Patients' and parents' perspectives of and experiences with assessing nursing students' paediatric clinical practice.

PURPOSE: To explore patients' and parents' involvement in the formative assessment of undergraduate nursing students' paediatric clinical practice. METHODS: We conducted semi-structured interviews with paediatric patients between 14 to 18 years old and parents who received care from a nursing student while admitted to a paediatric tertiary care hospital in Canada. We analysed the data using qualitative content analysis as well as Lincoln and Guba's criteria for establishing trustworthiness. The Consolidated criteria for reporting qualitative studies (COREQ) checklist was completed for the quality appraisal of this article. FINDINGS: Three categories emerged from the data: 1) how patients and parents are currently involved in the formative assessment of nursing students' paediatric clinical practice; 2) how patients and parents would prefer to be involved in the formative assessment of nursing students' paediatric clinical practice; and 3) the potential benefits and challenges of involving patients and parents in the formative assessment of nursing students' paediatric clinical practice. CONCLUSION: This study provided an understanding of patients' and parents' past encounters with nursing students and the elements of care that they have assessed as well as those that they would prefer to assess and provide feedback on, while considering the potential benefits and challenges of their involvement. The findings of this study will assist clinical instructors in determining how and when to involve patients and parents in the assessment of nursing students. Academic institutions offering nursing programmes should consider the study findings when improving or changing formative assessment strategies.

Experiences of Nephrology Nurses in Assessing and Managing Pain in Patients Receiving Maintenance Hemodialysis.

Chronic kidney disease (CKD) is a major health problem. The purpose of this qualitative study was to describe nephrology nurses' experiences in assessing and managing pain in patients who were receiving maintenance hemodialysis at outpatient units within a tertiary care institution. Semi-structured interviews were conducted with seven nurses, and a thematic analysis was used to analyze data. Themes emerged related to the complexity of pain assessment and management in these patients, who were often elderly. Nurses had to ascertain whether the pain was related to hemodialysis treatment, renal failure, or comorbidities. Nurses described managing pain within the context of the hemodialysis unit, and this required working as a team. Nurses also described the need for a palliative approach in patient care.

The pain experience of patients on maintenance hemodialysis.

This article describes the pain experience of patients on maintenance hemodialysis. Nephrology nurses have noted that patients on maintenance hemodialysis experience pain; however, it may not be adequately assessed or treated. A qualitative approach was utilized. Data were analyzed using content analysis. Twenty-five patients on outpatient hemodialysis were interviewed during their scheduled hemodialysis treatments. Patient pain experiences were related to physical pain, such as joint pain, as well as discomfort from being immobile. There were also descriptions of emotional and social pain. Patients utilized analgesics and other approaches, such as exercise, for pain. Patients also described pain management within the context of a dialysis unit. Patients'pain experiences require additional assessment and intervention. Further research is warranted to identify strategies to facilitate comfort.

Living with sensor-augmented pump therapy in type 1 diabetes: adolescents' and parents' search for harmony.

OBJECTIVE: Adolescents have difficulty successfully sustaining use of continuous glucose monitoring even when it is introduced to experienced pump users. However, little is known about how adolescents and parents perceive and manage sensor-augmented pump therapy (SAPT) in daily life. The purpose of this study was to explore adolescents' and parents' daily experience of living with SAPT. METHODS: We used an interpretive phenomenological study design. We conducted in-depth, digitally recorded interviews with 7 adolescents and 9 parents recruited through 1 Canadian pediatric diabetes program. Adolescents who participated were 13 to 17 years of age with type 1 diabetes mellitus and had experience (current or past) living with SAPT. Transcripts of the interviews were subjected to a thematic analysis guided by the procedure outlined by Colaizzi. RESULTS: The overarching theme, seeking harmony, reflected adolescents' and parents' daily struggles with balancing multiple tensions that arose from managing SAPT and harmonizing seemingly opposing choices that were brought to the fore, while also struggling to live with both wellness and chronic illness. Four themes constituted the struggle to find harmony living with diabetes managed with SAPT: struggling with hopes and expectations for SAPT, being ready for SAPT, living the burdens of continuous glucose monitoring and creating partnerships. CONCLUSIONS: Healthcare providers can facilitate adolescent and parental decision-making about the optimal timing for SAPT introduction. Success with SAPT requires exploration of adolescent and parental expectations for SAPT as well as the degree to which parents have previously fostered their adolescent's involvement in and responsibility for diabetes management.