The lived experience of parents whose children discharged to home after cardiac surgery for congenital heart disease.

BACKGROUND: Congenital Heart Diseases (CHDs) afflicting children are estimated in 8 per 1000 live births. Recent advances in surgery and medical treatments allowed an improvement in survival rates leading to changes in diseases management as chronic conditions. Parents involvement during clinical pathways is considered an essential component of care, but frequently they experience stress and anxiety conditions during the care path. These feelings are typical of the pre and peri-operative period, however they don't disappear easily and sometimes they can increase after hospital discharge, affecting the family environment and its behaviors. AIM OF THE WORK: The purpose of this qualitative study is to examine the lived experience of parents during the time just after their children return home from hospital after undergoing surgery for CHD. METHODS: Parents were enrolled and interviewed as a prepositive sampling until concept saturation using Cohen's phenomenology approach. A quantitative approach was also applied using SF-12 questionnaire. The study was conducted in two Italian hospitals: the Pediatric Heart Surgery Center of the Fondazione Toscana G. Monasterio Institute in Massa and the Pediatric Cardiac Surgery Center of the Federico II University Hospital in Naples. RESULTS: The main themes emerged after the analysis were "happiness and uncertainty"; "chronic psychophysical fatigue"; "the rediscovery of a strong link with health care professionals". CONCLUSIONS: Fully understand the life experience of these families will allow the implementation of targeted health interventions through the implementation of shared strategies and tools to reduce families and children discomfort after hospital discharge.

Comparative Analysis: Implementation of a Pre-operative Educational Intervention to Decrease Anxiety Among Parents of Children With Congenital Heart Disease.

PURPOSE: The present study evaluated the efficacy of a nursing educational intervention in alleviating the level of parental anxiety in the parents of children who required heart surgery for the first time. DESIGN AND METHODS: A comparative study was used to explore the parents of children who had to undergo cardiac surgery. Parents of children were randomized into 2 groups: 1) control group and 2) experimental group or parents that received the educational intervention about PICU stay. RESULT: The results of STAY-1 showed that the average anxiety score of group 1 was lower than that of group 2 (63.0 [SD=3.5] vs. 70.4 [SD=2.8]). CONCLUSION: In order to decrease levels of parental anxiety and stress prior to paediatric surgery, parents should be adequately informed about planned therapeutic procedures. PRACTICE IMPLICATIONS: We speculate that pre-surgery parent education on what to expect before, during and after their child's cardiac surgery may improve parents' knowledge and satisfaction and decrease anxiety.

[Mechanical ventilation and early weaning: a qualitative study on patient's experiences in an intensive care unit]. / Ventilazione meccanica ed estubazione precoce: studio qualitativo sul vissuto dei degenti di una terapia intensiva cardiochirurgia.

SUMMARY: Mechanical ventilation and early weaning: a qualitative study on patient's experiences in an intensive care unit. INTRODUCTION: The weaning from mechanical ventilation of intensive care unit (ICU) patients may cause anxiety. The feelings and experience during this procedure may affect their physical and psychological wellbeing. AIM: To describe patients' feelings during intubation time and weaning. METHOD: Phenomenological study on 16 patients who underwent an off pump bypass and mechanical ventilation <24 hours. The patients were contacted 5-7 days after discharge from ICU. RESULTS: The analysis of the interviews generated three issues arising from patients' experience: the discomfort mainly for the endotracheal tube, the fear of extubation and sense of safety for the presence of the nurse. CONCLUSIONS: Mechanical ventilation and weaning, in spite of the evolution of the anesthetic techniques, continue to generate unpleasant feelings.