RESUMO
PURPOSE: The aim of this study was to describe nurses' experiences of the prerequisites for implementing family-centered care to prevent pediatric delirium. DESIGN: The research employed a qualitative, descriptive study design. METHODS: A total of 10 nurses working in the pediatric intensive care unit at 1 university hospital participated in the study. The quality data were collected using individual semistructured interviews, and the data were then analyzed by inductive content analysis. RESULTS: The prerequisites for implementing family-centered care to prevent delirium among pediatric patients consisted of 30 subcategories that were grouped into 11 generic categories. The generic categories were further grouped into 5 main categories: (1) an environment that supports family presence, (2) psychosocial support for the family, (3) individual family involvement, (4) family participation in shared decision-making, and (5) nurses' professional competence. CONCLUSIONS: According to the nurses' experiences, the implementation of a family-centered approach to preventing delirium in pediatric patients requires creating a supportive environment for families, providing psychosocial support, encouraging family involvement in decision-making, and ensuring that all nurses have the necessary skills.
Assuntos
Delírio , Enfermagem Familiar , Pesquisa Qualitativa , Humanos , Delírio/prevenção & controle , Delírio/enfermagem , Criança , Recursos Humanos de Enfermagem Hospitalar/psicologia , Atitude do Pessoal de Saúde , Adulto , Feminino , Relações Profissional-Família , Enfermagem Pediátrica , Masculino , Unidades de Terapia Intensiva Pediátrica , Família/psicologia , Assistência Centrada no PacienteRESUMO
AIM: This study aimed to describe nurses' attitudes and beliefs towards the importance of family in nursing care and explore differences in nurses' attitudes and beliefs towards family-centered care between different healthcare institutions, such as community healthcare centers and hospitals. BACKGROUND: Family significantly affects the well-being and health of individuals. Therefore, nurses should support family engagement in nursing care. In recent years, family nursing research has emphasized the importance of teaching family nursing skills in continued education in healthcare institutions. Research has indicated that nurses who believe that illness concerns the family as a whole are more likely to involve the family in patient care. DESIGN: A cross-sectional research design was used. METHOD: Data were collected at one timepoint between March and September 2019 from 425 nurses working at the Primary Health Care Centers of the Capital Area (n=112) and in clinical settings at the University Hospital in Iceland (n=313). RESULTS: The main findings indicated that nurses working in the women-and-child division at the University Hospital reported significantly more positive attitudes towards family evolvement in patient care than nurses working in the intensive care or surgical units. For nurses working at healthcare centers, a significant difference was also found in the nurses' attitudes towards involving families in patient care. The nurses who were working in home care had significantly more positive attitudes when compared to those working in the infant and young children health promotion units. CONCLUSIONS: Greater collaboration is required between healthcare providers and families to improve the quality of care and health-related outcomes. Therefore, it is crucial to enhance nurses' knowledge about the importance of families during patient care. TWEETABLE ABSTRACT: This study aimed to describe nurses' attitudes and beliefs towards family care. Differences were found between nurse's attitudes by units but not by institutions.
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Atitude do Pessoal de Saúde , Humanos , Estudos Transversais , Feminino , Adulto , Masculino , Inquéritos e Questionários , Islândia , Pessoa de Meia-Idade , Enfermagem Familiar , Enfermeiras e Enfermeiros/psicologia , Relações Profissional-Família , Cuidados de Enfermagem/psicologia , Família/psicologiaRESUMO
This is a theoretical study aimed at reflecting on the contribution of the concept of family myth to nursing care for children in psychological distress. It is methodologically structured around three topics: the importance of the family in caring for children; the perspective of family-centered nursing care for children in psychological distress; and the contribution of the understanding of family myth to nursing care for children in psychological distress. The following dialectic is considered: the family, considered by current literature to be a harmonious unit, also triggers family conflicts that can be the cause of psychological suffering. The concept of family myth emerges as a possible theoretical anchor for nursing care for children in psychological distress, as it allows nurses to consider the signifiers that mark the child's psychological structure and construct their symptoms. Uncovering the place that the family assigns to the child enables nurses to help them construct and elaborate their own place as a subject in their subjectivity.
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Angústia Psicológica , Humanos , Criança , Família/psicologia , Estresse Psicológico , Enfermagem Familiar , Enfermagem PediátricaRESUMO
The goal of baby and family-centered care in the neonatal intensive care unit (NICU) is to recognize the baby's needs exhibited through the baby's individual behavior and communication and support parent education, engagement, and interaction with the baby to build a nurturing relationship. Health care providers and caregivers must guide rather than control the role of the parents from birth through NICU care, transition to home, and continuing care at home. Parents are health care team members, primary caregivers, and shared decision-makers in caring for their babies.
Assuntos
Unidades de Terapia Intensiva Neonatal , Pais , Humanos , Recém-Nascido , Enfermagem Familiar/organização & administração , Unidades de Terapia Intensiva Neonatal/organização & administração , Terapia Intensiva Neonatal/organização & administração , Pais/educação , Assistência Centrada no Paciente , Relações Profissional-FamíliaRESUMO
BACKGROUND: Family-centred care (FCC), while a core value of paediatric hospitals, has not been well-studied in the paediatric cardiac intensive care unit (PCICU). AIM: To describe parents' perceptions of FCC provided by nurses in the PCICU during their infant's recovery from neonatal cardiac surgery and explore associations of perceptions of FCC on parent post-traumatic stress (PTS) 4 months post-discharge. STUDY DESIGN: Data obtained from a previously conducted randomized clinical trial (RCT) on telehealth home monitoring after neonatal cardiac surgery at three free-standing paediatric hospitals were analysed from a subset of 164 parents who completed the FCC Scale at hospital discharge, which measures a parent's experience of nursing care that embodies core principles of FCC. The RCT intervention was provided after hospital discharge, having no influence on parent's perception of FCC. The intervention also had no effect on PTS. RESULTS: Perceived FCC was lowest for items 'nurses helped me feel welcomed' and 'nurses helped me feel important in my child's care'. Having 12%-19% points lower perception of FCC at hospital discharge was associated with parent experience of six or more PTS symptoms, at least moderate PTS symptom severity, or PTS disorder diagnosis at 4-month follow-up. Every 10% increase in parental perceptions of FCC was associated with less PTS symptoms (ß = -0.29, SE = 0.12; p = .02) and lower PTS symptom cluster scores of arousal (ß = -0.18, SE = 0.08; p = .02). CONCLUSIONS: Parents who perceived lower FCC during their infants' hospitalization were at increased risk for the development of PTS symptoms, more PTS symptom severity and PTS disorder diagnosis 4-months post-discharge. RELEVANCE TO CLINICAL PRACTICE: Nurses have a prominent role to support the implementation of FCC for infants with cardiac defects and their parents. FCC may positively influence overall parent mental health and well-being, reducing the trauma and distress of the PCICU experience.
Assuntos
Unidades de Terapia Intensiva Pediátrica , Pais , Transtornos de Estresse Pós-Traumáticos , Humanos , Pais/psicologia , Feminino , Masculino , Transtornos de Estresse Pós-Traumáticos/psicologia , Lactente , Recém-Nascido , Adulto , Enfermagem Familiar , Relações Profissional-Família , Alta do PacienteRESUMO
Background/objectives: The Family Nurse Partnership is an intensive home visiting programme for adolescent mothers. We aimed to evaluate the effectiveness of the Family Nurse Partnership on outcomes up to age 7 using national administrative data. Design: We created a linked cohort of all mothers aged 13-19 using data from health, educational and children's social care and defined mothers enrolled in the Family Nurse Partnership or not using Family Nurse Partnership system data. Propensity scores were used to create matched groups for analysis. Setting: One hundred and thirty-six local authorities in England with active Family Nurse Partnership sites between 2010 and 2017. Participants: Mothers aged 13-19 at last menstrual period with live births between April 2010 and March 2019, living in a Family Nurse Partnership catchment area and their firstborn child(ren). Interventions: The Family Nurse Partnership includes up to 64 home visits by a family nurse from early pregnancy until the child's second birthday and is combined with usual health and social care. Controls received usual health and social care. Main outcome measures: Indicators of child maltreatment (hospital admissions for injury/maltreatment, referral to social care services); child health and development (hospital utilisation and education) outcomes and maternal hospital utilisation and educational outcomes up to 7 years following birth. Data sources: Family Nurse Partnership Information System, Hospital Episode Statistics, National Pupil Database. Results: Of 110,520 eligible mothers, 25,680 (23.2%) were enrolled in the Family Nurse Partnership. Enrolment rates varied across 122 sites (range: 11-68%). Areas with more eligible mothers had lower enrolment rates. Enrolment was higher among mothers aged 13-15 (52%), than 18-19 year-olds (21%). Indicators of child maltreatment: we found no evidence of an association between the Family Nurse Partnership and indicators of child maltreatment, except for an increased rate of unplanned admissions for maltreatment/injury-related diagnoses up to age 2 for children born to Family Nurse Partnership mothers (6.6% vs. 5.7%, relative risk 1.15; 95% confidence interval 1.07 to 1.24). Child health and developmental outcomes: there was weak evidence that children born to Family Nurse Partnership mothers were more likely to achieve a Good Level of Development at age 5 (57.5% vs. 55.4%, relative risk 1.05; 95% confidence interval 1.00 to 1.09). Maternal outcomes: There was some evidence that Family Nurse Partnership mothers were less likely to have a subsequent delivery within 18 months of the index birth (8.4% vs. 9.3%, relative risk 0.92; 95% confidence interval 0.88 to 0.97). Younger and more vulnerable mothers received higher numbers of visits and were more likely to achieve fidelity targets. Meeting the fidelity targets was associated with some outcomes. Limitations: Bias by indication and variation in the intervention and usual care over time and between areas may have limited our ability to detect effects. Multiple testing may have led to spurious, significant results. Conclusions: This study supports findings from evaluations of the Family Nurse Partnership showing no evidence of benefit for maltreatment outcomes measured in administrative data. Amongst all the outcomes measured, we found weak evidence that the Family Nurse Partnership was associated with improvements in child development at school entry, a reduction in rapid repeat pregnancies and evidence of increased healthcare-seeking in the mother and child. Future work: Future evaluations should capture better measures of Family Nurse Partnership interventions and usual care, more information on maternal risk factors and additional outcomes relating to maternal well-being. Study registration: The study is registered as NIHR CRN Portfolio (42900). Funding: This award was funded by the National Institute of Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/99/19) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.
The Family Nurse Partnership is an intensive home visiting service that offers first-time young mothers up to 64 visits with a family nurse from pregnancy to their child's second birthday. The Family Nurse Partnership aims to improve birth outcomes, child health and development and promote economic self-sufficiency among young mothers. Previous research in England found no differences in birthweight, maternal smoking, repeat pregnancies or accident and emergency attendances between mothers who did or did not take part in the Family Nurse Partnership. However, children in the Family Nurse Partnership group had better measures of development at school age. We aimed to add to the evidence from earlier studies, by using electronic records that are routinely collected as part of health, education and social care services, to compare outcomes for around 26,000 mothers enrolled in the Family Nurse Partnership between 2010 and 2019 with similar mothers who were not enrolled. This study showed that around one in four mothers who were eligible for the programme were enrolled in the Family Nurse Partnership, and family nurses gave priority to mothers who were younger, more deprived or who had other markers of vulnerability (e.g. a history of substance misuse violence, self-harm or mental health conditions). We found no evidence of a difference in indicators of child maltreatment between mothers who were enrolled in the Family Nurse Partnership and those who were not enrolled, but we found weak evidence to suggest that children born to mothers enrolled in the Family Nurse Partnership were more likely to achieve a Good Level of Development at school entry (age 5). We also saw that mothers enrolled in the Family Nurse Partnership were less likely than those who were not enrolled to have their next child within 18 months of their first child. More research is needed to understand which elements of intensive home visiting services work best, for whom and when. This will help inform decisions about whether it is better to offer highly intensive services for a small portion of the target population or to extend and enhance existing universal health visiting services to better support all adolescent mothers.
Assuntos
Maus-Tratos Infantis , Enfermagem Familiar , Visita Domiciliar , Humanos , Feminino , Adolescente , Inglaterra , Criança , Adulto Jovem , Enfermagem Familiar/organização & administração , Pré-Escolar , Lactente , Armazenamento e Recuperação da Informação , Gravidez , Recém-Nascido , Estudos de Coortes , Mães/estatística & dados numéricosRESUMO
Supporting families experiencing critical illness through family interventions is essential to ease illness burden, enable family management, and reduce their risk for adverse health. Thus far, there is no validated German instrument to measure the perceived support families receive from nurses. We translated the 14-item Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) and tested its psychometric properties with 77 family members of intensive care patients. Compared with the original instrument, the construct validity of the German ICE-FPSQ (FPSQ-G) showed unstable results with a partially divergent structure, most likely caused by the limited sample size. The first two principal components explained 61% of the overall variance and a good internal consistency with a Cronbach's alpha of .92. The FPSQ-G is a promising instrument to measure family members' perceptions of the support they received from nurses in the acute critical care setting but requires further validation.
Assuntos
Família , Psicometria , Humanos , Psicometria/normas , Psicometria/instrumentação , Masculino , Feminino , Inquéritos e Questionários/normas , Estudos Transversais , Pessoa de Meia-Idade , Islândia , Adulto , Família/psicologia , Reprodutibilidade dos Testes , Idoso , Apoio Social , Traduções , Alemanha , Estado Terminal/psicologia , Enfermagem Familiar/normas , TraduçãoRESUMO
Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani's five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.
Assuntos
Enfermagem Familiar , Humanos , Enfermagem Familiar/organização & administraçãoRESUMO
Family members' experience of integrating chronic illnesses or chronic conditions into family life is valuable information for health care professionals, such as nurses, to understand, improve, and adjust the care provided to families of chronically ill patients. Furthermore, the assessment of the experience of integrating chronic illness into family life can support family nursing interventions and reduce suffering. This study aimed to adapt and psychometrically test a new Likert-type questionnaire on the experience of integrating pediatric chronic illness into family life (EICI-FLQ) in two European samples. A sample of 164 primary caregivers of children/adolescents with chronic illnesses/conditions in Iceland and another sample of 237 primary caregivers with children/adolescents with chronic illnesses/conditions in Portugal completed the online questionnaire. Exploratory factor analysis of the Icelandic sample yielded support for a one-factor solution with acceptable internal reliability (Cronbach's α = .866). Confirmatory factor analysis of the one-factor structure in the Portuguese sample indicated good model fit and similar internal reliability (Cronbach's α = .838). This instrument has good psychometric characteristics and is a promising tool for measuring the experience of integrating pediatric chronic illness into family life in clinical and research settings.
Assuntos
Cuidadores , Psicometria , Humanos , Masculino , Feminino , Doença Crônica/psicologia , Inquéritos e Questionários/normas , Criança , Adulto , Portugal , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Adolescente , Islândia , Cuidadores/psicologia , Análise Fatorial , Família/psicologia , Pré-Escolar , Enfermagem Familiar/normasRESUMO
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
Assuntos
Cuidadores , Enfermagem Familiar , Estudos de Viabilidade , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Estudos Longitudinais , Adulto , Enfermagem Familiar/métodos , Cuidadores/psicologia , Glioma/psicologia , Inquéritos e Questionários , Neoplasias Encefálicas/psicologia , Neoplasias Encefálicas/enfermagem , Família/psicologia , Grupos Focais , Assistência Centrada no Paciente/métodosRESUMO
There is increasing evidence that highlights the benefits of Family-oriented Therapeutic Conversations (FAM-TC) for the patient and the family; however, studies show variability regarding the content and the way these interventions are offered. This may hamper its further development in clinical practice. This review systematically maps the available literature on nurse-led FAM-TC and offers a solid synthesis of the characteristic, effectiveness, and feasibility of these interventions. A systematic search in PubMed, CINAHL, Cochrane, Web of Science, PsycINFO, Trip (Turning Research Into Practice), BASE (Bielefeld Academic Search Engine), OATD (Open Access Theses and Dissertations), and ProQuest databases identified 37 studies. The interventions varied in interventionist nurses' profile, the intervention content, or the duration of the sessions offered. Most of the interventions showed beneficial effects on perceived family support and family functioning. This review offers suggestions for future studies, such as the inclusion of specific theoretical frameworks for intervention design, targeting both the patient and the family and offered by nurses with family nursing competency.
Assuntos
Enfermagem Familiar , Humanos , Feminino , Masculino , Adulto , Comunicação , Relações Profissional-Família , Pessoa de Meia-Idade , Família/psicologia , Idoso , Idoso de 80 Anos ou maisRESUMO
OBJECTIVE: This study is conducted as a bibliometric analysis to determine the trends in studies related to family-centered care in children. MATERIALS AND METHODS: The Web of Science database was used to collect study data. A search was conducted on Web of Science using the keywords "family-centered care", "family centered care", "family-centred care", "family centred care", "family-integrated care", "family integrated care", "patient and family centered care", "patient- and family-centered care" and "child" or "pediatric" or "pediatrics" or "child" or "newborn" or "neonatal" or "adolescent" together. The VOSviewer program was used for data analysis and visualization. The analysis included the number of publications by year, distribution by journals, most cited studies, countries with the highest publication output, most frequently used keywords, and co-authorship dimensions, presented with visual maps. RESULTS: A total of 2525 studies conducted from 1980 onwards were analyzed. The analysis revealed that the initial publications related to the subject emerged in 1980, and the United States was identified as the country with the highest number of publications, based on the Web of Science database. The Journal of Pediatric Nursing: Nursing Care of Children and Families (JPN) was determined as the journal with the highest number of publications, while the journal receiving the most citations was PEDIATRICS. CONCLUSION: The study found an increasing importance given to the Family-Centered Care Approach since the 1980s, with a majority of studies being descriptive in nature. It was determined that the studies were concentrated in the USA indicating a lack of global interest in the Family-Centered. PRACTICAL IMPLICATIONS: Nursing researchers can build upon this study in the field of family-centered care by conducting more specific and in-depth investigations. This contributes to adding new information to the nursing literature and filling gaps in this area.
Assuntos
Bibliometria , Assistência Centrada no Paciente , Criança , Feminino , Humanos , Masculino , Enfermagem Familiar , Pesquisa em Enfermagem/estatística & dados numéricos , Enfermagem PediátricaRESUMO
Existing NICU family centered care models lack the key elements of equity, inclusion and cultural humility. These models were conceived to support families during the stressful life event of an infant's NICU admission. Their development, however, occurred prior to recognition of the medical field's systematic shortcomings in providing equitable care and their impact on outcome disparities for marginalized communities; thus, they do not include cultural or equitable healthcare considerations. Given the significant neonatal care inequities for marginalized groups, incorporating the experience of these patients in a targeted manner into family centered care frameworks is of critical importance to ensure culturally humble and thus more just and equitable treatment. Here, we review past approaches to NICU family centered care and propose a novel, updated framework which integrates culturally humble care into the NICU family centered care framework.
Assuntos
Unidades de Terapia Intensiva Neonatal , Humanos , Recém-Nascido , Assistência Centrada no Paciente , Assistência à Saúde Culturalmente Competente , Disparidades em Assistência à Saúde/etnologia , Enfermagem Familiar , Terapia Intensiva Neonatal , Competência CulturalRESUMO
As famílias com filhos adolescentes deparam-se com uma nova fase do ciclo vital pautadas por diversas alterações provocadas por mudanças na vida do adolescente. A dinâmica e funcionalidade familiar têm um papel importante nesta transição, sendo que os adolescentes pertencentes a famílias desequilibradas estarão mais propensos a adotar comportamentos de risco. Desta forma, a avaliação da coesão e da adaptação das famílias é essencial para perceber se as famílias se encontram aptas para gerir situações de crise e transições com sucesso. Objetivos: O estudo desenvolvido tem como objetivos conhecer a coesão e a adaptabilidade de famílias com filhos adolescentes, nomeadamente tendo em conta o tipo de família, a fase da adolescência em que se encontram e as habilitações literárias dos pais. Metodologia: É um estudo de natureza quantitativa, transversal, descritivo e correlacional. A amostra é composta por 30 famílias com filhos adolescentes, correspondendo a 91 elementos. O instrumento de colheita de dados contém duas partes, a primeira é constituída por um questionário sociodemográfico e a segunda é constituída pela escala de FACES IV. Resultados: Os principais resultados revelaram que a maioria das famílias participantes enquadra-se na tipologia de família equilibrada, apresentam níveis elevados de flexibilidade e coesão, e níveis baixos de desmembramento e caoticidade. As famílias estudadas apresentam níveis baixos e muito baixos quanto à satisfação. Foi também possível perceber (com significância marginal) que: as famílias monoparentais tendem a enquadrar-se na tipologia desmembrada; as famílias com adolescentes entre os 14 e 15 anos estarão mais propensas a percecionar a sua família como desmembrada; e os pais que têm como habilitações literárias o ensino secundário têm maior tendência a classificarem as suas famílias como caóticas e podem ter maior tendência a se percecionarem como famílias desmembradas. Conclusão: Os resultados encontrados reforçam a importância do estudo do funcionamento das famílias pelos enfermeiros especialistas de saúde familiar, identificando famílias com maior probabilidade de apresentarem alterações ao nível da coesão e adaptação familiar, permitindo perceber que famílias apresentarão mais dificuldades na sua transição de vida. Contudo, esta constitui uma área pouco estudada e com escassez de trabalhos publicados em Portugal com a escala de FACES IV, sendo uma área a investir na saúde familiar. Enfermagem Familiar; Família; Adolescentes; Coesão; Adaptação
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Ajustamento Social , Família , Adolescente , Enfermagem Familiar , Enfermeiros de Saúde da Família , Coesão SocialRESUMO
BACKGROUND: Family-centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. AIM: To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. STUDY DESIGN: The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. RESULTS: Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. CONCLUSION: The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. RELEVANCE TO CLINICAL PRACTICE: Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes.
Assuntos
Grupos Focais , Unidades de Terapia Intensiva Neonatal , Pesquisa Qualitativa , Humanos , Unidades de Terapia Intensiva Neonatal/organização & administração , Gana , Masculino , Feminino , Recém-Nascido , Adulto , Atitude do Pessoal de Saúde , Relações Profissional-Família , Família/psicologia , Entrevistas como Assunto , Enfermagem Familiar/organização & administraçãoRESUMO
ABSTRACT Objective: To analyze the meanings attributed by family members to the situation of caring for a child with a chronic condition (CCC), in the light of the Family Management Style Framework (FMSF). Method: A mixed-methods, parallel-convergent study, guided by the FMSF theoretical framework, using the conceptual component "Definition of the Situation". Fifty-three CCC families took part. Data was collected using a semi-structured interview, a questionnaire to characterize the participants and a Family Management Measure scale. Descriptive and inferential statistical analysis was carried out on the quantitative data and the qualitative data was subjected to deductive thematic analysis. Results: Family members reported a view of normality in relation to CCC, also verified by the Child's Daily Life scale. However, they indicate the repercussions of the chronic condition on the family, and that they devote more attention and time to meeting the child's care needs, which was also verified in the View of the Impact of the Condition and Management Effort scales. Conclusion: Families have a positive view of the situation of caring for CCC at home, but point out some negative effects, such as the greater time spent caring for the child.
RESUMEN Objetivo: Analizar los significados atribuidos por los familiares a la situación de cuidado de un hijo con una condición crónica (CCC), a la luz del Marco de Estilos de Gestión Familiar (FMSF). Método: Estudio de métodos mixtos, paralelo-convergente, orientado por el marco teórico del FMSF, utilizando el componente conceptual "Definición de la Situación". Participaron 53 familias CCC. Los datos se recogieron mediante una entrevista semiestructurada, un cuestionario para caracterizar a los participantes y una escala de Medida de Gestión Familiar. Se analizaron estadísticas descriptivas e inferenciales para los datos cuantitativos y los datos cualitativos se sometieron a un análisis temático deductivo.. Resultados: Los familiares relataron una visión de normalidad en relación al CCC, verificada también por la escala de Vida Cotidiana del Niño. Sin embargo, señalan las repercusiones de la condición crónica en la familia, y que dedican más atención y tiempo a la atención de las necesidades de cuidado del niño, lo que también fue verificado en las escalas Visión del Impacto de la Condición y Esfuerzo de Gestión. Conclusión: Las familias tienen una visión positiva de la situación de cuidar de CCC en casa, pero señalan algunos efectos negativos, como el mayor tiempo dedicado al cuidado del niño.
RESUMO Objetivo: Analisar os significados atribuídos por familiares a situação de cuidar de uma criança com condição crônica (CCC), à luz do Family Management Style Framework (FMSF). Método: Pesquisa de métodos mistos, do tipo paralelo convergente, orientada pelo referencial teórico FMSF, utilizando o componente conceitual "Definição da Situação". Participaram 53 famílias de CCC. Os dados foram coletados por entrevista semiestruturada, questionário de caracterização dos participantes e escala de Medida de Manejo Familiar. Realizou-se análise estatística descritiva e inferencial dos dados quantitativos e os dados qualitativos foram submetidos à análise temática do tipo dedutiva. Resultados: Familiares referem uma visão de normalidade em relação à CCC, verificada também pela escala Vida Diária da Criança. Contudo, indicam as repercussões da condição crônica na família, e que dedicam maior atenção e tempo para atender às necessidades de cuidado da criança, também verificado nas escalas de Visão do Impacto da Condição e Esforço de Manejo. Conclusão: As famílias possuem uma visão positiva da situação de cuidar das CCC no domicílio, apontando, contudo, alguns efeitos negativos, como é o caso do maior tempo despendido na atenção à criança.
Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Enfermagem Pediátrica , Doença Crônica , Enfermagem Familiar , Família , Cuidado da CriançaRESUMO
This study established the clinical conclusiveness of Cochrane reviews (CRs) in family nursing. We extracted relevant characteristics of CRs to determine the methods of obtaining high-level evidence for family nursing. We performed a systematic search of all CRs on family nursing published in the Cochrane Library between January 2014 and April 2023. After screening 1212 titles and abstracts, we identified seven potentially relevant articles. Upon reviewing their full texts, we included six CRs with a total of 34 interventions. Of these, 22 (64.7%) interventions were conclusive and 12 (55%) were inconclusive. Thus, the number and percentage of conclusive CRs is lower in family nursing versus other fields.
Assuntos
Enfermagem Familiar , Humanos , Revisões Sistemáticas como AssuntoRESUMO
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.