Butler Ashleigh, Copnell Beverley, Willetts Georgina
ICU, Monash Medical Centre, Clayton, Vic., Australia; School of Nursing and Midwifery, Monash University, Clayton, Vic., Australia.
J Clin Nurs. 2014 Aug;23(15-16):2086-99. doi: 10.1111/jocn.12498. Epub 2013 Dec 26.
To review extant research on family-centred care in a paediatric intensive care environment and identify gaps in the literature.
Family-centred care is currently a core concept in paediatric nursing, focusing on the premise that families are central to a child's well-being, and as such, should be included as equal members of the child's healthcare team. Due to the nature of critical care, family-centred care may be challenging to implement and maintain.
An integrative literature review.
The review was conducted using the Cumulative Index to Nursing and Allied Health Literature, PubMed, OVID MEDLINE and Google Scholar databases, from 1990 to present. The search focused on the following terms: 'p(a)ediatric critical care', 'paediatric intensive care unit', 'family cent(e)red care', 'parental needs', 'family presence' and 'family/nurse roles'. Additionally, the search was limited to studies conducted in a developed country and published in English.
Eighteen studies were included in the review. The results demonstrated that implementing family-centred care into a paediatric intensive care environment posed several challenges. The discrepancy between nurses' and parents' perception of their roles, the reluctance of medical staff to share potentially negative or rapidly changing information, restrictive family presence and poor understanding of family needs emerged as the key difficulties. No studies evaluated strategies to improve family-centred care practice.
Family-centred care presents many challenges in a paediatric intensive care environment; however, nurses are uniquely positioned to foster relationships with families, encourage accurate and honest information sharing and advocate for families to be present when they choose.
This review outlines the extant research to enhance awareness of the unique state of family-centred care in paediatric intensive care and makes recommendations for future research.
回顾儿科重症监护环境中以家庭为中心的护理的现有研究，并找出文献中的空白。
以家庭为中心的护理目前是儿科护理的核心概念，其前提是家庭对儿童的幸福至关重要，因此应作为儿童医疗团队的平等成员被纳入其中。由于重症监护的性质，实施和维持以家庭为中心的护理可能具有挑战性。
综合文献综述。
使用护理及相关健康文献累积索引、PubMed、OVID MEDLINE和谷歌学术数据库进行本次综述，时间跨度为1990年至今。搜索重点关注以下术语：“儿科重症监护”、“儿科重症监护病房”、“以家庭为中心的护理”、“父母需求”、“家属陪伴”和“家庭/护士角色”。此外，搜索仅限于在发达国家进行并以英文发表的研究。
该综述纳入了18项研究。结果表明，在儿科重症监护环境中实施以家庭为中心的护理面临若干挑战。护士和父母对各自角色认知的差异、医务人员不愿分享潜在负面或快速变化的信息、对家属陪伴的限制以及对家庭需求的理解不足成为关键困难。没有研究评估改善以家庭为中心护理实践的策略。
在儿科重症监护环境中，以家庭为中心的护理面临诸多挑战；然而，护士在促进与家庭的关系、鼓励准确和诚实的信息共享以及倡导家属在他们选择时在场方面具有独特的地位。
本综述概述了现有研究，以提高对儿科重症监护中以家庭为中心护理独特状况的认识，并为未来研究提出建议。
