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Lehman R, Moriarty H. Limited English Proficiency and Outcomes in the Intensive Care Unit: An Integrated Review. J Transcult Nurs 2024; 35:226-236. [PMID: 38351583 DOI: 10.1177/10436596241229485] [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] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Language barriers place patients at risk of substandard care. Hospitalized patients with limited English proficiency (LEP) face unique challenges, especially in the intensive care unit (ICU). The purpose of this review is to critique and synthesize quantitative evidence on LEP and ICU outcomes. METHODOLOGY Quantitative studies published in English between 1999 and 2022 were queried using intentional terminology. RESULTS Searches yielded 138 results, with 12 meeting inclusion criteria. The analysis resulted in the extrapolation of five themes pertinent to outcomes of ICU patients or families with LEP: (a) knowledge deficit relating to conditions and care; (b) lack of language-appropriate care; (c) alienation from care process; (d) decreased confidence and ownership of care; and (e) relationship to clinical quality indicators. DISCUSSION Outcomes associated with LEP were largely negative and revealed unmet needs for ICU patients with LEP. More research is needed to improve linguistically and culturally congruent care in the ICU.
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Sudhinaraset M, Kolodner RA, Nakphong MK. Maternity Care at the Intersections of Language, Ethnicity, and Immigration Status: A Qualitative Study. Womens Health Issues 2023; 33:618-625. [PMID: 37244759 PMCID: PMC10843860 DOI: 10.1016/j.whi.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 04/04/2023] [Accepted: 04/21/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Women of color and immigrant women are more likely than US-born White women to report mistreatment and poor quality of care during their reproductive health care. Surprisingly little research exists on how language access may impact immigrant women's experiences of maternity care, particularly by race and ethnicity. METHODS We conducted qualitative in-depth, one-on-one semi-structured interviews from August 2018 to August 2019 with 10 Mexican and eight Chinese/Taiwanese women (n = 18) living in Los Angeles or Orange County who gave birth within the past 2 years. Interviews were transcribed and translated, and data were initially coded based on the interview guide questions. We identified patterns and themes using thematic analysis methods. RESULTS Participants described how a lack of translators and language- and cultural-concordant health care providers and staff impeded their access to maternity care services; in particular, they described barriers to communication with receptionists, providers, and ultrasound technicians. Despite Mexican immigrants' ability to access Spanish-language health care, both Mexican and Chinese immigrant women described how lack of understanding medical concepts and terminology resulted in poor quality of care, lack of informed consent for reproductive procedures, and subsequent psychological and emotional distress. Undocumented women were less likely to report using strategies that leveraged social resources to improve language access and quality care. CONCLUSIONS Reproductive autonomy cannot be achieved without access to culturally and linguistically appropriate health care. Health care systems should ensure that comprehensive information is given to women, in a language and manner they can understand, with particular attention toward providing in-language services across multiple ethnicities. Multilingual staff and health care providers are critical in providing care that is responsive to immigrant women.
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Affiliation(s)
- May Sudhinaraset
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
| | - Rebecca A Kolodner
- School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Michelle Kao Nakphong
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Nalwadda C, Tusubira AK, Nambuya H, Namazzi G, Muwanguzi D, Waiswa P, Kurinczuk J, Kelley M, Nair M. Transition from hospital to home care for preterm babies: A qualitative study of the experiences of caregivers in Uganda. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000528. [PMID: 37155601 PMCID: PMC10166523 DOI: 10.1371/journal.pgph.0000528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
Improving care for preterm babies could significantly increase child survival in low-and middle income countries. However, attention has mainly focused on facility-based care with little emphasis on transition from hospital to home after discharge. Our aim was to understand the experiences of the transition process among caregivers of preterm infants in Uganda in order to improve support systems. A qualitative study among caregivers of preterm infants in Iganga and Jinja districts in eastern Uganda was conducted in June 2019 through February 2020, involving seven focus group discussions and five in-depth interviews. We used thematic-content analysis to identify emergent themes related to the transition process. We included 56 caregivers, mainly mothers and fathers, from a range of socio-demographic backgrounds. Four themes emerged: caregivers' experiences through the transition process from preparation in the hospital to providing care at home; appropriate communication; unmet information needs; and managing community expectations and perceptions. In addition, caregivers' views on 'peer-support' was explored. Caregivers' experiences, and their confidence and ability to provide care were related to preparation in the hospital after birth and until discharge, the information they received and the manner in which healthcare providers communicated. Healthcare workers were a trusted source of information while in the hospital, but there was no continuity of care after discharge which increased their fears and worries about the survival of their infant. They often felt confused, anxious and discouraged by the negative perceptions and expectations from the community. Fathers felt left-out as there was very little communication between them and the healthcare providers. Peer-support could enable a smooth transition from hospital to home care. Interventions to advance preterm care beyond the health facility through a well-supported transition from facility to home care are urgently required to improve health and survival of preterm infants in Uganda and other similar settings.
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Affiliation(s)
- Christine Nalwadda
- Makerere University College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Andrew K Tusubira
- Makerere University College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | | | - Gertrude Namazzi
- Makerere University College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | | | - Peter Waiswa
- Makerere University College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Jenny Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Maureen Kelley
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Manisha Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Types, Evidence, and Resources of Interventions Focused on Improving the Psychosocial Well-being of Parents of Premature/Sick Infants: A Scoping Review. Adv Neonatal Care 2022; 22:E138-E151. [PMID: 34224480 DOI: 10.1097/anc.0000000000000913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Parents of infants born premature and/or sick and who require neonatal care are at risk of poor mental health. Currently, there is no comprehensive knowledge about interventions (ie, types, evidence, resources) that have been exclusively designed to improve the psychosocial well-being of this population group. PURPOSE To undertake a systematic scoping review of interventions focused on improving the psychosocial well-being of parents of sick/premature infants who required neonatal care to identify the ( a ) types of interventions, ( b ) evidence of the interventions, and ( c ) level of resources required to deliver the interventions. SEARCH STRATEGY e searched 7 databases (MEDLINE, CINAHL, PsycINFO, Cochrane, EMBASE, Web of Science, and Global Index), reviewed references, and followed up key authors. RESULTS From 10,516 hits, 38 articles met the inclusion criteria (36 different studies/interventions). Studies included creative oriented (n = 11), group/peer support (n = 4), relaxation/mindfulness (n = 3), spiritual/religious (n = 4), psychotherapeutic-based (n = 11), and "other" (n = 3) (eg, sleep, acupuncture). Most had been undertaken in high-income settings with mothers and required varying levels of resources within and between the different intervention types. While some interventions were effective, there was high heterogeneity with similar interventions using different designs, protocols, and outcomes. Most intervention types included studies that highlighted what parents valued (eg, self-care, relaxation, social opportunities). IMPLICATIONS FOR RESEARCH Evidence highlights a wide range of potential interventions for nursing and other specialist staff to consider and offers insights into potential mechanisms of effectiveness to underpin future intervention design.
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Torr C. Culturally competent care in the neonatal intensive care unit, strategies to address outcome disparities. J Perinatol 2022; 42:1424-1427. [PMID: 35241768 DOI: 10.1038/s41372-022-01360-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 11/09/2022]
Abstract
In the past two years, we have witnessed social unrest, the unequal effects of a pandemic across our society, and a focus on how systems in the United States produce unequal outcomes along racial and cultural divides. With increased national awareness, there has also been a call for change in healthcare, specifically racial inequities in Neonatal Intensive Care Unit (NICU) outcomes (1). While race may be a data point used to classify outcomes, it has no basis in biology, and merely identifying it does not make it simple to address. To address these inequities we need to look past the social construct of race and to the social aspects of our care in the NICU. Focusing on small and large changes that we can make as individuals, units, and as a specialty that can improve the care and outcomes of this at-risk patient population. This perspective focuses on culturally congruent care, trauma-informed care, and other approaches to reduce disparities in neonatal outcomes.
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Affiliation(s)
- Carrie Torr
- University of Utah School of Medicine, Salt Lake City, UT, USA.
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Implementation Outcomes and Challenges of Partnerships between Resource Parents and Parents with Sick Infants in Intensive Neonatal Care Units: A Scoping Review. CHILDREN 2022; 9:children9081112. [PMID: 35892615 PMCID: PMC9331213 DOI: 10.3390/children9081112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022]
Abstract
Parents with a sick child in a neonatal intensive care unit (NICU) usually experience stress, anxiety, and vulnerability. These precarious feelings can affect early parent–child interactions and have consequences for the child’s neurodevelopment. Parents who have had a sick child in an NICU (veteran parents) can offer helpful interventions for these vulnerable families. This article is a scoping review of parental interventions used with the families of NICU infants, and an overview of French perspectives. Two independent reviewers studied the scientific literature published in English between 2001 to 2021 using Covidence software. The databases used were MEDLINE, ISI Web of Science, the Cochrane Database, and Google Scholar. Themes were identified from the articles’ results using an open coding approach. The data are presented in a narrative format. Ten articles were included, and four major themes addressed: (1) description of activities, (2) recommendations, (3) impact, and (4) barriers (resulting from recruitment, training, remuneration, and organization). Activities were very diverse, and a step-by-step implementation was recommended by all authors. Peer-support interventions might be a potential resource for those anxious parents and improve their NICU experiences. These challenges are described by SOS Préma in France. This article brings together recent studies on partnership in the NICU. It is an innovative topic in neonatology with vast issues to explore.
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Brignoni-Pérez E, Scala M, Feldman HM, Marchman VA, Travis KE. Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit. J Dev Behav Pediatr 2022; 43:e304-e311. [PMID: 34723932 PMCID: PMC9046459 DOI: 10.1097/dbp.0000000000001029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the rate, frequency, and duration of kangaroo care (KC) in the neonatal intensive care unit (NICU) compared with preterm infants of higher SES or primarily English-speaking families. METHODS Participants were infants born <32 weeks' gestational age (GA), N = 116. We defined SES by the infants' health insurance (private/higher vs public/lower) and language by the language mothers used to communicate with clinical staff (English vs Other language). SES or language groups were compared on (1) rate of KC infants experienced during hospitalization per visitation days, (2) frequency of KC per visitation days, and (3) duration of KC events per day. RESULTS Infants in the lower SES and Other language groups experienced KC in reduced amounts, lower frequencies, and shorter durations than infants in either the higher SES or English language groups. SES and language group differences remained significant after controlling for family visitation and GA at birth. After controlling for SES, language group differences in KC duration remained significant. CONCLUSION Our findings revealed disparities in the rate, frequency, and duration of KC experienced in the NICU as a function of both SES and language. Such disparities reduced infants' access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize these disparities.
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Affiliation(s)
- Edith Brignoni-Pérez
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Melissa Scala
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, USA
| | - Heidi M. Feldman
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
| | | | - Katherine E. Travis
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
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Smith S, Tallon M, Clark C, Jones L, Mörelius E. "You Never Exhale Fully Because You're Not Sure What's NEXT": Parents' Experiences of Stress Caring for Children With Chronic Conditions. Front Pediatr 2022; 10:902655. [PMID: 35832577 PMCID: PMC9271768 DOI: 10.3389/fped.2022.902655] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Children with chronic conditions are experiencing improved survival worldwide, and it is well-known that their parents are stressed. Yet, despite this knowledge, parents continue to experience stress. Our study explored the lived experience of parental stress when caring for children with various chronic conditions to identify opportunities to potentially reduce stress for these parents. This was an exploratory qualitative study using semi-structured interviews. To ensure appropriate research priorities were addressed, the study was co-designed with consumer and stakeholder involvement. Twenty parents were interviewed. Parents were recruited through a recognized family support organization for children with various care needs in Western Australia. Interviews were audio-recorded, transcribed verbatim, anonymized, and analyzed using Interpretative Phenomenological Analysis. Two superordinate themes were identified: (1) Gut instinct to tipping point included parents as unheard experts and their experiences of stress and becoming overwhelmed. (2) Losses and gains covered the parents' identity and relationship challenges and coping strategies with their children's unpredictable conditions. Parents' experiences of stress caring for children with chronic conditions can be applied to the Job-Demand Control-Support Model for occupational stress. Not only does this application provide a useful framework for practitioners but it adds a unique perspective that reflects the dual role of parents in caring for their children with chronic conditions as a parent but also a professional with a 24/7 workload. The parents' experiences highlight a need for improved support access, effective communication between parents and health care professionals, discharge preparation and information provision, and regular screening of parental stress with a referral pathway.
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Affiliation(s)
- Stephanie Smith
- School of Nursing and Midwifery, Edith Cowan University, Joondaulup, WA, Australia.,Perth Children's Hospital, Nursing Research Department, Nedlands, WA, Australia
| | - Mary Tallon
- School of Nursing, Curtin University, Bentley, WA, Australia
| | - Carrie Clark
- Kalparrin, Perth Children's Hospital, Nedlands, WA, Australia
| | | | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Joondaulup, WA, Australia.,Perth Children's Hospital, Nursing Research Department, Nedlands, WA, Australia
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Tibil PE, Ganle JK. What Support Systems do Women Caring for Preterm Infants at Home Require in Urban Ghana? A Qualitative Study. Matern Child Health J 2021; 26:1239-1245. [PMID: 34837598 DOI: 10.1007/s10995-021-03288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Caring for preterm infants and ensuring their survival beyond neonatal intensive care units remain a challenge in many low-income settings. While studies highlight the difficulties of caring for preterm infants at home, few have focused on the forms, sources, and accessibility to support systems. This study explored the forms of support systems women caring for preterm infants at home in urban Ghana require, and their accessibility to such support systems. METHODS An explorative cross-sectional qualitative study was conducted. A total of 19 women who were caring for preterm infants aged 2-6 months at home were purposively sampled. In-depth interviews were conducted and thematic content analysis used to analyse the data. RESULTS Women reported four main forms of support which they require: psychosocial support, practical support, material support and spiritual support. However, accessibility to these support systems was highly unequal, often depended on one's social status and the quality of one's family and interpersonal relationships prior to giving birth to a preterm infant. CONCLUSION Women caring for preterm infants at home require a variety of support systems; but effective accessibility remains a challenge for many in urban settings. Interventions to strengthen community and home-based support for women caring for preterm infants at home, including use of social media-based peer support groups, are urgently needed.
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Affiliation(s)
| | - John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, P.O. Box LG 13, Accra, Ghana.
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White-Traut R, Brandon D, Kavanaugh K, Gralton K, Pan W, Myers ER, Andrews B, Msall M, Norr KF. Protocol for implementation of an evidence based parentally administered intervention for preterm infants. BMC Pediatr 2021; 21:142. [PMID: 33761902 PMCID: PMC7988259 DOI: 10.1186/s12887-021-02596-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/07/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Multi-sensory behavioral interventions for preterm infants have the potential to accelerate feeding, growth, and optimize developmental trajectories and increase parents' interactive engagement with their infants. However, few neonatal intensive care units (NICUs) provide evidence-based standardized early behavioral interventions as routine care. Lack of implementation is a major gap between research and clinical practice. H-HOPE, is a standardized behavioral intervention with an infant- directed component (Massage+) and a parent-directed component (four participatory guidance sessions that focus on preterm infants' behaviors and appropriate responses). H-HOPE has well documented efficacy. The purpose of this implementation study is to establish H-HOPE as the standard of care in 5 NICUs. METHODS The study employs a Type 3 Hybrid design to simultaneously examine the implementation process and effectiveness in five NICUs. To stagger implementation across the clinical sites, we use an incomplete stepped wedge design. The five participating NICUs were purposively selected to represent different acuity levels, number of beds, locations and populations served. Our implementation strategy integrates our experience conducting H-HOPE and a well-established implementation model, the Consolidated Framework for Implementation Research (CFIR). The CFIR identifies influences (facilitators and barriers) that affect successful implementation within five domains: intervention characteristics, outer setting (the hospital and external events and stakeholders), inner setting (NICU), implementers' individual characteristics, and the implementation process. NICUs will use the CFIR process, which includes three phases: Planning and Engaging, Executing, and Reflecting and Evaluating. Because sustaining is a critical goal of implementation, we modify the CFIR implementation process by adding a final phase of Sustaining. DISCUSSION This study builds on the CFIR, adding Sustaining H-HOPE to observe what happens when sites begin to maintain implementation without outside support, and extends its use to the NICU acute care setting. Our mixed methods analysis systematically identifies key facilitators and barriers of implementation success and effectiveness across the five domains of the CFIR. Long term benefits have not yet been studied but may include substantial health and developmental outcomes for infants, more optimal parent-child relationships, reduced stress and costs for families, and substantial indirect societal benefits including reduced health care and special education costs. TRIAL REGISTRATION ClinicalTrials.gov registration number NCT04555590 , Registered on 8/19/2020.
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Affiliation(s)
- Rosemary White-Traut
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA.
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
| | - Debra Brandon
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Karen Kavanaugh
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Karen Gralton
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
| | - Wei Pan
- School of Nursing and Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Evan R Myers
- Division of Women's Community and Population Health, Department of Obstetrics & Gynecology, Duke University School of Medicine, Duke University, Durham, North Carolina, USA
| | - Bree Andrews
- College of Medicine, Department of Pediatrics, University of Chicago, Chicago, IL, USA
| | - Michael Msall
- College of Medicine, Department of Pediatrics, University of Chicago, Chicago, IL, USA
| | - Kathleen F Norr
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Jallow M, Haith-Cooper M, Hargan J, Balaam MC. A systematic review to identify key elements of effective public health interventions that address barriers to health services for refugees. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01519-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Salway S, Such E, Preston L, Booth A, Zubair M, Victor C, Raghavan R. Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people.
Objectives
The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives.
Data sources
Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants.
Review methods
Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness.
Results
The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness.
Limitations
There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked.
Conclusions
Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited.
Future work
UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities.
Study registration
This study is registered as PROSPERO CRD42017077378.
Funding
This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sarah Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Elizabeth Such
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Louise Preston
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Maria Zubair
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Christina Victor
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Raghu Raghavan
- School of Nursing and Midwifery, De Montfort University, Leicester, UK
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Tan A, Pelone F, Arnold S, Anderson J, Kennedy G, Goodman J. Support and information needs of parents and carers of preterm babies requiring respiratory support on the neonatal unit: A qualitative systematic review. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kynoe NM, Fugelseth D, Hanssen I. When a common language is missing: Nurse–mother communication in the NICU. A qualitative study. J Clin Nurs 2020; 29:2221-2230. [DOI: 10.1111/jocn.15212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/09/2020] [Accepted: 02/03/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Nina Margrethe Kynoe
- Department of Master and Postgraduate Education Lovisenberg Diaconal University College Oslo Norway
- Department of Neonatal Intensive Care Oslo University Hospital Oslo Norway
| | - Drude Fugelseth
- Department of Neonatal Intensive Care Oslo University Hospital Oslo Norway
- Division of Child and Adolescent Medicine Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Ingrid Hanssen
- Centre for Clinical Nursing Research, Lovisenberg Diaconal University College Oslo Norway
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Hunt H, Abbott R, Boddy K, Whear R, Wakely L, Bethel A, Morris C, Prosser S, Collinson A, Kurinczuk J, Thompson-Coon J. “They’ve walked the walk”: A systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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McGowan EC, Abdulla LS, Hawes KK, Tucker R, Vohr BR. Maternal Immigrant Status and Readiness to Transition to Home From the NICU. Pediatrics 2019; 143:peds.2018-2657. [PMID: 31036673 PMCID: PMC6564064 DOI: 10.1542/peds.2018-2657] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evaluate effects of immigrant status on perceptions of discharge readiness in mothers of preterm infants <37 weeks' gestation and identify the impact of primary language and years in the United States. METHODS Immigrant (n = 176) and native (n = 556) mothers of preterm infants cared for in the NICU for >5 days between 2012 and 2015 completed the Fragile Infant Parental Readiness Evaluation (FIPRE), a NICU-discharge readiness questionnaire. Group comparisons were made on the basis of immigrant status. Regression models examined effects of immigrant status, primary language, and years in the United States on discharge readiness. RESULTS Immigrant mothers were more likely to be older, gravida >1, multiracial or people of color, and non-English speaking; have less than a high school education; and receive Medicaid but less likely to have child protective services involvement, substance abuse, and mental health disorder (MHD). Whereas rates of non-English primary language, low education, and Medicaid decreased, rates of MHDs increased with years in the United States. At NICU discharge, immigrant mothers had poorer perceptions of infant well-being, maternal well-being, maternal comfort, and time impact. In adjusted analyses, immigrant status, non-English primary language, and MHD predicted unfavorable scores. Among immigrant mothers, increased years in the United States and MHD predicted unfavorable scores. CONCLUSIONS Although findings suggest acculturation with increased years in the United States, immigrant mothers perceived less discharge readiness in multiple domains, highlighting the need for culturally competent care and discharge services specifically tailored to help this vulnerable population.
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Affiliation(s)
- Elisabeth C. McGowan
- Warren Alpert Medical School,,Division of Neonatology, Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island; and
| | | | - Katheleen K. Hawes
- Warren Alpert Medical School,,Division of Neonatology, Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island; and,College of Nursing, The University of Rhode Island, Kingston, Rhode Island
| | - Richard Tucker
- Division of Neonatology, Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island; and
| | - Betty R. Vohr
- Warren Alpert Medical School,,Division of Neonatology, Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island; and
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Fowler C, Green J, Elliott D, Petty J, Whiting L. The forgotten mothers of extremely preterm babies: A qualitative study. J Clin Nurs 2019; 28:2124-2134. [PMID: 30786101 PMCID: PMC7328789 DOI: 10.1111/jocn.14820] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home. BACKGROUND Mothers of extremely preterm infants (28 weeks' gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home. METHOD An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi-structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six-phase thematic analysis approach. The COREQ checklist has been used. RESULTS Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events. CONCLUSION The mothers were at high risk of developing post-traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home. RELEVANCE TO CLINICAL PRACTICE This study highlights the need for nurses to include a focus on the mothers' psychosocial needs. Supporting maternal mental health both improves maternal well-being and enables mothers to be emotionally available and responsive to their extremely preterm infant.
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Affiliation(s)
- Cathrine Fowler
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Janet Green
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Doug Elliott
- University of Technology Sydney, Sydney, New South Wales, Australia
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Improving neonatal care with the help of veteran resource parents: An overview of current practices. Semin Fetal Neonatal Med 2018; 23:44-51. [PMID: 29111298 DOI: 10.1016/j.siny.2017.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Over the past decade, veteran parents who have lived a neonatal intensive care unit (NICU) experience have become increasingly involved as 'resource parents' to provide peer-to-peer support to "new" NICU parents. These parents can provide a unique form of support to new parents. They can also assume other roles in clinical care, research, administration and/or teaching, but those roles are rarely described in the literature. This article reviews many of the activities performed by resource parents in neonatology. These activities were identified/examined and classified according to the location of involvement (hospital or not), the presence/absence of direct interaction with families and providers, and the topic of involvement. We have also identified gaps in knowledge relative to recruitment and training, development and evaluation of programs, structuring of responsibilities, and remuneration of resource parents. Future research is needed to measure the impact of resource parents on neonatal care.
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Patriksson K, Berg M, Nilsson S, Wigert H. Communicating with parents who have difficulty understanding and speaking Swedish: An interview study with health care professionals. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jnn.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Maternal Characteristics Associated With Social Support in At-Risk Mothers of Premature Infants. J Obstet Gynecol Neonatal Nurs 2017; 46:824-833. [DOI: 10.1016/j.jogn.2017.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 11/30/2022] Open
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21
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Rallying the Troops: How Sharing Knowledge With Grandparents Supports the Family of the Preterm Infant in Neonatal Intensive Care Unit. Adv Neonatal Care 2017; 17:E1-E10. [PMID: 27902505 DOI: 10.1097/anc.0000000000000360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Research concludes that there is a need for educational programs for grandmothers, as well as networking opportunities; educational programs for other extended family members have long been sought by parents, relatives, and nurses in neonatal intensive care unit. PURPOSE To describe the effect of having premature infants' extended families participating in family-centered care (FCC) groups in the neonatal intensive care unit. An intervention based on dialogue, including topics as own reactions, general knowledge about the premature infants, parenthood, and how the extended families can support the new families during hospitalization and after discharge. METHODS A qualitative content analysis of 2 focus group interviews involving 16 purposefully sampled extended family members, who had participated in 1½ hours of FCC group interventions. FINDINGS The overall theme was: Accepting the individuality of the infant and providing the family with realistic expectations for the future. This theme emerged during the analysis of 4 categories: knowledge sharing, same basis for understanding, access to the immediate family, and competent supporting role. The interrelationship between the categories also emerged, surprisingly, during the analysis. IMPLICATIONS FOR PRACTICE Extended family members should be recognized as an essential part of the new family's life from the time of the premature infant's admission to neonatal intensive care unit. Family-centered care group interventions should be integrated into ward practice and policy. IMPLICATIONS FOR RESEARCH The study reinforces the need for further research, utilizing both qualitative and quantitative methods, into age and ethnicity aspects of FCC group interventions. There is also a need to compare the new parents' perceived level of stress and support from the FCC group intervention in relation to participating and nonparticipating extended families.
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22
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Eneriz-Wiemer M, Saynina O, Sundaram V, Lee HC, Bhattacharya J, Sanders LM. Parent Language: A Predictor for Neurodevelopmental Follow-up Care Among Infants With Very Low Birth Weight. Acad Pediatr 2016; 16:645-52. [PMID: 27130810 DOI: 10.1016/j.acap.2016.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/05/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Preterm/very low birth weight infants may suffer neurodevelopmental delays. Pediatricians should monitor neurodevelopment and pursue timely referrals. Yet parents who speak non-English primary languages (NEPL) report worse health care communication and fewer appropriate specialty referrals for their children. We sought to determine whether infants of NEPL parents receive recommended outpatient follow-up care for neurodevelopment. We hypothesized that these infants received less care than infants of English speakers. METHODS We linked paid claims from California Children's Services to clinical data from California Perinatal Quality Care Collaborative (58% linkage rate, 1541 subjects) for publicly insured infants with birth weight <1500 g or gestational age ≤32 weeks. Our primary outcomes were completion of 1) preventive visits and 2) ophthalmology visits; and receipt of 3) influenza vaccination and 4) palivizumab. To compare group differences, we also assessed 5) hospital length of stay and 6) readmissions. Analyses were adjusted for medical severity and sociodemographic characteristics. RESULTS A total of 433 infants (28%) had NEPL parents. Infants of NEPL parents had 38% higher odds of receiving influenza vaccination (95% confidence interval 9-75, P = .008) and completed 8% more preventive visits (95% confidence interval 1-64, P = .019) than infants of English speakers. Infants of NEPL parents did not have longer lengths of stay or more readmissions. CONCLUSIONS Infants of NEPL parents were more likely than infants of English speakers to receive some aspects of recommended outpatient follow-up care. Regardless of language, all infants received far lower rates of follow-up care than recommended by national guidelines. Future study should address the causes of these gaps.
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Affiliation(s)
- Monica Eneriz-Wiemer
- Department of Pediatrics, Palo Alto Medical Foundation, Palo Alto, Calif; Division of General Pediatrics, Stanford University School of Medicine, Los Gatos, Calif.
| | - Olga Saynina
- Center for Policy, Outcomes, and Prevention, Stanford University, Stanford, Calif
| | - Vandana Sundaram
- Quantitative Services Unit, Stanford University School of Medicine, Palo Alto, Calif
| | - Henry C Lee
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, Calif; California Perinatal Quality Care Collaborative, Stanford, Calif
| | - Jay Bhattacharya
- Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford, Calif
| | - Lee M Sanders
- Division of General Pediatrics, Stanford University School of Medicine, Los Gatos, Calif; Center for Policy, Outcomes, and Prevention, Stanford University, Stanford, Calif
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23
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Tavallali AG, Jirwe M, Kabir ZN. Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences. Scand J Caring Sci 2016; 31:54-62. [PMID: 26800093 DOI: 10.1111/scs.12314] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 11/09/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. AIM The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. METHOD A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. ETHICAL CONSIDERATIONS The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). RESULTS The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. CONCLUSIONS Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters.
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Affiliation(s)
- Azar Gashasb Tavallali
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Jirwe
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Zarina Nahar Kabir
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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24
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Hall SL, Ryan DJ, Beatty J, Grubbs L. Recommendations for peer-to-peer support for NICU parents. J Perinatol 2015; 35 Suppl 1:S9-13. [PMID: 26597805 PMCID: PMC4694192 DOI: 10.1038/jp.2015.143] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/18/2015] [Indexed: 11/09/2022]
Abstract
Peer-to-peer support provided by 'veteran' neonatal intensive care unit (NICU) parents to those with current NICU babies is a legitimate and unique form of support that can complement or supplement, but not replace, services provided by professional NICU staff. Peer support can be delivered through hospital- or community-based programs that offer one-to-one in-person or telephone matches, or support groups that meet in-person or via the Internet. Issues in program development, volunteer training and program operation are discussed. Recommendations for offering peer support to all NICU parents as an integral component of family-centered care and comprehensive family support are presented.
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Affiliation(s)
- S L Hall
- Division of Neonatology, St John's Regional Medical Center, Oxnard, CA, USA
| | - D J Ryan
- School of Nursing, Elmira College, Elmira, NY, USA
| | - J Beatty
- Program Director, Hand to Hold, Austin, TX, USA
| | - L Grubbs
- Founder and President, NICU Helping Hands, Fort Worth, TX, USA
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25
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Higginbottom GMA, Morgan M, Alexandre M, Chiu Y, Forgeron J, Kocay D, Barolia R. Immigrant women's experiences of maternity-care services in Canada: a systematic review using a narrative synthesis. Syst Rev 2015; 4:13. [PMID: 26187687 PMCID: PMC4506414 DOI: 10.1186/2046-4053-4-13] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. Our focus was on (a) the accessibility and acceptability of maternity-care services for immigrant women and (b) the effects of the perceptions and experiences of these women on their birth and postnatal outcomes. METHODS We conducted a systematic review using a systematic search and narrative synthesis of peer-reviewed and non-peer-reviewed reports of empirical research, with the aim of providing stakeholders with perspectives on maternity-care services as experienced by immigrant women. We partnered with key stakeholders ('integrated knowledge users') to ensure the relevancy of topics and to tailor recommendations for effective translation into future policy, practice and programming. Two search phases and a three-stage selection process for published and grey literature were conducted prior to appraisal of literature quality and narrative synthesis of the findings. RESULTS Our knowledge synthesis of maternity care among immigrants to Canada provided a coherent evidence base for (a) eliciting a better understanding of the factors that generate disparities in accessibility, acceptability and outcomes during maternity care; and (b) improving culturally based competency in maternity care. Our synthesis also identified pertinent issues in multiple sectors that should be addressed to configure maternity services and programs appropriately. CONCLUSIONS Although immigrant women in Canada are generally given the opportunity to obtain necessary services, they face many barriers in accessing and utilising these services. These barriers include lack of information about or awareness of the services, insufficient supports to access these services and discordant expectations between the women and their service providers. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42012002185 .
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Affiliation(s)
- Gina M A Higginbottom
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
| | - Myfanwy Morgan
- King's College London, Primary Care and Public Health Sciences London, London, SE1 3QD, UK.
| | - Mirande Alexandre
- Citizenship and Immigration Canada, New Multiculturalism Grants and Contributions Program, Canada Place, Edmonton, AB, T5J 4C3, Canada.
| | - Yvonne Chiu
- Multicultural Health Brokers Co-operative, Edmonton, AB, T5H 2M6, Canada.
| | - Joan Forgeron
- Lois Hole Hospital, Alberta Health Services, Edmonton, AB, T5H 3V9, Canada.
| | - Deb Kocay
- Health Canada, Public Health Agency of Canada, Calgary, AB, T2G 4X3, Canada.
| | - Rubina Barolia
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
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Hendson L, Reis MD, Nicholas DB. Health Care Providers’ Perspectives of Providing Culturally Competent Care in the NICU. J Obstet Gynecol Neonatal Nurs 2015; 44:17-27. [DOI: 10.1111/1552-6909.12524] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Parents of newborns in the neonatal intensive care unit (NICU) find themselves in a world of unknown medical terminology, advanced technology, and the realization that their dream of a healthy baby has been shattered. The unique partnership with trained parent-to-parent volunteers, who have had previous NICU experiences, enhances professional support and helps new NICU parents adjust to these unexpected challenges. This practice-based article describes the Helen DeVos Children's Hospital NICU Parent-to-Parent Partnership's (PPP) 40-year commitment to the parent-to-parent philosophy and its comprehensive approach to delivering trained volunteer PPP services to NICU families. A historical review of the literature, including this hospital's original research, current programming, recruiting, training, supervision, and survey feedback, is outlined.
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28
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Merritt L. Communicating with Chinese American families in the NICU using the Giger and Davidhizar transcultural model. Neonatal Netw 2013; 32:335-341. [PMID: 23985471 DOI: 10.1891/0730-0832.32.5.335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Having an infant admitted to the neonatal intensive care unit (NICU) can be a frightening experience for parents. However, it can be even more frightening for them when they are from a different culture and speak a different language than the health care team. Hence, a nurse needs to be culturally competent in order to provide proper care to a multicultural society. The purpose of this article is to describe how NICU nurses can communicate with one such culture, the Chinese American, the largest Asian group in the United States. A transcultural nursing model will be described to use as a guide to help the nurse. The culture, Chinese Americans, will be described to help nurses provide culturally competent care. Research studies will be presented so the reader can develop an understanding of how parents of Chinese descent perceive the care they receive. Interventions and recommendations will be presented on how to enhance communication between the nurses and this cultural group.
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Higginbottom GMA, Hadziabdic E, Yohani S, Paton P. Immigrant women's experience of maternity services in Canada: a meta-ethnography. Midwifery 2013; 30:544-59. [PMID: 23948185 DOI: 10.1016/j.midw.2013.06.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/06/2013] [Accepted: 06/11/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVE to synthesise data on immigrant women's experiences of maternity services in Canada. DESIGN a qualitative systematic literature review using a meta-ethnographic approach METHODS a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings. FINDINGS the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE in order to implement woman-centered care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care.
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Affiliation(s)
| | - Emina Hadziabdic
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sophie Yohani
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
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