How nurses and other health professionals use learning principles in parent education practice: A scoping review of the literature

Development of an atraumatic care education model based on family-centered care to improve maternal behavior in reducing children's stress during hospitalization

PURPOSE

this study aimed to develop an atraumatic care education model based on family centered care to improve maternal behavior in minimizing hospitalization stress.

DESIGN AND METHODS

This study utilized a quantitative research design with a cross-sectional approach. A total of 120 mothers of hospitalized children were selected through purposive sampling. A self-designed questionnaire was administered, which included sections on nurse competency, maternal factors, service factors, and learning facilities. Data analysis was conducted using inferential statistics, specifically employing Smart PLS for structural equation modeling (SEM).

RESULTS

The results indicated that the atraumatic care education model, based on family-centered care, was directly influenced by nurse competency (t = 2.829, p = 0.005), maternal factors (t = 3.237, p = 0.001), service factors (t = 4761, p = 0.000), and learning facilities (t = 2.005, p = 0.046). However, none of these factors had a significant impact on maternal behavior in reducing child hospitalization stress (t = 0.970, 0.794, 0.039, 1.290; p = 0.333, 0.429, 0.969, 0.198). On the other hand, the atraumatic care education model based on family-centered care was found to directly influence maternal behavior in minimizing child hospitalization stress (t = 34.065, p = 0.000).

CONCLUSIONS

The atraumatic care education model based on family-centered care, includes four key variables: nurse competency, maternal factors, service factors, and learning facilities. This model can be used as a framework to enhance maternal behavior in reducing stress associated with child hospitalization.

PRACTICAL IMPLICATIONS

The findings suggest that the atraumatic care education model based on family-centered care, can be a valuable tool in improving maternal behavior and reducing stress during child hospitalization. Healthcare providers, especially pediatric nurses, should focus on enhancing their competency in delivering atraumatic care education, as well as addressing factors related to the mother, the quality of services, and the availability of learning resources.

Australian Women's Experiences of Establishing Breastfeeding after Caesarean Birth

Breastfeeding exclusivity and duration rates are lower after caesarean birth, yet the factors contributing to these are not well understood. This mixed-methods study used an anonymous online questionnaire to examine the facilitators and barriers to establishing breastfeeding as identified by Australian women after a caesarean birth. Quantitative data were reported using descriptive statistics, and multivariable models were used to determine the factors associated with breastfeeding outcomes including the timing of breastfeeding initiation, birth experience, and commercial infant formula use. Qualitative data were analysed using an inductive thematic analysis. Data were obtained for N = 961 women, of which <50% reported skin-to-skin contact during breastfeeding initiation. The barriers to breastfeeding included aspects of clinical care and reduced mobility, while unrushed care, partner support, and physical help with picking up the baby were helpful. Following a non-elective caesarean birth, women had half the odds of early breastfeeding initiation (OR = 0.50; 95% CI: 0.36, 0.68; p ≤ 0.001) and 10 times the odds to report a negative birth experience (OR = 10.2; 95% CI: 6.88, 15.43; p < 0.001). Commercial milk formula use was higher in primiparous women (OR = 2.16; 95% CI: 1.60, 2.91; p < 0.001) and in those that birthed in a private hospital (OR = 1.67; 95% CI: 1.25, 2.32; p = 0.001). Pain and reduced mobility, as well as conflicting and rushed care, negatively impacted breastfeeding after a caesarean birth, while delayed breastfeeding initiation, higher pain ratings, and negative birth experiences were more common for women that birthed by non-elective caesarean. This study adds valuable insights into the physical, emotional, and clinical care needs of women in establishing breastfeeding after a surgical birth. Clinical staffing and care should be modified to include full access to partner support to meet the specific needs of breastfeeding women after a caesarean birth.

Child development education in the Neonatal Unit: Understanding parent developmental literacy needs, priorities and preferences

OBJECTIVE

To describe child development knowledge needs, priorities, and preferences for education to enhance developmental literacy among parents with children admitted to the neonatal unit (NNU).

METHODS

Two separate cohorts completed a survey; 1) Parents with children graduated from Australian NNUs (n = 316); 2) Parents with infants' inpatient at two South Australian NNUs (n = 209).

RESULTS

Parents considered it extremely important to understand child development (Graduates: 80%; Inpatients: 71%). Inpatient parents reported lower child development knowledge. Almost half (42%) of graduate parents described the child development education provided by neonatal staff as poor or inadequate. There was consistency in preferences for developmental literacy education provision. Parents desired education to commence during NNU and continue post discharge. Priorities included content specific to preterm birth and how to support child development over the first two years of life. Individualised education by a Neonatal Nurse/Midwife was most preferred.

CONCLUSION

Mothers and fathers value guidance to support their child's development during NNU admission and early childhood. Our study highlights the importance of improved early developmental literacy education for parents with children admitted to the neonatal unit.

PRACTICE IMPLICATIONS

Our findings can be used to inform the creation of future educational resources targeting improved parent developmental literacy.

Applying Learning Principles Within Parent Education: Exploring Nurses' Practice and Parents' Experiences

Purpose

In parent-education practice nurses use Learning Principles (LPs) when helping parents to develop the knowledge and skills required to care for their children. LPs are basic precepts of learning, comprising people's beliefs, behaviors and reasoning processes. LPs underpin parents' active engagement, confidence building and decision-making, as information provided becomes usable knowledge. However, the ways nurses apply LPs in parent-education practice are poorly explained in healthcare. Likewise, descriptions of parents' learning experiences, associated with the use of LPs in nurse/parent-education interactions, are lacking. This study aimed to explore and describe nurses' perceptions and use of LPs, and parents' learning experiences in one healthcare organization.

Participants and Methods

Using an action research design, 25 nurses and 18 parent participants were purposively recruited across metropolitan Adelaide, Australia. Data were collected through observations and semi-structured interviews and thematically analyzed simultaneously June-December 2017.

Results

The LPs nurses used, and those important to parents' learning experiences created three overarching themes: 1) collaborative relationships, 2) deepening learning insights, 3) the learning environment. Despite their apparent use, nurses struggled to explicitly describe how they perceived LPs, believing their knowledge and use was sub-conscious - tacit. However, tacit knowledge hinders communication and explanation of LPs used within parent-education to other nurses. The member-checking of interview data helped to stimulate the nurses' metacognition (thinking about their thinking), unlocking their LPs awareness.

Conclusion

Nurses used LPs in practice but their knowledge was tacit. Through metacognition, nurses started to recognize the ways LPs influenced their practice and parents' learning capabilities. Increasing healthcare constraints, including time allowed for parent-education, require nurses to optimize their use of LPs. Future research should identify ways nurses can communicate their use of LPs, potentially enhancing parents' active learning experiences and concordance with health recommendations.

Health education provided by nurses to children and young people: parents' assessment

BACKGROUND

Healthy literacy is a determinant key children/teenager's health and health outcomes. The aim of this study to identify the parents' assessment about Health Education practice to children and teenagers.

METHODS

We opted for a descriptive, quantitative and cross-sectional research, with a non-probabilistic convenience sample. The inclusion criteria were: being a parent who uses attending children health appointments in primary health care; being a parent who has a child hospitalized and is accompanying him/her in the pediatric hospital inpatient ward. A questionnaire survey was built with three sections: sample characterization, Health Education practices performed by nurses (5 questions) and a scale that measured Health Education Assessment Scale (HEAS), which contained 48 items and was validated. It was applied from September to December 2018.

RESULTS

The survey was filled in by 113 parents. The results showed that 100% (n = 113) of the parents feel comfortable to talk with nurses about children/teenagers health; 79.6% (n = 90) consider that nurses have time availability for the doubts clarification; 61.9% (n = 70) point out that nurses identify child/teenager needs; Healthy eating" (60.2%; n = 68), the "National Vaccination Plan" (53.1%; n = 60) and "Harmful behaviors prevention" (46.9%; n = 53) are the most important topics; 56.6% (n = 64) of the parents, when in doubt, turn first to the pediatrician, and 66.4% (n = 75) considered that this practice was equal important, compared with other nursing interventions.

DISCUSSION

This study shows that Health Education provided by nurses is based on the need's identification, with a perspective of involvement and participation, promoting health and conscious changes which reinforces the nurses' position as health educators.

Parents as Adult Learners in Occupational Therapy for Children With Sensory Challenges: A Scoping Review

IMPORTANCE

Parent training is an essential part of occupational therapy intervention for children with sensory processing and sensory integration (SP-SI) challenges, and parents' learning needs should be considered.

OBJECTIVE

To identify the extent to which adult learning needs are considered in occupational therapy literature addressing parent training as a part of intervention for children with SP-SI challenges.

DATA SOURCES

Searches were performed of the following databases: MEDLINE, PsycINFO, CINAHL, Web of Science, EMBASE, and ERIC. The date range was limited to 1990 to 2019 to capture literature focused on family-centered care.

STUDY SELECTION AND DATA COLLECTION

Using Arksey and O'Malley's framework for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist, the following criteria were used to guide the literature searches: population (parents and families of children with SP-SI challenges), intervention (parent training), outcomes (parent learning needs), and concept (parents as adult learners).

FINDINGS

Searches produced 133 peer-reviewed articles, and 5 met the criteria for inclusion. Qualitative thematic analysis, including stakeholder interviews, revealed two themes: (1) Parents focus on children's needs, not their own, and (2) parents benefit from connection with peers and learn through shared experiences.

CONCLUSIONS AND RELEVANCE

Parent training is an essential component of occupational therapy; however, there is limited occupational therapy evidence examining parents' learning needs, specifically parents of children with SP-SI challenges. Future studies should investigate parents' learning needs in relation to occupational therapy intervention for families of children with SP-SI challenges. What This Article Adds: Parents' learning needs are both rarely considered in the occupational therapy literature and important for best practice in pediatric therapy for children with SP-SI challenges. The results of this scoping review point to the need for further investigation of parent training programs specifically examining parents as adult learners.

‘I am the educator and the learner at the same time’: a qualitative survey of the knowledge and use of adult learning theory in UK musculoskeletal physiotherapists' patient education

Background/Aims

Patient education is a core component of musculoskeletal care, yet broad definitions exist and effective delivery methods are unclear. Musculoskeletal physiotherapists' use of patient education has been described as individualised and collaborative, reflecting a person-centred model of care. However, discrepancies between perceived and actual practice, and therapist-centred approaches to education, have been observed. Little is known about the theoretical basis of musculoskeletal physiotherapists' patient education practice, yet the adult learning theory frames how adults interact with education and echoes the principles of person-centred care. The aim of this study was to analyse the use of adult learning theory to inform patient education practice among UK musculoskeletal physiotherapists.

Methods

This study used a novel, online questionnaire to collect quantitative and qualitative data from a self-selecting sample of UK musculoskeletal physiotherapists, using a multimodal recruitment strategy. Complete responses were provided by 66 participants. Categorical and narrative data were collected and descriptive and thematic analyses undertaken.

Results

Participants generally self-rated their educational competencies highly, with the exception of evaluating patient education. Participants were more familiar with reflective and self-directed learning than with other adult learning theories. Two main themes were described: implicit adult learning theory knowledge and challenges in applying adult learning theory.

Conclusions

The results suggest that musculoskeletal physiotherapists may have implicit knowledge of adult learning theory, yet challenges exist in applying them. This finding supports the establishment of ongoing training in educational skills for physiotherapists and could be used as a catalyst for musculoskeletal physiotherapists to reflect on their knowledge and use of adult learning theory.

Digital Interventions to Improve Health Literacy Among Parents of Children Aged 0 to 12 Years With a Health Condition: Systematic Review

Background

Parental health literacy is associated with child health outcomes. Parents are increasingly turning to the internet to obtain health information. In response, health care providers are using digital interventions to communicate information to assist parents in managing their child’s health conditions. Despite the emergence of interventions to improve parental health literacy, to date, no systematic evaluation of the effectiveness of the interventions has been undertaken.

Objective

The aim of this review is to examine the effect of digital health interventions on health literacy among parents of children aged 0-12 years with a health condition. This includes evaluating parents’ engagement (use and satisfaction) with digital health interventions, the effect of these interventions on parental health knowledge and health behavior, and the subsequent impact on child health outcomes.

Methods

This systematic review was registered a priori on PROSPERO (International Prospective Register of Systematic Reviews) and developed according to the Joanna Briggs Institute methodology for systematic reviews. The databases CINAHL, MEDLINE, and PsycINFO were searched for relevant literature published between January 2010 and April 2021. Studies were included if they were written in English. A total of 2 authors independently assessed the search results and performed a critical appraisal of the studies.

Results

Following the review of 1351 abstracts, 31 (2.29%) studies were selected for full-text review. Of the 31 studies, 6 (19%) studies met the inclusion criteria. Of the 6 studies, 1 (17%) was excluded following the critical appraisal, and the 5 (83%) remaining studies were quantitative in design and included digital health interventions using web-based portals to improve parents’ health knowledge and health behavior. Owing to heterogeneity in the reported outcomes, meta-analysis was not possible, and the findings were presented in narrative form. Of the 5 studies, satisfaction was measured in 3 (60%) studies, and all the studies reported high satisfaction with the digital intervention. All the studies reported improvement in parental health literacy at postintervention as either increase in disease-specific knowledge or changes in health behavior. Of the 5 studies, only 1 (20%) study included child health outcomes, and this study reported significant improvements related to increased parental health knowledge.

Conclusions

In response to a pandemic such as COVID-19, there is an increased need for evidence-based digital health interventions for families of children living with health conditions. This review has shown the potential of digital health interventions to improve health knowledge and behavior among parents of young children with a health condition. However, few digital health interventions have been developed and evaluated for this population. Future studies with robust research designs are needed and should include the potential benefits of increased parent health literacy for the child.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42020192386; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192386

Parent needs assessment instruments in neonatal intensive care units: Implications for parent education interventions

OBJECTIVES

Psychosocial and educational interventions based on standardized needs assessment can help alleviate distress among parents of premature infants. This study aims to (1) provide an overview of standardized instruments used to assess parental needs in neonatal intensive care units (NICUs) and (2) discuss their potential to facilitate the provision of appropriate support to parents of premature babies.

METHODS

A systematic literature review was conducted. PubMed, CiNAHL, PsychARTICLES, PsychINFO, and Medline were searched for studies reporting on the use of validated parental needs assessment instruments in the NICU.

RESULTS

Following the analysis of 33 publications, 6 instruments designed to assess the needs of premature infants' parents were identified. Based on their good psychometric properties and practicality, the NICU Family Needs Inventory, the Critical Care Maternal Needs Inventory, and the Nurse Parent Support Tool were considered particularly relevant for use in clinical and research settings.

CONCLUSIONS

Validated parent needs assessment instruments are available for use in the NICU setting. Further research evaluating the benefits and usability of standardized parental needs assessment in the NICU is needed.

PRACTICE IMPLICATIONS

Validated needs assessment instruments should be consistently used to facilitate the development of targeted psychosocial and educational interventions for parents in the NICU.

Healthcare Providers and Caregivers' Perspectives on the Quality of Child Health Services in Urban Indonesia: A Mixed-Methods Study

Although Indonesia’s child mortality rate has decreased in tandem with the global trend, healthcare services can be further improved for children. This study aims to explore the perceptions of healthcare providers and caregivers of children aged below five years to improve child health in urban Indonesia. A mixed-methods study design was adopted. Quantitative data were collected via questionnaires from the caregivers. Qualitative data were collected via semi-structured interviews from the healthcare providers. Analysis of 540 caregiver questionnaires regarding the care provided to their child revealed that the majority of them were very satisfied (46.1%) and satisfied (52.2%) with the care received. Analysis of 12 interviews with healthcare providers derived three major themes: (1) importance of one’s role as a healthcare provider; (2) factors affecting the delivery of healthcare; and (3) the way forward in caring for young children. Although caregivers were very satisfied with the care received for their children, the perception of healthcare providers regarding their responsibility in delivering care to children under five years old provides insights into improving the quality of services for children in Indonesia. Our findings suggest that mortality and morbidity of children aged below five years can be best reduced by optimizing primary and secondary preventive measures.

Children living with long-term conditions: A meta-aggregation of parental experiences of partnership nursing

AIM

To explore how parents of children with long-term conditions experience partnership in paediatric and neonatal nursing care and to identify existing partnership barriers and facilitators.

BACKGROUND

Parent-nurse partnership is fundamental to paediatric and neonatal nursing. Partnership is characterised by five attributes: parental participation, negotiation, mutual trust and respect, shared roles and decision-making, and communication. Little is known about the parental experiences of partnership nursing specific to children living with a long-term condition.

DESIGN

A qualitative meta-aggregation review following Joanna Briggs Institute meta-aggregation approach.

METHODS

A comprehensive search was conducted in six electronic databases. Studies were assessed according to the inclusion and exclusion criteria. Qualitative findings with illustrative quotes from included studies were extracted and grouped into categories which informed the synthesised findings. This review has been reported according to the PRISMA guidelines.

FINDINGS

A total of 4,404 studies were screened, 162 full-text studies were assessed against the inclusion and exclusion criteria, and a total of six studies were included. The meta-aggregation developed three overarching synthesised findings which were as follows: (a) empowering parents to become involved, (b) effective communication to recognise mutual expertise and (c) collaborative nurse-family relationships.

CONCLUSION

Parents valued collaboration where both parents and nurses are recognised equally for their skills and expertise. A power struggle existed between parents and nurses when expertise was not recognised. Parents appreciated nurses who empowered them to develop new skills and knowledge in the care of their own child.

RELEVANCE TO CLINICAL PRACTICE

Nurses need to recognise the skills and knowledge that parents have surrounding the care requirements of their own children. Collaboration and negotiation are key to successful partnership between nurses and parents. Nurses need to frequently reflect on how they are successfully partnering with both parents and children and ensure all parties in the nurse/parent/child triad feel supported and empowered.

A practical approach to obesity prevention: Healthy home habits

ABSTRACT

Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.