Investigation of stress and nursing support in mothers of preterm infants in neonatal intensive care units

BACKGROUND

The birth and hospitalisation of a premature infant in a neonatal intensive care unit (NICU) are stressful experiences for the mother and the family. The support of neonatal nurses is necessary to control and reduce the stress of mothers. And nurse-parent support may play a role in effective stress management and make a positive contribution to the health of mothers.

AIM

To determine the correlation of stress and nurse-parent support levels with mothers' age and educational status, number of children, gestational week of the infant and the hospitalisation period of the infant among mothers of premature infants hospitalised in the NICU.

METHODS

This descriptive and cross-sectional study was conducted in the NICUs of two medical faculties. The study was conducted between March and June 2017 with the participation of 106 mothers with hospitalised premature infants. The data of the study were collected using a 'mother information form', Parental Stressor Scale: Neonatal Intensive Care Unit and Nurse-Parent Support Tool. Number, percentage, mean, standard deviation, t-test, analysis of variance test, Pearson's correlation and multiple regression analysis were used to analyse the data.

RESULTS

It was determined that the stress levels were high in mothers regarding their PSS: NICU parental role subscale. The stress levels of mothers with infants connected to mechanical ventilation and fed parenterally were high (p < 0.05). The nurse support levels of mothers with middle- and low-income status were high. Multiple regression analysis, mechanical ventilation was determined to be effective in the use of the PSS:NICU total score (p < 0.05).

CONCLUSIONS

As a result, it was determined that mechanical ventilation and parenteral nutrition of the infant increased the stress level of mothers. Furthermore, in the study, the Nurse-Parent Support score of the mothers with middle- and low-income status was higher.

Health transition experiences of Canadian ventilator-assisted adolescents and their family caregivers: A qualitative interview study

Purpose

No studies have explored the experiences of Canadian mechanical ventilator-assisted adolescents (VAAs) living at home as they transition from paediatric to adult health providers. A better understanding of the needs of this growing population is essential to provide transition services responsive to VAAs and caregiver-identified needs.

Methods

We conducted semistructured telephone interviews with adolescents and family caregivers who had recently initiated or completed transition to adult care recruited from three Canadian university-affiliated paediatric home ventilation programs. We analyzed transcripts using a theoretical framework for understanding facilitators and barriers to transition.

Results

We interviewed 18 individuals representing 14 episodes of paediatric to adult transition. Participants identified early planning, written informational materials and joint paediatric-adult provider-family transition meetings as facilitators of care transition to adult services and providers. Barriers included insufficient information, limited access to interprofessional (nursing and allied health) providers and reduced funding or health services. Barriers resulted in service disruption and a sense of 'medical homelessness'. While most families related a positive transition to a new 'medical home', families caring for VAAs with moderate-to-severe cognitive and/or physical dependence more commonly reported transition difficulties.

Conclusions

Important opportunities exist to enable improvements in the transition experiences of VAAs and their family caregivers. To maximize service continuity during paediatric to adult transition, future research should focus on transition navigator roles, interprofessional health outreach and the needs of families caring for VAAs with cognitive and physical deficits.

Translating best care practices to improve nursing documentation regarding pediatric patients dependent on home mechanical ventilation and tracheostomy tube support: a quality improvement initiative

An increasing number of children are dependent on tracheostomies or mechanical ventilation at home. Documentation of the care provided at home is important in evaluating care quality. The purpose of this project was to apply evidence to improve nursing documentation and ultimately quality of care for children who are dependent on tracheostomies and/or mechanical ventilation at home.

Home mechanical ventilation and specialised health care in the community: Between a rock and a hard place

Background

Home mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. The aim of this study was both to explore the challenges experienced by health care professionals in community health care services when caring for patients dependent on home mechanical ventilation, continual care and highly advanced technology, and their proposed solutions to these challenges.

Methods

Using qualitative research methods, a grounded theory influenced approach was used to explore the respondents' experiences and proposed solutions. A total of 34 multidisciplinary respondents from five different communities in Norway were recruited for five focus groups.

Results

The core category in our findings was what health care professionals in community health care services experience as "between a rock and a hard place," when working with hospitals, family members, and patients. We further identified four subcategories, "to be a guest in the patient's home," "to be accepted or not," "who decides," and "how much can we take." The main background for these challenges seems to stem from patients living and receiving care in their private homes, which often leads to conflicts with family members. These challenges can have a negative effect on both the community health caregivers' work environment and the community health service's provision of professional care.

Conclusions

This study has identified that care of individuals with complex needs and dependent on home mechanical ventilation presents a wide range of immense challenges for community health care services. The results of this study point towards a need to define the roles of family caregivers and health care professionals and also to find solutions to improve their collaboration. The need to improve the work environment for caregivers directly involved in home-care also exists. The study also shows the need for more dialogue concerning eligibility requirements, rights, and limitations of patients in the provision and use of ventilatory support in private homes.

A Transcultural Strengths Assessment Interview Guide for Parent Caregivers

The Haley Transcultural Strengths Assessment interview guide for parent caregivers is an instrument for nurses and related health care providers to identify, better understand, and promote the development of strengths of parents for children with ongoing, complex health needs. Assisting these caregivers to build on their strengths, as identified through their own cultural perspective, is crucial not only to promote their health and well-being, but also to the quality of care they deliver to their child. The development of the instrument is discussed. The interview guide and description of how to use it are presented. This is a versatile instrument that may be used across cultures in the home or clinical setting, or in research. It frames the strengths of the parent caregiver, so these strengths can be encouraged and woven into the parent's life, promoting a positive sense of energy, empowerment, and harmony.