Seoul National University Hospital, Seoul, Republic of Korea.
Seoul National University College of Nursing, The Research Institute of Nursing Science, Seoul, Republic of Korea.
Nurs Crit Care. 2024 Nov;29(6):1654-1662. doi: 10.1111/nicc.12985. Epub 2023 Oct 11.
Although a child- and family-centred care (CFCC) philosophy has been emphasized and adopted for decades in paediatric critical care settings in several countries, numerous issues from parents' perspectives regarding the philosophy remain unresolved. To facilitate the full translation of CFCC into clinical practice, health care professionals need an in-depth understanding of family experiences. Real-life mothering experiences, including maternal roles and identities, remain largely unknown at paediatric intensive care units (PICUs) in the Republic of Korea, where family visitation, presence, and participation are restricted.
To explore mothering experiences at a PICU where family visitation is strictly constrained, and to identify maternal needs and values.
We conducted a qualitative descriptive study of eight individual in-depth interviews with seven mothers of hospitalized children. Qualitative data were analysed using inductive thematic analysis.
Five major themes, along with four subthemes, emerged: (1) shifts in maternal roles and responsibilities, (2) shifts in interpersonal relationships, (3) desire for CFCC in the PICU, (4) practising self-defined mothering roles, and (5) reconstructing maternal identities. The themes revealed the experiences of becoming mothers of a child in a constrained PICU. Ultimately, mothers demanded that the unit improve its physical and cultural environments through, for example, liberalized family visitation and participation in the care of their children.
Nursing professionals should lead the charge for humanizing a restrictive PICU in the Republic of Korea by ensuring a safe and open environment and mothering continuity based on child- and family-centred holistic care.
Effective interventions must be developed and tested to globally establish and fully implement strong evidence-based CFCC in PICUs; constant co-commitment among children, families, health care professionals, and institutions is also necessary.
尽管在一些国家的儿科重症监护环境中，以儿童和家庭为中心的护理（CFCC）理念已经强调和采用了几十年，但从父母的角度来看，该理念仍存在许多未解决的问题。为了促进 CFCC 全面转化为临床实践，医护人员需要深入了解家庭的经验。在韩国的儿科重症监护病房（PICU），由于家庭探视、存在和参与受到限制，现实生活中的母亲养育经验，包括母亲的角色和身份，在很大程度上仍然未知。
探讨在家庭探视受到严格限制的 PICU 中母亲的养育经验，并确定母亲的需求和价值观。
我们对 7 名住院儿童的母亲进行了 8 次个人深入访谈的定性描述性研究。使用归纳主题分析对定性数据进行分析。
出现了 5 个主要主题和 4 个次主题：（1）母亲角色和责任的转变，（2）人际关系的转变，（3）在 PICU 中对 CFCC 的渴望，（4）实践自我定义的母亲角色，以及（5）重建母亲身份。这些主题揭示了在限制严格的 PICU 中成为孩子母亲的经历。最终，母亲们要求该单位通过例如放宽家庭探视和参与子女护理等方式，改善其物理和文化环境。
护理专业人员应通过确保安全和开放的环境以及基于儿童和家庭为中心的整体护理的育儿连续性，率先为韩国的限制严格的 PICU 人性化。
必须制定和测试有效的干预措施，以在全球范围内建立和全面实施强有力的基于证据的 CFCC；还需要儿童、家庭、医护人员和机构之间不断共同承诺。
