Staveski Sandra L, Parveen V P, Madathil Sai B, Kools Susan, Franck Linda S
1Cincinnati Children's Hospital Medical Center,Research in Patient Services,Heart Institute,Cincinnati,Ohio,United States of America.
2Amrita Institute of Medical Sciences,Ponekkara,Kochi,Kerala,India.
Cardiol Young. 2016 Aug;26(6):1168-75. doi: 10.1017/S1047951115002164. Epub 2015 Oct 12.
Introduction Parents of children with CHD require home care knowledge in order to ensure their child's health and safety, but there has been no research on how to achieve this in a resource-constrained environment. The aim of this investigation was to compare parent and nurse perceptions of parent readiness for discharge after a structured nurse-led parent discharge teaching programme in India. Materials and methods A pre-post design was used to compare parent and nurse perceptions of parental uncertainty and readiness for hospital discharge before and after introduction of the parent education discharge instruction programme in a paediatric cardiac surgery unit.
Parents (n=68) and nurses (n=63) participated in this study. After the discharge programme implementation, parents had less uncertainty (M=93.3 SD=10.7 versus M=83.6 SD=4.9, p=0.001) and ambiguity (M=40.8 SD=6.8 versus M=33.4 SD=3.7, p=0.001) about their child's illness; however, they rated themselves as being less able to cope with the transition to home (M=24.3 SD=4.1 versus 23.1 SD=2.2, p=0.001) and as having less support at home than that required (M=31.5 SD=9.9 versus 30.9 SD=3.2, p=0.001). Parents' and nurses' perception of parental readiness for hospital discharge were more closely aligned after implementation of a nurse-led discharge programme (r=0.81, p=0.001).
The results of this study suggest that the discharge programme had positive and negative effects on parental perceptions of uncertainty and readiness for discharge. Further examination is warranted to delineate these influences and to design methods for supporting parents during the transition to home care.
引言 患有先天性心脏病(CHD)患儿的家长需要掌握家庭护理知识,以确保孩子的健康和安全,但在资源有限的环境下,尚没有关于如何实现这一目标的研究。本调查旨在比较印度一项由护士主导的结构化家长出院指导计划实施后,家长和护士对家长出院准备情况的看法。材料与方法 采用前后对照设计,比较在小儿心脏外科病房引入家长教育出院指导计划前后,家长和护士对家长出院不确定性和准备情况的看法。
68名家长和63名护士参与了本研究。出院计划实施后,家长对孩子病情的不确定性(均值=93.3,标准差=10.7;对比均值=83.6,标准差=4.9,p=0.001)和模糊性(均值=40.8,标准差=6.8;对比均值=33.4,标准差=3.7,p=0.001)降低;然而,他们认为自己应对回家过渡的能力较差(均值=24.3,标准差=4.1;对比23.1,标准差=2.2,p=0.001),且家中获得的支持比所需支持少(均值=31.5,标准差=9.9;对比30.9,标准差=3.2,p=0.001)。在实施护士主导的出院计划后,家长和护士对家长出院准备情况的看法更为一致(r=0.81,p=0.001)。
本研究结果表明,出院计划对家长出院不确定性和准备情况的看法有积极和消极影响。有必要进一步研究以明确这些影响,并设计在向家庭护理过渡期间支持家长的方法。