Cardiac surgery discharge questionnaires: meeting information needs of patients and families

Tailoring discharge teaching information to the unique learning needs of cardiac surgery patients and their caregivers may improve information acquisition and retention and positively influence the transition home for these individuals. Two questionnaires were developed, one for adult cardiac surgery patients, and one for their caregivers, to explore their self-identified information needs regarding discharge teaching information. The questionnaires were adapted from the Patient Learning Needs Scale of Bubela et al. (1990). The content of the questionnaires was based on informal discussions with patients and their caregivers and nurses of the cardiac surgery department of a university teaching hospital. In addition, previous research exploring discharge teaching content post cardiac surgery and perceived discharge information needs of this population was reviewed. Preliminary testing of the tools indicated content validity. The questionnaires may enhance the efficiency and quality of discharge teaching, as they enable nurses to address the unique information needs of patients and caregivers. This, in turn, may assist patients and caregivers to cope with the transition home. Formal piloting and evaluation of the tools with all stakeholder groups is indicated, in order to determine the effectiveness of the questionnaires and to evaluate and validate their content and format.     

An evaluation of interventions for meeting the information needs of families of critically ill patients.

OBJECTIVE: To evaluate the effectiveness of two methods of meeting the information needs of families of critically ill patients: an open visiting hour policy and a family information booklet. SETTING: Medical intensive care unit of a university medical center. SUBJECTS: Family members (N = 147) of patients admitted to the medical intensive care unit. INTERVENTIONS: Implementation of an open visiting hour policy and information booklet. MEASUREMENTS AND MAIN RESULTS: Questionnaires were distributed to family members 24 to 48 hours after the patient's admission. The questionnaire addressed family satisfaction with having specific information needs met and posed questions that tested their knowledge of unit policies and personnel. The questionnaire was distributed to three groups: families who had restricted visiting hours and no booklet (group 1, n = 48), families who had open visiting hours but no booklet (group 2, n = 50), and families who had open visiting hours and an information booklet (Group 3, n = 49). Implementation of an open visiting hour policy increased family satisfaction. Families exposed to both the open visiting hours and the information booklet were more knowledgeable about specific details than were those exposed to only the open visiting hour policy. CONCLUSIONS: Flexible visiting hours and information booklets were two practical methods of meeting the information needs of families. Open visiting hours, as a singular intervention, significantly improved family satisfaction. The effectiveness of the booklet in assisting families to recall discrete pieces of information supports the further development and use of preprinted materials to assist in meeting family information needs.     

A critical pathway for meeting the needs of families of patients with severe traumatic brain injury.

Family members of patients recovering from severe traumatic brain injuries have needs that are best met through early assessment and proactive intervention. A critical pathway addressing the needs of families during the acute and postacute phases of hospitalization was developed and implemented in the neuroscience intensive care and step-down units of a university hospital. A team of 10 neurosurgical nurses used and evaluated the program.     

Sexual health: meeting adolescents' needs

BACKGROUND: The UK has the highest rate of sexually transmitted infections (STIs), especially among young people, in western Europe. Knowledge of what influences young people's sexual behaviour is limited which highlights a need to understand adolescent development and recognise that they are at increased risk of acquiring an STI compared with other groups. This article examines the risks of acquiring STIs in adolescence and discusses how nurses feel about treating young people with sexual health needs. CONCLUSION: Postgraduate training needs to incorporate specific modules relating to young people within sexual health. Sexual health providers go some way to providing an adolescent-friendly service, but more creative approaches to service delivery such as flexible opening hours and contraception outreach services would make them more accessible to young people.     

The use of music therapy in meeting the multidimensional needs of hospice patients and families

This article presents four case studies which demonstrate the use of music therapy in assisting palliative care patients and families cope with grief and loss, pain and anxiety, disorientation and dementia, lack of meaning, and hopelessness. Music therapy techniques are illustrated and patient-related goals are defined within the case studies. A review of the literature supports the use of music therapy in palliative care, and a variety of qualitative and quantitative studies are reported in the article.     

Teaching families to be caregivers for the elderly

Abstract The number of elderly citizens in Samoa is increasing and caregivers are needed to meet the challenge of home care. Nurses provided a low-cost and effective workshop for family caregivers of the elderly. The purposes of the study were to determine a relatively inexpensive method to educate many caregivers; to determine the impact of the workshops on the individual caregivers; to assess the impact on the care given to the elderly as a result of the workshops and to determine potential policy issues related to the elderly for Samoa. The results of this qualitative study indicate information sessions were effective, a support network for the caregivers developed, the quality of care of the elderly improved, community awareness about the needs of the elderly increased, and an interdisciplinary group met to formulate a policy for government action to provide needed services for the elderly.     

Early intervention for children and families: with special needs

The purpose of this article is to provide a general overview of early intervention and how nurses can interface with this important program for children. "Early intervention" in this context refers to services for young children (birth to age 3) who have developmental delays or are at risk for delays, as well as for their families. These programs are administered by each state but are federally funded under Part C of the Individuals with Disabilities Act. The primary objective of early intervention is to maintain or maximize a child's development; a wide range of services may be provided including nursing, physical therapy, occupational therapy, and family counseling. Overall, early intervention programs have been shown to improve developmental outcomes, strengthen parent-child interactions, and provide a supportive family environment. There is a continued need for research, however, in many areas, including assessing the long-term effects of services for specific groups, determining the most effective means of providing services, and evaluating outcomes of family functioning.     

A partnership approach to service needs assessment with family caregivers of an aging relative living at home: A qualitative analysis of the experiences of caregivers and practitioners

Background

As the global population ages, support for family caregivers who provide the bulk of care to community-dwelling older people is becoming ever more important. However, in many countries, homecare-service practitioners currently do not follow a systematic approach to assessing and responding to caregiver needs.

Objectives

The aim of this study was to explore the experiences of caregivers and practitioners who took part in a field test of the Family Caregivers Support Agreement (FCSA) tool, a modified version of the Carers Outcome Agreement Tool (COAT) initially developed as the result of an Anglo-Swedish study. Both the COAT and the FCSA are designed to facilitate partnerships between caregivers and practitioners so that needs assessment and subsequent support services are negotiated and agreed so as to meet caregiver expectations.

Design and participants

A qualitative design was adopted and data were collected through focus groups with six practitioners (nurses and social workers) working in two Local Community Service Centres in the province of Quebec (Canada). These practitioners had previously completed the FCSA tool with 17 primary caregivers of frail elderly relatives who were clients of homecare services. Individual interviews were conducted with the caregivers to explore their experiences. Data were analyzed to identify significant themes, from the perspectives of caregivers and practitioners, which provided insights into their experiences and the strategies used by practitioners to facilitate partnership working.

Findings

To facilitate meaningful exchanges, practitioners adopted strategies such as sensitive listening and the use of enabling questions to identify and contextualize caregiver needs and to highlight the ability of caregivers to find their own creative solutions to the challenges they face. The caregivers described experiencing a climate of trust that allowed them to express their concerns, to reflect upon their situation and to participate in the development of an action plan for their support.

Conclusions

The study reaffirms findings from Sweden and UK that the use of a tool such as the FCSA enhances partnership working and creates a caregiver-practitioner relationship based on a genuine alliance. As a result, both parties gain new insights into the caring situation. The approach underpinning the FCSA tool has potential for a more widespread application in different contexts.