Suppr超能文献

儿科重症监护病房住院患者家庭面临的挑战:来自Navigate 数据集的预先计划的二次分析。

Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset.

机构信息

Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI.

Department of Psychology, Southern Illinois University-Carbondale, Carbondale, IL.

出版信息

Pediatr Crit Care Med. 2024 Feb 1;25(2):128-138. doi: 10.1097/PCC.0000000000003385. Epub 2023 Oct 27.

Abstract

OBJECTIVES

To describe challenges experienced by parents of children hospitalized in the PICU during PICU admission as reported by family navigators.

DESIGN

A preplanned secondary analysis of open-response data coded via inductive qualitative approach from the Navigate randomized controlled trial (RCT) dataset (ID NCT02333396).

SETTING

Two university-affiliated PICUs in the Midwestern United States as part of an RCT.

PATIENTS

Two hundred twenty-four parents of 190 PICU patients.

INTERVENTIONS

In 2015-2017, trained family navigators assessed and addressed parent needs, offered weekly family meetings, and provided post-PICU discharge parent check-ins as part of a study investigating the effectiveness of a communication support intervention ("PICU Supports").

MEASUREMENTS AND MAIN RESULTS

We analyzed qualitative data recorded by family navigators weekly across 338 encounters. Navigators described families' "biggest challenge," "communication challenges," and ways the team could better support the family. We used an inductive qualitative coding approach and a modified member-checking exercise. The most common difficulties included home life , hospitalization , and diagnosis distress (45.2%, 29.0%, and 17.2% of families, respectively). Navigators often identified that parents had co-occurring challenges. Communication was identified as a "biggest challenge" for 8% of families. Communication challenges included lack of information, team communication , and communication quality (7.0%, 4.8%, and 4.8% of families, respectively). Suggestions for improving care included better medical communication, listening, rapport, and resources.

CONCLUSIONS

This study describes families' experiences and challenges assessed throughout the PICU stay. Family navigators reported families frequently experience stressors both internal and external to the hospital environment, and communication challenges between families and providers may be additional sources of distress. Further research should develop and assess interventions aimed at improving provider-family communication and reducing stressors outside the hospitalization itself, such as home life difficulties.

摘要

目的

描述在儿科重症监护病房(PICU)住院期间,由家庭导航员报告的 PICU 入院儿童的父母所经历的挑战。

设计

对 Navigate 随机对照试验(RCT)数据集(ID NCT02333396)的开放式响应数据进行的预先计划的二次分析,采用归纳定性方法进行编码。

设置

美国中西部的两个大学附属 PICU,作为 RCT 的一部分。

患者

190 名 PICU 患者的 224 名父母。

干预措施

在 2015 年至 2017 年期间,经过培训的家庭导航员评估并满足了父母的需求,提供每周的家庭会议,并在 PICU 出院后为父母提供检查,作为一项调查沟通支持干预措施(“PICU 支持”)有效性的研究的一部分。

测量和主要结果

我们分析了家庭导航员在 338 次相遇中每周记录的定性数据。导航员描述了家庭的“最大挑战”,“沟通挑战”,以及团队可以更好地支持家庭的方式。我们使用了归纳定性编码方法和修改后的成员核对练习。最常见的困难包括家庭生活、住院和诊断困扰(分别为 45.2%、29.0%和 17.2%的家庭)。导航员经常发现父母有共同的挑战。沟通是 8%家庭的“最大挑战”。沟通挑战包括信息缺乏、团队沟通和沟通质量(分别为 7.0%、4.8%和 4.8%的家庭)。改善护理的建议包括更好的医疗沟通、倾听、融洽关系和资源。

结论

本研究描述了整个 PICU 住院期间家庭的经历和挑战。家庭导航员报告说,家庭经常经历医院环境内外的压力源,家庭和提供者之间的沟通挑战可能是额外的困扰源。进一步的研究应该开发和评估旨在改善提供者-家庭沟通和减少住院本身以外的压力源的干预措施,例如家庭生活困难。

相似文献

1
Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset.
Pediatr Crit Care Med. 2024 Feb 1;25(2):128-138. doi: 10.1097/PCC.0000000000003385. Epub 2023 Oct 27.
2
A Randomized Comparative Trial to Evaluate a PICU Navigator-Based Parent Support Intervention.
Pediatr Crit Care Med. 2020 Sep;21(9):e617-e627. doi: 10.1097/PCC.0000000000002378.
7
Caregiver Perspectives on Provider Continuity During Prolonged PICU Hospitalizations: A Single-Center Qualitative Study, 2021-2022.
Pediatr Crit Care Med. 2024 Dec 1;25(12):1159-1167. doi: 10.1097/PCC.0000000000003626. Epub 2024 Dec 4.
9
Racial Minority Families' Preferences for Communication in Pediatric Intensive Care Often Overlooked.
J Natl Med Assoc. 2020 Feb;112(1):74-81. doi: 10.1016/j.jnma.2019.09.005. Epub 2019 Oct 22.
10
Barriers to Communication in a PICU: A Qualitative Investigation of Family and Provider Perceptions.
Pediatr Crit Care Med. 2019 Sep;20(9):e415-e422. doi: 10.1097/PCC.0000000000002070.

本文引用的文献

1
Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.
J Intensive Care Med. 2024 Feb;39(2):159-169. doi: 10.1177/08850666231195754. Epub 2023 Aug 21.
2
Pediatric Critical Care-Associated Parental Traumatic Stress: Beyond the First Year.
Pediatr Crit Care Med. 2023 Feb 1;24(2):93-101. doi: 10.1097/PCC.0000000000003129. Epub 2023 Jan 20.
3
Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors.
Int J Environ Res Public Health. 2022 Sep 12;19(18):11450. doi: 10.3390/ijerph191811450.
4
Prognostic and Goals-of-Care Communication in the PICU: A Systematic Review.
Pediatr Crit Care Med. 2023 Jan 1;24(1):e28-e43. doi: 10.1097/PCC.0000000000003062. Epub 2022 Sep 7.
5
Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study.
Front Pediatr. 2021 Nov 4;9:740598. doi: 10.3389/fped.2021.740598. eCollection 2021.
6
Parent and Physician Report of Discussions About Prognosis for Critically Ill Children.
Pediatr Crit Care Med. 2021 Sep 1;22(9):785-794. doi: 10.1097/PCC.0000000000002764.
7
A global perspective on parental stress in the neonatal intensive care unit: a meta-analytic study.
J Perinatol. 2020 Dec;40(12):1739-1752. doi: 10.1038/s41372-020-00798-6. Epub 2020 Sep 8.
8
A Randomized Comparative Trial to Evaluate a PICU Navigator-Based Parent Support Intervention.
Pediatr Crit Care Med. 2020 Sep;21(9):e617-e627. doi: 10.1097/PCC.0000000000002378.
10
Racial Inequality in Psychological Research: Trends of the Past and Recommendations for the Future.
Perspect Psychol Sci. 2020 Nov;15(6):1295-1309. doi: 10.1177/1745691620927709. Epub 2020 Jun 24.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验