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AlNaqbi HA, Kim M, Al-Yateem N, Hegazy F. Parents' satisfaction with physiotherapy services for neuropediatric outpatients in government and private hospitals in the United Arab Emirates: a cross-sectional study. F1000Res 2024; 13:739. [PMID: 39086771 PMCID: PMC11289589 DOI: 10.12688/f1000research.151041.1] [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] [Accepted: 06/04/2024] [Indexed: 08/02/2024] Open
Abstract
Background Healthcare, like other industries, emphasizes performance, quality, and consumer experience while also attempting to reduce costs. However, high-quality healthcare remains paramount for vulnerable and ill patients. This study aimed to investigate parents' and caregivers' level of satisfaction with physiotherapy services provided to neuropediatric outpatients on the United Arab Emirates (UAE). Methods This descriptive cross-sectional study included 103 parents/caregivers of children with neurological disabilities that were randomly selected from different Emirates Health Services Hospitals in the UAE. Data was collected using the long-form Patient Satisfaction Questionnaire (PSQ-III). Results The overall mean satisfaction was 159±7.73 (out of 250 points). Communication (20.36/25), interpersonal factors (20.17/35), and doctor-patient time (20.17/35) had the highest mean satisfaction scores (8.06/10). The lowest mean satisfaction scores were for access/availability/convenience (34.60/60), technical quality (33.17/50), and economic elements (23.83/40). Conclusion Despite participants' overall satisfaction scores being positive, some service domains require improvement to improve satisfaction, specifically the access/availability/convenience, technical quality, and economic elements. These areas should be prioritized by service providers and managers to improve patients' experiences and clinical outcomes.
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Affiliation(s)
- Hanadi Ahmed AlNaqbi
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
| | - Meeyoung Kim
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
- Laboratory of Health Science & Nanophysiotherapy, Department of Physical Therapy, Graduated School, Yongin University, Yongin, South Korea
- Neuro musculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Science, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
| | - Fatma Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
- Laboratory of Health Science & Nanophysiotherapy, Department of Physical Therapy, Graduated School, Yongin University, Yongin, South Korea
- Department of Paediatrics Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Giza Governorate, Egypt
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Nist MD, Spurlock EJ, Pickler RH. Barriers and Facilitators of Parent Presence in the Neonatal Intensive Care Unit. MCN Am J Matern Child Nurs 2024; 49:137-144. [PMID: 38240753 DOI: 10.1097/nmc.0000000000001000] [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: 04/30/2024]
Abstract
PURPOSE The purpose of this study was to describe system-level and personal factors influencing parent presence in the neonatal intensive care unit (NICU) and identify differences in factors by sociodemographic characteristics. STUDY DESIGN AND METHODS In a cross-sectional national survey study using social media recruitment, participants rated the frequency of 13 potential barriers and 12 potential facilitators using a 5-point Likert scale. Experiences of discrimination and parent-staff engagement were also measured. RESULTS Valid responses were analyzed from 152 participants. Uncomfortable facilities and home responsibilities were the most highly reported system-level and personal barriers, respectively. Encouragement to participate in caregiving and social support were the most highly reported system-level and personal facilitators, respectively. Participants reported low to moderate levels of discrimination and moderate levels of parent-staff engagement. Latent class analysis revealed three sociodemographic clusters. Differences in barriers, facilitators, discrimination, and engagement were found among clusters. CLINICAL IMPLICATIONS NICU facilities are uncomfortable and may discourage parent presence. Allowing support persons to accompany parents, providing comfortable facilities, and engaging parents in caregiving may promote greater parent presence and improved parent and child outcomes. Studies of potential bias toward parents with lower education and income and effects on parent presence and infant outcomes are needed.
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Jaeger CB, Altimier L. NICU Couplet Care: metrics to guide an evolving model of care. J Perinatol 2023; 43:30-34. [PMID: 38086964 DOI: 10.1038/s41372-023-01783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/25/2023] [Accepted: 09/19/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE The evidence-based science of maternal and neonatal care has been rapidly changing. As a result, clinical practice and the design of physical space have evolved in order to provide neuroprotection for the baby and meet expectations of family presence and participation. SETTING The concept and practice of NICU Couplet Care supports positive health well-being/outcomes and early relationship building between the mother-baby-father/partner. RESULTS Monitoring evidence-based measures and metrics of standardized care, performance competence, neuro-physical and psychosocial outcomes, environmental design, family and staff satisfaction, and sustainability are essential to the evolution of quality, safe, efficient, effective, ethical, and cost-effective care for the mother, baby, and family. Transparency in the dissemination of evidence, practice standards, and outcome data is important to guide parents/families and health professionals in making informed shared decisions regarding the clinical care provided and the environment where care takes place.
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Affiliation(s)
- Carol B Jaeger
- Advanced Practice Nurse Programs, The Ohio State University College of Nursing, Columbus, OH, USA.
| | - Leslie Altimier
- SSM Health: Cardinal Glennon Children's Hospital, St. Louis, MO, USA
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Weis J, Beck SA, Jensen A, Brødsgaard A, Latour JM, Greisen G. Psychometric testing of a Danish version of the empowerment of parents in the intensive care - Neonatology questionnaire has confirmed validity. Acta Paediatr 2023; 112:708-718. [PMID: 36607258 DOI: 10.1111/apa.16661] [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: 10/01/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/07/2023]
Abstract
AIM Investigating parent satisfaction with care is important to guide quality development. In this study, we translated and validated a Danish version of the empowerment of parents in the intensive care - neonatology (EMPATHIC-N) questionnaire to determine validity in Danish contexts. METHOD A psychometric study design was applied. Translation was performed according to recommended international standards. Confirmatory factor analyses including standardised factor loadings, Cronbach's α reliability estimates, congruent validity and non-differential validity testing were applied. The study was performed from June 2017 to November 2019 at a 33-bed level IV neonatal intensive care unit. RESULTS Participants were 311 parents (response rate = 42,8%). Confirmative factor analyses disclosed a moderate model fit of the instrument with Comparative Fit Index (CFI) values of 0.83-0.92. Cronbach's α showed good reliability (0.82-0.93). Congruent validity showed good positive correlations (0.48-0.71) between the instrument domains and four overall satisfaction indicators. In search of improved model fit, a version including 27 items was tested. This version showed a better model fit with CFI values of 0.92-0.99 and satisfactory Cronbach's α values. CONCLUSIONS Model fit for the Danish full EMPATIC-N was moderate. The shorter version showed better psychometric properties.
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Affiliation(s)
- Janne Weis
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sanne Allermann Beck
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andreas Jensen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Brødsgaard
- Research Unit for Nursing and Health, Faculty of Health, University of Aarhus, Aarhus, Denmark.,Department of Paediatrics and Adolescent Medicine & Gynaecology and Obstetrics, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Gorm Greisen
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
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Alle YF, Akenaw B, Seid S, Bayable SD. Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study. BMC Health Serv Res 2022; 22:1266. [PMID: 36261864 PMCID: PMC9583552 DOI: 10.1186/s12913-022-08645-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Parental satisfaction is a well-established outcome indicator and tool for assessing a healthcare system’s quality, as well as input for developing strategies for providing acceptable patient care. This study aimed to assess parental satisfaction with neonatal intensive care unit service and its associated factors. Method A cross-sectional study design was conducted on parents whose neonates were admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by adopting an EMPATHIC-N instrument during the day of neonatal discharge, after translating the English version of the instrument to the local language (Amharic). Both Bivariable and multivariable logistic analyses were done to identify factors associated with parental satisfaction with neonatal intensive care unit service. P < 0.05 with 95% CI was considered statistically significant. Results The data analysis was done on 385 parents with a response rate of 95.06%. The overall average satisfaction of parents with neonatal intensive care unit service was 47.8% [95% CI= (43.1–52.5)]. The average parental satisfaction of neonatal intensive care unit service in the information dimension was 50.40%; in the care and treatment dimension was 36.9%, in the parental participation dimension was 50.1%, in the organization dimension was 59.0% and the professional attitude dimension was 48.6%. Gender of parents, residency, parental hospital stay, birth weight, and gestational age were factors associated with parental satisfaction. Conclusion There was a low level of parental satisfaction with neonatal intensive care unit service. Among the dimensions of EMPATHIC-N, the lowest parental satisfaction score was in the care and treatment while the highest parental satisfaction score was in the organization dimension.
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Affiliation(s)
- Yewlsew Fentie Alle
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia.
| | - Bantigegn Akenaw
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Shimelis Seid
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Samuel Debas Bayable
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Aurora M, Keyes ML, Acosta JG, Swartz K, Lombay J, Ciaramitaro J, Rudnick A, Kelleher C, Hally S, Gee M, Madhavan V, Roumiantsev S, Cummings BM, Nelson BD, Lerou PH, Matute JD. Standardizing the Evaluation and Management of Necrotizing Enterocolitis in a Level IV NICU. Pediatrics 2022; 150:189570. [PMID: 36164852 PMCID: PMC10026590 DOI: 10.1542/peds.2022-056616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Necrotizing enterocolitis (NEC) is a severe intestinal inflammatory disease and a leading cause of morbidity and mortality in NICUs. Management of NEC is variable because of the lack of evidence-based recommendations. It is widely accepted that standardization of patient care leads to improved outcomes. This quality improvement project aimed to decrease variation in the evaluation and management of NEC in a Level IV NICU. METHODS A multidisciplinary team investigated institutional variation in NEC management and developed a standardized guideline and electronic medical record tools to assist in evaluation and management. Retrospective baseline data were collected for 2 years previously and prospectively for 3.5 years after interventions. Outcomes included the ratio of observed-to-expected days of antibiotics and nil per os (NPO) on the basis of the novel guidelines and the percentage of cases treated with piperacillin/tazobactam. Balancing measures were death, surgery, and antifungal use. RESULTS Over 5.5 years, there were 124 evaluations for NEC. Special cause variation was noted in the observed-to-expected antibiotic and NPO days ratios, decreasing from 1.94 to 1.18 and 1.69 to 1.14, respectively. Piperacillin/tazobactam utilization increased from 30% to 91%. There were no increases in antifungal use, surgery, or death. CONCLUSIONS Variation in evaluation and management of NEC decreased after initiation of a guideline and supporting electronic medical record tools, with fewer antibiotic and NPO days without an increase in morbidity or mortality. A quality improvement approach can benefit patients and decrease variability, even in diseases with limited evidence-based standards.
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Affiliation(s)
- Megan Aurora
- Divisions of aNewborn Medicine
- Departments of Pediatrics
- These authors contributed equally to this work
| | - Madeline L Keyes
- Divisions of aNewborn Medicine
- Departments of Pediatrics
- Harvard Neonatal-Perinatal Medicine Fellowship Program, Boston, Massachusetts
- These authors contributed equally to this work
| | | | | | - Jesiel Lombay
- Divisions of aNewborn Medicine
- Departments of Pediatrics
| | | | | | | | | | - Michael Gee
- Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | | | | | | | | | - Paul H Lerou
- Divisions of aNewborn Medicine
- Departments of Pediatrics
- These authors co-supervised this work
| | - Juan D Matute
- Divisions of aNewborn Medicine
- Departments of Pediatrics
- These authors co-supervised this work
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Adal Z, Atomsa G, Tulu G. Parental Satisfaction with Neonatal Intensive Care Unit Services and Associated Factors in Jimma University Medical Center, Ethiopia. RESEARCH AND REPORTS IN NEONATOLOGY 2022. [DOI: 10.2147/rrn.s351224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Zhuang Y, Zhang R, Gao XR, Zhu LH, Latour JM. Validation of the Chinese Empowerment of Parents in the Intensive Care (EMPATHIC-30) Questionnaire Among Parents in Neonatal Intensive Care Units: A Prospective Cross-Sectional Study. Front Pediatr 2022; 10:851291. [PMID: 35433534 PMCID: PMC9005953 DOI: 10.3389/fped.2022.851291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are no specific validated questionnaires assessing satisfaction of family-centered care experienced by parents of infants hospitalized in Chinese Neonatal Intensive Care Units (NICU). AIM To adapt and test the reliability and validity of the Chinese version of the EMPATHIC-30 questionnaire in NICU settings. METHODS A prospective, cross-sectional design was adopted. The EMPATHIC-30 questionnaires were completed by parents of infants admitted to one of the four NICUs at Hunan Children's Hospital, China, between November 2018 and 2019. Inclusion criteria were parents whose infants were admitted to the NICU for at least 5 days. Exclusion criteria were parents whose children were discharged within 5 days after admission or whose infants died in the NICU. Reliability was tested with Cronbach's alpha. The congruent validity was tested using Spearman's Rank correlation analysis, and the non-differential validity was tested using Cohen's d. RESULTS Parents of 619 infants discharged from the NICUs completed and returned the questionnaire. Most infants were male (n = 337, 54.4%) and infants' length of stay was a median of 21 days (IQR = 14-37). Mostly, mothers completed the questionnaire (n = 523, 84.5%). The Cronbach's alpha values of the five individual domains were between 0.67 and 0.95, and the alpha of the total questionnaire was.90, providing an adequate internal consistency. Congruent validity was measured by correlating the five domains with four standard satisfaction scales, documenting a weak correlation (r s -0.025-0.327). Non-differential validity showed some significant effect size between four binary variables (mechanical ventilation, unplanned admission, admission after surgery, length of stay) four of the five domains. CONCLUSION The Chinese version of EMPATHIC-30 questionnaire showed acceptable psychometric properties. This instrument might be considered a suitable instrument to measure parent satisfaction among Chinese parents whose infants are admitted to an NICU. Measuring parent satisfaction with this instrument might contribute to improving family-centered care initiatives in NICUs with Chinese parents.
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Affiliation(s)
- Yan Zhuang
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Rong Zhang
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Xi-Rong Gao
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Li-Hui Zhu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Jos M Latour
- Nursing Department, Hunan Children's Hospital, Changsha, China.,Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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Gulo B, Miglierina L, Tognon F, Panunzi S, Tsegaye A, Asnake T, Manenti F, Dall'Oglio I. Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N. Front Pediatr 2021; 9:738863. [PMID: 34692612 PMCID: PMC8531748 DOI: 10.3389/fped.2021.738863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022] Open
Abstract
Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains. Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided. Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67-5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33-5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience. Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.
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Affiliation(s)
- Berhanu Gulo
- Doctors With Africa CUAMM, Addis Ababa, Ethiopia
| | | | - Francesca Tognon
- Doctors With Africa CUAMM, Padua, Italy.,Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Silvia Panunzi
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Tina Asnake
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Immacolata Dall'Oglio
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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