PETS-D (parents education through simulation-diabetes): Parents' qualitative results

Improving the self-efficacy of caregivers of children with seizures using evidence-based practice

BACKGROUND

Epilepsy is considered a widespread chronic illness; it is estimated that approximately 1% of all children have the condition. Parents and caregivers of children with seizures experience fear and anxiety relative to their perceived confidence to manage their child's seizures after leaving the hospital. Evidence supports the use of simulation to educate caregivers to improve their perceived level of self-efficacy.

METHODS

The evidence-based practice project examined the impact of utilizing a simulation training session on the self-efficacy of caregivers of children with seizures at a large pediatric medical center in the southern United States. Caregivers of children with newly diagnosed seizures or with a recent change to their seizure treatment plan attended a simulation training session individualized to their discharge instructions. Demographic data, pre- and post-training self-efficacy measurements, and program satisfaction data were collected.

FINDINGS

The 31 caregivers who participated during the 3-month implementation period experienced a statistically significant increase in self-efficacy (p < .0001 to 0.002) and reported being satisfied with the simulation education training.

DISCUSSION

The project outcomes suggested simulation training was an effective method for improving the self-efficacy of caregivers of children with seizures and could be a feasible practice change at organizations with access to simulation technology.

APPLICATION TO PRACTICE

The outcomes of the project aligned with the evidence available in the literature. The results reinforced that education that includes simulated learning opportunities was generally well-received by caregivers and may improve their confidence to care for their child after discharge.

Experience and Educational Needs of Arab Parental Caregivers Regarding their Children Newly Diagnosed with Type 1 Diabetes in Saudi Arabia: A Qualitative Study

Type 1 diabetes (T1DM) is a common chronic health condition in children that necessitates close monitoring and care. Parents face numerous challenges when caring for children with T1DM, particularly at home owing to self-care. There is little information available about Arab parents’ experiences and educational needs when caring for children with TIDM. The purpose of this study was to explore the experiences and educational needs of Arab parental caregivers in Saudi Arabia who live with and care for children diagnosed with T1DM. An inductive qualitative descriptive design was used in this study. The data were amassed over a 4 month period through audio-recorded semi-structured interviews with 16 Arab parents of children aged 18 years and under who had been diagnosed with T1DM within the previous 6 months. Data were analyzed through a qualitative content analysis. The results could be classified into 3 categories related to the parents’ experience of caring for a child newly diagnosed with T1DM and their educational needs and can be described as follows: (1) management of uncertainty regarding T1DM; (2) management of new daily life situations; and (3) self-care management within the family. The Arab parents of children with T1DM accentuated the need for continuous professional support to manage uncertainty due to changes in everyday life situations. The findings confirmed the significance of culturally and contextually relevant education regarding T1DM for parents, children, and school personnel. Educational interventions and support in the community are recommended to improve daily life situations for families and children with T1DM.

Current Research Priorities in Healthcare Simulation: Results of a Delphi Survey

INTRODUCTION

In 2011 and 2017, the Society for Simulation in Healthcare Research Committee convened summits to develop a forward-thinking agenda for simulation research. After the second summit, the Society for Simulation in Healthcare Research Committee sought expert opinion on the most important research questions in healthcare simulation. This study used systematic methodology to develop a prioritized research agenda for healthcare simulation.

METHODS

A modified Delphi approach was conducted in 3 survey rounds. During round 1, individuals with expertise in healthcare simulation research were recruited to submit important research questions. Submitted questions were reviewed and duplicates were removed. Remaining questions were synthesized into a concise, high-level list for further rating. During round 2, these reformulated questions were distributed to the same experts who ranked their importance on a 5-point Likert scale. Average question importance ratings were calculated and shared during round 3, and a final vote was taken to identify the highest priority items.

RESULTS

Seventeen experts submitted 74 questions, which were reduced to 21 reformulated items. Variability in expert responses decreased significantly across survey rounds, indicating that consensus had been achieved. The top 3 research question identified by the experts were related to (1) the impact of system level simulation interventions on system efficiency, patient safety, and patient outcomes; (2) the return on investment of simulation for healthcare systems, and (3) whether a dose-response relationship exists between simulation training and performance/patient outcomes.

CONCLUSIONS

The agenda developed in this study may help guide and focus researcher efforts and funding agency decisions, ultimately helping advance the field.

Simulation-based childbirth education for Chinese primiparas: A pilot randomized controlled trial

OBJECTIVE

To evaluate the effectiveness and feasibility of simulation-based childbirth education (SBCE) on reducing fear of childbirth (FOC) of Chinese primiparas.

METHODS

A total of 56 primiparas completed the trial including 26 in the intervention group and 30 in the control group. The intervention group received four sessions of SBCE while the control group received routine prenatal care. Chinese versions of the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) and Childbirth Self-Efficacy Inventory (CBSEI) were used to evaluate FOC and childbirth self-efficacy. Birth outcomes including delivery method, labor duration and Apgar scores were collected.

RESULTS

Scores on the WDEQ-A of the intervention group were statistically lower than those of the control group (P < 0.05). The CBSEI scores of the intervention group were significantly higher than those of the control group (P < 0.05). The cesarean birth rate of the intervention group was lower than that of the control group (34.61% vs 46.67%, P > 0.05).

CONCLUSION

Simulation-based childbirth education alleviates FOC, increases childbirth self-efficacy and improves birth outcomes, providing a new perspective to alleviate FOC of primiparas in the future.

PRACTICE IMPLICATIONS

Simulation-based childbirth education is an effective and feasible method to educate women about childbirth. Its integration into routine prenatal care of Chinese primiparas should be encouraged to reduce FOC.

Being Simultaneously Curious and Stressed, Precipitants to Methamphetamine Initiation Among Chinese Men Who Have Sex With Men: Findings From a Qualitative Study

ABSTRACT

The cultural context and precipitants for initiating methamphetamine (MA) using among Chinese men who have sex with men (MSM) are unclear. This qualitative descriptive study, which explores the specific precipitants of MA initiation within a cultural context among MSM in China, was conducted with data from semistructured, face-to-face interviews with 24 MA-using MSM (8 HIV positive). Two themes were identified, internal precipitants included the following: (a) curiosity, (b) desire for maximum sexual pleasure, (c) experience with other drugs, and (d) strong sense of self-control capacity. External precipitants included (a) Xiao (filial piety), (b) peer pressure, (c) negative life events, (d) parental emotional neglect, and (e) experiences of homophobia. Internal precipitants to MA initiation for Chinese MSM are consistent with past research. External precipitants were more culture specific. This exacerbates the vulnerability of MSM to MA initiation and keeps it hidden among this population. Future drug use prevention interventions for MSM should address external precipitants and integrate culture-specific strategies.

"Ready SIM Go": An Adapted Simulation "Service Line" for Patients and Caregivers

SUMMARY STATEMENT

Changing healthcare systems and efforts to decrease medical costs have resulted in many more patients and caregivers (PCs) needing to manage life-sustaining therapies on their own. Given the potential for underpreparedness to result in increased morbidity and mortality, developing safe and efficient homecare training methods for PCs is essential. Medical simulation with PCs is an underused tool, which has the potential to decrease anxiety and increase preparedness through opportunities for repeated practice of medical procedures within a safe, controlled environment. This article describes the development of a hospital-based simulation service line for PCs, leveraging lessons learned from training for 250 patients and 450 caregivers in 14 different departments and subspecialties, and explains adaptations of standard simulation methods necessary for safe and effective use of simulation with this unique population. Process blueprint, examples of specific programs, as well as feedback from participants and clinicians are included.

Advocating for Your Patients and Families: Simulation as an Educational Tool for Home Caregivers of Children with Chronic Conditions

Simulation-based education for home caregivers of children with chronic conditions provides hands-on training set in a safe, confidential, supportive learning environment that is founded on the principles of patient-and family-centered care. This type of education and approach has been favored over traditional educational methods and may also improve caregivers' comfort, confidence, knowledge, skills, and ability to manage their child's routine and emergent care at home. Pediatricians play a vital role in this type of education as an advocate for their patients and families and as key stakeholders and collaborators in the process. Open collaboration and information sharing among home caregivers, simulation experts, pediatricians, and the rest of the medical team can lead to the development and implementation of successful simulation curricula. This in turn has the potential to lead to improved patient safety, quality of care, and patient outcomes. [Pediatr Ann. 2021;50(1):e39-e43.].

S.O.S! My Child is at School: A Hermeneutic of the Experience of Living a Chronic Disease in the School Environment

PURPOSE

The purpose of the present study is to understand the experience of living a chronic disease in the school, from the perspective of the parents.

DESIGN AND METHODS

A Grounded Theory study was proposed with a sample of 14 affected families with children between three and eleven years old, all of them from the west and south of Spain. Information was collected using semi-structured surveys and the constant comparative method was used for the analysis.

RESULTS

Results are divided into three main themes: SOS! My child is at school, The Systems (don't) Answer and Families Answer. Parents live school enrolment in a state of constant alertness, characterized by distrust, worry, fear, anguish, and indignation. The responses to the problem given by the education and health systems are insufficient, uncoordinated and inefficient. Therefore, parents end up not expecting anything, they transmit the information, organize training sessions, and solve any occurring incident by themselves, often at the expense of quitting their jobs.

CONCLUSION

The presence of a school nurse would mean for these parents the integration between the education and health systems.

PRACTICE IMPLICATIONS

As findings highlight, more collaboration and sensitivity between the healthcare and educational system is needed, and the school nurse has been indicated as a crucial figure in this matter.

[Use of simulation in healthcare for therapeutic training of the parents of children with hereditary angioedema]

BACKGROUND

C1INH-deficiency hereditary angioedema (HAE) is characterized by recurrent episodes of potentially severe oedema. Icatibant for SC injection will soon be approved for use in children and it is necessary to train parents in recognising severe episodes of AOH and in the technique for injection of icatibant. Simulation in healthcare (SH) is a set of educational methods for improving skills in a safe environment. We wished to assess the feasibility of a therapeutic training session (TTS) involving scripted scenarios for the parents of children with HAE.

PATIENTS AND METHODS

The TTS session included pre- and post-training testing on AOH, two scenarios (calling emergency services for lingual AO; gastrointestinal AO) involving actors and a volunteer parent, a workshop for learning the SC injection technique, and a satisfaction questionnaire. We analysed the answers on the questionnaire and noted down parents' verbatim observations during debriefing sessions.

RESULTS

Eight parents from 5 families took part in this session. Parents rated their overall satisfaction as 9.3/10. The parents commented that during the simulations, they felt "in the thick of it" and that they "experienced stress while viewing the scenes", thus attesting to the realism and relevance of the simulated scenarios.

DISCUSSION

This session met the parents' expectations in terms of being able to cope and having adequate know-how, based on both the simulations and the level of knowledge acquired. The main limitation lay in the parents' difficulty in confronting certain situations reminiscent of traumatic past experiences. TTS shares many common features with SH for the parents of sick children. The place of the latter in TTS must be evaluated.

Construction and validation of a low-cost simulator for training patients with diabetes mellitus and/or their caregivers in insulin administration

Abstract Objective: The objective of this study was to construct and validate a low-cost simulator to train diabetes mellitus patients and their caregivers on the administration of insulin. Method: Action research study with a qualitative approach, through a validation methodological study. Results: A low-fidelity simulator was constructed with the areas recommended for insulin administration adapted to allow skill training. Validation was done by nine experts on the subject. Conclusions: The prototype has low cost and greater anatomical functional fidelity than the models currently available in the market. Implications for practice: The simulator developed can be used by health professionals, caregivers or by the patients themselves as a tool in the training for insulin administration. Its use may favor the identification of critical points related to the application technique, allowing the planning of more directive and effective educational interventions.

Simulation-based research to improve infant health outcomes: Using the infant simulator to prevent infant shaking

Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator. Finally, we will discuss previous and future research using simulation to reduce morbidity and mortality from abusive head trauma, the most common cause of traumatic death in infancy.

CDE Perspectives of Providing New-Onset Type 1 Diabetes Education Using Formal Vignettes and Simulation

Purpose

The purpose of this article is to describe the 4 Parent Education Through Simulation-Diabetes (PETS-D) nurse certified diabetes educators’ (CDEs) perspectives of teaching parents of children with newly diagnosed type 1 diabetes mellitus (T1DM) early diabetes management skills using formal vignettes and a human patient simulator/human patient simulation (HPS) to augment/enhance the teaching–learning process.

Methods

A qualitative descriptive approach was used. Four CDEs were interviewed by phone about their teaching experiences. Meticulous notes were taken. Data were analyzed using qualitative content analysis.

Results

The vignettes (and use of HPS) provided structure, especially for parents who were struggling to learn. Certified diabetes educators described a short learning curve to master the use of the HPS manikin. Human patient simulation-enhanced education was described as helpful for teaching multiple caregivers about diabetes. Certified diabetes educators also described factors that affect parent learning, mechanical issues with the HPS, and additional space requirements for HPS-enhanced education.

Conclusion

Vignettes and HPS-enhanced education can successfully be used to educate parents of children with new-onset T1DM and were preferred by the CDEs when compared with previous teaching strategies. The results of this study support the use of both vignette-based and HPS-enhanced education when a child is newly diagnosed with T1DM. Further studies need to be done to see if these effects persist with different populations, during different stages of the disease, and for individuals with other chronic illnesses.

Simulation training for primary caregivers in the neonatal intensive care unit

Simulation is a hands-on educational modality that creates a safe, confidential learning environment that is closely aligned with the principles of patient- and family-centered care. This makes it an ideal training tool for families and caregivers of medically complex infants as they prepare for their care at home. Multidisciplinary collaboration and participation is vital to the success of these simulations and encourages the development of needs assessments and learning objectives that are congruent with the family's goals, beliefs, and culture. Simulation scenarios and curricula may be tailored and delivered in ways that optimize learning and allow for outcomes to be measured. Debriefing with specific and supportive feedback may increase families' and caregivers' confidence in handling their child's medical issues. This may lead to improved patient safety and quality of care delivered in the home environment.