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Jeppesen E, Schmidt AA, Skjødt CK, Hybschmann J, Gjærde LK, Thestrup J, Hansson H, Sørensen JL. Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review. Eur J Pediatr 2024; 183:2015-2028. [PMID: 38430279 PMCID: PMC11035470 DOI: 10.1007/s00431-024-05455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
To identify and describe educational programmes in patient- and family-centred care for paediatric healthcare professionals. This scoping review was conducted and reported according to the JBI Manual for Evidence Synthesis and the PRISMA guideline. The databases searched included MEDLINE (PubMed), PsycINFO, CINAHL, Scopus, Cochrane, and Embase. Inclusion criteria were experimental, observational and qualitative studies about educational programmes on patient- and family-centred care for paediatric healthcare professionals. Exclusion criteria were reviews and non-peer-reviewed literature. Two reviewers independently screened and extracted the data using Covidence. Of the 13922 records identified, 49 articles met the inclusion criteria. There was a large variety of educational programmes, half of which were interdisciplinary, that mainly targeted nurses and doctors. The median number of participants was 51 (range 7 to 1411). The predominant target population was children with chronic disabilities and neonatal intensive care units, and only one programme specifically targeted adolescents. The median duration was one day (range 5 min to 3.5 years). Development of competencies was the most common objective. We identified 12 different educational content areas. Content mainly focused on communication and relational competencies, including partnership, which involved shared decision-making, mutual agenda setting, and negotiation of a plan. Many kinds of educational strategies were found but experiential learning through simulation and roleplay was used most. Conclusion: A large variety of educational programmes in paediatric patient- and family-centred care exist. Educational content mainly focused on communication and relational competencies. Experiential learning including roleplay and simulation was the most used educational strategy. What is Known: • Delivery of patient- and family-centred care improves parental satisfaction of care but requires clinicians have a certain attitude towards involving the child and parents in a healthcare partnership as well as advanced triadic communication skills. Little is known about how this attitude, and more broadly, patient- and family-centred care, can be facilitated through education and training. What is New: • This scoping review found a wide array of programmes.. Workshops with simulation or roleplay was the most frequent educational strategy. The programmes, which typically targeted nurses and doctors, chiefly focused on basic and advanced communication and relational competencies, including partnership, which involved shared decision-making and negotiation of plans.
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Affiliation(s)
- Elisabeth Jeppesen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.
- Department of Respiratory Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Anne Aarslev Schmidt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Camilla Kriegbaum Skjødt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Hansson
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Thestrup J, Sørensen JL, Hybschmann J, Topperzer MK, Graber K, O'Farrelly C, Gibson J, Ramchandani P, Frandsen TL, Gjærde LK. Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study. Eur J Pediatr 2024; 183:1595-1605. [PMID: 38183437 PMCID: PMC11001713 DOI: 10.1007/s00431-023-05411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives. Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.
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Affiliation(s)
- Jakob Thestrup
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark.
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | | | - Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Jenny Gibson
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
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Thestrup J, Hybschmann J, Madsen TW, Bork NE, Sørensen JL, Afshari A, Borgwardt L, Berntsen M, Born AP, Aunsholt L, Larsen VA, Gjærde LK. Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis. Hosp Pediatr 2023; 13:e301-e313. [PMID: 37727937 DOI: 10.1542/hpeds.2023-007289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
CONTEXT Nonpharmacological strategies are increasingly used in pediatric procedures, but in pediatric MRI, sedation and general anesthesia are still commonly required. OBJECTIVES To evaluate the effectiveness of nonpharmacological interventions in reducing use of sedation and general anesthesia in pediatric patients undergoing MRI, and to investigate effects on scan time, image quality, and anxiety. DATA SOURCES We searched Ovid Medline, CINAHL, Embase, and CENTRAL from inception through October 10, 2022. STUDY SELECTION We included randomized controlled trials and quasi-experimental designs comparing the effect of a nonpharmacological intervention with standard care on use of sedation or general anesthesia, scan time, image quality, or child and parental anxiety among infants (<2 years), children, and adolescents (2-18 years) undergoing MRI. DATA EXTRACTION Standardized instruments were used to extract data and assess study quality. RESULTS Forty-six studies were eligible for the systematic review. Limited to studies on children and adolescents, the meta-analysis included 20 studies with 33 873 patients. Intervention versus comparator analysis showed that nonpharmacological interventions were associated with reduced need for sedation and general anesthesia in the randomized control trials (risk ratio, 0.68; 95% confidence interval, 0.48-0.95; l2 = 35%) and nonrandomized studies (risk ratio, 0.58; 95% confidence interval, 0.51-0.66; l2 = 91%). The effect was largest among children aged 3 to 10 years when compared with older children and adolescents aged 11 to 18 years. LIMITATIONS There was substantial heterogeneity among nonrandomized studies. CONCLUSIONS Nonpharmacological interventions must be considered as standard procedure in infants, children, and adolescents undergoing MRI.
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Affiliation(s)
| | | | | | | | - Jette L Sørensen
- Juliane Marie Centre and Mary Elizabeth's Hospital
- Department of Clinical Medicine, Faculty of Health and Medicine Sciences
| | | | | | | | | | - Lise Aunsholt
- Neonatology
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke A Larsen
- Radiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Line K Gjærde
- Juliane Marie Centre and Mary Elizabeth's Hospital
- Pediatrics and Adolescent Medicine, Neuropaediatric Unit
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