Exploring family-centered care among pediatric oncology nurses

xii, 191 leaves ; 29 cmFamily-centered care (FCC) is important within the practice of pediatric oncology nurses. Such nurses face challenges and barriers when attempting to provide FCC. The purpose of this study was to understand the experiences of pediatric oncology nurses in relation to FCC; identify how pediatric oncology nurses implemented FCC into their practice; identify what facilitated and enabled pediatric oncology nurses to implement FCC; and discern the barriers and challenges that were present in their setting when implementing FCC. A qualitative approach utilizing person-centered interviewing was used to collect data. Nurses (N=20) from the Alberta Children‟s Hospital were recruited through purposeful convenience sampling and were then interviewed. Five major themes were identified from the data set: ACH support f FCC, How participants defined FCC, Establishing FCC, Enhancing FCC, and Barriers and Challenges to providing FCC. Recommendations for future research and implications for practice and education are offered

Cross-Sectional Study Protocol for the COVID-19 Impact Survey of Mothers and Their 7–11 Year Old Children in Alberta, Canada

Objectives: Our aim is to understand the effect of the COVID-19 pandemic on families who have been followed longitudinally in two cohorts studied in Alberta, Canada. We will examine household infections during the COVID-19 pandemic, financial impact, domestic violence, substance use, child school and daily life and relationships in the home. We will identify risk and protective factors for maternal mental health outcomes using longitudinal data that can inform policy and government resource allocation in future disasters.Methods: Mothers who are currently participating in two longitudinal studies, Alberta Pregnancy Outcomes and Nutrition (APrON; N = 1,800) and All Our Families (AOF: N = 2,534) were eligible to participate. Mothers were invited to complete the baseline COVID-19 Impact Survey (20–30 min) within 4 months of March 15, 2020, which was when the province of Alberta, Canada, implemented school closures and physical-distancing measures to prevent the spread of COVID-19. Mothers were asked to report on their own, their child's and their family's functioning. Mothers were re-surveyed at 6 months after completion of the initial COVID-19 Impact Survey, and will be re-surveyed again at 12 months.Results: Responses from participants in both cohorts will be examined in harmonized analyses as well as separately. Descriptive, multivariable analysis will be undertaken to examine risk and resiliency over time and factors that predict mental health and well-being.Conclusions: This study will provide timely information on the impact of COVID-19 for Albertan families. It will identify risk and protective factors for mental health and well-being among contemporary urban families supported by a publicly funded health care system to inform allocation of resources to support those most vulnerable during a global pandemic

Processes of Care for Medically Fragile Infants on an Inpatient Pediatric Unit: A Grounded Theory Study

Today, increasing numbers of Medically Fragile Infants (MFI) born with severe, life-threatening illnesses are surviving the neonatal period due to medical and technological advancements in care. Such infants require long-term hospitalization and remain dependent on technology for survival. MFI are defined as preterm or full-term infants who (a) have a life-threatening chronic medical illness that require technology for survival, (b) remain hospitalized for several weeks to months, and (c) are expected to be discharged with a chronic health problem. Parenting MFI is typified by frequent health setbacks and uncertainty, which adds complexity, impediments, and complications to becoming a parent. Also, parents of MFI have higher than average rates of anxiety, depression, chronic stress, and post-traumatic stress disorder. The literature reflects that outcomes for MFI and their parents are poor. The aim of this grounded theory study was to create a deeper understanding of the processes of care provided to MFI from the perspectives of parents and Health Care Professionals (HCP). Specifically, I explored what it was like for parents to provide care to hospitalized MFI, and why some struggled. Also, I explored why caring for MFI was stressful for HCP, and why frustrating encounters often transpired between parents and HCP. I used Charmaz’ approach to grounded theory to gain this understanding. The findings suggest that parents and HCP have different yet interconnected experiences of caring for MFI within the inpatient pediatric unit. Parents experienced grief and multiple stressors, and they utilized internal and external coping mechanism to manage their grief and stressors. When they were unable to cope with grief and stressors, they experienced difficulty in their parental role and mental health difficulties. HCP experienced stress and burnout due to the complexity of MFI and the complex parental experience of today. HCP aimed at developing trust with parents so they could establish a supportive relationship. The relationship was a means to educate and empower parents to care for their hospitalized infant and work collaboratively with parents in the planning and delivery of care. However, HCP encountered multiple frustrating encounters with parents that were barriers to the development of a therapeutic relationship because of the complexity and high demands of MFI’ care needs and parental ability, or lack thereof, to cope with their grief and stressors. The parent and HCP’ experiences were compared and contrasted; areas where concepts and themes overlapped were identified and the grounded theory emerged: “Journeying Along Side One Another”. The space where parental and HCP’ different, yet interconnected, experiences came together was in the liminal space between their experiences, where parents and HCP interacted with one another. When key factors were present beneficial interactions transpired between HCP and parents, and supportive relationships built on trust were established; experiences and interactions became shared and interconnected, and parents and HCP journeyed together. When the key factors were absent, parents and HCP did not engage in mutually beneficial interactions, and supportive relationships built on trust were not established; difficult interactions transpired between parents and HCP, and they did not journey together. Parental and HCP’ characteristics impacted beneficial interactions in conjunction with key factors

Impacts of Parental Technoference on Parent-Child Relationships and Child Health and Developmental Outcomes: A Scoping Review

Background: With increases in the ubiquity of cellphones, parental technoference poses a relevant concern for parent-child relationships (i.e., parent-child interactions, attachment and bonding), children's development (i.e., gross and fine motor, language, social, cognitive) and children’s health (i.e., psychological, biological). Parental technoference refers to disrupted interactions between a parent and their child due to a parent’s use of a technological device. Researchers have started to report associations between parental technoference and parent-child relationships (e.g., reduced parental responsiveness toward their child) and children’s health outcomes (e.g., increased risk for behavioral concerns). Although previous reviews have been conducted on parental technoference, our scoping review comprises the first comprehensive, systematic review on the impacts of parental technoference on parent-child relationships and children's health and development. Objective: We aim to map, describe and summarize existing evidence from published research articles on the impacts of parental technoference on parent-child relationships and child health and developmental outcomes and identify limitations in the studies or gaps in the literature. Inclusion criteria: This scoping review will include primary research studies and review papers (i.e., systematic, scoping) that evaluate the impacts of parental technoference on parent-child relationships and children's health and developmental outcomes. In our review, parents are defined as primary caregivers (i.e., biological, adopted, foster parents) of children under the age of 18 years. Methods: This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. Databases will include APA PsycInfo, MEDLINE, Central, Cochrane Database for Systematic Reviews, JBI EBP and Embase (OVID). CINAHL (Ebsco) and Scopus will also be searched. Grey and popular literature will be excluded, with the exception of dissertations. Studies will be written in English with no time limit. Two reviewers will screen titles, abstracts, and full texts of studies according to inclusion and exclusion criteria. Articles will be appraised with the Newcastle-Ottawa Scale. Data will be extracted into a data charting table including; author(s), year of publication, country, research aim, methodology/design, population and sample size, variables/concepts and corresponding measures and main results. Data will mapped and presented in tables and figures along with a corresponding narrative summary. Significance: This review will illuminate the current state of evidence and identify gaps in the literature on the impacts of technoference on parent-child relationships and children’s health and development. The findings from this review will inform future research to enhance understanding of the impacts of parental technoference and aid in the development of interventions and programs to promote positive parent-child relationships and children’s health and development in an increasingly digital world

Experiences of inpatient healthcare services among children with medical complexity: A scoping review

Background: Children with medical complexity (CMC) have multiple chronic conditions in addition to highly complex care needs. The population of CMC has increased considerably in the recent decade and has among the highest health care utilization in pediatrics. CMC and their parental caregivers' experiences of care differ in important ways from other populations and CMC and their parental caregivers have reported poor experiences of care when compared to other pediatric populations. Importantly, CMC are at increased risk of adverse events during their hospitalizations. Objective: The objective of this review is to map the existing literature related to CMC and their parental caregivers’ experiences of receiving inpatient healthcare services, and to identify important knowledge gaps. Inclusion criteria: This review will include studies pertaining to the experiences of healthcare services for CMC, along with their parental caregivers, in the inpatient hospital setting. In our review, CMC are defined as children with (a) multiple chronic conditions, (b) high health care utilization, (c) high care needs in the home and community, and (c) functional limitations. Experiences of health care is described as interactions shaped by an organization's culture that influence patients' perceptions across the continuum of care. Unique settings, such as the NICU and mental health units, and populations, such as medically fragile infants, will be excluded. Methods: Using the Joanna Briggs Institute methodology, articles related to CMC and the inpatient care setting will be identified through EMBASE, CINAHL, Web of Science, MEDLINE and PsycInfo. Search period will be from the year 2000 to the current date. All types of research designs will be included but not grey literature. Studies will be limited to English. Screening of titles, abstracts and full-text articles will be conducted by two independent researchers. Disagreements will be resolved by discussion with a third researcher. Data will be extracted using a data extraction form including authors, country, participants, objectives, methodology, setting and key findings. Articles will be appraised with the Consolidated Criteria for Reporting Qualitative Studies (COREQ), Newcastle-Ottawa Scale (NOS) for cohort and case-control studies and the Consolidated Standards of Reporting Trials (CONSORT) for randomized controlled trials. Data tables and figures will be created to map and present data, and themes from data will be presented in a narrative summary. Significance: This review will aid in developing a comprehensive understanding of inpatient experiences of care for CMC and their parental caregivers. This understanding will contribute to further research on the development of models of care and potential interventional research projects among CMC and their parental caregivers in inpatient hospital settings. Collating and mapping this evidence is necessary to determine critical aspects of experiences of care that will help prioritize health services interventions and evaluation, as well as identify areas that require further investigation

An exploration of the concept of trust among paediatric nurses and children and their families: A scoping review protocol

The objective of this scoping review is to identify, examine and summarize available evidence on the concept of trust among paediatric nurses and children and their families. Trust is central to the development of nurse-patient relationships. Well established patient trust in health care providers is known to improve health outcomes and patient satisfaction with care, however, paediatric nurses encounter difficulties developing trust with patients and families. In this scoping review, we will include research studies (i.e., qualitative, quantitative and mixed methods designs), reviews and dissertations that investigate, discuss or present findings on the experiences of trust among paediatric nurses and their patients and families. Paediatric patients must be under the age of 18. Families include primary caregivers and siblings. The setting will include both hospital and community settings where paediatric nurses provide care to children and their families. The Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews will be used. APA PsycInfo, MEDLINE, Central, Cochrane Database for Systematic Reviews, JBI EBP and EMBASE (OVID), CINAHL (Ebsco) and Scopus will be search for relevant studies with no time limits published in English. Two reviewers will independently screen all titles and abstracts and data of included studies will be extracted by one reviewer into a developed data extraction table and checked by another. Extracted data will be presented in tabular form along with a narrative summary

Experiences and Impacts of the COVID-19 Pandemic: A Thematic Analysis

The COVID-19 pandemic prompted global public health restrictions that impacted Canadians in multiple ways. The effects of the pandemic are well examined in specific populations and in researcher-defined areas (e.g., mental health, physical activity, social connections, and financial impacts). Few studies explore the complex perspectives of adults who experienced and were impacted by the pandemic. The purpose of this study was to understand Canadian adults’ perspectives of pandemic impacts over time. Methods: A sample of 347 Canadian adults were recruited during the first six months of the COVID-19 pandemic to respond to open-ended questions about the pandemic’s impacts, administered every two weeks between April 2020 and January 2021. The responses were amalgamated into epochs, defined by dates that paralleled infection rates and public health responses in Canada. Qualitative thematic analysis identified major themes for each epoch and changes in themes over time. Results: The participants predominately reported adverse impacts of the pandemic during each epoch assessed, particularly with respect to mental health, future-oriented worry, activity restrictions, and social, and employment disruptions. Key concerns were potentially driven by changes in infection rates and public health policy changes. Conclusions: The COVID-19 pandemic impacted individuals in predominantly negative and complex ways that varied over time with public health responses. Findings from the present study may direct future pandemic responses to mitigate adverse effects to best prevent infection while preserving wellbeing