Poole Emily I, Ryan Molly, Walls Martha, Slumkoski Corey, Curran Janet A, Seabrook Jamie A, Foster Jennifer R
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Critical Care, Dalhousie University, Halifax, NS, Canada.
Front Pediatr. 2024 Jan 8;11:1308682. doi: 10.3389/fped.2023.1308682. eCollection 2023.
Parental presence at the bedside during a stressful pediatric intensive care unit (PICU) admission may improve child comfort, reduce parental anxiety, and enable family engagement. We performed this study to identify factors that parents perceive impact their capability, opportunity, and motivation to be at the bedside in PICU.
We conducted a qualitative descriptive study using semi-structured interviews based on the Theoretical Domains Framework (TDF). We included parents of children admitted to the PICU for at least 24 h at IWK Health in Nova Scotia, Canada. Interviews were coded independently by two researchers using a directed content approach based on the TDF. We generated themes and subthemes, with the subthemes identified as factors impacting parental presence, and assigned TDF domains to each of the subthemes.
Fourteen primary caregivers (8 mother figures, 6 father figures) participated in 11 interviews. The factors associated with parental presence were captured by 6 themes: ; and . Fifty-two barriers and enablers were identified within 13 TDF domains; 10 TDF domains were determined to be relevant to parental presence, which may be used to guide design of future interventions. Participants emphasized the importance of self-care to enable them to remain physically at their child's bedside and to be engaged in their care.
Parents perceive multiple factors within 6 themes act as barriers or enablers to presence with their critically ill child in the PICU. Guided by relevant TDF domains, interventions may be designed to optimize presence, particularly engaged presence, which may improve health-related outcomes of children and their parents.
在儿科重症监护病房（PICU）紧张的住院期间，父母陪伴在床边可能会提高孩子的舒适度，减轻父母的焦虑，并促进家庭参与。我们开展这项研究以确定父母认为会影响他们在PICU陪伴在孩子床边的能力、机会和动机的因素。
我们基于理论领域框架（TDF），采用半结构化访谈进行了一项定性描述性研究。我们纳入了在加拿大新斯科舍省IWK健康中心入住PICU至少24小时的儿童的父母。两位研究人员使用基于TDF的定向内容分析法对访谈进行独立编码。我们生成了主题和子主题，将子主题确定为影响父母陪伴的因素，并为每个子主题分配TDF领域。
14名主要照顾者（8名母亲角色，6名父亲角色）参与了11次访谈。与父母陪伴相关的因素由6个主题涵盖： ； 以及 。在13个TDF领域内确定了52个障碍因素和促进因素；确定10个TDF领域与父母陪伴相关，可用于指导未来干预措施的设计。参与者强调自我照顾的重要性，以使他们能够实际陪伴在孩子床边并参与孩子的护理。
父母认为6个主题中的多种因素是他们在PICU陪伴重症孩子的障碍或促进因素。在相关TDF领域的指导下，可以设计干预措施来优化陪伴，特别是积极的陪伴，这可能会改善孩子及其父母的健康相关结局。
