The Use and Intended Outcomes of Presence: A Focus Group Study

PURPOSE

To explore and understand the use and intended outcomes of presence from the perspective of and as experienced by nurses.

METHODS

Twenty‐seven nurses participated in one of four focus groups. Data were analyzed using Giorgi's phenomenological method.

FINDINGS

Four themes emerged: (1) therapeutic communication; (2) nurse well‐being; (3) dimensions of presence; and (4) intention to improve client outcomes.

CONCLUSIONS

Presence was described as a multidimensional intervention that required therapeutic communication and nurse well‐being with the intention of improving client outcomes. Study findings provide evidence of the significance of presence in the face of human interaction that is shifting to virtual, impersonal communication.     

Witnessed resuscitation: A concept analysis

BackgroundThe advance in the practice of resuscitation is globally recognised and fully sanctioned in scientific world. However, practicing family presence during resuscitation, also known as witnessed resuscitation, is yet to be endorsed by healthcare professionals. Many professional nursing and physician organisations have endorsed the practice of witnessed resuscitation by issuing guidelines. These organisations support family presence during resuscitation due to the research proving its benefit for patients and families.PurposeThe purpose of this paper is to analyse the concept of witnessed resuscitation.MethodA concept analysis was undertaken using Rodger’s (2000) evolutionary method.FindingsThe concept analysis suggests that witnessed resuscitation refers to the presence of a family member or relative during a resuscitation procedure, mostly in emergency and complex critical care areas. The defining attributes are family centred care approach, exercising patients and family rights and autonomy in end of life care decisions and involvement of family as active and passive observers during a resuscitation event.ConclusionClarity surrounding witnessed resuscitation will guide the development of a conceptual framework, expand nursing knowledge and identify the research required to advance understanding of witnessed resuscitation in practice.     

Offspring psychological and biological correlates of parental posttraumatic stress: Review of the literature and research agenda

Millions of individuals with posttraumatic stress disorder (PTSD) are parents. A burgeoning literature suggests that offspring of parents with this condition may be at increased risk for psychological problems. The current paper provides an integrative and comprehensive review of the diverse research literature examining the sequelae of parental posttraumatic stress among offspring. Over 100 studies that evaluated psychological and/or biological variables among children of parents with PTSD are reviewed. Findings suggest parental symptoms of posttraumatic stress are uniquely related to an array of offspring outcomes, including internalizing-type problems, general behavioral problems, and altered hypothalamic-pituitary-adrenal axis functioning. Although very little work has directly evaluated mechanisms of transmission, there is increasing support for genetic and epigenetic effects as well as parenting behaviors. These and other mechanisms are discussed; drawing upon findings from other literatures to consider how parental PTSD may impart psychobiological vulnerability upon offspring. We conclude with a detailed discussion of the methodological strengths and challenges of the extant research, along with a recommended agenda for future research in this important area of study.     

Factors that influence parents’ experiences with results disclosure after newborn screening identifies genetic carrier status for cystic fibrosis or sickle cell hemoglobinopathy

Objective

Newborn screening (NBS) identifies genetic carriers for sickle cell hemoglobinopathy and cystic fibrosis. We aimed to identify factors during initial NBS carrier results disclosure by primary care providers (PCPs) that influenced parents’ experiences and reactions.

Methods

Open-ended responses from telephone interviews with 270 parents of carriers were analyzed using mixed-methods. Conventional content analysis identified influential factors; chi-square tests analyzed relationships between factors and parent-reported reactions.

Results

Parents reported positive (35%) or negative (31%) reactions to results disclosure. Parents’ experiences were influenced by specific factors: content messages (72%), PCP traits (47%), and aspects of the setting (30%). Including at least one of five specific content messages was associated (p < 0.05) with positive parental reactions; omitting at least one of four specific content messages was associated (p < 0.05) with negative parental reactions. Parents reported positive reactions when PCPs avoided jargon or were perceived as calm. Parents reported negative reactions to jargon usage and results disclosure by voicemail.

Conclusion

Parents identified aspects of PCP communication which influenced their reactions and results disclosure experiences.

Practice implications

Our findings suggest ways PCPs may improve communication of carrier results. PCPs should provide specific content messages and consider how their actions, characteristics, and setting can influence parental reactions.     

Multimedia based health information to parents in a pediatric acute ward: A randomized controlled trial

Objective

To determine whether multimedia based health information presented to parents of children with breathing difficulties in a pediatric acute ward, is more effective than verbal information, to reduce parental anxiety and increase satisfaction.

Methods

This randomized controlled trial was conducted in a pediatric acute ward in Norway, from January to March 2011. Parents were randomly assigned to a multimedia intervention (n = 53), or verbal health information (n = 48). Primary outcome measure was parental anxiety, and secondary outcome measures were parental satisfaction with nursing care and health information.

Results

Parental anxiety decreased from arrival to discharge within both groups. At discharge the anxiety levels in the intervention group were no lower than in the control group. There was no difference in satisfaction with nursing care between the groups, but parents in the intervention group reported higher satisfaction with the health information given in the acute ward (p = .005).

Conclusion

Multimedia based health information did not reduce anxiety more than verbal information, among parents to children with breathing difficulties. However, after discharge the parents were more satisfied with the multimedia approach.

Practice implications

More research is needed to recommend the use of multimedia based information as a routine to parents in pediatric emergency care.     

Social Inequality in Birth Outcomes in Korea, 1995-2008

Social inequality in adverse birth outcomes has been demonstrated in several countries. The present study examined the separate and joint effects of parental education and work in order to investigate the causal pathways of social class effects on adverse birth outcomes in Korea. The occurrence of low birth weight, preterm births, and intrauterine growth retardation was examined among 7,766,065 births in Korea from 1995 to 2008. The effect of social inequality, as represented by parental education and work, was examined against adverse birth outcomes using multivariate logistic regression after controlling for other covariates. Parental education had the most significant and greatest effect on all three adverse outcomes, followed by parental work and employment, which had lesser effects. For adverse birth outcomes, the gap between educational levels increased steadily in Korea from 1995 to 2008. Throughout the analysis, the effect of maternal manual work on adverse birth outcomes was apparent in the study results. Given this evidence of social inequality in education and employment, social interventions should aim at more in-depth and distal determinants of health.     

PDCA护理干预对小儿哮喘的护理质量及家长满意度作用评价

目的 探讨PDCA 护理干预对小儿哮喘的护理质量及家长满意度作用。方法 研究对象为90 例哮喘患儿,研究时间为2017 年2 月～2018 年9 月,按照抽签方法分为两组,即对照组给予常规护理,观察组给予PDCA 护理干预,各45 例,且对两组患儿的哮喘发作次数、住院次数、FVC、FEV1、PEF 及护理质量、家长满意度进行观察及评估。结果 两组干预前哮喘发作次数及住院次数无明显差异（P＞0.05）;观察组干预后哮喘发作次数及住院次数低于对照组（P＜0.05）。两组干预前FVC、FEV1、PEF 无明显差异（P＞0.05）;观察组干预后FVC、FEV1、PEF 低于对照组（P＜0.05）。观察组护理质量高于对照组（P＜0.05）。观察组家长满意度高于对照组（P＜0.05）。结论PDCA 护理干预应用于小儿哮喘中具有较高的临床价值,能够在改善肺功能的同时提升护理质量,对提高家长满意度具有积极作用,值得应用及推广。     

The internet is parents' main source of information about psychiatric manifestations of 22q11.2 deletion syndrome (22q11.2DS)

With advances in laboratory technology, an increasing number of potentially pathogenic CNVs is recognised. The phenotypic effects of some CNVs are well characterised, however, it remains unclear how much information reaches the parents of affected children and by what route. The 22q11.2 deletion syndrome (del22q11.2) is caused by the deletion of approximately 40 genes from the long arm of chromosome 22 and was first described in 1955 [1]. Our study reports the extent to which parents of an affected child are aware of the various manifestation of the condition and describes how they first learned about these potential problems.