Background
There is very little research on the parent's experiences of having a child admitted to a paediatric intensive care unit. Identifying and describing ‘such experiences’ could facilitate ...better parental support from the paediatric intensive care team and help the parents manage a stressful situation.
Aims
This study aimed to describe parents' experiences of having their child admitted to a paediatric intensive care unit.
Methods
Interviews were conducted with 12 parents whose children had been admitted to a paediatric intensive care unit. A qualitative design was used, and the interviews were analysed based on content analysis.
Result
The analysis revealed two categories: ‘being involved’ and ‘being informed’ with seven subcategories: ‘caring for the parents’, ‘security and trust’, ‘altering the parental role’, ‘stress and fear’, ‘the importance of knowing’, ‘interaction in the care process’ and ‘being prepared’. An overarching theme emerged: the experience was ‘like being in another world’. The study concludes that a child's admission to a paediatric intensive care unit is a stressful situation, and for the parents to be able to handle the anxiety and stress, they need to be informed of and involved in their child's care.
Conclusions
The parents' experience when their child is admitted to a paediatric intensive care unit is fraught with a range of emotion and fear. There are indications that things such as good information, involvement and a positive experience of the transfer to the paediatric ward reduce the stress and anxiety associated with paediatric intensive care admission. The result of this study could be used as a basis for a post‐paediatric intensive care follow‐up service for the children and their families.
Background
Discharge from a neonatal care unit is often experienced as a vulnerable time for parents. By communicating through digital technology, it may be possible to improve the support for ...parents and thereby make the transition from hospital to home less stressful.
Aim
To develop an eHealth device supporting the transition from hospital to home for parents with a preterm‐born child in Sweden using participatory design.
Method
Employing a framework of complex interventions in health care using participatory design. Parents of preterm‐born infants and professionals at a neonatal department identified specific technical requirements for an eHealth device to be developed in the context of neonatal care and neonatal home care. The prospective end‐users – parents and professionals – were continuously involved in the process of designing solution prototypes through meetings, verbal and written feedback, and interviews. The interviews were analysed using thematic analysis.
Results
Technical development was carried out with the perspectives of professionals and parents in mind, resulting in an eHealth application for computer tablets. The findings from the interviews with the parents and professionals revealed three categories: The tablets felt secure, easy to use and sometimes replaced visits to hospital and at home.
Conclusion
The use of participatory design to develop an eHealth device to support a safe transition from hospital to home can benefit parents, the child, the family, and professionals in neonatal care.
Background
Mothers of preterm infants are at greater risk of symptoms of stress and anxiety compared to mothers of term infants.
Aims
This study aimed to explore mothers’ experiences after coming ...home from the hospital with a moderately to late preterm infant.
Methods
A qualitative and explorative method was used. Ten mothers who had given birth to a preterm baby with a gestational age between 30.0 and 36.0 were interviewed. The interviews were conducted two to three months after the mothers and their babies were discharged from hospital. The data were analysed by means of latent and manifest qualitative content analysis.
Findings
One overall theme emerged from the analysis: ‘Seeing the light at the end of the tunnel’ and four categories were identified ‘Finding a safe haven at home’, ‘Gaining support and learning to ensure optimal feeding’, ‘Seeing the child's possibilities’ and ‘Receiving professional attention and reassurance’. In particular, adequate breastfeeding guidance and help with practical tasks at home were emphasised as important for the mothers, and need to be incorporated into the practice of public health nurses.
Conclusions
Practical help and support from close people, combined with individual professional follow‐up, were important for the mothers’ ability to cope with the hospital‐to‐home transition. There should be a strong focus on breastfeeding guidance as the mothers experienced problems for several months after discharge, and felt they were missing out on breastfeeding guidance given to term babies in hospital.
For parents, having a child admitted to a paediatric intensive care unit (PICU) is a very stressful experience filled with anxiety. Parents are often scared and traumatised. This stress can lead to ...PTSD.
The aim was to describe parents’ experiences and the effect on the family two years after their child was admitted to a paediatric intensive care unit.
Ten parents were interviewed according to a semi-structured interview guide. An inductive approach was applied for the study and qualitative content analysis was used to analyse the data.
The parents carried vivid memories and they were still strongly affected by the experience of having their child admitted to a paediatric intensive care unit. They could clearly recall the environment, feelings that affected them and how they felt powerless. The relationship between the parents had been strengthened.
Parents, siblings and the ill child could all show symptoms of anxiety, stress and sleeping disorders. The parents valued life differently.
Aims and objectives
To extend nurses’ descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional ...understandings and perspectives of nurses’ views of caring in relation to a coronary care patient case.
Background
Scientific literature from the 1970s–1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic – particularly in the context of coronary care – is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses.
Design
Qualitative descriptive study.
Methods
Twenty‐one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis.
Results
The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses’ views of caring could now also be understood as: person‐centredness ‘lurking’ in the shadows; limited ‘potential’ for safeguarding patients’ best interests; counselling as virtually the ‘only’ nursing intervention; and caring preceded by the ‘almighty’ context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it.
Conclusion
Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients’ preferences.
Relevance to clinical practice
To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person‐centred way, while sustaining their professional values.
Parents of children with a congenital heart defect needing complex heart surgery are at high risk of developing health problems. One can assume that parents whose child undergoes heart surgery abroad ...will undoubtably face added and unique stressors and health vulnerabilities. The aim of this qualitative study was to explore the transition experiences of parents of children who underwent a complex heart surgery abroad as newborns 1-5 years ago. The qualitative content analysis methodology by Graneheim and Lundman was used. A purposive sample of twelve parents, whose child had undergone a heart surgery abroad, participated in face-to-face, semi-structured interviews. Interviews were transcribed and analyzed using inductive qualitative content analysis. The overarching theme of "living with the memories" emerged from parents' experiences, emphasizing the long-lasting impact this stressful event had on their lives. These experiences were characterized by four main categories: (1) being in an unknown situation; (2) feeling connected; (3) wishing to be accepted; and (4) finding closure. The findings show that the transition of having a newborn child undergo heart surgery abroad superimposed on the expected parenthood. That parents need to feel connected and included as legitimate clients was highlighted in their stories of experienced vulnerabilities. The results highlight the need for interdisciplinary teams to support these vulnerable families, particularly with follow-up care.
Ear acupuncture is used as a non-pharmacological complement in psychiatric and addiction care to reduce anxiety, depression and insomnia. The aim of this study was to describe health care ...professionals' perceptions of giving ear acupuncture in different psychiatric settings. Twenty-four professionals providing ear acupuncture to patients with a variety of psychiatric symptoms and/or addiction were interviewed in focus groups. Data were analyzed with a phenomenographic approach. Ear acupuncture was provided, individually or in groups, to in- and outpatients with a variety of psychiatric symptoms and/or addiction. Three descriptive categories emerged: Another tool in the toolbox, Strengthening the profession and Person-centered care. Participants perceived ear acupuncture to be an effective and safe therapeutic tool, easy to use in concert with other methods and easy to adjust to the patients' needs and requests. They perceived that their professional self-confidence increased when having this non-verbal, person-centered and non-pharmacological tool in their hands as a complement to ordinary care. Professionals perceived that patients trained their social skills while participating in acupuncture, and that the treatment helped patients to influence their subjective psychiatric health through gaining control over symptoms. Acupuncture helped professionals to build a trustful relationship and communicate with their patients, verbally and non-verbally. The finding shows ear acupuncture as a safe treatment and promising in relieving psychiatric and somatic symptoms. Acupuncture facilitates the communication with patient, emphasizing participation and shared decision-making, valuable dimensions of person-centered care. Managers' role and attitude in supporting staff needs to be explored in future research.
The costly and complex needs for children with long-term illness are challenging. Safe eHealth communication is warranted to facilitate health improvement and care services. This mixed-methods study ...aimed to describe parents’ usage and experiences of communicating with professionals during hospital-to-home-transition after their child’s preterm birth or surgery for colorectal malformations, using an eHealth device, specifically designed for communication and support via nurses at the hospital. The eHealth devices included the possibility for daily reports, video calls, text messaging, and sending images. Interviews with 25 parents were analyzed with qualitative content analysis. Usage data from eHealth devices were compiled from database entries and analyzed statistically. Parents using the eHealth device expressed reduced worry and stress during the initial period at home through effective and safe communication. Benefits described included keeping track of their child’s progress and having easy access to support whenever needed. This was corroborated by usage data indicating that contact was made throughout the day, and more among families living far away from hospital. The eHealth device potentially replaced phone calls and prevented unnecessary visits. The eHealth technique can aid safe self-treatment within child- and family-centered care in neonatal and pediatric surgery treatment. Future research may consider organization perspectives and health economics.
Scand J Caring Sci; 2013; 27; 260–266
Primary health care resources for rehabilitation and secondary prevention after myocardial infarction – a questionnaire survey
Background: During the first year ...after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes.
Aim: This study describes the primary health care centres’ (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region.
Method: A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned.
Result: Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty‐one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long‐term secondary prevention programmes, and few (6%) had any routines for offering socio‐economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations.
Conclusions: The PHCCs need to improve the strategies and long‐term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long‐term care programmes for CHD patients.
Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of ...nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring.
A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth's description of phenomenography.
The analysis mirrored four qualitatively different ways of understanding caring from the nurses' perspective: caring as person-centredness, caring as safeguarding the patient's best interests, caring as nursing interventions and caring as contextually intertwined.
The most comprehensive feature of the nurses' collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.
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