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知情感与知情度:儿科急诊就诊后家庭认知和行为的混合方法分析。

Feeling Informed Versus Being Informed: Mixed-Methods Analysis of Family Perceptions and Behavior Following a Pediatric Emergency Department Visit.

机构信息

Nursing Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Spain.

Nursing Department, Faculty of Medicine, Universitat Autonoma de Barcelona, Spain; Grup de REcerca Multidisciplinar en SAlut i Societat (GREMSAS), (2017 SGR 917), Spain.

出版信息

J Pediatr Nurs. 2021 Sep-Oct;60:e87-e95. doi: 10.1016/j.pedn.2021.03.027. Epub 2021 Apr 8.

Abstract

PURPOSE

To examine perceptions of family-centered care, satisfaction, and quality of communication with health professionals during a pediatric emergency department visit, and to evaluate the perceived usefulness of the information received and whether provider treatment recommendations were followed after discharge.

DESIGN

Embedded mixed methods design with two concurrent phases. Participants in phase 1 were 385 adult relatives of children (age 6 days-17 years, mean 5.0 years, SD 4.5) seen in a pediatric emergency department. On the day of the visit, relatives completed questionnaires exploring perceptions of family-centered care, satisfaction (CSQ-8), and quality of communication with professionals (ad hoc instrument). For phase 2, we conducted daily structured telephone interviews with 37 of these parents over the six consecutive days following the emergency visit.

RESULTS

Satisfaction with the visit was significantly related to the perception of family-centered care (B = 0.25; 95% CI [0.20, 0.29]; p < .001). Follow-up interviews revealed that 45.9% (n = 17) of families did not follow the prescribed treatment and 32.4% (n = 12) made a further appointment with their primary care pediatrician. Qualitative analysis suggested that families lacked certain information from care providers.

CONCLUSIONS

Elements of a family-centered approach were rated positively and families believed that the information they received was useful. Importantly, more than half of the families who were followed up by telephone had doubts about provider treatment recommendations.

PRACTICE IMPLICATIONS

Family-centered care in the pediatric emergency department could enhance communication and help to ensure that treatment recommendations are followed at home.

摘要

目的

考察儿科急诊就诊期间家庭为中心的护理、满意度和与卫生专业人员沟通质量的认知,评估所获得信息的实用性以及出院后是否遵循了提供者的治疗建议。

设计

嵌入的混合方法设计,有两个同时进行的阶段。第 1 阶段的参与者是 385 名儿童(6 天至 17 岁,平均 5.0 岁,SD 4.5)的成年亲属,他们在儿科急诊就诊。在就诊当天,亲属完成了调查问卷,调查了他们对家庭为中心的护理、满意度(CSQ-8)和与专业人员沟通质量的认知(特定仪器)。对于第 2 阶段,我们对这些父母中的 37 人进行了为期 6 天的日常结构化电话访谈。

结果

就诊满意度与家庭为中心的护理认知显著相关(B = 0.25;95%置信区间[0.20, 0.29];p <.001)。后续访谈显示,45.9%(n = 17)的家庭未遵循规定的治疗方案,32.4%(n = 12)与他们的初级保健儿科医生预约了进一步的就诊。定性分析表明,家庭缺乏来自护理提供者的某些信息。

结论

家庭为中心方法的要素得到了积极评价,家庭认为他们所获得的信息是有用的。重要的是,通过电话随访的家庭中,超过一半的家庭对提供者的治疗建议表示怀疑。

实践意义

儿科急诊中的家庭为中心的护理可以加强沟通,并有助于确保在家中遵循治疗建议。

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