[Professional social support during the postpartum hospital stay]. / Soutien des parents par les professionnel-les de santé lors du séjour postpartum.

Social support is a protective factor during the transition to parenthood. However, first-time parents report insufficient professional support. Moreover, their actual needs and perception of professional support are unknown. To this end, we tried to understand parents' social support needs and how professionals' help behaviors are perceived. We found that mothers' and fathers' needs differed in that emotional care was favored by mothers, while fathers considering themselves as the main support for their partner, expressed fewer needs. Promoting individualised care and empowering parents were perceived as helpful. Professionals should be aware of how they provide aid, as it shapes parent's early postpartum experience. Being well-trained in interpersonal support may thus help professionals provide sensitive individualised care.

Le soutien social prodigué par les soignant-es est crucial pour la transition à la parentalité, mais il n'est pas toujours approprié. Les besoins des parents ayant un premier enfant et leur perception d'être soutenu par les soignant-es sont méconnus. Afin de surmonter ce défi, nous avons cherché à mieux comprendre leurs besoins et perceptions et démontré que les besoins des parents diffèrent dans le couple. Les mères désirent souvent plus un support émotionnel. Les pères se considèrent comme source de soutien pour leur partenaire exprimant peu de besoin. Promouvoir des soins individualisés et favoriser leur autonomie est perçu par les deux parents comme aidant. Cela montre que les soignant-es ont un rôle clé dans le soutien des parents influençant leur expérience du séjour postpartum, d'où l'importance de la formation en soutien.

First-time parents' perception of midwives' and other healthcare professionals' support behaviours: A qualitative study.

PROBLEM: Parents often report not being satisfied with the support received from midwives and nurses during their postpartum hospital stay. BACKGROUND: Social support is an important protective factor during the transition to parenthood. However, little is known on how first-time parents perceived the behaviours demonstrated by healthcare professionals to support them. OBJECTIVE: To describe social support behaviours of midwives and nurses as perceived by first-time parents during the early postpartum period. METHODS: This qualitative study used individual semi-structured interviews to collect data. A purposeful sample of first-time parents staying on the postpartum ward of a Swiss university hospital were included. Thematic analysis was performed to identify themes and sub-themes. FINDINGS: A total of 26 parents (15 mothers and 11 fathers) were interviewed. Parents reported behaviours perceived either as positive or negative. These behaviours were summarized into five themes: "Welcoming parents on the postpartum ward", "Establishing a partnership with parents", "Guiding parents in acquiring their new parenting role", "Caring for parent's emotions", and "Creating a peaceful environment". DISCUSSION AND CONCLUSION: This study reported a wide variety of professional support behaviours. Behaviours promoting individualised care and related to empowering parents in their infant care were perceived as helpful by parents. Midwives and nurses should be aware of the way they provide support, as this shapes the early postpartum experience of first-time parents. Being sufficiently staffed and being well-trained, especially in providing interpersonal support, could help midwives and nurses provide better sensitive individualised care.

Effectiveness and family experiences of interventions promoting partnerships between families and pediatric and neonatal intensive care units: a mixed methods systematic review.

OBJECTIVE: The objective of this mixed methods review was to examine the effectiveness and family experiences of interventions promoting partnerships between families and the multidisciplinary health care team in pediatric and neonatal intensive care units. INTRODUCTION: Hospitalization of infants and children in neonatal intensive care units and pediatric intensive care units has a significant effect on their families, including increased stress, anxiety, and depression. Available evidence syntheses focused on specific family-centered care, but not on partnership, which is another aspect that may improve families' outcomes and experiences. INCLUSION CRITERIA: This review considered studies that focused on effectiveness or family experiences of interventions by health professionals in partnership with families of infants or children hospitalized in an intensive care unit. For the quantitative component of the review, the type of intervention was a partnership between the health care team and the family, and focused on outcomes of stress, anxiety, depression, quality of life, attachment, or satisfaction with family-centered care. For the qualitative component, the phenomenon of interest was family experiences of interventions that included collaboration and partnering with the health care team in the pediatric or neonatal intensive care unit. Quantitative, qualitative, and mixed methods studies, published from 2000 to August 2022 in English or French, were eligible for inclusion. METHODS: The JBI methodology for convergent segregated mixed methods systematic reviews was followed using the standardized JBI critical appraisal and data extraction tools. Ten databases were searched in December 2019 and again in August 2022. Study selection, critical appraisal, and data extraction were performed by 2 reviewers independently. Findings of quantitative studies were statistically pooled through meta-analysis and those that could not be pooled were reported narratively. Qualitative studies were pooled through meta-synthesis. RESULTS: This review included 6 qualitative and 42 quantitative studies. The methodological quality varied, and all studies were included regardless of methodological quality. Meta-analyses showed improvements in anxiety, satisfaction with family-centered care, and stress, yet no conclusive effects in attachment and depression. These results should be interpreted with caution due to high heterogeneity. Qualitative analysis resulted in 2 synthesized findings: "Interventions that incorporate partnerships between families and the health care team can improve the family's experience and capacity to care for the child" and "Having a child in intensive care can be an experience of significant impact for families." Integration of quantitative and qualitative evidence revealed some congruence between findings; however, the paucity of qualitative evidence minimized the depth of this integration. CONCLUSIONS: Partnership interventions can have a positive impact on parents of children in intensive care units, with improvements reported in stress, anxiety, and satisfaction with family-centered care. REVIEW REGISTRATION: PROSPERO CRD42019137834. SUPPLEMENTAL DIGITAL CONTENT: A Chinese-language version of the abstract of this review is available at http://links.lww.com/SRX/A50 . A French-language version of the abstract of this review is available at http://links.lww.com/SRX/A51 .

Analgesia e sedação em situações de emergência e unidades de tratamento intensivo pediátrico / Analgesia and sedation in emergency situations and in the pediatric intensive care unit

OBJETIVO: Revisar as atuais estratégias de uso de analgésicos e sedativos em salas de emergência e em unidades de tratamento intensivo pediátrico. FONTES DOS DADOS: Revisão de bibliografia realizada na base de dados da Medline, além de capítulos de livros de terapia intensiva pediátrica e da experiência dos serviços dos autores. SíNTESE DOS DADOS: Apesar de todos os avanços e pesquisas no campo da dor, o uso de sedativos e analgésicos em unidades intensivas pediátricas continua deficitário. A dor e o desconforto associados a situações de urgência, procedimentos invasivos e internações prolongadas ainda resultam em significativa morbidade aos pacientes pediátricos criticamente enfermos. A dificuldade de comunicação do paciente pediátrico com a equipe médica, a grande quantidade de procedimentos invasivos necessários à manutenção da vida, aliados à antiga premissa de que os mecanismos de dor não estão bem desenvolvidos nas crianças, fazem desse tema um desafio nas unidades de terapia intensiva pediátrica. Neste estudo, revisamos as drogas mais utilizadas no manejo da dor e sedação, apresentando novas opções terapêuticas mais largamente estudadas recentemente. CONCLUSÕES: Nos últimos dez anos, desenvolveu-se uma consciência mais crítica em relação à necessidade de promover um adequado alívio da dor e da ansiedade inerentes aos ambientes de emergência e de UTI, devendo ser esta uma prioridade no planejamento terapêutico de crianças extremamente doentes.