(Re)'Thinking' family in nursing care in pandemic times

Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study

The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients' needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses caring for COVID-19 patients in intensive and sub-intensive care units and patients. In the first phase, we collected data through a survey that assessed patients' needs from the perspective of nurses and patients, as well as patient satisfaction. In the second phase, qualitative data were collected through interviews with patients and nurses. In the third phase, we extracted quantitative data from patients' records. Our sample included 100 nurses, 59 patients, 15 patient records, and 31 interviews (15 patients, 16 nurses). The results from the first phase showed patients and nurses agreed on the most important difficulties: "breathing", "sleep/rest", and "communication". Nursing care was rated positively by 90% of the patients. In the second phase, four themes were identified through the patients' interviews: "my problems", "my emotions", "helpful factors", and "nursing care". Five themes were identified through the nurses' interviews: "the context", "nurses' experiences and emotions", "facilitators and barriers to patient care", "nursing care", and "the professional role". From the third phase, the analysis of the clinical documentation, it was not possible to understand the nursing care model used by the nurses. In conclusion, nurses adopted a reactive-adaptive approach, based on experience/knowledge, pursuing generalized objectives, and adapting their response to the clinical evolution. In difficult contexts, nursing care requires a constant competent technical-relational presence at the patient's bedside.

Implications of the COVID-19 Pandemic on the Family Structural Dimensions: A Correlational Study

The COVID-19 pandemic caused changes in the families' social support network, employment status, and family income, which are the focus of attention of family health nurses. This study aims to describe the pandemic's repercussions in the areas of attention of the structural dimension of families according to the Dynamic Model of Family Assessment and Intervention, as perceived by Portuguese families, and to relate the changes in their employment status according to the variables of the structural dimension. A quantitative, descriptive, and correlational study was conducted using snowball sampling. A questionnaire of sociodemographic characterization and assessment of the family structural dimension according to the model's operational matrix was applied to 235 family members. Changes were found in their employment status; family income; intensity and frequency of contact with family, friends, and coworkers; frequency of contact with educational/health/religious institutions and community groups; cultural activities; and housing comfort conditions such as the use of heating/air conditioning, gas, and water consumption. Changes in employment status were related to family income, interaction with friends, frequency of cultural activities, and use of air conditioning and heating. Knowing the implications of the pandemic on the family's structural dimension results in a nursing intervention more focused on family needs.

Attitudes and perceptions of healthcare professionals related to family participation in surgical cancer care-A mixed method study

AIM

This study investigated healthcare professionals' attitudes and perceptions towards the family's participation in surgical cancer care.

DESIGN

A prospective mixed method study.

METHODS

The study was conducted at three hospitals in Sweden with registered nurses, assistant nurses and surgeons. Data included 43 completed Families Importance in Nursing Care (FINC-NA) questionnaires answered by registered nurses and qualitative data from 14 interviews with surgeons and assistant nurses. Data analysis was performed according to the Creswell convergent parallel mixed method.

RESULTS

Both quantitative and qualitative data demonstrated that the family was an important resource in nursing care, was highly valued as a conversational partner and had resources that should be considered. Each family should be supported in determining their role and as implements for maintaining a functioning family constellation and increasing their participation.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Factors associated with nurses' positive attitudes towards families' involvement in nursing care: A scoping review

AIM

To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge.

BACKGROUND

Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses.

DESIGN

A scoping review based on the steps proposed by the Joanna Briggs Institute.

METHODS

Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care- Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA-ScR.

RESULTS

Twenty-six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal-longer working career (42.3%) and older age (26.9%); (b) educational-higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace-working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%).

CONCLUSIONS

Personal variables such as age and time of service are non-modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice.

RELEVANCE TO CLINICAL PRACTICE

Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family-focused care.