1
|
Alqarawi N, Alhalal E. Nurses' practices of children and family-centered care for chronically ill children: A cross-sectional study. J Pediatr Nurs 2024; 77:172-179. [PMID: 38522211 DOI: 10.1016/j.pedn.2024.03.030] [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: 12/02/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE There is limited evidence of children and family-centered care (CFCC) practice in different cultural contexts, particularly regarding the factors that predict it among nurses providing care to chronically ill children. Also, the CFCC's impact on the quality of care has not been well studied. This study aimed to test a hypothesized model in which nurses' attributes and care environments predict CFCC, thereby increasing the quality of nursing care. DESIGN AND METHODS A multicenter cross-sectional study recruited a convenience sample of 405 nurses caring for chronically ill children in Saudi Arabia for an online survey between February 2023 and August 2023. Structural Equation Modeling evaluated the hypothesized model. RESULTS The hypothesized model fits the data based on the fit indices. Care environment affected CFCC (β = 0.831, p = .000), while nursing attributes only indirectly affected CFCC practices through the mediating effect of the work environment (β = 0.553, p = .000). The CFCC practices positively affect the quality of nursing care (β = 0.636, p = .000). CONCLUSIONS Nursing attributes impact the work environment, which affects the practice of CFCC and enhances the quality of care for chronically ill children. Investing in nurses' attributes and a positive work environment is crucial for nursing leaders to enhance CFCC practice and the quality of care. PRACTICAL IMPLICATIONS The findings of this study can be used to shape policies and develop interventions to improve nursing CFCC practices and promote better quality of care for chronically ill children.
Collapse
Affiliation(s)
- Nada Alqarawi
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Eman Alhalal
- Community and mental health nursing, Nursing college, King Saud University Riyadh, Saudi Arabia
| |
Collapse
|
2
|
Phiri PGMC, Chan CWH, Wong CL, Cheung AT, Shah S, Daradkeh FAK. The moderating effects of nurses' background characteristics on the relationship between family-centred care perception and practice for hospitalized children and their families in Malawi. J Pediatr Nurs 2023; 73:169-176. [PMID: 37696168 DOI: 10.1016/j.pedn.2023.09.004] [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] [Received: 03/20/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE Globally, limited information is available on the relationship between the perception and practice of family-centered care (FCC), and the moderating effects of nurses' background characteristics on this relationship. This study investigated the relationship between FCC perception and FCC practice and the moderating effects of the nurses' background characteristics on this relationship. DESIGN AND METHODS A cross-sectional study was conducted using a two-stage stratified sampling method. Data were collected from 444 nurses using the Family Centered Care Questionnaire-Revised and analyzed using IBM SPSS Version 25. The Hayes PROCESS macro model, version 3, was integrated into SPSS to examine the moderating effects at a significance level of 0.05. RESULTS The response rate was 98%, and a statistically significant positive association was found between FCC perception and FCC practice (r = 0.353, p < .001). Gender of a nurse (ΔR2 = 0.0206, p < .002), having children (ΔR2 = 0.0231, p < .001), experience (ΔR2 = 0.0107, p = .028), and working in a medical-surgical ward (ΔR2 = 0.0208, p = .008) had a statistically significant moderating effect on the relationship between FCC perception and FCC practice. CONCLUSION These findings provide minimal evidence of the existence of non-modifiable moderators of FCC. Future studies with modifiable moderators are therefore needed. PRACTICE IMPLICATIONS Understanding the moderating effects of nurses' background characteristics on the relationship between FCC perception and FCC practice may facilitate the development of FCC interventions that favor these background characteristics and facilitate the integration of FCC into routine policies and practices.
Collapse
Affiliation(s)
- Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Ankie T Cheung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Suleman Shah
- Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates
| | - Fares Ahmad Khalil Daradkeh
- Institute of Applied Technology, Fatima College of Health Sciences, P.O. Box 24162, Al Maqam, Al Ain, Abu Dhabi, United Arab Emirates
| |
Collapse
|
3
|
Vázquez-Sánchez MÁ, Casals-Vázquez A, López-Leiva I, Sánchez-Ojeda MA, Río-Urenda SD, Navarro-Prado S, García-Gámez M, Casals C. Cultural adaptation and validation of the Family Nursing Practice Scale (FNPS) for use with Spanish-speaking Nursing Degree students. Nurse Educ Pract 2023; 72:103756. [PMID: 37625362 DOI: 10.1016/j.nepr.2023.103756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/13/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023]
Abstract
AIM The task proposed was to conduct a cultural adaptation of the Family Nursing Practice Scale and to assess the psychometric properties of the resulting instrument. BACKGROUND Nursing students must obtain sufficient personal competence and confidence to act with patients and their families. For this purpose, an assessment scale is needed to inform teachers of the student's progress and to determine whether further training or changes in teaching methods are required. DESIGN A cross-sectional study design was used. METHODS The researchers conducted this study with 202 students of nursing at two Spanish universities. In the cultural adaptation, the following steps were followed: definition of concepts, translation, back translation, expert group review and implementation by a pilot group with a subsequent cognitive interview. Internal consistency was determined by Cronbach's alpha. Reliability was verified by an initial application of the scale, followed by a repetition after seven days, analysing the results obtained in terms of the intraclass correlation coefficient, the construct validity (by Spearman's non-parametric correlation test) and confirmatory factor analysis (using JASP 0.16.4 statistical software). RESULTS Cronbach's alpha resulted in 0.95. Spearman's correlation coefficient Family Nursing Practice Scale total with the course year was -0.26 < 0.001. The intraclass correlation coefficient for the total score of the scale was 0.91. The confirmatory factor analysis was performed on a model in which the total score for the scale was considered in relation to the two subscales, and each subscale in relation to its constituent items. The p-value associated with the chi-square was 0.550. The root mean square error of approximation and comparative fit indices presented values of <0.001 (90 % C.I. <0.001-0.048) and 1.000, respectively. CONCLUSIONS These results indicate that the Spanish version presents good internal consistency, construct validity and reliability. Moreover, the confirmatory factor analysis confirms that it presents a good fit to the model initially proposed for this scale for Nursing Degree students.
Collapse
Affiliation(s)
| | | | - Inmaculada López-Leiva
- Faculty of Health Sciences, Department of Nursing, University of Málaga, Malaga, Andalucía 29071, Spain
| | | | - Susana Del Río-Urenda
- Faculty of Health Sciences, Department of Nursing, University of Málaga, Malaga, Andalucía 29071, Spain
| | - Silvia Navarro-Prado
- Faculty of Health Sciences, Department of Nursing, Melilla Campus, University of Granada, Melilla 52005, Spain
| | - Marina García-Gámez
- Faculty of Health Sciences, Department of Nursing, University of Málaga, Malaga, Andalucía 29071, Spain
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Puerto Real 11519, Spain
| |
Collapse
|
4
|
Han J, Oh WO, Heo Y, Kim S. Psychometric Validation of the Korean Version of the Family-Centered Care Questionnaire-Revised. J Nurs Meas 2023; 31:347-359. [PMID: 37558256 DOI: 10.1891/jnm-2021-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Background and Purpose: Family-centered care (FCC) is a philosophy of care that applies to all areas of pediatric nursing and is a key component of the care model for patient safety and management activities in the medical environment of hospitalized children. The aim of this study was to translate and evaluate the psychometric properties of the Korean version of the Family-Centered Care Questionnaire-Revised (FCCQ-R). Methods: A total of 239 questionnaires were completed by pediatric nurses at four consenting general hospitals. Results: Fourteen items were removed from the original questionnaire through exploratory factor analysis and nine subscales were reduced to five. The factor loadings of the 30 items on the five subscales ranged from 0.50-0.80. The model of the Korean version of the questionnaire was validated by an exploratory and confirmatory factor analysis. Reliability analysis for internal consistency showed an acceptable to high Cronbach's α of 0.96 in total and the subscales ranged from 0.59-0.92. Conclusions: This study verified the validity and reliability of the tool to measure the perception of FCC. Future research will need to correlate FCC with more relevant measures, such as the nurse-parent partnership measure tool, to confirm predictive and concurrent validity. The Korean version of the FCCQ-R of 30 questions on five subscales is a valid and reliable measurement of Korean nurses' perceptions of FCC.
Collapse
Affiliation(s)
- Jihee Han
- College of Nursing, Korea University, Seongbuk-gu, Seoul, South Korea
| | - Won-Oak Oh
- College of Nursing, Korea University, Seongbuk-gu, Seoul, South Korea
| | - YooJin Heo
- College of Nursing, Korea University, Seongbuk-gu, Seoul, South Korea
| | - Sunho Kim
- Department of Nursing, U1 University, Yeongdong-gun, Chugbuk, South Korea
| |
Collapse
|
5
|
McDonald R, Moloney W. Improving the Implementation of Family-Centered Care Within the Neonatal Care Unit: Empowering Parents to Participate in Infant Care. J Perinat Neonatal Nurs 2023; 37:242-251. [PMID: 37494692 DOI: 10.1097/jpn.0000000000000738] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Internationally, approximately 15 million babies are born prematurely every year. In New Zealand, 1 neonatal ward may care for 1000 infants annually. Family-centered care (FCC) is a philosophy used in neonates to enhance positive outcomes for infants, parents, and staff by recognizing the strengths and needs of infants and their families. OBJECTIVE This research assessed how a neonatal environment could be improved to ensure parents feel welcomed and empowered to participate in their infant's care. PARTICIPANTS Survey data from 67 health professionals and 51 parents of infants who received neonatal care for more than 7 days. Four in-depth interviews with parents and 5 with health professionals. METHODS A mixed-methods research design was used. Phase 1 collected quantitative data using the Family-Centered Care Questionnaire. Phase 2 composed of face-to-face interviews with health professionals and parents. RESULTS Implementing FCC practices to improve health outcomes for infants, parents, and staff is important. Recommendations for improvement were formulated from the themes. CONCLUSION The perspectives of parents and health professionals have enabled the development of recommendations to improve the implementation of FCC practice in the neonatal environment. These may lead to better parental experience and improved infant health outcomes.
Collapse
Affiliation(s)
- Rebecca McDonald
- Kidz First Neonatal Care, Middlemore Hospital, Auckland, New Zealand (Ms McDonald); and University of Auckland, Auckland, New Zealand (Dr Moloney)
| | | |
Collapse
|
6
|
Franck LS, Axelin A, Van Veenendaal NR, Bacchini F. Improving Neonatal Intensive Care Unit Quality and Safety with Family-Centered Care. Clin Perinatol 2023; 50:449-472. [PMID: 37201991 DOI: 10.1016/j.clp.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
There is strong evidence that family-centered care (FCC) improves the health and safety of infants and families in neonatal settings. In this review, we highlight the importance of common, evidence-based quality improvement (QI) methodology applied to FCC and the imperative to engage in partnership with neonatal intensive care unit (NICU) families. To further optimize NICU care, families should be included as essential team members in all NICU QI activities, not only FCC QI activities. Recommendations are provided for building inclusive FCC QI teams, assessing FCC, creating culture change, supporting health-care practitioners and working with parent-led organizations.
Collapse
Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA 94143, USA.
| | - Anna Axelin
- Department of Nursing Science, University of Turku, 20014 University of Turku, Finland. https://twitter.com/AnnaAxelin
| | - Nicole R Van Veenendaal
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. https://twitter.com/nicolevan_vee
| | - Fabiana Bacchini
- Canadian Premature Babies Foundation, 4225-B Dundas Street West, Etobicoke, ON M8X 1Y3, Canada. https://twitter.com/fabianabacchini
| |
Collapse
|
7
|
Winkelmann ZK, Uriegas NA, Mensch JM, Montgomery CE, Torres-McGehee TM. Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4942. [PMID: 36981852 PMCID: PMC10049324 DOI: 10.3390/ijerph20064942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Family-centered care (FCC) includes collaboration between families and healthcare providers, the creation of flexible policies, and the family taking an active role in the delivery of care. Secondary school athletic trainers provide care for underage patients in school-based health systems, making them responsible for maintaining communication with parents, guardians, and/or caregivers. This cross-sectional survey investigated the extent to which athletic trainers (n = 205) include aspects of FCC in their daily secondary school clinical practice (current practices = CP) and whether they believe that aspect of care is necessary for FCC to be provided in athletic training (perceived necessary = PN) in their everyday practice using the Family-Centered Care Questionnaire-Revised tool. The total mean score for the CP scale (mean = 26.83 ± 4.36) was significantly lower (p ≤ 0.01) than the PN scale (mean = 35.33 ± 4.17). All FCC subscales compared between CP and PN were significantly different (p ≤ 0.01), with each being of higher importance than CP in athletic training. Data analysis revealed four themes related to enhancing FCC in secondary schools: limited education and resources, staffing and space concerns, non-technical skills, and social determinants of health. Attention should be placed on developing resources and interventions for secondary school athletic trainers to collaboratively work with children and their support systems.
Collapse
Affiliation(s)
- Zachary K. Winkelmann
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Nancy A. Uriegas
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - James M. Mensch
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | | | | |
Collapse
|
8
|
Implementation and Practice Barriers of Family-Centered Care Encountered by Neonatal Nurses. Adv Neonatal Care 2022; 22:432-443. [PMID: 34596093 DOI: 10.1097/anc.0000000000000948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Approximately 7 out of every 100 births in the United States result in admission to the neonatal intensive care unit (NICU), which contributes to a delay in initial physical contact between the parents and their newborn. While family-centered care (FCC) increases opportunities for parent-infant connection, implementation barriers persist in clinical practice. Research has yet to examine whether organizational and nursing factors of empowerment and compassion fatigue (CF) in the NICU are associated with FCC practice. PURPOSE The aim of this study was to determine the relationship between empowerment, CF, and FCC practices among NICU nurses. METHODS This quantitative portion of a mixed-methods study used a cross-sectional, descriptive correlational design. Bedside NICU nurses with at least 6-month experience were recruited to complete an anonymous online survey using established, valid, and reliable instruments. RESULTS Except for organizations with Magnet status, there were no significant differences in FCC practice within individual and institutional characteristics. Hierarchical linear regression model indicated nurse empowerment was a strong predictor of FCC practice (β= 0.31, R2 = 0.35, P < .001). There was only a weak, inverse association between CF and FCC practices ( r =-0.199, P < .001). IMPLICATION FOR RESEARCH AND PRACTICE Further qualitative research will integrate these findings to understand the process by which neonatal nurses engage in FCC practices in the context of NICU setting. Future studies should examine facilitators and barriers of FCC practice in the NICU. Strategies (eg, policies and trainings) to increase nurse empowerment and support for FCC implementation should be developed and evaluated.
Collapse
|
9
|
Dall’Oglio I, Mascolo R, Portanova A, Ragni A, Amadio P, Fiori M, Tofani M, Gawronski O, Piga S, Rocco G, Tiozzo E, Latour JM. Staff Perceptions of Family-Centered Care in Italian Neonatal Intensive Care Units: A Multicenter Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091401. [PMID: 36138710 PMCID: PMC9498145 DOI: 10.3390/children9091401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022]
Abstract
Family Centered Care (FCC) in Neonatal Intensive Care Units (NICUs) included family involvement in the care process of newborns and infants. Staff perceptions of FCC may influence clinical practice and management strategies in NICUs, with an impact on quality and humanization of the care. The Family-Centred Care Questionnaire-Revised (FCCQ-R) was adapted for the NICU setting, therefore the FCCQ-R@it-NICU was developed and used for the present study in 32 Italian NICUs. We calculated internal consistency using Cronbach’s alpha correlation between Current and Necessary dimensions of the scale using the Pearson correlation coefficient. Furthermore, we investigated which characteristics could influence staff perceptions of FCC in NICUs. 921 NICU professionals participated in the study. The FCCQ-R@it-NICU revealed good internal consistency (0.96) and good correlation between dimensions (p < 0.05). Statistical and significant differences in Current and Necessary dimensions were found and some demographic characteristics were found predictable on FCC practice. The FCCQ-R@it-NICU is a valid tool to investigate staff perceptions about FCC in NICU settings. Profession, education level and work experience seem to positively influence the perception of what is required for FCC practice within NICUs.
Collapse
Affiliation(s)
- Immacolata Dall’Oglio
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
- Correspondence:
| | - Rachele Mascolo
- Semi-Intensive Care Area/Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Anna Portanova
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Angela Ragni
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Patrizia Amadio
- Neonatal Surgery Unit, Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Martina Fiori
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Marco Tofani
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Simone Piga
- Unit of Epidemiology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship of Nursing Professional Order, Rome Nursing College, 00146 Rome, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Jos M. Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, WA 6102 Perth, Australia
| | | |
Collapse
|
10
|
Buek KW, O'Neil M, Mandell DJ. Opportunities and challenges for family-centered postpartum care during the COVID-19 pandemic: a qualitative study of nurse perspectives. BMC Nurs 2022; 21:99. [PMID: 35473562 PMCID: PMC9042661 DOI: 10.1186/s12912-022-00875-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background The global COVID-19 pandemic has forced the health care sector to make wide-ranging changes to protect patients as well as providers from the risk of infection. Many of these changes are likely to have greatest impact in contexts of care that employ family-centered care (FCC) models, including perinatal and maternity care. Research conducted in perinatal care settings during the pandemic has shown that some of these restrictions have negatively impacted patient and family experiences and outcomes, while others have been perceived as beneficial. The present qualitative study aimed to understand what changes have occurred in postpartum nursing practice during the pandemic, and how these changes have affected nurses, women and families during their stay in the hospital following a new birth. Methods Structured interviews were completed with 20 postpartum nurses from five hospitals across Texas. The interview protocol was designed to elicit information about changes to hospital policies in postpartum units during the pandemic, nurses’ attitudes about these changes, perceived benefits and challenges for performance of their duties, and perceived effects on patients and their families. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by video conference using Zoom and lasted approximately 30 to 45 min. Data were analyzed using a qualitative descriptive approach. Results Participants reported that their hospitals placed restrictions on the number and mobility of support persons allowed to stay with the mother in the unit and prohibited all other visitation. Some challenges of these policies included reduced opportunities for hands-on learning and an increased number of patients opting for early discharge. Perceived benefits for patient education and outcomes included improved frequency and effectiveness of nurse-family communication, increased father involvement, and greater opportunities for maternal rest, breastfeeding, skin-to-skin care and family bonding. Conclusions Study findings suggest that some limitations on postpartum hospital visitation may achieve important, family-centered goals. Protected time for family-bonding, maternal rest, breastfeeding, father involvement and individualized education are critical to quality FCC. Research must examine which visitation policies maximize these benefits while preserving patient access to family and social support.
Collapse
Affiliation(s)
- Katharine W Buek
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA.
| | - Molly O'Neil
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA
| | - Dorothy J Mandell
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA
| |
Collapse
|
11
|
Handley SC, Passarella M, Martin AE, Lorch SA, Srinivas SK, Nembhard IM. Development and Testing of a Survey Measure of Organizational Perinatal
Patient‐Centered
Care Culture. Health Serv Res 2022; 57:806-819. [PMID: 35128641 PMCID: PMC9264452 DOI: 10.1111/1475-6773.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To develop and test a measure of patient-centered care (PCC) culture in hospital-based perinatal care. DATA SOURCES Data were obtained from US perinatal hospitals: one provided survey development data and 14 contributed data for survey testing. STUDY DESIGN We used qualitative and quantitative methods to develop the mother-infant centered care (MICC) culture survey. Qualitative methods included observation, focus group, interviews, and expert consultations to adapt items from other settings and create new items capturing dimensions of PCC articulated by The Commonwealth Fund. We quantitatively assessed survey psychometric properties using reliability (Cronbach's α and Pearson correlation coefficients) and validity (exploratory and confirmatory factor analysis [CFA]) statistics, and refined the survey. After confirming aggregation suitability (ICCs), we calculated "MICC culture scores" at the individual, unit, and hospital level and assessed associations between scores and survey-collected, staff-reported outcomes to evaluate concurrent validity. DATA COLLECTION Survey development included 12 site-visit observations, one semi-structured focus group (five participants), two semi-structured interviews, five cognitive interviews, and three expert consultations. Survey testing used online surveys administered to obstetric and neonatal unit staff (N = 316). PRINCIPAL FINDINGS Using responses from 10 hospitals with ≥4 responses from both units (n = 240), the 20-item MICC culture survey demonstrated reliability (Cronbach's α = 0.95) while capturing all PCC dimensions (subscale Cronbach's α = 0.72-0.87). CFA showed validity through goodness-of-fit (overall chi-square = 214 [p-value = 0.012], SRMR = 0.056, RMSEA = 0.041, CFI = 0.97, and TLI = 0.96). Aggregation statistics (ICCs < 0.05) justify unit- and hospital-level aggregation. Demonstrating preliminary validity, individual-, unit-, and hospital-level MICC culture scores were associated with all outcomes (satisfaction with care provided, within-unit team effectiveness, and relational coordination [RC] between units) (p-values < 0.05), except for neonatal unit scores and RC (p-value = 0.11). CONCLUSIONS The MICC culture survey is a psychometrically sound measure of PCC culture for hospital-based perinatal care. Survey scores are associated with staff-reported outcomes. Future studies with patient outcomes will aid identification of improvement opportunities in perinatal care.
Collapse
Affiliation(s)
- Sara C. Handley
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
| | - Molly Passarella
- Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia PA
| | - Ashley E. Martin
- Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia PA
| | - Scott A. Lorch
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
| | - Sindhu K. Srinivas
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
- Department of Obstetrics and Gynecology Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
| | - Ingrid M. Nembhard
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
- The Wharton School University of Pennsylvania Philadelphia PA
| |
Collapse
|
12
|
Improving Family-Centered Care for Infants in Neonatal Intensive Care Units: Recommendations From Frontline Healthcare Professionals. Adv Neonatal Care 2022; 22:79-86. [PMID: 33993155 DOI: 10.1097/anc.0000000000000854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely. PURPOSE The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care. METHODS Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents. RESULTS Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff-parent communications. IMPLICATIONS FOR PRACTICE The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement. IMPLICATIONS FOR RESEARCH Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.
Collapse
|
13
|
Uuksulainen M, Rajala M, Kanste O, Pölkki T. Translation and cultural adaptation of the Family Centered Care Assessment Scale (FCCAS) for Finnish pediatric nursing. J Pediatr Nurs 2022; 62:51-59. [PMID: 34801323 DOI: 10.1016/j.pedn.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to translate and culturally adapt the Family Centered Care Assessment Scale (FCCAS) to evaluate family-centered care in the context of Finnish pediatric nursing. DESIGN AND METHODS The translation and cultural adaptation were done according guidelines of International Society for Pharmacoeconomics and Outcomes (ISPOR), which constitute a systematic process including ten phases. The presented research included cognitive interviews conducted with the end user of the scale: parents of hospitalized children. RESULTS The FCCAS was successfully translated and culturally adapted to the Finnish context. Translational, clinical and parental expertise were used to develop the scale. Conceptual equivalence was achieved in the translation. In the cultural adaptation, some of the items were modified based on experts' assessments to make them comprehensible and appropriate to the Finnish culture. The scale showed good evidence of content. Reporting of the study adheres to the COSMIN checklist. CONCLUSIONS Combining ISPOR guidelines and cognitive interviews are recommended to use in the translation and cultural adaptation process. Nursing staff and parents' involvement and awareness of family-centered care have been concretized. Systematic translation and cultural adaptation have prepared a Finnish version of the scale for psychometric testing. PRACTICE IMPLICATIONS The study outlines how rigorous methodological approaches can be applied to the translation and cultural adaptation of a measurement tool. The developed scale includes items which comprehensively cover family-centered care characteristics. In following study, it will be possible to evaluate the extent to which family-centered care is implemented in Finnish pediatric nursing.
Collapse
Affiliation(s)
- Minttu Uuksulainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Mira Rajala
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Outi Kanste
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Tarja Pölkki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
14
|
Phiri PGMC, Chan CWH, Wong CL, Choi KC, Ng MSN. Discrepancies between nurses' current and perceived necessary practices of family-centred care for hospitalised children and their families: A cross-sectional study. J Pediatr Nurs 2022; 62:e25-e31. [PMID: 34229915 DOI: 10.1016/j.pedn.2021.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/04/2021] [Accepted: 06/27/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE This study investigated (1) the discrepancies between the nurses' current and perceived necessary practices of family-centred care (FCC), and (2) the nurses' demographic characteristics associated with current and perceived necessary practices of FCC for hospitalised children and their families in Malawi. DESIGN AND METHODS A cross-sectional study involving 444 nurses was conducted. The Family-Centred Care Questionnaire-Revised was used to examine the discrepancies between the nurses' current and perceived necessary practices of FCC. Univariate and multivariate statistical analyses were performed to identify the nurses' demographic characteristics associated with current and perceived necessary practices of FCC. RESULTS The total mean score of the nurses' current practices of FCC (M = 34.78, SD = 7.06) was significantly lower than that of the nurses' practices of FCC that were perceived as necessary (M = 38.63, SD = 5.60, p < 0.001). The nurses who were over 40 years of age (regression coefficient, β = 9.162, p = 0.014), had a postgraduate qualification (β = 23.314, p < 0.001), were separated or widowed (β = 9.661, p = 0.029), had a Tumbuka cultural background (β = 12.984, p < 0.001), were Seventh-day Adventist members (β = 8.863, p = 0.026), and worked in mission hospitals (β = 16.401, p = 0.021) were more likely to implement current practices of FCC. Conversely, the nurses who were members of the Moslem, Buddhist, or Hindi religious denomination (β = 6.587, p = 0.040), had a Tonga or Ngonde cultural background (β = 6.625, p = 0.046), and were nurse midwife technicians (β = -23.528, p = 0.012) were more likely to implement practices of FCC that they perceived as necessary. CONCLUSION Significant differences between the nurses' current and perceived necessary practices of FCC suggested that there were barriers to implementing necessary practices of FCC. The nurses' cultural and religious backgrounds were predictors of current practices of FCC, and this finding could direct the future development and testing of FCC interventions in Malawi. PRACTICE IMPLICATIONS Continued educational activities and research on the factors that contributed to the discrepancies between the nurses' current and perceived necessary practices of FCC and their impact on FCC in Malawi are critical.
Collapse
Affiliation(s)
- Patrick G M C Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| | - Marques S N Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong Special Administrative Region
| |
Collapse
|
15
|
A Multisite Survey of NICU Healthcare Professionals' Perceptions About Family-Centered Care. Adv Neonatal Care 2021; 21:205-213. [PMID: 33417328 DOI: 10.1097/anc.0000000000000805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Family-centered care contributes to improved outcomes for preterm and ill infants. Little is known about the perceptions of neonatal intensive care unit (NICU) healthcare professionals regarding the degree to which their NICU practices or values family-centered care. PURPOSE The aims of this study were to describe attitudes and beliefs of NICU healthcare professionals about family-centered care and to explore professional characteristics that might influence those views. METHODS Data were derived from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care with mobile-enhanced family-integrated care. Neonatal intensive care unit healthcare professionals completed the Family-Centered Care Questionnaire-Revised (FCCQ-R), a 45-item measure of 9 core dimensions of Current Practice and Necessary Practice for family-centered care. RESULTS A total of 382 (43%) NICU healthcare professionals from 6 NICUs completed 1 or more of the FCCQ-R subscales, 83% were registered nurses. Total and subscale scores on the Necessary Practice scale were consistently higher than those on the Current Practice scale for all dimensions of family-centered care (mean: 4.40 [0.46] vs 3.61 [0.53], P < .001). Only years of hospital experience and NICU site were significantly associated with Current Practice and Necessary Practice total scores. IMPLICATIONS FOR PRACTICE Ongoing assessment of the perceptions of NICU healthcare professionals regarding their current practice and beliefs about what is necessary for the delivery of high-quality family-centered care can inform NICU education, quality improvement, and maintenance of family-centered care during the COVID-19 pandemic. IMPLICATIONS FOR RESEARCH Further research is needed to identify additional factors that predict family-centered care perceptions and behaviors.
Collapse
|
16
|
Handley SC, Bell S, Nembhard IM. A Systematic Review of Surveys for Measuring Patient-centered Care in the Hospital Setting. Med Care 2021; 59:228-237. [PMID: 33229897 PMCID: PMC7878319 DOI: 10.1097/mlr.0000000000001474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient-centered care (PCC) is a core component of quality care and its measurement is fundamental for research and improvement efforts. However, an inventory of surveys for measuring PCC in hospitals, a core care setting, is not available. OBJECTIVE To identify surveys for assessing PCC in hospitals, assess PCC dimensions that they capture, report their psychometric properties, and evaluate applicability to individual and/or dyadic (eg, mother-infant pairs in pregnancy) patients. RESEARCH DESIGN We conducted a systematic review of articles published before January 2019 available on PubMed, Web of Science, and EBSCO Host and references of extracted papers to identify surveys used to measure "patient-centered care" or "family-centered care." Surveys used in hospitals and capturing at least 3 dimensions of PCC, as articulated by the Picker Institute, were included and reviewed in full. Surveys' descriptions, subscales, PCC dimensions, psychometric properties, and applicability to individual and dyadic patients were assessed. RESULTS Thirteen of 614 articles met inclusion criteria. Nine surveys were identified, which were designed to obtain assessments from patients/families (n=5), hospital staff (n=2), and both patients/families and hospital staff (n=2). No survey captured all 8 Picker dimensions of PCC [median=6 (range, 5-7)]. Psychometric properties were reported infrequently. All surveys applied to individual patients, none to dyadic patients. CONCLUSIONS Multiple surveys for measuring PCC in hospitals are available. Opportunities exist to improve survey comprehensiveness regarding dimensions of PCC, reporting of psychometric properties, and development of measures to capture PCC for dyadic patients.
Collapse
Affiliation(s)
- Sara C. Handley
- Division of Neonatology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Sydney Bell
- The Wharton School, University of Pennsylvania, Philadelphia, PA
| | - Ingrid M. Nembhard
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- The Wharton School, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
17
|
Xiang X, Xia S, Zhu X, Gao X, Gao X, Zhang A, Lee SK, Hei M. Attitudes and concerns of neonatologists and nurses to family-integrated-care in neonatal intensive care units in China. Transl Pediatr 2020; 9:603-609. [PMID: 33209722 PMCID: PMC7658773 DOI: 10.21037/tp-20-60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Parents in China are denied visitation of their newborns in neonatal intensive care unit (NICU), leading to a prolonged period of parent-infant separation. The family-integrated care (FICare) model, which supports the integration of parents into the NICU team, is gradually being introduced in China. Considering resistance to the implementation of FICare, this study aimed to assess the attitudes and concerns of neonatologists and nurses towards FICare in China. METHODS Using a before and after study design, a qualitative analysis was conducted to determine the perceptions and attitudes of medical professionals towards FICare in China. A total of 34 neonatologists and 94 nurses from 5 tertiary NICUs in China were enrolled. A self-developed questionnaire was used. The study steps included reading session and then survey for the first time (survey 1), a FICare getting buy-in education session (4 hours), a group discussion session, and finally repeat the questionnaire (survey 2). The surveys were completed by trained researchers regarding willingness, acceptance and concerns of implementing FICare in NICUs in China. Differences in attitudes towards FICare were compared between groups (Chi-square/correction for continuity). RESULTS There are positive responses in neonatologists and nurses regarding the necessity (Survey 1: 58.8% and 57.4%; Survey 2: 88.2% and 67.0%), feasibility (Survey 1: 17.6% and 19.1%; Survey 2: 32.3% and 34.0%), and interest in joining FICare (Survey 1: 82.4% and 83.0%; Survey 2: 97.1% and 85.1%). A higher proportion of neonatologists indicated that FICare could promote breastfeeding in the NICU comparing to nurses (Survey 1: 47.1% vs. 19.1%; Survey 2: 61.8% and 46.8% respectively). Most of the neonatologists and nurses are not sure whether FICare can shorten the hospital stay (Survey 1: 82.3% and 68.1%; Survey 2: 85.3% and 60.6%) or improve the doctor-patient relationship (Survey 1: 58.8% and 68.1%; Survey 2: 73.5% and 69.1%). Challenges concerning the implementation of FICare were identified as inadequate ward space, lack of human resources, and potential increases in nosocomial infection. CONCLUSIONS The getting buy-in education program in introducing new paradigms of neonatal care may help on how to design and implement more effective educational tools for FICare.
Collapse
Affiliation(s)
- Xiying Xiang
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Child Health, Beijing, China
| | - Shiwen Xia
- Department of Neonatology, Hubei Province Women and Children Hospital, Wuhan, China
| | - Xing Zhu
- Department of Pediatrics, the Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyu Gao
- Department of Pediatrics, Southeast University Affiliated Xuzhou Hospital, Xuzhou, China
| | - Xirong Gao
- Department of Neonatology, Hunan Children's Hospital, Changsha, China
| | - Aiming Zhang
- Department of Pediatrics, Hunan Provincial People's Hospital, Changsha, China
| | - Shoo K Lee
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Mingyan Hei
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Child Health, Beijing, China
| |
Collapse
|
18
|
Alabdulaziz H, Cruz JP. Perceptions of female Saudi undergraduate nursing students toward family-centered care. NURSE EDUCATION TODAY 2020; 89:104421. [PMID: 32311632 DOI: 10.1016/j.nedt.2020.104421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/02/2020] [Accepted: 03/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND While family-centered care is considered a vital part of nursing care, nursing students seem to struggle in incorporating family-centered care in the clinical setting. Several factors such as minimal exposure in family interactions throughout their clinical practice, lack of experience in organizing family-centered clinical experiences, access to restricted clinical areas, and inadequate supervision from clinical instructors present as challenges among nursing students in practicing family-centered care. OBJECTIVES This study explored the perceptions of nursing students toward family-centered care in Saudi Arabia. DESIGN This study used the quantitative approach through the cross-sectional survey method. SETTINGS The study was conducted in the Faculty of Nursing of a government university in Saudi Arabia. PARTICIPANTS A total population sample comprising 232 female junior and student nurses participated in the study. METHODS After the approval of the Ethical Board Committee had been secured, a survey containing a demographic information sheet and the Family-Centered Care Questionnaire was distributed to the students from June 2018 to February 2019. RESULTS The overall mean of the students' responses in the questionnaire was 3.76 (SD = 0.67, range = 3.40-4.08), indicating a modest perception toward family-centered care. The dimension "family is the constant" received the most positive response from the students (M = 3.90, SD = 0.77), whereas the dimension "parent-to-parent support" was rated the lowest with a mean of 3.64 (SD = 0.89). Junior nursing students had more positive perception toward family-centered care than the seniors. Weak negative correlations were observed between students' age and family-centered care perception. CONCLUSIONS This study provides insights into family-centered care, which could be used in crafting policies and interventions in various health care settings and nursing education in Saudi Arabia. Such insights could foster positive perceptions toward family-centered care among student nurses and guarantee excellent family-centered care nursing practice.
Collapse
Affiliation(s)
- Hawa Alabdulaziz
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Jonas Preposi Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawdmi, Saudi Arabia.
| |
Collapse
|
19
|
Prasopkittikun T, Srichantaranit A, Chunyasing S. Thai nurses' perceptions and practices of family-centered care: The implementation gap. Int J Nurs Sci 2020; 7:74-80. [PMID: 32099863 PMCID: PMC7031120 DOI: 10.1016/j.ijnss.2019.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/28/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses. Methods This mixed-methods study consisted of two phases. In the first phase, a descriptive comparative design using the Family-Centered Care Questionnaire - Revised (FCCQ-R) was administered to 142 pediatric nurses from a university hospital in Bangkok, Thailand. In the second phase, qualitative interviews were conducted with 16 pediatric nurses to gather complementary information regarding the major findings from the first phase. Results The results revealed that family strengths and individuality were rated the highest as the most important elements and the most frequent practices. Parent/professional collaboration was perceived as the least important element, while the design of the heath care delivery system was rated as the least frequent practice. The qualitative data revealed that the major reasons for suboptimal implementation included a common perception that family-centered care is a Western concept, nurses' weak attitudes towards their roles, and a shortage of nurses. Conclusions Nurses agreed that the identified elements of family-centered care were necessary but that they did not incorporate the concepts into their daily nursing practice to maintain their endorsement of the family-centered care model. Further study is needed to explore how family-centered care is understood and operationalized by Thai nurses and how hospital administration and environments can be modified to support this care model.
Collapse
Affiliation(s)
| | | | - Sirisopa Chunyasing
- Department of Nursing Siriraj Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
20
|
Huizing MJ, Villamor-Martínez E, Meus S, de Jonge FM, Villamor E. Dutch Neonatal Intensive Care Nurses' Perceptions of Pulse Oximeter Saturation Target Limits for Preterm Infants. J Pediatr Nurs 2019; 49:e36-e41. [PMID: 31439356 DOI: 10.1016/j.pedn.2019.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To conduct a national survey to assess practice, knowledge, barriers, and perceptions regarding oxygen saturation (SpO2) target limits among Dutch neonatal intensive care unit (NICU) nurses. DESIGN AND METHODS Cross-sectional, web-based survey among 667 nurses from 9 level 3 Dutch NICUs. Part of the questions were based on a clinical scenario (28-weeks preterm infant, treated with CPAP, FiO2 0.4). RESULTS 328 (53.6%) nurses responded to the survey. Of these, 281 (85.7%) reported to know the local policy of SpO2 target limits, and 261 (79.6%) and 244 (74.4%) rightly identified the lower and upper limit, respectively. Six NICUs recently increased their lower SpO2 limit and for 62.0% of their nurses this led to a significant alarm increase. For the majority of the respondents, the baby from the clinical scenario would spend <10% of the time outside the lower or upper SpO2 limits. Automated oxygen control systems were considered a good idea by 59.2% of the respondents, but 53.9% considered allowing parents to participate in FiO2 titration a bad or very bad idea. CONCLUSIONS: The majority of the respondents identified their unit's policy-specified SpO2 target limits and reported that the increase in SpO2 target limits may have led to more alarms. Titration of FiO2 is a part of care that respondents were reluctant to share with parents. PRACTICE IMPLICATIONS A potential increase in the number of SpO2 alarms may lead to alarm fatigue. Although family-centered care philosophy is widely accepted across Dutch NICUs, there are still barriers to overcome.
Collapse
Affiliation(s)
- Maurice J Huizing
- Department of Pediatrics, Neonatal Intensive Care Unit, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Eduardo Villamor-Martínez
- School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - Stefanie Meus
- Department of Pediatrics, Neonatal Intensive Care Unit, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Fred M de Jonge
- Department of Pediatrics, Neonatal Intensive Care Unit, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Eduardo Villamor
- Department of Pediatrics, Neonatal Intensive Care Unit, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.
| |
Collapse
|
21
|
The Family-Centered Care Assessment Scale: Development and Psychometric Evaluation in a Turkish Sample. J Pediatr Nurs 2019; 48:e35-e41. [PMID: 31262604 DOI: 10.1016/j.pedn.2019.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose of this study was to develop a family-centered care assessment scale for the parents of hospitalized children and to evaluate the psychometric characteristics of the new scale. METHOD This is a methodological study carried out in three phases. The study was conducted between on September 2017 and February 2018 with the parents of 360 children treated at the pediatric clinics of two medical faculty hospitals in Konya. DESIGN/METHODS The study was conducted with parents (n = 360). The data was collected via the Socio-demographic Information Form, the Family-Centered Care Scale (parallel form) and the draft scale developed by the researcher. Data was analyzed by construct validity index, exploratory and confirmatory factor analyses. End of the exploratory factor analysis FCCAS consisted of 21 items and three sub-dimensions. The content validity index was 0.92. The internal consistency coefficient (Cronbach's Alpha) was 0.94 for the total scale. The strong correlations was found between test and re-test (r = 0.90, p < .001). Confirmatory factor analysis has confirmed the three-factor structure. CONCLUSION In this study developed family-centered care assessment scale (FCCAS) is a valid and reliable measurement tool. PRACTICE IMPLICATIONS This scale can be used to evaluate family-centered care in pediatric clinics (excluding neonatal care units). It can be used as a measurement tool in descriptive and intervention studies examining family centered care.
Collapse
|
22
|
Alfaro Díaz C, Esandi Larramendi N, Gutiérrez-Alemán T, Canga-Armayor A. Systematic review of measurement properties of instruments assessing nurses' attitudes towards the importance of involving families in their clinical practice. J Adv Nurs 2019; 75:2299-2312. [PMID: 31099435 DOI: 10.1111/jan.14049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/12/2019] [Accepted: 05/08/2019] [Indexed: 01/05/2023]
Abstract
AIMS To identify, appraise and describe the characteristics and measurement properties of instruments assessing nurses' attitudes towards the importance of involving families in their clinical practice. DESIGN Psychometric systematic review. DATA SOURCES The PubMed, CINAHL, PsycINFO, Web of Science, and Cochrane Library databases were searched from their time of inception to June 2018. REVIEW METHODS Two reviewers independently assessed the eligibility of studies, extracted data, and appraised the methodological quality of the studies using the COSMIN checklist. RESULTS A total of 19 studies representing 5 instruments were included. Two instruments-a revised version of the Families' Importance in Nursing Care: Nurses' Attitudes scale (FINC-NA-R) and the Family Nurse Practice Scale (FNPS)-obtained higher scores for most of their properties. The instruments used in the remaining eight studies require further assessment of their psychometric properties. CONCLUSION This psychometric review offers a synthesis of the quality of the available instruments and gives a better understanding of nursing theory-based tools. The FNPS and FINC-NA-R instruments seem to be the most suitable measures of nurses' attitudes towards the importance of involving families in their clinical practice. IMPACT The growing emphasis on improving nurse-family relationships and the quality of care provided makes it necessary to have valid and reliable instruments for assessing nurses' attitudes towards the importance of involving families in their clinical practice. This paper provides evidence that will help clinicians and researchers make decisions about the most suitable instrument based on a critical appraisal and comparison of the measurement properties according to a rigorous methodology.
Collapse
Affiliation(s)
- Cristina Alfaro Díaz
- School of Nursing, Department of Nursing Care for Adult Patients, University of Navarra, Pamplona, Spain
| | - Nuria Esandi Larramendi
- School of Nursing, Department of Nursing Care for Adult Patients, University of Navarra, Pamplona, Spain.,IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Teresa Gutiérrez-Alemán
- School of Nursing, Department of Nursing Care for Adult Patients, University of Navarra, Pamplona, Spain
| | - Ana Canga-Armayor
- School of Nursing, Department of Nursing Care for Adult Patients, University of Navarra, Pamplona, Spain.,IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| |
Collapse
|
23
|
Dall'Oglio I, Di Furia M, Tiozzo E, Gawronski O, Biagioli V, Di Ciommo VM, Paoletti S, Bianchi N, Celesti L, Raponi M, Antonielli G, Baronio B, Bergami A, Cianchi D, Ciliento G, Vittoria Di Toppa M, Fabbiani A, Fagioli D, Frillici C, Guerrieri S, Lazo J, Madeddu R, Molinari F, Niccolò R, Padrini S, Paolucci F, Pomponi M, Ragni A, Tramutola P, Ventura M. Practices and Perceptions of Family Centered Care among Healthcare Providers: A Cross-sectional Study in a Pediatric Hospital. J Pediatr Nurs 2018; 43:e18-e25. [PMID: 30139704 DOI: 10.1016/j.pedn.2018.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/26/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study aimed to: (1) investigate the extent to which Family Centered Care (FCC) principles are currently applied in clinical practice by healthcare providers working in inpatient units; (2) evaluate the extent to which FCC principles are perceived as necessary; and (3) examine the associations between FCC principles and socio-demographic and job characteristics of participants. Design and Methods A cross-sectional study was conducted at a large pediatric hospital using the Italian version of the FCC Questionnaire Revised (FCCQ-R). Univariate and multivariate analyses were performed. RESULTS Data from 469 healthcare providers were used for analysis. Scores for the FCC daily practices (Current activities) were significantly lower than those for their perceived necessity (Necessary activities) (p < .001). Participants who were male, younger, with work experience >20 years and working in rehabilitation reported a significantly higher perception of Current activities of FCC than others. The older and the more educated the participants, the greater was the perceived necessity of FCC activities. Female, older, and less experienced participants employed by the hospital but not working in the rehabilitation setting perceived a greater gap between Necessary and Current activities of FCC. CONCLUSIONS Scores for the Current and Necessary activities of FCC were lower than those reported in other studies. The lower scores in the Current activities and the significant gap can be due to organizational barriers or lack of skills, but the lower scores in the Necessary activities should be interpreted as a deficit of knowledge about FCC. PRACTICE IMPLICATIONS There is a need for further education about FCC in order to increase its perceived relevance in clinical practice.
Collapse
Affiliation(s)
- Immacolata Dall'Oglio
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Michela Di Furia
- Department of Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Emanuela Tiozzo
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Orsola Gawronski
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Valentina Biagioli
- Nursing and Allied Health Professional Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Vincenzo M Di Ciommo
- Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Silvia Paoletti
- Department of Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Natalia Bianchi
- Nursing and health allied professionals Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Lucia Celesti
- Hospitality and Family Services, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Jung SY. Health Care Providers’ Perceptions of Family-centered Care in Pediatrics. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.4.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
25
|
Abstract
What is family-centred care of a hospitalized child? A critical understanding of the concept of family-centred care is necessary if this widely preferred model is to be differentiated from other health care ideals and properly evaluated as appropriate to the care of hospitalized children. The article identifies distinguishable interpretations of family-centred care that can pull health professionals in different, sometimes conflicting directions. Some of these interpretations are not qualitatively different from robust interpretations of the ideals of parental participation, care-by-parent and partnership in care that are said to be the precursors of family-centred care. A prominent interpretation that regards the child and his or her family collectively as the 'unit of care' arguably arises from ambiguity and is significantly problematic as a model for the care of hospitalized children. Clinical practice driven by this interpretation can include courses of action that do not aim to do what will best promote a hospitalized child's welfare, and such cases will not be unusual. More broadly, this interpretation raises challenging questions about the responsibilities and authority of health professionals in relation to the interests of hospitalized children and their families.
Collapse
Affiliation(s)
- Suzanne Uniacke
- 1 School of Humanities and Social Sciences, Faculty of Arts and Education, Charles Sturt University, Canberra, Australia
| | - Tamara Kayali Browne
- 1 School of Humanities and Social Sciences, Faculty of Arts and Education, Charles Sturt University, Canberra, Australia.,2 School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Linda Shields
- 3 Faculty of Science, Charles Sturt University, Bathurst, New South Wales, Australia.,4 School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
26
|
Khajeh M, Dehghan Nayeri N, Bahramnezhad F, Sadat Hoseini AS. Family centered care of hospitalized children: A hybrid concept analysis in Iran. Health Promot Perspect 2017; 7:210-215. [PMID: 29085798 PMCID: PMC5647356 DOI: 10.15171/hpp.2017.37] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/31/2017] [Indexed: 02/01/2023] Open
Abstract
Background: Family centered care of hospitalized children (FCCHC) is a multidimensional concept, which is directly associated with the context and healthcare system. This study was conducted to analyze the concept of FCCHC in Iran. Methods: This concept analysis was conducted with the use of hybrid model in 3 phases: a literature review in the theoretical phase, semi-structured interviews and descriptive observations in the fieldwork phase, and combination of the results of 2 previous phases in the final analytical phase. Results: The 4 main themes extracted in theoretical phase included "family and healthcare professional participation", "information sharing with families", "family and healthcare professional relationship based on dignity and respect" and "individualized care of family".Moreover, 4 themes were emerged in the fieldwork phase, including "family as a nonparticipant visitor", "one-way education", "non-supportive interactions" and "non-specific care of family". In third phase with combination of the results of 2 phases, the final definition of the concept was presented. Conclusion: FCCHC is a comprehensive care that is affected by human and organizational factors and requires full participation of staff and family, effective interaction with family, education and information sharing with them, and individualized care of each family. By knowing the dimensions of the FCCHC, we will be able to run our activities to provide facilities and features for its optimal implementation in Iran.
Collapse
Affiliation(s)
- Mahboobeh Khajeh
- Department of Pediatric Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Department of Critical Care Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
27
|
|
28
|
Alabdulaziz H, Moss C, Copnell B. Paediatric nurses’ perceptions and practices of family-centred care in Saudi hospitals: A mixed methods study. Int J Nurs Stud 2017; 69:66-77. [DOI: 10.1016/j.ijnurstu.2017.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 10/20/2022]
|
29
|
Concepcion M, Murphy S, Canham D. School Nurses’ Perceptions of Family-Centered Services: Commitment and Challenges. J Sch Nurs 2016; 23:315-21. [DOI: 10.1177/10598405070230060301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Family-centered service is a service delivery model that recognizes the central role of families, builds on their strengths, and seeks to fully involve them in all aspects of their child’s health, learning, and development. Family-centered service has been associated with positive outcomes in health and education and has been viewed as best practice. This study examined school nurses’ perceptions of their work practices with families and the implementation of family-centered services in the school health setting. An established instrument, the Measure of Processes of Care for Service Providers, was used to survey a convenience sample of school nurses practicing in California. Quantitative and qualitative results indicated that school nurses value family-centered service and use the core elements regularly in their work with families. Qualitative data further illustrated school nurses’ solid commitment to families even in the face of challenges such as high student-nurse ratios, lack of time, and limited support. Suggestions for overcoming these barriers include development of parent centers, employment of school social workers/case managers, and advocating for changes in legislation to support the hiring of more school nurses.
Collapse
Affiliation(s)
- Michelle Concepcion
- Michelle Concepcion, RN, MS, is the program manager of Health Services, New Haven Unified School District, Union City, CA
| | - Susan Murphy
- Susan Murphy, RN, MS, DNS, is professor emerita, School of Nursing, San Jose State University, San Jose, CA
| | - Daryl Canham
- Daryl Canham, RN, EdD, BC, is an associate professor at the School of Nursing, San Jose State University, San Jose, CA, and the coordinator of the School Nurse Credential Program
| |
Collapse
|
30
|
Parent and nurse perceptions on the quality of family-centred care in 11 European NICUs. Aust Crit Care 2016; 29:201-209. [DOI: 10.1016/j.aucc.2016.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 11/20/2022] Open
|
31
|
Jones L, Taylor T, Watson B, Fenwick J, Dordic T. Negotiating Care in the Special Care Nursery: Parents' and Nurses' Perceptions of Nurse-Parent Communication. J Pediatr Nurs 2015; 30:e71-80. [PMID: 25934580 DOI: 10.1016/j.pedn.2015.03.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 03/28/2015] [Accepted: 03/30/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Nursing staff are an important source of support for parents of a hospitalized preterm infant. This study aimed to describe parents' and nurses' perceptions of communicating with each other in the context of the special care nursery. METHOD A qualitative descriptive design was employed. Thirty two parents with a newborn admitted to one of two special care nurseries in Queensland, Australia participated, and 12 nurses participated in semi-structured interviews. Thematic analysis was used to analyze the interviews. RESULTS Nurses and parents focused on similar topics, but their perceptions differed. Provision of information and enabling parenting were central to effective communication, supported by an appropriate interpersonal style by nurses. Parents described difficulties accessing or engaging nurses. Managing enforcement of policies was a specific area of difficulty for both parents and nurses. CONCLUSION The findings indicated a tension between providing family-centered care that is individualized and based on family needs and roles, and adhering to systemic nursery policies.
Collapse
Affiliation(s)
- Liz Jones
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD Australia.
| | - Tara Taylor
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD Australia
| | - Bernadette Watson
- School of Psychology, The University of Queensland, St Lucia, QLD Australia
| | - Jennifer Fenwick
- School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD Australia
| | - Tatjana Dordic
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD Australia
| |
Collapse
|
32
|
Mirlashari J, Sadeghi T, Sagheb S, Khanmohammadzadeh T. Nurses’ and physicians’ Perspective about Barriers to Implement Family Centered Care in Neonatal Intensive Care Units. ACTA ACUST UNITED AC 2015. [DOI: 10.29252/ijn.28.93.94.140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
33
|
Eustace RW, Gray B, Curry DM. The Meaning of Family Nursing Intervention: What Do Acute Care Nurses Think? Res Theory Nurs Pract 2015; 29:125-42. [DOI: 10.1891/1541-6577.29.2.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Understanding the concept of family nursing intervention from the perspective of practicing nurses is essential for implementing a family-centered approach in the acute care context. Data from this qualitative study were analyzed using a colloquial concept analysis method derived from Rodgers’ evolutionary theory. Five main attributes of family nursing interventions were identified. Family nursing interventions were viewed as a time-limited, collaborative process, initiated and/or facilitated by nurses and directed at either the individual or the family to solve problems. The antecedents of family nursing interventions were “family assessment,” “the presence of a family-related problem,” “willingness to participate (provider and family)” and a “supportive organizational structure.” The most common consequences (outcomes) were identified as positive (good) or negative (bad) individual or family-related outcomes following a family nursing intervention. The analysis suggests that family nursing interventions are essential but variable in nature within nursing practice. In addition, the analysis implies a need for further inquiry in diverse settings to define the concept and test relationships between the antecedents and outcomes to advance nurses’ translational knowledge of culturally appropriate family nursing interventions.
Collapse
|
34
|
Abstract
PURPOSE To evaluate current transport team communication practices and identify areas for improvement from the parents' perspective. We also sought to determine whether parents perceived that they were active participants in the care of their infants during the transport process, consistent with the concepts of providing family-centered care (FCC). SUBJECTS Purposeful sampling of mothers and fathers (or maternally designated support person if the father was not involved) of 25 infants who were transported for acute care to a level III neonatal intensive care unit (NICU) between October 1, 2012, and September 18, 2013. DESIGN This quality improvement project used quantitative and qualitative analysis of a parent questionnaire. METHODS Mothers and fathers (or the support person) of transported infants were invited to complete a questionnaire consisting of yes/no and open-ended questions within the first 2 weeks of their infants' transport to a level III NICU. The questions were related to the communication and information parents received and their ability to participate in the transport process. RESULTS Twenty-seven parents completed the questionnaire. Responses to yes/no questions identified areas for improvement for the transport team. These included providing parents the opportunity to view an informational video; ensuring that mothers had the opportunity to provide colostrum or breast milk before transport; and providing an explanation to parents about their role as active participants in their infants' care. Responses to the open-ended questions indicated that approximately 40% of parents felt they had received adequate information about their infants' care during the transport and many parents (40%) cited separation from their infants as very concerning and causing distress. More than one-third (40%) of the parents specifically stated that at least 1 parent should accompany the infant during the transport. One father in this sample had been able to accompany his infant to the tertiary center. CONCLUSIONS The integration of FCC core concepts during an acute neonatal transport is important to parents. The orientation of parents to FCC during the transport process may facilitate communication and help them become active participants in their infants' care.
Collapse
|
35
|
|
36
|
Watts R, Zhou H, Shields L, Taylor M, Munns A, Ngune I. Family-centered care for hospitalized children aged 0-12 years: a systematic review of qualitative studies. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1683] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
37
|
Abstract
The purpose of this study was to develop, implement, and evaluate a nursing education program to support family-integrated care in a Canadian neonatal intensive care unit (NICU). A total of 44 nurses volunteered to take part in the family-integrated care program, 35 of whom received additional education in the form of a 4-hour workshop. Of the 35 nurses who attended, 21 were interviewed regarding the impact and content of the workshop. The study design included the development, implementation, and qualitative assessment of the nursing education component of a family-integrated care program. The multidisciplinary program team conducted a literature review and then designed and conducted a survey to assess the educational requirements of nurses regarding family-integrated care. A nursing workshop was then developed on the basis of the literature review, staff survey responses, and discussions with staff and parents who had experienced having an infant in the NICU. Six months into the program, the contribution of the nursing workshop content to nurses' participation in the family-integrated care program was evaluated using individual structured interviews. Nurses who were interviewed described the workshop as valuable and reported that the information provided on nursing versus parental responsibilities in infant care, the parent experience in the NICU, and developmental care strategies was the most useful. Interviewees also identified the need for ongoing staff mentoring to maximize their ability to facilitate family-integrated care. Specific education for nurses facilitates family-integrated care in the NICU.
Collapse
|
38
|
Thomson G, Moran VH, Axelin A, Dykes F, Flacking R. Integrating a sense of coherence into the neonatal environment. BMC Pediatr 2013; 13:84. [PMID: 23697687 PMCID: PMC3663664 DOI: 10.1186/1471-2431-13-84] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 05/15/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Family centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes. DISCUSSION In this paper we present a new perspective to neonatal care based on Aaron Antonovksy's Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed. SUMMARY Consideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.
Collapse
Affiliation(s)
- Gill Thomson
- Maternal and Infant Nutrition and Nurture (MAINN), University of Central Lancashire, Preston PR1 2HE, UK.
| | | | | | | | | |
Collapse
|
39
|
Shields L, Zhou H, Pratt J, Taylor M, Hunter J, Pascoe E. Family-centred care for hospitalised children aged 0-12 years. Cochrane Database Syst Rev 2012; 10:CD004811. [PMID: 23076908 DOI: 10.1002/14651858.cd004811.pub3] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This is an update of the Cochrane systematic review of family-centred care published in 2007 (Shields 2007). Family-centred care (FCC) is a widely used model in paediatrics, is thought to be the best way to provide care to children in hospital and is ubiquitous as a way of delivering care. When a child is admitted, the whole family is affected. In giving care, nurses, doctors and others must consider the impact of the child's admission on all family members. However, the effectiveness of family-centred care as a model of care has not been measured systematically. OBJECTIVES To assess the effects of family-centred models of care for hospitalised children aged from birth (unlike the previous version of the review, this update excludes premature neonates) to 12 years, when compared to standard models of care, on child, family and health service outcomes. SEARCH METHODS In the original review, we searched up until 2004. For this update, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library, Issue 12 2011); MEDLINE (Ovid SP); EMBASE (Ovid SP); PsycINFO (Ovid SP); CINAHL (EBSCO Host); and Sociological Abstracts (CSA). We did not search three that were included in the original review: Social Work Abstracts, the Australian Medical Index and ERIC. We searched EMBASE in this update only and searched from 2004 onwards. There was no limitation by language. We performed literature searches in May and June 2009 and updated them again in December 2011. SELECTION CRITERIA We searched for randomised controlled trials (RCTs) including cluster randomised trials in which family-centred care models are compared with standard models of care for hospitalised children (0 to 12 years, but excluding premature neonates). Studies had to meet criteria for family-centredness. In order to assess the degree of family-centredness, we used a modified rating scale based on a validated instrument, (same instrument used in the initial review), however, we decreased the family-centredness score for inclusion from 80% to 50% in this update. We also changed several other selection criteria in this update: eligible study designs are now limited to randomised controlled trials (RCTs) only; single interventions not reflecting a FCC model of care have been excluded; and the selection criterion whereby studies with inadequate or unclear blinding of outcome assessment were excluded from the review has been removed. DATA COLLECTION AND ANALYSIS Two review authors undertook searches, and four authors independently assessed studies against the review criteria, while two were assigned to extract data. We contacted study authors for additional information. MAIN RESULTS Six studies found since 2004 were originally viewed as possible inclusions, but when the family-centred score assessment was tested, only one met the minimum score of family-centredness and was included in this review. This was an unpublished RCT involving 288 children post-tonsillectomy in a care-by-parent unit (CBPU) compared with standard inpatient care.The study used a range of behavioural, economic and physical measures. It showed that children in the CBPU were significantly less likely to receive inadequate care compared with standard inpatient admission, and there were no significant differences for their behavioural outcomes or other physical outcomes. Parents were significantly more satisfied with CBPU care than standard care, assessed both before discharge and at 7 days after discharge. Costs were lower for CPBU care compared with standard inpatient care. No other outcomes were reported. The study was rated as being at low to unclear risk of bias. AUTHORS' CONCLUSIONS This update of a review has found limited, moderate-quality evidence that suggests some benefit of a family-centred care intervention for children's clinical care, parental satisfaction, and costs, but this is based on a small dataset and needs confirmation in larger RCTs. There is no evidence of harms. Overall, there continues to be little high-quality quantitative research available about the effects of family-centred care. Further rigorous research on the use of family-centred care as a model for care delivery to children and families in hospitals is needed. This research should implement well-developed family-centred care interventions, ideally in randomised trials. It should investigate diverse participant groups and clinical settings, and should assess a wide range of outcomes for children, parents, staff and health services.
Collapse
Affiliation(s)
- Linda Shields
- TropicalHealth ResearchUnit forNursing andMidwifery Practice, JamesCookUniversity, Townsville, Australia.
| | | | | | | | | | | |
Collapse
|
40
|
Zhou H, Shields L, Watts R, Taylor M, Munns A, Ngune I. Family-centred care for hospitalized children aged 0-12 Years: A systematic review of qualitative studies. ACTA ACUST UNITED AC 2012; 10:3917-3935. [DOI: 10.11124/01938924-201210570-00006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
41
|
Shields L, Zhou H, Taylor M, Hunter J, Munns A, Watts R. Family-centred care for hospitalised children aged 0-12 Years: A systematic review of quasi-experimental studies. ACTA ACUST UNITED AC 2012; 10:2559-2592. [PMID: 27820551 DOI: 10.11124/jbisrir-2012-32] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Family-centred care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. It is a widely used model in paediatrics, and is felt instinctively to be the best way to provide care to children in hospital. However, its effectiveness has not been established. OBJECTIVES The objective of this review was to identify the effectiveness of family-centred models of care for children (excluding premature neonates) when compared to standard models of care. INCLUSION CRITERIA The review considered quasi-experimental studies of children aged 0-12 years, their families and/or attending health professionals. Interventions for inclusion were family-centred polices, family support, communication, educational and environmental. Outcomes of interest covered three categories: the child, parent and staff. These included psychological, behavioural, physical, developmental, knowledge, satisfaction and attitudinal outcomes. The degree of family-centredness for eligible studies was scored using a modified rating scale based on that developed by Trivette.This review considered studies that included hospitalised children aged 0-12 years (excluding premature neonates), their family and/or health care professionals.The review considered studies that evaluated the effectiveness of family-centred models of care for hospitalised children when compared to standard models of care.The review considered quasi-experimental studies for inclusion to enable the identification of current best evidence regarding the effectiveness of family-centred models of care on child, family and health service outcomes. Quasi-experimental design includes experimental studies in which participants are not randomly assigned to treatment conditions.This review considered studies that included the following outcome measures: SEARCH STRATEGY: The search strategy identified published and unpublished studies dated from 2004 to December 2011. Individual search strategies were developed for six databases and eight resources. METHODOLOGICAL QUALITY To be considered for inclusion in the review, each study had to meet a pre-established level of family-centredness, as determined using a modified rating scale based on that developed by Trivette.The study that met the required degree of family-centredness and other eligibility criteria was then assessed by two independent reviewers for methodological quality prior to inclusion in the review, using standardised critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. The third reviewer was not required. DATA COLLECTION Data were independently extracted from this remaining quasi-experimental study by two independent reviewers, using a standardised data extraction tool. Data were extracted including specific details about the interventions, population, study methods and outcomes of significance to the review question and specific objectives. The third reviewer was not required as there were no disagreements between the reviewers. DATA SYNTHESIS Pooling of quantitative data was not possible as only one study was included in this review. Therefore, the quantitative results of the study have been presented in narrative form. RESULTS Only one study met the inclusion criteria for this review. The study addressed three interventions (information sharing, joint decision making, and participating in care activities), and two outcomes (self-efficacy in participatory involvement in child care and satisfaction with nursing care). The study found that at Day 5 after Paediatric Intensive Care Unit admission the mothers' self-efficacy in participatory involvement in child care and satisfaction with nursing care in the experimental group were significantly higher than in the control group. CONCLUSIONS Based on this review alone, and the acknowledgement that only one quasi-experimental study met the inclusion criteria, no firm conclusion could be drawn about the effectiveness of family-centred care for children in hospital. However, taken with the recent Cochrane review update on the effectiveness of the model of family-centred care, we suggest that it is time to search for a more effective model of care delivery which supports the child and family without putting undue pressure on families to stay with their child if it is difficult to do so.
Collapse
Affiliation(s)
- Linda Shields
- 1. Tropical Health Research Unit, School of Nursing, Midwifery and Nutrition, James Cook University, Townsville; and School of Medicine, The University of Queensland; and WACEIHP; A Collaborating Centre of the Joanna Briggs Institute 2. School of Nursing and Midwifery, Curtin University; WACEIHP: A Collaborating Centre of the Joanna Briggs Institute 3. Library and Information Service, Child and Adolescent Health Service Princess Margaret Hospital, Western Australia. 4. Nursing and Quality, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK 5. School of Nursing & Midwifery, Curtin University, Perth, Western Australia 6. WACEIHP, Curtin University Bentley WA Australia and Princess Margaret Hospital for Children Subiaco WA Australia, a Collaborating Centre of the Joanna Briggs Institute, School of Nursing and Midwifery, Curtin University, Perth, Western Australia
| | | | | | | | | | | |
Collapse
|
42
|
Miller G. Application of theory to family-centered care: a role for social workers. SOCIAL WORK IN HEALTH CARE 2012; 51:89-106. [PMID: 22352359 DOI: 10.1080/00981389.2011.609774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Family-centered care is an emerging trend in health care settings today. An explanation, principles, and a definition of family-centered care are offered and discussed. A theoretical framework, Balance Theory of Coordination, which can be utilized by social workers to develop and enhance family-centered care practices, is explained and discussed. Various family-centered care practices are examined within the context of Balance Theory of Coordination as examples.
Collapse
Affiliation(s)
- Gary Miller
- Department of Sociology, Anthropology, and Social Work, Central Michigan University, Mt. Pleasant, MI, USA.
| |
Collapse
|
43
|
Coyne I, O’Neill C, Murphy M, Costello T, O’Shea R. What does family-centred care mean to nurses and how do they think it could be enhanced in practice. J Adv Nurs 2011; 67:2561-73. [DOI: 10.1111/j.1365-2648.2011.05768.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Psychosocial issues and care in pediatric oncology: medical and nursing professionals' perceptions. Cancer Nurs 2011; 33:E12-20. [PMID: 20555261 DOI: 10.1097/ncc.0b013e3181d5c476] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with cancer and their families have psychosocial support needs. Medical and nursing professionals in pediatrics and pediatric oncology are in a position to identify and help manage these. However, little is known about their perceptions of psychosocial issues and interventions. OBJECTIVE The purpose of this study was to investigate physicians' and nurses' perceptions of psychosocial issues in pediatric oncology including their awareness of the psychosocial impact of childhood cancer on families and their knowledge and views of psychosocial interventions. METHODS A phenomenological approach was taken whereby semistructured interviews were conducted with a purposive sample of 10 physicians and nurses. RESULTS Findings showed that despite a lack of formal training in psychosocial issues, professionals identified a number of psychosocial issues associated with childhood cancer, including effects for family members. In addition, findings illustrated the psychosocial roles that they frequently adopt in relation to the identification, treatment, and referral of psychosocial issues. Finally, physicians and nurses recognized the value of formal intervention, reporting benefits for children, families, and themselves. CONCLUSION These findings give a preliminary insight into physicians' and nurses' perceptions and awareness of the psychosocial issues experienced by children with cancer and their families and their knowledge of psychosocial interventions. They highlight ways to enhance the delivery of care in pediatric oncology. IMPLICATIONS FOR PRACTICE Specifically, they suggest the need for more formal training on psychosocial issues for medical and nursing professionals, for additional experienced psychosocial professionals to be recruited, and for more access to services for both families and medical and nursing professionals.
Collapse
|
45
|
Abstract
The trend toward single-room neonatal intensive care units (NICUs) is increasing; however scientific evidence is, at this point, mostly anecdotal. This is a critical time to assess the impact of the single-room NICU on improving medical and neurobehavioral outcomes of the preterm infant. We have developed a theoretical model that may be useful in studying how the change from an open-bay NICU to a single-room NICU could affect infant medical and neurobehavioral outcome. The model identifies mediating factors that are likely to accompany the change to a single-room NICU. These mediating factors include family centered care, developmental care, parenting and family factors, staff behavior and attitudes, and medical practices. Medical outcomes that plan to be measured are sepsis, length of stay, gestational age at discharge, weight gain, illness severity, gestational age at enteral feeding, and necrotizing enterocolitis (NEC). Neurobehavioral outcomes include the NICU Network Neurobehavioral Scale (NNNS) scores, sleep state organization and sleep physiology, infant mother feeding interaction scores, and pain scores. Preliminary findings on the sample of 150 patients in the open-bay NICU showed a "baseline" of effects of family centered care, developmental care, parent satisfaction, maternal depression, and parenting stress on the neurobehavioral outcomes of the newborn. The single-room NICU has the potential to improve the neurobehavioral status of the infant at discharge. Neurobehavioral assessment can assist with early detection and therefore preventative intervention to maximize developmental outcome. We also present an epigenetic model of the potential effects of maternal care on improving infant neurobehavioral status.
Collapse
Affiliation(s)
- Barry M Lester
- Brown Center for Study of Children at Risk, Providence, RI 02905, USA.
| | | | | | | | | | | | | |
Collapse
|
46
|
Mikkelsen G, Frederiksen K. Family-centred care of children in hospital - a concept analysis. J Adv Nurs 2011; 67:1152-62. [DOI: 10.1111/j.1365-2648.2010.05574.x] [Citation(s) in RCA: 157] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
Family-centred care for hospitalised children aged 0-12 Years: A systematic review of quasi-experimental studies. ACTA ACUST UNITED AC 2011. [DOI: 10.11124/jbisrir-2011-341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
48
|
MacKay LJ, Gregory D. Exploring Family-Centered Care Among Pediatric Oncology Nurses. J Pediatr Oncol Nurs 2010; 28:43-52. [DOI: 10.1177/1043454210377179] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Family-centered care (FCC) is important within pediatric oncology nursing. However, pediatric oncology nurses often face challenges and barriers when attempting to provide FCC. The purpose of this study was to understand the experiences of pediatric oncology nurses in relation to FCC; identify how pediatric oncology nurses implemented FCC into their practice; identify what facilitated and enabled pediatric oncology nurses to implement FCC; and discern the barriers and challenges that were present in their setting when implementing FCC. A qualitative approach utilizing person-centered interviewing was used to collect data. Nurses (N=20) from a western Canadian children’s hospital were recruited through purposeful convenience sampling and were then interviewed. Five major themes were identified from the data set: Hospital support f FCC, How participants defined FCC, Establishing FCC, Enhancing FCC, and Barriers and Challenges to providing FCC. Recommendations for future research and implications for practice and education are offered.
Collapse
Affiliation(s)
| | - David Gregory
- University of Lethbridge, Lethbridge, Alberta, Canada
| |
Collapse
|
49
|
ASAI H. Predictors of nurses’ family-centered care practises in the neonatal intensive care unit. Jpn J Nurs Sci 2010; 8:57-65. [DOI: 10.1111/j.1742-7924.2010.00159.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
50
|
Harrison TM. Family-centered pediatric nursing care: state of the science. J Pediatr Nurs 2010; 25:335-43. [PMID: 20816555 PMCID: PMC2965051 DOI: 10.1016/j.pedn.2009.01.006] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 01/10/2009] [Accepted: 01/23/2009] [Indexed: 10/20/2022]
Abstract
The purposes of this article were to summarize the development of family-centered pediatric care, review the current state of nursing research in this area, and recommend directions for future study. A literature review of 30 nursing research studies between 1995 and 2006 was conducted. Results revealed that evidence of consistent provision of family-centered pediatric care is lacking. Many areas of research remain undeveloped, but there is a solid foundation for moving forward in conducting research focused on assisting nurses in implementing this basic philosophy of practice in all settings and situations in which children receive health care.
Collapse
Affiliation(s)
- Tondi M Harrison
- University of Minnesota School of Nursing, Minneapolis, MN, USA.
| |
Collapse
|