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家长对支持儿童接受有创机械通气出院的教育的看法。

Parent perspectives on education to support hospital discharge for children with invasive mechanical ventilation.

机构信息

Department of Nursing, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; College of Nursing, Rush University, Chicago, IL, USA.

Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Chicago, Chicago, IL, USA.

出版信息

J Pediatr Nurs. 2024 Sep-Oct;78:e167-e174. doi: 10.1016/j.pedn.2024.07.002. Epub 2024 Jul 17.

Abstract

BACKGROUND

Children with invasive mechanical ventilation (IMV) often live at home, but for safety, parents must be prepared to assume primary responsibility for all aspects of their child's medically complex care. Prior studies have described discharge education programs, however often without perspectives of parents with lived experience transitioning home.

PURPOSE

To describe parent perspectives on hospital-based education for discharging home a child with IMV.

DESIGN AND METHODS

A secondary qualitative analysis of 23 parent interviews between February 2019 to January 2022 on topics related to caring for a child with IMV. Each interview was coded independently and discussed to consensus. Data from codes related to parent education and training were analyzed to identify themes and sub-themes.

RESULTS

Parents of 23 children with IMV participated in the primary interviews a month after hospital discharge. Four main themes in the secondary dataset were identified: (1) Training context: The hospital can be a stressful and difficult learning environment; (2) Training characteristics: Parents receive thorough training from interdisciplinary providers; (3) Learner characteristics: Parents are motivated learners who independently seek out knowledge; (4) Post-discharge education: Parents gain confidence in their expertise after navigating an emergency.

CONCLUSIONS

Parents who have transitioned from hospital-to-home describe sufficiently detailed hospital-based education; many felt trained as capably as nurses. However, parents experienced in-hospital training as inflexible and stressful.

PRACTICE IMPLICATIONS

Parents of children with IMV are eager learners but parent education is not always family-centered. Reforming the hospital learning environment to match parent needs will improve family experiences and training.

摘要

背景

接受有创机械通气(IMV)治疗的儿童通常在家中生活,但出于安全考虑,父母必须准备好承担其子女复杂医疗护理的主要责任。先前的研究已经描述了出院教育计划,但往往没有从有过居家过渡经验的父母的角度来描述。

目的

描述父母对在家中接受有创机械通气患儿出院教育的看法。

设计和方法

对 2019 年 2 月至 2022 年 1 月期间与照顾有创机械通气患儿相关的 23 名父母访谈的二次定性分析。每个访谈都进行了独立编码,并进行了讨论以达成共识。对与父母教育和培训相关的编码数据进行了分析,以确定主题和子主题。

结果

23 名有创机械通气患儿的父母在出院后一个月参加了主要访谈。在二次数据集内确定了四个主要主题:(1)培训背景:医院可能是一个压力大且困难的学习环境;(2)培训特点:父母接受来自跨学科提供者的全面培训;(3)学习者特点:父母是积极主动的学习者,他们会独立寻求知识;(4)出院后教育:父母在应对紧急情况后对自己的专业知识充满信心。

结论

从医院过渡到家庭的父母描述了足够详细的基于医院的教育;许多父母觉得自己的培训能力与护士相当。然而,父母在医院内培训时感到不灵活且有压力。

实践意义

接受有创机械通气治疗的儿童的父母是渴望学习的,但家长教育并不总是以家庭为中心。改革医院学习环境以满足家长需求将改善家庭体验和培训。

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