Experiences of healthcare professionals, patients and families with video calls to stimulate patient- and family-centred care during hospitalization: A scoping review.

AIM: To synthesize the literature on the experiences of patients, families and healthcare professionals with video calls during hospital admission. Second, to investigate facilitators and barriers of implementation of video calls in hospital wards. DESIGN: Scoping review. METHODS: PubMed, CINAHL and Google Scholar were searched for relevant publications in the period between 2011 and 2023. Publications were selected if they focused on experiences of patients, families or healthcare professionals with video calls between patients and their families; or between families of hospitalized patients and healthcare professionals. Quantitative and qualitative data were summarized in data charting forms. RESULTS: Forty-three studies were included. Patients and families were satisfied with video calls as it facilitated daily communication. Family members felt more engaged and felt they could provide support to their loved ones during admission. Healthcare professionals experienced video calls as an effective way to communicate when in-person visits were not allowed. However, they felt that video calls were emotionally difficult as it was hard to provide support at distance and to use communication skills effectively. Assigning local champions and training of healthcare professionals were identified as facilitators for implementation. Technical issues and increased workload were mentioned as main barriers. CONCLUSION: Patients, families and healthcare professionals consider video calls as a good alternative when in-person visits are not allowed. Healthcare professionals experience more hesitation towards video calls during admission, as it increases perceived workload. In addition, they are uncertain whether video calls are as effective as in-person conservations. IMPLICATIONS FOR THE CLINICAL PRACTICE: When implementing video calls in hospital wards, policymakers and healthcare professionals should select strategies that address the positive aspects of family involvement at distance and the use of digital communication skills. PATIENT CONTRIBUTION: No patient or public contribution.

Informal caregivers' experiences of support from a tailored primary healthcare unit for older adults - A focus group study.

BACKGROUND: Informal caregivers are an essential part of health and social care systems worldwide. As such, they may need professional support. AIM: The aim of this study was to describe informal caregivers' experiences and need for support from a tailored primary health care (PHC) unit. METHODS: This is a qualitative descriptive study using data collected from five semi-structured focus group discussions with a purposeful sample of 16 informal caregivers of older relatives. Respondents were recruited from a tailored PHC unit for people aged 75 years or older in a region in central Sweden. The data were analysed by qualitative content analysis with an abductive approach, based on the principles of the patient- and family-centred care framework. RESULTS: The overarching theme was 'Striving for partnership'. The findings indicate that informal caregivers to some extent felt supported by the healthcare professionals. However, the caregivers expressed a need to be further acknowledged by the professionals in order to participate in the care of their older relatives in the way they wanted. Moreover, insufficient information regarding the older adult's health condition and care provided by the professionals had a negative impact on the caregiver's participation in care. CONCLUSIONS: Informal caregivers have unmet needs for support and strive for a partnership with the PHC professionals. PHC professionals should be more attentive and invite informal caregivers to participate in the care of the older adult in order to meet their support needs and build an equal partnership. The patient- and family-centred care framework may be of guidance when providing care for older adults in a PHC context.

Analyzing Co-Occurrence of Non-Suicidal Self-Injury With Suicidal Ideation and Related Factors Among Adolescents in Jeju Island.

Objectives: Non-suicidal self-injury (NSSI) and suicidal behavior, including suicidal ideation (SI) and suicide attempts, are important predictors of suicide in adolescents. This study aimed to investigate the associations between NSSI, SI, NSSI+SI, mental health problems, and family factors in Korean adolescents in Jeju Island, with an emphasis on key findings. Methods: A total of 561 adolescents completed self-report questionnaires regarding demographics, NSSI, SI, suicidal behavior, perceived family functioning, and mental health problems, which were assessed using Center for Epidemiological Studies Depression Scale for Children, Screen for Children Anxiety-Related Disorders (SCARED), and Youth Self-Report (YSR). Data were analyzed using descriptive statistics, one-way analysis of variance, chi-square test, post-hoc analyses, and multivariate logistic regression. Results: In this study, 22.3% of adolescents reported either NSSI or SI, with 5.5% reporting NSSI and 20.7% reporting SI. Combined (NSSI+SI) group showed a significantly higher SCARED score, anxiety/depression, thought problems, attention problem, and rule breaking on YSR than did the SI only group. Higher level of depression and anxiety were significantly associated with NSSI and SI. Female sex and perceived family dissatisfaction were significantly associated factors for SI, but not for NSSI in multivariate logistic regression. Conclusion: This study provides insights into the clinical characteristics and associated factors among adolescents with NSSI, SI, and NSSI+SI in Jeju Island. Identifying these results can inform the development of targeted prevention and intervention strategies to mitigate the negative consequences of these behaviors and contribute to a better understanding of the role of family in this context.

The combined effect of family environment and parents' characteristics on the use of food to soothe children.

Parental feeding practices, such as the use of food to soothe, can be shaped by various factors, including the family environment and parents' psychological characteristics and capacities. To our knowledge, the combined effect of these factors has not been studied. Furthermore, parental feeding practices have mainly been studied in women, resulting in a gender gap in the research. This study aims to investigate the combined effect of family environment and parental characteristics on the likelihood of using food to soothe children, taking the gender of both parents into account. This cross-sectional study included a sample of 846 parents (36.3% men) of 1-year-old children from different regions of Spain. Participants completed an online survey that included questionnaires to measure whether parents used food to soothe children, the family environment, parents' characteristics, and their psychological capacities. Binary logistic regression analyses were performed to identify associations between the variables. The final model showed that, within the family environment, higher levels of dyadic adjustment between couples (OR = 0.965; p = .026) were associated with a reduced likelihood of using food to soothe children, whereas the psychological characteristic of parental fatigue (OR = 1.053; p = .007) appeared to be associated with an increased likelihood. Also associated with an increased likelihood of this practice were higher parental sense of competence (OR = 1.028; p = .029) and the attention dimension of emotional intelligence (OR = 1.043; p = .007). Our study suggests that using food to soothe children may be influenced by factors at different levels, from the quality and adjustment of the couple's relationship to parental fatigue, self-competence, and emotional intelligence. For future research, it may be worthwhile contextualizing parental practices to gain a better understanding of children's behavior.

Storylines of family medicine III: core principles-primary care, systems and family.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'III: core principles-primary care, systems, and family', authors address the following themes: 'Continuity of care-building therapeutic relationships over time', 'Comprehensiveness-combining breadth and depth of scope', 'Coordination of care-managing multiple realities', 'Access to care-intersectional, systemic, and personal', 'Systems theory-a core value in patient-centered care', 'Family-oriented practice-supporting patients' health and well-being', 'Family physician as family member' and 'Family in the exam room'. May readers develop new understandings from these essays.

The impact of the COVID-19 pandemic on the mood and family relationships of runners.

Introduction: The aim of this study was to analyze the impact of the COVID-19 lockdown on the mood of amateur runners and on their relationships with their partners and families. Methods: Adult runners 18 years or older (N = 260) completed an online survey that included demographic information, standardized psychological assessments of Exercise Dependence (EDS-R) and mood (POMS), and, to measure relationship functioning, either the Dyadic Adjustment Scale (DAS) if they did not have children, or the Basic Family Evaluation Questionnaire (CERFB), measuring conjugal and parental relationships. Participants also answered questions about their exercise habits and the coping strategies they adopted during lockdown. Results: The results suggest that runners who saw the largest reductions in time spent exercising during lockdown tended to feel significantly less energetic (p < 0.05) and friendly (p < 0.01). In addition, they recorded significantly lower scores in marital satisfaction with their peers (p < 0.05). The runners with a higher degree of dependence on physical exercise registered significantly higher levels of depression, tension and anger than non-dependent runners (p < 0.001). Runners whose partners were physically active and did not have children had significantly higher scores marital satisfaction than runners whose partners were not physically active and had children (p < 0.05). Discussion: These findings seem to indicate that the psychological approach to athletes in the context of crises such as the pandemic should consider not only individual aspects, but also include the family perspective.

Characteristics and influencing factors of demoralization in patients with lung cancer: A latent class analysis.

OBJECTIVE: Demoralization has garnered increasing attention in recent years as a significant psychological distress. This study aims to identify latent classes of demoralization in lung cancer patients using Latent Class Analysis (LCA) from a person-centered perspective and to explore the factors influencing the latent classes of demoralization. METHODS: A cross-sectional study using convenience sampling was conducted among 567 lung cancer patients in three tertiary hospitals in China. LCA was employed to classify heterogeneous classes of demoralization. Multinomial logistic regression analyses were performed to explore the associations between demographic and clinical characteristics, as well as physical symptoms, resilience, family function, and coping strategies, with class membership in the identified heterogeneous subgroups of lung cancer patients. RESULTS: Three latent classes of demoralization were identified: the high demoralization group (Class 1, 14.8%), the moderate demoralization-distress and helplessness group (Class 2, 37.2%), and the low demoralization group (Class 3, 48.0%). In comparison to Class 3, lung cancer patients with hypertension, higher core symptom burden, poorer resilience, dysfunctional family dynamics, and resignation coping were more likely to belong to Class 1 and Class 2. CONCLUSIONS: The demoralization patterns in lung cancer patients were varied. Targeted intervention should be developed based on the characteristics of each class, and timely attention should be paid to high-risk patients.

Families tackling adolescent anorexia nervosa: family wellbeing in family-based treatment or other interventions. A scoping review.

PURPOSE: Family-based treatment (FBT) has contributed significantly to the treatment of anorexia nervosa (AN) in young people (YP). However, parents are concerned that FBT and the active role of parents in the task of refeeding may have a negative impact on family relations. The aim of the review is to assess whether families engaged in FBT for AN are more or less impacted in their family wellbeing and caregiver burden, compared to families with a YP diagnosed with AN, who are not undergoing treatment with FBT. METHOD: Computerized searches across six databases complemented by a manual search resulted in 30 papers being included in the scoping review. RESULTS: The review identified 19 longitudinal studies on change in family wellbeing in families in FBT-like treatments, and 11 longitudinal studies on change in family wellbeing in treatment where parents are not in charge of refeeding. Only three randomized controlled studies directly compare FBT to treatment without parent-led refeeding. CONCLUSION: The available research suggests no difference between intervention types regarding impact on family wellbeing. Approximately half of the studies find improvements in family wellbeing in both treatment with and without parent-led refeeding, while the same proportion find neither improvement nor deterioration. As parents play a pivotal role in FBT, there is a need for good quality studies to elucidate the impact of FBT on family wellbeing. Level of evidence Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Role of social support in culturally sensitive diabetes self-management education among an ethnic minority population in Denmark.

AIMS: CUSTOM is a culturally sensitive diabetes self-management education and support programme tailored to Urdu, Turkish and Arabic-speaking people in Denmark. The aim of this study was twofold: first, to examine the functional social support perceived by CUSTOM participants before and after the intervention; and, second, to explore how participants' structural social support affected the physical and mental health benefits of the intervention. METHODS: The participants were people with type 2 diabetes whose primary language was Urdu, Arabic or Turkish (n = 73). Outcomes included A1C, body fat percentage, diabetes distress, well-being and functional social support. Changes were observed between baseline and six months after participation in a single-group pre-test/post-test design. The Cochran-Armitage trend test was used to assess pre-post differences in functional social support. The role of structural social support was assessed using moderation regression analysis. RESULTS: Participants reported higher availability of functional social support after the programme (p < 0.05), although the change in loneliness was not significant. In addition, cohabitating with adult children increased the average body fat percentage reduction achieved following the programme, while living with a partner lowered the average body fat percentage reduction achieved. The intervention was particularly successful in improving diabetes distress among those with weak structural social support. CONCLUSIONS: Culturally sensitive diabetes self-management education and support can improve social support among people with an ethnic minority background. The structure of social relations may influence the benefit of culturally sensitive diabetes self-management education and support. Future programmes should include family members and other social relations more actively, drawing attention to both positive and negative aspects of social relations.

Healthcare professionals perspective of the facilitators and barriers to family engagement during patient-and-family-centered-care interdisciplinary rounds in intensive care unit: A qualitative exploratory study.

OBJECTIVES: Family engagement in care for critically ill patients remains an inconsistent practice and an understudied area of nursing science. Rounds for this study is an interdisciplinary activity conducted at the bedside in partnership with patients, their families, and the health care professionals involved in providing the care. We sought to explore and describe the facilitators and barriers to family engagement during patient and family-centered interdisciplinary rounds in the intensive care unit. RESEARCH METHODOLOGY/DESIGN: This qualitative exploratory study is part of a multisite experimental study (#Pro2020001614; NCT05449990). We analyzed the narrative data from the qualitative questions added in the survey from 52 healthcare professionals involved in a multisite experimental study using Braun and Clarke's (2006) constructionist, contextualist approach to thematic analysis. SETTING: The study was conducted in the intensive care unit of two medical centers. MAIN OUTCOME MEASURES: The findings presented are themes illuminated from thematic analysis namely communication gaps, family's lack of resources, familial and healthcare providers' characteristics, lack of leadership, interprofessional support, policy, and guidelines. FINDINGS: Family engagement in critical care during interdisciplinary rounds occurred within the intersectionality among families, healthcare professionals' practice, and organizational factors. The facilitators for family engagement include supported, championed, and advocated-for family adaptation, teams, and professional practice, and organizational receptivity, and support. Communication and leadership are the precursors to family engagement. CONCLUSIONS: The findings added new knowledge for exploring the nature and scope of family engagement in critical care. Family engagement must be incorporated into the organizational vision and mission, and healthcare delivery systems. IMPLICATIONS FOR CLINICAL PRACTICE: There is a need to further investigate the resources, organizational support mechanisms, and systems that affect patients, families, and healthcare professionals, and the establishment of policies that will aid in reducing barriers to family engagement in the intensive care unit.

Community Nurses' Perspectives on Conceptual Challenges Related to the Need for Nursing Care in Germany: A Constructivist Grounded Theory Study.

In Germany, a person's need for nursing care is assessed by evaluators according to the federal legal definition of the statutory long-term care insurance (LTCI). This definition and the associated standardized assessment tool constitute the conditions for providing nursing care in a community care setting in Germany. Furthermore, the community care setting is regulated by state law and negotiations between long-term care funds and associations of providers of nursing care. During nursing care, nurses engage in a variety of interactions with people. The extent to which the legal definition of the need for nursing care leads to challenges in these interactions is unclear. To address this knowledge gap, we conducted 22 problem-centered interviews with nurses in the community and analyzed the data using the constructivist grounded theory. The results revealed that the negotiation processes are settled within professional-family relationships and vary between the constructs of closeness and distance, advocacy and submission of responsibility, and ethos and technocracy; these are the central challenges nurses encounter in this setting. We discuss the implications and questions that arise from the findings for the nursing profession regarding its own current and future role as well as the design of nursing support in the community, to nurture more advanced nurse practitioners and community health nurses.

Chinese family care partners of older adults in Canada have grit: A qualitative study.

AIM: To explain the process taken by Chinese family care partners of older adults in the Greater Toronto Area, Canada, to access health and social services in their communities. The research question was: What mechanisms and structures impact the agency of Chinese family care partners of older adults, in the process of assisting them to access health and social services? DESIGN: This qualitative study was informed by critical realism. METHODS: Chinese family care partners of older adults in the Greater Toronto Area, Canada, were interviewed from August 2020 to June 2021. Transcripts underwent thematic analysis. FINDINGS: Twenty-eight Chinese family care partners expressed a firm commitment to maintain caregiving conditions and to judiciously access health and social services. Their commitment was made up of three parts: (a) legislative and cultural norms of family, work, and society; (b) their perseverance to fill gaps with limited social and financial resources; (c) the quality of their relationship to, and illness trajectory of the older adults. The social structures created tension in how Chinese family care partners made decisions, negotiated resources, and ultimately monitored and coordinated timely access with older adults. CONCLUSION: Participants' commitment and perseverance were conceptualized as "grit," central to their agency to conform to legislative and cultural norms. Moreover, findings support grit's power to motivate and sustain family caregiving, in order for older adults to age in place as long as possible with finite resources. IMPLICATIONS FOR THE PROFESSION: This study highlights the importance of cultural awareness education for nurses, enabling continuity of care at a systems level and for a more resilient healthcare system. IMPACT: Family care partners' grit may be crucial for nurses to harness when together, they face limited access to culturally appropriate health and social services in a system grounded in values of equity and inclusion, as in Canada. REPORTING METHOD: When writing this manuscript, we adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public involvement.

Reframing care while enduring the traumatic nature of witnessing disrupted family-patient-nurses' relationships during COVID-19.

AIM: To describe the lived experiences of nurses caring for patients and families in the context of COVID-19 in Brazil and United States. DESIGN: A phenomenological philosophical approach following the van Manen analysis method. METHODS: Participants were recruited in Brazil and the United States, including nurses working in health care settings caring for COVID-19 patients. Recruitment used purposive and snowball sampling. Participants completed a demographic survey and semi-structured interviews that were audio-recorded and transcribed for analysis. A cross-cultural examination occurred among researchers from each country. RESULTS: The result was described (n = 35) by the themes, representing the essences of each lifeworld (relationship, time, space and body). The nurses' lived experience was one of reframing care while enduring repeated trauma of witnessing disrupted patient-family-nurse relationships. Themes were as follows: (a) Living a silent and lonely experience; (b) Providing connectedness for disrupted patient and family relationships; (c) Feeling the burden of the demands; (d) Being a helping connector; (e) Reshaping spaces amidst evolving interventions and policies; (f) Creating safe spaces, surrounded by turmoil, threat, and distress within an unsafe environment; (g) Reorganizing care and reframing time; (h) Reconciling losses, regrets, victories and lessons. CONCLUSION: The nurses' lived experience of caring for patients and families during the COVID-19 pandemic prompted the need to respond to repeated traumas and distress posed by interrupted patient-family and nurse-own family relationships, vulnerable bodies, threatened space and dynamic and volatile time. IMPACT: Cultural nuances were discovered depending on the practice setting, political discourse and the autonomy of the nurse. Innovative models of care that create structures and processes to support nurses in caring for patients in threatening environments and the commitment to connecting family members have potential to contribute to the ongoing health of the nursing profession.

Elderly and youth: Reflections / Idosos (as) e jovens: reflexões

Objective The article aims to present reflections provoked through content analysis of interviews with families on the relationship between elderly people and young adults. Specifically, to make considerations on the characteristics and perceptions of both generations regarding the interactions between them. Method This is a qualitative, cross-sectional, and exploratory research. Twelve elderly people between 60 and 74 years old and 12 young adults between 19 and 40 years old participated, regardless of gender, social class, education, and profession. Data collection was carried out through a semi-structured interview script and a sociodemographic questionnaire. Data analysis was directed through thematic Content Analysis. Results The results showed that this is an intergenerational relationship permeated by nuances characteristic of the research subjects' age groups. Conclusion In this sense, there is a generation gap caused by the lack of quality time invested in these relationships.

Objetivo Apresentar reflexões provocadas através da análise de conteúdo de entrevistas com famílias acerca do relacionamento entre pessoas idosas e adultas jovens. Mais especificamente, tecer considerações sobre as características e percepções de ambas as gerações sobre as interações entre elas. Método Trata-se de uma pesquisa de natureza qualitativa, transversal e exploratória. Participaram 12 idosos na faixa etária entre 60 e 74 anos e 12 adultos jovens entre 19 e 40 anos de idade, independente de gênero, classe social, escolaridade e profissão. A coleta de dados foi realizada por meio de um roteiro de entrevista semiestruturada e questionário sociodemográfico. A análise dos dados foi direcionada através da Análise de Conteúdo temática. Resultados Os resultados demonstraram que se trata de um relacionamento intergeracional perpassado por nuances características das faixas etárias dos sujeitos da pesquisa. Conclusão Nesse sentido, existe um distanciamento entre as gerações ocasionado pela ausência da qualidade de tempo investido nessas relações.

Encontrar un nuevo equilibrio: Estudio cualitativo sobre los efectos del COVID-19 en la vida familiar / Striking a new balance: A qualitative study of how family life has been affected by COVID-19 / Conquistando um novo equilíbrio: Um estudo qualitativo de como a vida familiar foi afetada pela COVID-19

Objetivo: examinar las repercusiones de la pandemia en el sistema familiar enfocándose en la perspectiva de familiares que han contraído y padecido COVID-19. Método: estudio exploratorio de enfoque cualitativo realizado con 27 personas que tuvieron COVID-19. Los datos se recolectaron por medio de entrevistas telefónicas que se grabaron en audio y estuvieron guiadas por un instrumento semiestructurado. El análisis se basó en un proceso inductivo respaldado por Análisis Temático Reflexivo. Resultados: la pandemia y el hecho de que un familiar contrajera la enfermedad fueron fuerzas impulsoras que generaron movilizaciones nuevas e intensas en el sistema familiar. Inicialmente, notaron repercusiones negativas como preocupaciones, temor, angustia, estrés, distanciamiento y aislamiento social. Con el paso del tiempo y empleando tecnologías para facilitar la comunicación, comenzaron a percibir repercusiones positivas como más cercanía, fortalecimiento de vínculos, desarrollo de nuevos roles y cuidado mutuo. Las familias también identificaron que recuperaban una posición de equilibrio, con retorno de cierto reajuste en la dinámica y el funcionamiento familiar. Conclusión: los profesionales de la salud deben admitir que la enfermedad por COVID-19 ha generado repercusiones en los sistemas familiares, además de proponer intervenciones que ayuden a las familias a hacer frente a este momento y a recuperar más fácilmente una posición de equilibrio para su buen funcionamiento.

Objective: to examine the repercussions of the pandemic on the family system by focusing on the perspective of family members who contracted and experienced COVID-19. Method: an exploratory study with a qualitative approach conducted with 27 individuals who had COVID-19. Data collection took place through telephone interviews that were audio-recorded and guided by a semi-structured instrument. Data analysis was based on an inductive process supported by Reflexive Thematic Analysis. Results: the pandemic and illness of a family member acted as driving forces generating new and intense movements in the family system. Initially, they noticed negative repercussions such as concerns, fear, anguish, stress, distancing and social isolation. As time progressed and by using technologies to ease communication, they began to perceive positive repercussions such as increased proximity, strengthening of ties, development of new roles and care. The families also identified recovery of a balanced position, with return of certain readjustment in family dynamics and functioning. Conclusion: health professionals need to recognize that the COVID-19 disease has imposed repercussions on family systems, proposing interventions that help families face this moment and more easily recover a balanced position for their functioning.

Objetivo: examinar as repercussões da pandemia no sistema familiar a partir da perspectiva dos familiares que contraíram e vivenciaram a COVID-19. Método: estudo exploratório com abordagem qualitativa realizado com 27 indivíduos que tiveram COVID-19. A coleta de dados ocorreu por meio de entrevistas telefônicas gravadas em áudio e guiadas por um instrumento semiestruturado. A análise dos dados baseou-se num processo indutivo apoiado na Análise Temática Reflexiva. Resultados: a pandemia e o adoecimento de um familiar atuaram como motores geradores de novos e intensos movimentos no sistema familiar. Inicialmente, perceberam repercussões negativas como preocupações, medo, angústia, estresse, distanciamento e isolamento social. Com o passar do tempo e com o uso das tecnologias para facilitar a comunicação, os familiares começaram a perceber repercussões positivas como maior proximidade, fortalecimento dos laços, desenvolvimento de novos papéis e cuidado. As famílias também identificaram recuperação de uma posição equilibrada, com retorno de certo reajuste na dinâmica e funcionamento familiar. Conclusão: os profissionais de saúde precisam reconhecer que a doença COVID-19 impôs repercussões nos sistemas familiares, propondo intervenções que ajudem as famílias a enfrentar esse momento e recuperar mais facilmente uma posição equilibrada para seu funcionamento.

Percepções das mães que são profissionais de saúde sobre as relações na unidade neonatal / Health professionals mothers' perceptions about relationships in the neonatal unit / Percepciones de las madres profesionales de la salud sobre las relaciones en la unidad neonatal

Objetivo: discutir as percepções das mães que são profissionais de saúde sobre as relações na unidade neonatal. Método: estudo qualitativo, apoiado no Interacionismo Simbólico, com 11 mães de recém-nascidos pré-termo que são profissionais da saúde. Após aprovação pelo Comitê de Ética em Pesquisa, os dados foram coletados de maio a outubro de 2021, por meio de entrevistas individuais, e submetidos à análise de conteúdo temática. Resultados: apesar de as mães serem profissionais da saúde, as relações na unidade neonatal foram difíceis, sofridas, desconfortantes e restritivas ao processo de 'ser e tornar-se mãe'. Estas desvelaram sentimentos de não pertencimento ao cuidado e de afastamento de suas crianças. Conclusão: as relações entre mães e profissionais da saúde atuantes na unidade neonatal estiveram marcadas por sofrimentos, limitações e desconfortos, sendo lacunares em processos colaborativos, na contramão do Cuidado Centrado na Família.

Objective: to discuss the perceptions of mothers who are health professionals about relationships in the neonatal unit. Method: a qualitative study, based on Symbolic Interactionism, with 11 mothers of preterm newborns who are health professionals. After approval by the Research Ethics Committee, data was collected from May yo October 2021, through individual interviews, and subjected to thematic content analysis. Results: despite the mothers being health professionals, relationships in the neonatal unit were difficult, painful, uncomfortable, and restrictive to the process of 'being and becoming a mother'. They revealed feelings of not belonging to care and of being away from their children. Conclusion: the relationships between mothers and health professionals working in the neonatal unit were marked by suffering, limitations, and discomfort, and were lacking in collaborative process, going against Family-Centered Care.

Objetivo: discutir las percepciones de las madres profesionales de salud sobre las relaciones en la unidad neonatal. Método: estudio cualitativo, basado en el Interaccionismo Simbólico, con 11 madres de recién nacidos prematuros que son profesionales de la salud. Previa aprobación del Comité de Ética en Investigación, se recolectaron los datos de mayo a octubre de 2021, mediante entrevistas individuales y los sometieron a análisis temático de contenido. Resultados: aunque las madres eran profesionales de salud, las relaciones en la unidad neonatal fueron difíciles, dolorosas, incómodas y restrictivas al proceso de 'ser y volverse madre'. Revelaron sentimientos de no pertenencia a los cuidados y de alejamiento de sus hijos. Conclusión: las relaciones entre las madres y los profesionales sanitarios que trabajan en la unidad neonatal estaban marcadas por el sufrimiento, las limitaciones y la incomodidad, y carecían de procesos de colaboración, lo que iba en contra de la Atención Centrada en la Familia.

Soporte familiar en el tratamiento en pacientes con tuberculosis del Hospital Carlos Monge de Juliaca / Family support in the treatment of tuberculosis patients at Carlos Monge Hospital in Juliaca / Apoio familiar no tratamento de pacientes com tuberculose no Hospital Carlos Monge em Juliaca

La tuberculosis (TBC) se convirtió en un problema de salud pública, incrementándose en los últimos años en Perú con 17 mil casos, los factores que afectan son por el diagnóstico y el incumplimiento terapéutico de los pacientes. Un paciente que tenga TBC, requiere de un proceso de servicio hospitalario y se busca una estabilidad física y emocional en aras de una mejora de la calidad de vida, es allí donde la familia juega un papel trascendental en la recuperación del paciente. Objetivo. Determinar la influencia del soporte familiar en el proceso de adaptación al tratamiento en pacientes con tuberculosis. Materiales y métodos. El estudio se encuentra enmarcada dentro del enfoque cuantitativo, de tipo básica, de nivel explicativo, diseño no experimental de corte transaccional y de método hipotético-deductivo. Asimismo, la población fue universal de 40 pacientes, para la recolección de información se utilizó el cuestionario estructurado de tipo escala likert, la cual fue comprobada con el análisis no paramétrico, por medio del chi cuadrado. Resultados. Muestran que el soporte familiar influye significativamente en el proceso de adaptación al tratamiento en pacientes con TBC, ya que se detalla el valor de chi cuadrado y chi tabulada: x

Tuberculosis (TB) has become a public health problem, increasing in recent years in Peru with 17 thousand cases, the factors that affect the diagnosis and therapeutic noncompliance of patients. A patient with TB requires a hospital service process and physical and emotional stability is sought in order to improve the quality of life, where the family plays a transcendental role in the patient's recovery. Objective. To determine the influence of family support in the process of adaptation to treatment in patients with tuberculosis. Materials and methods. The study is framed within the quantitative approach, basic type, explanatory level, non-experimental design of transactional cut and hypothetical-deductive method. Likewise, the population was universal, 40 patients, and a structured Likert scale questionnaire was used for the collection of information, which was verified with the nonparametric analysis, by means of the chi-square test. Results. They show that family support significantly influences the process of adaptation to treatment in patients with TB, since the chi-square value and tabulated chi are detailed: x

A tuberculose (TB) tornou-se um problema de saúde pública, aumentando nos últimos anos no Peru, com 17.000 casos, e os fatores que afetam o diagnóstico e a não adesão terapêutica dos pacientes. O paciente com TB requer um processo de atendimento hospitalar e busca estabilidade física e emocional para melhorar sua qualidade de vida, onde a família desempenha um papel transcendental na recuperação do paciente. Objetivo. Determinar a influência do apoio familiar no processo de adaptação ao tratamento em pacientes com tuberculose. Materiais e métodos. O estudo se enquadra no enfoque quantitativo, tipo básico, nível explicativo, desenho não experimental de corte transacional e método hipotético-dedutivo. Da mesma forma, a população foi uma população universal de 40 pacientes, para a coleta de informações foi utilizado o questionário estruturado do tipo escala Likert, que foi verificado com a análise não paramétrica, por meio do qui-quadrado. Resultados. Mostram que o apoio familiar influencia significativamente o processo de adaptação ao tratamento em pacientes com TB, conforme detalham os valores do qui-quadrado e do qui-quadrado tabelado: x

Nurses' Work-Family Strategies during COVID-19 Lockdown and Their Association with Individual Health and Family Relations.

The COVID-19 lockdown forced people to stay at home and address their family duties more equally. However, since nurses themselves were involved in the closed-loop management in hospitals and unable to return home, there was also an increased likelihood of non-traditional work-family strategies emerging. To ascertain the extant and implications of this phenomenon, this cross-sectional study explores work-family management strategies among nurses during the COVID-19 lockdown and their association with nurses' individual health, family relationships, and job performance. Survey data were collected from 287 nurses who were involved in the closed-loop management in Shanghai hospitals from March to June 2022. Latent Class Analysis of seven categorical variables of nurses' work-family status (e.g., the division of childcare labor) produced a best-fit solution of five strategies (BLRT (p) < 0.001, LMR (p) = 0.79, AIC = 5611.34, BIC = 6302.39, SSA-BIC = 5703.65, Entropy = 0.938): (1) fully outsourcing to grandparents, (2) partially outsourcing to grandparents, with the husband filling in the gap, (3) the husband does it all, (4) egalitarian remote workers, and (5) a neo-traditional strategy. Nurses who applied the egalitarian strategy had less psychological distress and relationship tension and better performance than those who applied the neo-traditional strategy and performed most of the childcare. The "husband does it all" strategy and the outsourcing strategies seem to have double-edged effects, with better job performance and family relations but also more distress and fewer sleeping hours among nurses. Overall, with a view to future risk mitigation, policymakers and practitioners should be aware of the diversity of the work-family strategies among nurse families during the lockdown period, and their association with individual and family outcomes, and provide tailored support.

A experiência do puerpério para as famílias: uma travessia / The postpartum experience for families: a journey

Resumo: Puerpério é o termo utilizado para designar o período que sucede ao parto. Trata-se, no entanto, para além de um período de tempo, um momento com características peculiares, de transformações intensas e desafiadoras, tanto de cunho pessoal, quanto para o grupo social que o experiencia conjuntamente, a família. E por considerar este grupo social como significante nesse período é que este estudo busca compreender o significado da experiência do puerpério para as famílias; bem como desenvolver uma teoria substantiva representativa que explicite esta experiência; e propor contribuições para nortear o cuidado em saúde às famílias durante o puerpério. Trata-se de uma pesquisa qualitativa, do tipo interpretativista, que adotou como referencial metodológico a Teoria Fundamentada nos Dados em sua corrente Corbiniana e, como aporte teórico, a perspectiva do Interacionismo Simbólico. A coleta de dados ocorreu entre fevereiro de 2021 e dezembro de 2022, mediante construção de genogramas, ecomapas e entrevistas, realizados com 39 membros de 14 famílias que experienciavam o puerpério não patológico, distribuídas em dois grupos amostrais. Os dados foram organizados com o apoio do software NVivo®, apoiados pela construção de memorandos, diagramas, através da codificação dos dados nas seguintes etapas: aberta, axial e integrativa. Seus resultados levaram ao desenvolvimento da teoria substantiva "A experiência do puerpério para as famílias: uma travessia", representada pelo conceito central "Atravessando o puerpério", que se sustenta em 35 elementos, 9 subconceitos e 3 conceitos: "Identificando a etapa do puerpério"; "Movendo-se por mudanças intensas e desafios", e "Transformando-se no decorrer da travessia". Posteriormente à sua elaboração, a teoria passou por validação com representantes de três famílias que estavam percorrendo o puerpério. Percebeu-se que para as famílias o puerpério é singular, mas construído a partir das interações sociais que se desenvolvem ao longo da vida dos membros da família e incorre em transformações diversas, impactantes e acumulativas, tanto em nível pessoal, como social. Assim, sugere-se que a atuação dos profissionais de saúde no puerpério seja centrada na família e nas interações ocorridas dentro dela, de forma a contemplar as especificidades de cada contexto social em que as pessoas envolvidas se movem e interagem para superar a crise suscitada pela adição de seu novo integrante, conforme proposições no texto. Para viabilizar essa concepção ampliada do cuidar no puerpério, indica-se que isso aconteça através de diretrizes na formação profissional, enquanto conteúdo de disciplina/curso em áreas de concentração pertinentes, assim como, na prática por meio de educação permanente aos profissionais, bem como na construção de políticas públicas que superem um olhar do puerpério como um momento fisiológico, para integrar a percepção de seu cunho social. Almeja-se que essa construção teórica possa alcançar gestores, líderes, profissionais e famílias e que desperte o desejo de trocas profícuas em favor da melhoria da atenção à saúde às famílias em todas as ocasiões em que elas estiverem atravessando o puerpério.

Abstract: Postpartum is the term used to designate the period following childbirth. It is, nevertheless, not only a period of time, but a moment of singular characteristics, of intense and challenging transformation, both on a personal basis as for the social group experiencing it together, the family. By considering this social group as significant in this period, this study aims to understand the meaning of the postpartum experience for family members; to develop a representative substantive theory to explicate this experience; and to propose contributions to guide the healthcare of the families during postpartum. A qualitative research, of an interpretative nature, which adopted as methodological reference Corbin's Grounded Theory and, as theoretical contribution, the Symbolic Interactionism perspective. Data collection occurred between February 2021 and December 2022, through the design of genograms, ecomaps and interviews, conducted with 39 members of 14 families who experienced non-pathological postpartum, distributed into two sample groups. Data was organized using the NVivo® software, supported by the creation of memoranda, diagrams, through the coding of data in the following stages: open, axial and integrative. The results led to the development of the substantive theory "The postpartum experience for families: a journey", represented by the core concept "A journey through postpartum", which is based on 35 elements, 9 sub-concepts and 3 concepts: "Identifying the postpartum period"; "Moving through intense changes and challenges", and "Transforming oneself in the course of the journey". After its preparation, the theory was validated by representatives of three families who were going through the postpartum period. It was observed that for these families, postpartum is singular, but built from social interactions that were developed throughout the lives of the family members and results in various, impactful and cumulative transformations, both personally and socially. Accordingly, it is suggested that the work of health professionals be centered on the family and on interactions that occur within it, in order to consider the specificities of each social context in which the people involved move and interact in order to overcome any crises raised by the addition of a new member, according to the propositions of the text. To enable this expanded conception of healthcare during postpartum, this should occur through guidelines during professional training, as discipline/course content in pertinent areas of concentration, as well as during practice, through continued education for professionals, and the development of public policies overcoming the perspective of postpartum as a physiological moment, integrating the perception of its social nature. It is hoped that this theoretical construct may reach managers, leaders, professionals and families, awakening the will for fruitful exchanges in favor of improving the healthcare of families in their journey through the postpartum.

Relatives' experiences of care encounters in the general ward after ICU discharge: a qualitative study.

BACKGROUND: Care encounters at general wards have many reasons, and the complexity differs. Some arriving at the ward are relatives of discharged intensive care unit patients', who are usually more fragile than others due to what had happened to them. Research indicates that care encounters leave relatives dissatisfied. There is a lack of studies describing how relatives of adult patients experience the transfer from the intensive care unit. AIM: The purpose of this study was to describe relatives' experiences of care encounters with nurses during their loved ones' stay in the general ward after being discharged from the intensive care unit. METHODS: A qualitative descriptive design with an inductive approach was used. Semi-structured individual interviews were conducted with relatives [n = 14) of patients from different hospitals in Sweden. Data were analysed using content analysis. RESULTS: Relatives expressed feeling a huge responsibility for ensuring the quality of care for their loved ones. It was essential to encounter available, committed, and compassionate nurses in the general ward after being transferred from the intensive care unit. The theme 'longing for trust and struggling to be involved in their loved one's care' was illustrated in the two subthemes of 'wanting to be seen as an important piece of the puzzle' and 'being vigilant and worrying about the quality of care'. CONCLUSION: The relatives of patients experience their needs as unfulfilled in care encounters with nurses at the general ward after transfer from ICU. In order to meet the needs of relatives, nurses require well-developed non-technical skills to establish a compassionate interaction founded on trust and respect for the individual. Future research should investigate how relatives' needs can be met in practice. New nursing innovations are necessary to structure encounters with patients and relatives transitioning from the intensive care unit.