Harken Whitney, Maxwell Joan, Hainline Margaret, Pollack Lauren, Roberts Cristine
Children's Mercy Hospital, 5520 College Blvd, Ste 320, Overland Park, KS 66211, USA.
J Pediatr Nurs. 2017 May-Jun;34:e34-e41. doi: 10.1016/j.pedn.2017.02.008. Epub 2017 Mar 7.
To describe the perceptions of inpatient pediatric hospitalist physicians (HPs), registered nurses (RNs), and care assistants (CAs) at a tertiary pediatric hospital regarding caring for children with eating disorders (EDs) who are hospitalized for medical stabilization.
A qualitative descriptive study was conducted using semi-structured individual interviews with aforementioned health care workers (HCWs) to explore their perspectives on caring for children/adolescents with EDs in relation to recent initiatives to transform their care. These initiatives focused on admitting patients to a designated "ED Unit", development of an ED consult team, providing ED education to staff, and development of ED standardized order sets (SOSs).
Twenty HCWs representing the three disciplines completed individual interviews. Most participants reported that the system changes led to more consistent care of patients with ED. Content analysis of the interviews revealed the following themes: awkwardness and uncertainties of care, navigating family dynamics, establishing therapeutic boundaries, and finding rewards in ED care.
Education, structure, and support for staff improved care for adolescents with EDs as perceived by HCWs. HCWs found satisfaction in providing care during the medical stabilization process. Study findings were positive for staff and future studies should include perceptions of patients/families to further design a therapeutic environment.
Providing a standardized order set, expert consult team, and ongoing staff training can strengthen the therapeutic hospital environment for adolescents with EDs. Pediatric hospitals can provide excellent care for children with EDs while supporting their staff to provide a therapeutic environment.
描述一家三级儿科医院的住院儿科医生、注册护士和护理助理对照顾因医学稳定需求而住院的饮食失调患儿的看法。
采用定性描述性研究，对上述医护人员进行半结构化个人访谈，以探讨他们在近期改善护理举措背景下，对照顾患有饮食失调症的儿童/青少年的看法。这些举措包括将患者收治到指定的“饮食失调病房”、组建饮食失调咨询团队、为工作人员提供饮食失调相关教育，以及制定饮食失调标准化医嘱集。
代表这三个专业领域的20名医护人员完成了个人访谈。大多数参与者表示，系统变革使饮食失调患者得到了更一致的护理。访谈内容分析揭示了以下主题：护理的尴尬与不确定性、应对家庭动态、建立治疗边界，以及在饮食失调护理中找到回报。
医护人员认为，对工作人员的教育、结构调整和支持改善了对饮食失调青少年的护理。医护人员在医疗稳定过程中提供护理时感到满意。研究结果对工作人员来说是积极的，未来的研究应纳入患者/家庭的看法，以进一步设计治疗环境。
提供标准化医嘱集、专家咨询团队和持续的工作人员培训，可以加强针对饮食失调青少年的治疗性医院环境。儿科医院可以在支持工作人员提供治疗性环境的同时，为饮食失调患儿提供优质护理。
