The impact of the family-centered empowerment model on the children's quality of life with chemical burns and their parent’s perceived stress

Assessment of the effectiveness of a web-based family centered empowerment program for the parents of children with oncological problems: Randomized controlled trial

PURPOSE

The study aims to examine the effects of a web-based Family-Centered Empowerment Model based educational intervention given to parents of children with oncological problems on caregiving ability, self-efficacy, self-esteem, depression, anxiety, and stress.

DESIGN & METHODS

The present study used a parallel-group, randomized, controlled, single-blind experimental design. Participants (n = 76) were divided into two groups: intervention (I = 38) and control (C = 38). The intervention group participated in an eight-week web-based empowerment program. Data were collected before, after, and 1 month after the training using the Information Form, Scale for Assessing the Ability of Family Members Providing Care to Cancer Patients, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Depression, Anxiety, and Stress Scale. Data were analyzed using descriptive statistics, Pearson chi-square, Fisher Exact test, independent samples t-test, two-way repeated measures ANOVA, and post hoc Bonferroni analyses.

RESULTS

It was determined that the care ability and self-efficacy mean scores of the parents in the intervention group increased compared to the control group, while the self-esteem and depression, anxiety, and stress mean scores decreased.

CONCLUSION

Web-based empowerment program is an effective method for improving parents' caregiving abilities, increasing their self-efficacy and self-esteem, and reducing depression, anxiety, and stress levels.

IMPLICATIONS FOR PRACTICE

In the management of this process, which is more difficult than other diseases, the web-based AMGM-based training program is an easy-to-implement and effective care approach that primarily aims to empower the caregiver. In addition, the developed website is a practical guide that parents can use at home to manage the problems they encounter.

Effectiveness of a family-management program for family having children with acute lymphoblastic leukemia: a quasi-experimental study

PURPOSE

To examine the impact of a family-management program (FMP) on family management, family, and child quality of life (QOL) among parents of children with acute lymphoblastic leukemia (ALL).

METHODS

Participants included 46 parents of children aged 2-5 years with ALL. Participants were recruited via a convenience sampling method at a tertiary hospital in Thailand. Twenty-three intervention participants received a 3-weekly FMP and routine care while the other 23 control participants received only routine cancer care. Data was collected in the hospital setting and/or via telephone follow-up calls. Study outcomes were evaluated at 3 time points (i.e., baseline, post-intervention, and follow-up) using the following: Family Management Measure, Beach Center Family Quality of Life Scale, and Quality of Life of Children with cancer module. Data were analyzed using two-way repeated-measures analysis of variance (ANOVA).

RESULTS

The findings revealed that family management and child QOL in the intervention group was higher than the control group at follow-up (p < .05), but not for family QOL. Within the intervention group, there was significant improvement in family management, family QOL and child QOL at post-intervention and follow-up.

CONCLUSIONS

The FMP was effective in fostering improved outcomes among enrolled parents that received the FMP compared to parents in the control group. Healthcare providers, especially nurses that work with parents of children with ALL, can easily offer the FMP to parents to help foster optimal family management, family QOL, and child QOL.

A Scoping Review Protocol: Parenting Experiences and Family Dynamics in Pediatric Burn Care Settings from Hospitalization to the Return Home

Background: Evidence indicates that pediatric burns are a significant form of trauma. They affect not only children but also their parents, who often experience short- and long-term psychopathological symptoms. The body of knowledge on the impact of hospitalization on parents has expanded; however, there is a dearth of evidence on the dynamics of parental relationships, parental experiences, and how these experiences affect their parenting. Objectives: This study aims to map and summarize the available literature on the repercussions of trauma associated with pediatric burns and hospitalization on parental and family dynamics. Methods: A scoping review will be carried out in accordance with the JBI methodology, based on the PCC. Studies involving hospitalized children (up to the age of 18) who have suffered accidental burns and their parents or caregivers will be included. The literature study will examine the effects of pediatric burn-related trauma on family and parental dynamics, emphasizing interventions and adjustment strategies that support children and families affected by this injury. Studies related to hospital settings and returning home will be included and analyzed by two independent reviewers using a standardized form developed for this study. The databases consulted will be Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, Collection of Psychology and Behavioral Sciences (via EB-SCO), PsycInfo, Cochrane Library, Embase, and Web of Science (Clarivate). Results: The results will be summarized narratively, presented in tables or diagrams, to highlight key findings related to parental experiences with burned children, the trauma associated with this episode, and its impact on parenting. In addition, strategies developed within the framework of the care partnership will be highlighted. Conclusions: Understanding how family dynamics change after a child suffers a burn injury and goes through the hospitalization process is crucial for nurses to improve their practice. We hope that this review will promote partnership-oriented, family-centered nursing practice in the care of child burn victims and their families, as well as assist in the identification of knowledge gaps in the literature and potential areas for future research and development.

Phase I-IIa clinical trial to evaluate the safety, feasibility and efficacy of the use of a palate mucosa generated by tissue engineering for the treatment of children with cleft palate: the BIOCLEFT study protocol

INTRODUCTION

The current gold standard treatment for patients with orofacial clefts is surgical repair of the palatal defect (uranostaphylorrhaphy), which is associated with growth defects and hypoplasia of the maxillofacial structures. This trial aims to evaluate the potential of a bioengineered artificial palate mucosa, created through tissue engineering with autologous stromal and epithelial cells and nanostructured fibrin-agarose biomaterials, to enhance treatment outcomes for patients with unilateral cleft lip and palate.

METHODS AND ANALYSIS

This phase I-IIa clinical trial aims to evaluate the feasibility and biosafety of a procedure involving grafting bioartificial palate mucosa onto the areas of denudated bone in patients undergoing uranostaphylorrhaphy. The control patients will undergo standard surgical treatment. Five patients will be included in the first biosafety phase. In the second phase, 10 patients will be randomly assigned to the intervention or control group (1:1). The intervention group will undergo standard surgical treatment followed by the application of autologous bioartificial palate mucosa. Feasibility will be analysed at the time of surgery. Nine postimplant visits will be scheduled over a 2-year follow-up period, in which local and systemic biosafety will be investigated by determining graft evolution, including signs of necrosis, rejection, inflammation and patient factors. Preliminary signs of efficiency will be explored by sequentially evaluating craniomaxillofacial development, hearing impairment, speech capability and quality of life of the family. The research will be published in journals and posted in the relevant repositories when available.

ETHICS AND DISSEMINATION

This study has been approved by the Committee of Ethics in Research with Medicinal Products (CEIm) and authorised by the Spanish Medicines Agency (AEMPS). The results of this study will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT06408337; ClinicalTrials.gov: EuclinicalTrials. eu: 2023-506913-23-00.

Feasibility of Home-Based Early Infant Hybrid Therapy in Children with Unilateral Cerebral Palsy

Background: The first stage of childhood is characterized by great neuronal plasticity. In Unilateral Cerebral Palsy (UCP), it is essential to carry out early treatment, with family involvement. The aim of this study was to investigate the feasibility of Early Infant Hybrid Therapy (eI-Hybrid) applied at home with family involvement in children with UCP aged 9-18 months, and to assess its preliminary effectiveness on bimanual functional performance. Methods: A single group of 10 children (12.8 months, SD = 3.4) performed the eI-Hybrid therapy. The main outcome was measured with the mini Assisting Hand Assessment scale (mini-AHA), functional goals were measured with the Goal Attainment Scale (GAS), and satisfaction expectations on intensive therapy were also recorded. Three measures were performed (week 0, week 10, and month 6). A repeated-measures ANOVA test was performed on the mini-AHA in order to observe the statistically significant differences in pairwise comparison. Results: Ten children completed the study and the parents' expectations were fulfilled, indicating high caregiver compliance and high adherence to the treatment. Clinically relevant changes were observed between pre- and post-intervention measurements in BFP (pre: 41.9 (SD: 7.7), post: 50.9 (SD: 6.0) and in the follow-up at 6 months (50.3 (SD:5.6); p < 0.001). Families reported a high satisfaction. Conclusions: infant hybrid treatment is feasible to be performed at home with the family's involvement, obtaining improvements in the affected upper limb for early-age UCP.

Effectiveness of family centred interventions for family caregivers: A systematic review and meta-analysis of randomized controlled trials

AIMS AND OBJECTIVES

To examine the effectiveness of family-centred interventions among family caregivers.

BACKGROUND

Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers.

DESIGN

A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist.

METHODS

Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'.

RESULTS

This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=-0.79, 95% CI[-1.22,-0.36], p = 0.0003) than on adult patients (SMD=-0.37, 95% CI [-0.61,-0.12], p = 0.004).

CONCLUSIONS

Family-centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning.

RELEVANCE TO CLINICAL PRACTICE

Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers.

TRIAL REGISTRATION DETAILS

The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).

Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial

INTRODUCTION

Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack.

AIM

To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program.

METHODS

This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL).

RESULTS

The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group.

CONCLUSION

This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations.

TRIAL REGISTRATION

This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.

Effects of family centered nursing model on children with primary nephrotic syndrome: A systematic review and meta-analysis

BACKGROUND

Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS.

METHODS

The electronic databases included China National Knowledge Internet, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, Cochrane Library, and Embase, were searched to collect randomized controlled trials on family-centered nursing model in the treatment of children with PNS. Fixed effect models or fixed effect models were used to analyze the outcomes. The primary outcomes were length of hospital stay and nursing satisfaction, and the second outcomes were quality of life (QoL) and behavioral problems.

RESULTS

A total of 12 studies involving 996 pediatric patients were included, of which 500 children received family centered care and 496 children received routine care. The results showed that family centered nursing model could significantly improve the QoL of children with PNS (P < .05), increase the nursing satisfaction of family members (P < .0001, SMD = 7.37, 95%CI = 4.15-13.08), reduce the time of hospitalization (P < .0001, standard mean difference [SMD] = -2.30, 95%CI = -2.57 to -2.03), and decrease the scores of psychosomatic disorders and impulsivity hyperactivity in children with PNS (P < .0001, SMD = -3.13, 95%CI = -4.12 to -2.15; P < .0001, SMD = -3.29, 95%CI = -4.29 to -2.28). However, there was no significant statistical difference in the impact on the scores of conduct problems, learning problems, anxiety, and hyperactivity (P > .05).

CONCLUSION

Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems.