Department of Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
Pediatr Crit Care Med. 2011 Sep;12(5):e211-5. doi: 10.1097/PCC.0b013e3181fe3193.
To explore similarities and differences in perceptions on pediatric intensive care practices between parents and staff by using data from two studies.
A two-round Delphi method among nurses and physicians followed by an empiric survey among parents.
Pediatric intensive care units at eight university medical centers.
Parents whose child has been admitted to a pediatric intensive care unit, nurses, and physicians.
None.
Outcome measures were 74 satisfaction-with-care items divided into five domains: 1) information; 2) care and cure; 3) organization; 4) parental participation; and 5) professional attitude. The Delphi study was completed by 218 nurses and 46 physicians and the survey by 559 of 1042 (54%) parents. Parents rated 31 items more important than the professionals based on the standardized mean difference (Cohen's d, 0.21-1.18, p < .003). Ten of these were related to information provision. Information on the effects of medication had the largest effect size (Cohen's d 1.18, p = .001). Correct medication administration by professionals was also rated significantly more important by parents (Cohen's d 0.64, p = .001). The professionals rated 12 items more important than the parents (Cohen's d -0.23 to -0.73, p < .005), including three about multicultural care. Significant differences remained on two of the three multicultural care items when the Dutch (n = 483) and non-Dutch parents (n = 76) were separately compared with professionals. On the domain level, parents rated the domains information and parental participation more important than the professionals (Cohen's d 0.36 and 0.26, p = .001).
Compared with the parents' perceptions, nurses and physicians undervalued a substantial number of pediatric intensive care unit care items. This finding may reflect a gap in the understanding of parental experiences as well as incongruity in recognizing the needs of parents.
通过两项研究的数据，探索父母和医护人员对儿科重症监护实践的看法的异同。
对护士和医生进行两轮 Delphi 法研究，然后对父母进行实证调查。
八所大学医学中心的儿科重症监护病房。
其子女已入住儿科重症监护病房的父母、护士和医生。
无。
结果测量是 74 项满意护理项目，分为五个领域：1）信息；2）护理和治疗；3）组织；4）父母参与；和 5）专业态度。德尔菲研究由 218 名护士和 46 名医生完成，调查由 1042 名父母中的 559 名（54%）完成。根据标准化均数差（Cohen's d，0.21-1.18，p<.003），父母对 31 项护理内容的重要性评分高于专业人员。其中 10 项与信息提供有关。关于药物影响的信息具有最大的效应量（Cohen's d 1.18，p=.001）。父母还对专业人员正确的药物管理评价显著更高（Cohen's d 0.64，p=.001）。专业人员对 12 项护理内容的重要性评分高于父母（Cohen's d -0.23 至-0.73，p<.005），包括三项关于多元文化护理的内容。当荷兰父母（n=483）和非荷兰父母（n=76）与专业人员分别比较时，这三项多元文化护理内容中的两项仍存在显著差异。在领域水平上，父母对信息和父母参与领域的评价高于专业人员（Cohen's d 0.36 和 0.26，p=.001）。
与父母的看法相比，护士和医生低估了大量儿科重症监护病房护理内容的重要性。这一发现可能反映了对父母体验的理解差距，以及对父母需求的认识不一致。
