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