but not acutely ill, yielding significant results on both factors (p < 0.001). A final test of concurrent validity was performed on the parents of children with special needs measures of parent need with their reported impact on the family yielding significant correlations on predicted variables. CONCLUSIONS The PNS can measure parents' needs with demonstrated psychometric validity and reliability.
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Jung SY. Health Care Providers’ Perceptions of Family-centered Care in Pediatrics. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.4.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Iwata M, Saiki-Craighill S, Nishina R, Doorenbos AZ. "Keeping pace according to the child" during procedures in the paediatric intensive care unit: A grounded theory study. Intensive Crit Care Nurs 2018; 46:70-79. [PMID: 29550158 PMCID: PMC6004326 DOI: 10.1016/j.iccn.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 02/12/2018] [Accepted: 02/20/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The goal was to explore how nurses interact with children in the paediatric intensive care unit during potentially painful procedures. RESEARCH METHODOLOGY/DESIGN This was a qualitative research study that used grounded theory approach. Data were collected through participant observation and interviews. Nurse-child interactions were observed and recorded during potentially painful procedures performed by nurses. Following observation of a procedure, nurses were interviewed about their intentions, feelings and emotions during the procedure. SETTING The study took place in a seven-bed paediatric intensive care unit in an academic teaching hospital in Japan. FINDINGS Children's acceptance of a procedure was induced by nurses' pacing, particularly in a pattern of "keeping pace according to the child." Such pacing involved soothing the child, explaining what was being done to the child at each step and acknowledging the child's emotions. All of these child-centred procedures provoked cooperation from the children even during painful procedures. CONCLUSIONS Our study suggests that a collaborative practice approach, in which nurses use a series of calming tactics, might improve children's perceptions of painful procedures.
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Affiliation(s)
- Masayuki Iwata
- Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; University of Washington, Box 357266, Seattle, WA 98195-7266, USA.
| | | | - Ryouhei Nishina
- Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Ardith Z Doorenbos
- University of Washington, Box 357266, Seattle, WA 98195-7266, USA; Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan.
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Foster M, Whitehead L. Parent and staff perceptions of parental needs during a child's hospital admission to a paediatric high-dependency unit: A New Zealand study. J Paediatr Child Health 2017; 53:1167-1175. [PMID: 28799260 DOI: 10.1111/jpc.13645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 05/07/2017] [Accepted: 05/28/2017] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to identify parents' and staff's perceptions of parents' needs during a paediatric high-dependency unit admission and the relationships between needs, socio-demographic and clinical variables and explores if these perceptions have changed. METHODS This study uses a cross-sectional descriptive correlational design, and 104 parents whose children received care and 88 staff who worked within a paediatric high-dependency unit at a tertiary hospital in New Zealand completed the Needs of Parents' Questionnaire in 2011. RESULTS Parents' and staff's perceptions of the importance of needs were congruent, but differences arose between parents and staff on whether these needs were met. Parents were more likely to rate needs as having been met than staff members. Admission type, age and gender influenced parents' and staff's perceptions of parents' needs. CONCLUSION Synergy between parent and staff satisfaction scores will be enhanced when care delivery is more closely aligned to parents' priorities for care and staff receive feedback on positive health-care experiences.
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Affiliation(s)
- Mandie Foster
- Christchurch Public Hospital, Child and Family Health, Paediatrics, Christchurch Hospital, Christchurch, New Zealand.,Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.,School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Lisa Whitehead
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.,School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
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Foster M, Whitehead L. Family centred care in the paediatric high dependency unit: Parents' and Staff's perceptions. Contemp Nurse 2017; 53:489-502. [PMID: 29173077 DOI: 10.1080/10376178.2017.1410067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM This study explored parent and staff perceptions of family centred care (FCC) within a paediatric high dependency in one New Zealand hospital. BACKGROUND FCC is a partnership approach to healthcare delivery where the child's treatment is aligned to the family's needs. Despite widespread endorsement of FCC, variations between parents and staff in healthcare settings continues to be evident. METHOD A descriptive qualitative cross-sectional design was used with a convenience sample where written responses for one open ended question from 91 parents and 66 staff resident with their child or working within a paediatric high dependency unit in New Zealand. RESULTS The parents' responses generated three themes (family, treatment and relationships) and the staff's responses generated two themes (family and treatment). CONCLUSION Whilst there were similarities in describing the meaning of family centred care between parents and staff, their views on the central focus of this differed.
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Affiliation(s)
- Mandie Foster
- a School of Nursing and Midwifery , Edith Cowan University , 270 Joondalup Drive, Building 21, Joondalup , WA 6027 , Australia
| | - Lisa Whitehead
- a School of Nursing and Midwifery , Edith Cowan University , 270 Joondalup Drive, Building 21, Joondalup , WA 6027 , Australia.,b Centre for Postgraduate Nursing Studies , University of Otago , Christchurch , New Zealand
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Richards CA, Starks H, O'Connor MR, Bourget E, Lindhorst T, Hays R, Doorenbos AZ. When and Why Do Neonatal and Pediatric Critical Care Physicians Consult Palliative Care? Am J Hosp Palliat Care 2017; 35:840-846. [PMID: 29179572 DOI: 10.1177/1049909117739853] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. OBJECTIVE To describe neonatal and pediatric critical care physician perspectives on indicators for when and why to involve palliative care consultants. METHODS Semistructured interviews were conducted with 22 attending physicians from neonatal, pediatric, and cardiothoracic ICUs in a single quaternary care pediatric hospital. Transcribed interviews were analyzed using content and thematic analyses. RESULTS We identified 2 themes related to the indicators for involving palliative care consultants: (1) palliative care expertise including support and bridging communication and (2) organizational factors influencing communication including competing priorities and fragmentation of care. CONCLUSIONS Palliative care was most beneficial for families at risk of experiencing communication problems that resulted from organizational factors, including those with long lengths of stay and medical complexity. The ability of palliative care consultants to bridge communication was limited by some of these same organizational factors. Physicians valued the involvement of palliative care consultants when they improved efficiency and promoted harmony. Given the increasing number of children with complex chronic conditions, it is important to support the capacity of ICU clinical teams to provide primary palliative care. We suggest comprehensive system changes and critical care physician training to include topics related to chronic illness and disability.
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Affiliation(s)
- Claire A Richards
- 1 Health Services Research & Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Helene Starks
- 1 Health Services Research & Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,3 Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - M Rebecca O'Connor
- 6 Department of Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA
| | - Erica Bourget
- 7 Department of Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Taryn Lindhorst
- 8 School of Social Work, University of Washington, Seattle, WA, USA
| | - Ross Hays
- 3 Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.,4 Department of Bioethics and Humanities, School of Medicine, University of Washington, Seattle, WA, USA.,10 Palliative Care Program, Seattle Children's Hospital, Seattle, WA, USA.,11 The Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA.,12 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Ardith Z Doorenbos
- 4 Department of Bioethics and Humanities, School of Medicine, University of Washington, Seattle, WA, USA.,5 Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA.,12 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA.,13 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
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Andrade RC, Leite ACAB, Alvarenga WDA, Martimiano RR, Santos CBD, Nascimento LC. Translation and cultural adaptation of the Needs of Parents Questionnaire (NPQ) to be used in Brazil. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To translate, culturally adapt, and assess the internal consistency of the adapted version of the Needs of Parents Questionnaire (NPQ) to be used in Brazil with a sample of parents of hospitalized children. Method: Methodological study, essentially based on the DISABKIDS® method and conducted in a public university hospital. The stages included translation, assessment by an expert committee, back translation, semantic validation, and pilot study. Results: After the original instrument was translated into Brazilian Portuguese and then back-translated, the semantic validation was performed with 30 parents and adjustments were implemented until the translated version was understandable by most participants. Afterwards, a pilot test was implemented with another 59 parents, the internal consistency of which was satisfactory. Conclusions: The Brazilian version of the NPQ proved to be reliable and, after assessing other psychometric properties in the field study, it will be useful to assess the needs of parents of hospitalized children, qualifying nursing care.
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Stremler R, Haddad S, Pullenayegum E, Parshuram C. Psychological Outcomes in Parents of Critically Ill Hospitalized Children. J Pediatr Nurs 2017; 34:36-43. [PMID: 28274664 DOI: 10.1016/j.pedn.2017.01.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/12/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Abstract
Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS). Using hospital data and self-administered questionnaires, information on child and parent characteristics and psychological outcomes were collected. Objective measures of parental sleep also were examined using actigraphy and sleep diaries. The research findings indicated that 24% of parents achieved scores characteristic of severe anxiety. Proportions of parents with symptoms indicative of major depression and significant decisional conflict were 51% and 26% respectively. For all psychological outcomes, higher levels of social support were protective. Inconsistency in sleep schedule and sleep location affected psychological outcomes and are possible targets for future interventions. Given evidence that parents of children admitted to the PICU are at risk for developing post-traumatic stress symptoms, future studies should examine the effects of hospitalization on long-term parental psychological outcomes. Screening for those at risk and implementing interventions to promote coping strategies and reduce decisional conflict may be beneficial. Pediatric nurses have a critical role in assessing parents' psychological distress and promoting family health during a child's hospitalization.
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Affiliation(s)
- Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada.
| | - Summer Haddad
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada
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Ayub EM, Sampayo EM, Shah MI, Doughty CB. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care. PREHOSP EMERG CARE 2016; 21:233-241. [PMID: 27858502 DOI: 10.1080/10903127.2016.1241326] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. RESULTS A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. CONCLUSIONS Based on debriefings from simulated scenarios, some prehospital providers identified the provision of emotional support and effective communication as important components to the delivery of PFCC. Other providers revealed several perceived barriers to providing PFCC, though potential solutions to overcome many of these barriers were also identified. These findings can be utilized to integrate effective communication and emotional support techniques into EMS protocols and provider training to overcome perceived barriers to PFCC in the prehospital setting.
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Leino-Kilpi H, Gröndahl W, Katajisto J, Nurminen M, Suhonen R. Participation of family members and quality of patient care - the perspective of adult surgical patients. J Clin Nurs 2016; 25:2242-50. [PMID: 27334560 DOI: 10.1111/jocn.13262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to describe the participation of family members in the care of Finnish adult surgical patients and the connection of the participation with the quality of patient care as perceived by surgical patients. BACKGROUND The family members of adult surgical patients are important. Earlier studies vary concerning the nature of participation, its meaning and the connection of participation with patient-centred quality of care. In this study, we aim to produce new knowledge about adult surgical patients whose family members have participated in their care. DESIGN This was a cross-sectional descriptive survey study. METHODS The data were collected among adult surgical patients (N = 481) before being discharged home from hospital with two instruments: the Good Nursing Care scale and the Received Knowledge of Hospital Patients. RESULTS Based on the results, most adult surgical patients report that family members participate in their care. Participation was connected with received knowledge and preconditions of care, which are components of the quality of patient care. CONCLUSIONS In future, testing of different solutions for improving the participation of surgical patients' family members in patient care should be implemented. Furthermore, the preconditions of family members' participation in care and the concept of participation should be analysed to emphasise the active role of family members. RELEVANCE TO CLINICAL PRACTICE The results emphasised the importance of family members for the patients in surgical care. Family members' participation is connected with the quality of patient care.
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Affiliation(s)
| | | | | | - Matti Nurminen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
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Caring for Long-Stay Critically Ill Children and Infants Refers Back to the Fundamentals of Patient- and Family-Centered Care. Pediatr Crit Care Med 2016; 17:575-6. [PMID: 27261652 DOI: 10.1097/pcc.0000000000000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Feeg VD, Paraszczuk AM, Çavuşoğlu H, Shields L, Pars H, Al Mamun A. How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study. J Pediatr Nurs 2016; 31:267-76. [PMID: 26712214 DOI: 10.1016/j.pedn.2015.11.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 11/16/2022]
Abstract
UNLABELLED Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." DESIGN AND METHODS The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). RESULTS The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. CONCLUSIONS Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. PRACTICE IMPLICATIONS The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation.
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Affiliation(s)
| | | | | | - Linda Shields
- Charles Sturt University, Bathurst, NSW, Australia; University of Queensland, Herston, Australia
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Abstract
BACKGROUND Existing evidence suggests that a person-centred approach can improve coordination and access to health care and services. OBJECTIVES This overview sought to: (1) identify and define components of person-centred care; (2) explore nursing and health-care provider behaviours that are person-centred; and (3) identify systems level supports required to enable person-centred care. METHODS An overview of reviews was conducted to locate synthesized literature published between June 2005 and April 2014. Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. RESULTS A total of 46 articles were deemed relevant to this overview. This paper synthesizes the results of 43 of the 46 articles. A universal definition of person-centred care was not found, however; common components, associated health-care provider behaviours and the organizational supports required for person-centred care are discussed. CONCLUSIONS Key findings from this review outline that health-care providers and organizations need to promote person-centred care by engaging persons in partnerships, shared decision-making, and meaningful participation in health system improvement.
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Affiliation(s)
- Tanvi Sharma
- a International Affairs & Best Practice Guidelines Program , Registered Nurses' Association of Ontario , 158 Pearl Street, Toronto , ON , Canada M5H 1L3
| | - Megan Bamford
- a International Affairs & Best Practice Guidelines Program , Registered Nurses' Association of Ontario , 158 Pearl Street, Toronto , ON , Canada M5H 1L3
| | - Denise Dodman
- b Bluewater Health , 89 Norman Street, Sarnia , ON , Canada N7T 6S3
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Foster M, Whitehead L, Maybee P. The Parents', Hospitalized Child's, and Health Care Providers' Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research. JOURNAL OF FAMILY NURSING 2016; 22:6-73. [PMID: 26706128 DOI: 10.1177/1074840715618193] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Family-centered care (FCC) purports that unlimited presence and involvement of the family in the care of the hospitalized child will optimize the best outcome for the child, family, and institution. A systematic appraisal was conducted of peer-reviewed, English-language, primary quantitative research conducted within a pediatric critical care setting reported from 1998 to 2014. The aim of this review was to explore the parents', hospitalized child's, and health care providers' perception of FCC within pediatric critical care. Fifty-nine articles met the criteria that generated themes of stress, communication, and parents' and children's needs. This review highlighted that communication tailored to meet the parents' and child's needs is the key to facilitating FCC and positive health outcomes. Health care providers need to be available to provide clinical expertise and support throughout the health care journey. Future initiatives, education, and research are needed to evaluate the benefits of parent- and child-led FCC practice.
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Affiliation(s)
- Mandie Foster
- 1 University of Otago, Christchurch, New Zealand
- 2 Christchurch Hospital, New Zealand
| | - Lisa Whitehead
- 3 Edith Cowan University, Joondalup, Western Australia, Australia
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Heath G, Montgomery H, Eyre C, Cummins C, Pattison H, Shaw R. Developing a Tool to Support Communication of Parental Concerns When a Child is in Hospital. Healthcare (Basel) 2016; 4:healthcare4010009. [PMID: 27417597 PMCID: PMC4934543 DOI: 10.3390/healthcare4010009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/16/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022] Open
Abstract
The involvement of parents in their child’s hospital care has been strongly advocated in paediatric healthcare policy and practice. However, incorporating parental worries about their child’s condition into clinical care can be difficult for both parents and healthcare professionals. Through our “Listening To You” quality improvement project we developed and piloted an innovative approach to listening, incorporating and responding to parental concerns regarding their child’s condition when in hospital. Here we describe the phases of work undertaken to develop our “Listening To You” communications bundle, including a survey, literature review and consultation with parents and staff, before findings from the project evaluation are presented and discussed.
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Affiliation(s)
- Gemma Heath
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK.
| | | | - Caron Eyre
- Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
| | - Carole Cummins
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Helen Pattison
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK.
| | - Rachel Shaw
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK.
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