The Aga Khan University Hospital-Clinical Trials Unit, Karachi, Pakistan.
Int J Nurs Stud. 2013 Jun;50(6):717-26. doi: 10.1016/j.ijnurstu.2012.05.009. Epub 2012 Jun 15.
Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child, and be actively involved in decision-making about care. However in developing countries such as Pakistan, daily bedside rounds include the physician, residents, medical students and a nurse/technician. Parents are not currently a part of these rounds.
To assess whether family-centered rounds improve parents' and health care professionals' satisfaction, decrease patient length of stay, and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate, socioeconomic status, and different cultural values and beliefs.
A non-randomized before-after study design.
A private hospital in Karachi, Pakistan.
A convenience sample of 82 parents, whose children were hospitalized for a minimum of 48h, and 25 health care professionals able to attend two consecutive rounds.
During the before phase, traditional bedside rounds were practiced; and during after phase, family-centered rounds were practiced. Parents and health care professionals completed a questionnaire on the second day of rounds. An observational form facilitated data collection on length of stay and time utilization during.
Parents' ratings during the family-centered rounds were significantly higher for some parental satisfaction items: evidence of team work (p=0.007), use of simple language during the rounds (p=0.002), feeling of inclusion in discussion at rounds (p=0.03), decision making (p=0.01), and preference for family-centered rounds (p=<0.001). No significant differences were found in health care professionals' satisfaction between rounds. Patient length of stay was significantly reduced in the family-centered rounds group, while no significant difference was found in the duration of rounds. Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation.
Parents were satisfied with both forms of rounds; however, they appeared to have a greater preference for family-centered rounds than health care professionals. Family-centered rounds were a resource for Pakistani parents, enabling direct communication with the medical team without impacting on the time required to complete rounds. Family-centered rounds may improve quality of care such as decreasing length of stay or preventing critical incidents.
让家属参与床边查房是实施以家庭为中心的护理的一种策略，有助于家属获取患儿相关信息，并积极参与医疗决策。然而，在巴基斯坦等发展中国家，日常床边查房包括医生、住院医师、医学生和护士/技师。目前，患儿家属还未参与到这些查房中。
评估在一个文化价值观和信仰不同、文化程度低、社会经济地位低的人群中，与传统的日常查房相比，以家庭为中心的查房是否能提高家属和医护人员的满意度、缩短患者的住院时间并提高时间利用率。
非随机前后对照研究设计。
巴基斯坦卡拉奇的一家私立医院。
82 名至少住院 48 小时的患儿家属和 25 名能够连续参加两轮查房的医护人员，纳入了便利抽样。
在前期阶段，实施传统的床边查房；在后期阶段，实施以家庭为中心的查房。查房第二天，家长和医护人员完成一份调查问卷。采用观察表收集住院时间和查房期间的时间利用数据。
在以家庭为中心的查房中，家长对以下一些家长满意度项目的评分显著更高：团队合作的证据（p=0.007）、查房过程中使用简单的语言（p=0.002）、感觉被邀请参与查房讨论（p=0.03）、决策制定（p=0.01）和对以家庭为中心的查房的偏好（p<0.001）。在查房期间，医护人员对两种查房形式的满意度没有显著差异。以家庭为中心的查房组患者的住院时间显著缩短，而查房时间无显著差异。以家庭为中心的查房为家长提供了一个与医疗团队直接沟通的机会，而不会影响完成查房所需的时间。
家长对两种查房形式都感到满意，但他们似乎比医护人员更倾向于以家庭为中心的查房。以家庭为中心的查房是巴基斯坦家长的一种资源，使他们能够与医疗团队进行直接沟通，而不会影响完成查房所需的时间。以家庭为中心的查房可能会提高护理质量，例如缩短住院时间或预防危急事件。
