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Parent’s experiences of their child’s withdrawal syndrome: a driver for reciprocal nurse-parent partnership in withdrawal assessment
Institution:1. Department of Anaesthesia, Alder Hey Children’s NHS Foundation Trust, East Prescot Road, Liverpool L14 5AB, UK;2. Edge Hill University, Faculty of Health and Social Care, Ormskirk, Lancashire L39 4QP, UK;3. Department of Applied Mathematics, James Parsons Building, Byrom Street, Liverpool L3 3AF, UK;4. Faculty of Health & Applied Sciences, University of the West of England, Blackberry Hill, Bristol BS16 1DD, UK;1. Department of Medicine, McMaster University, Hamilton, Canada;2. Hamilton Health Sciences, Hamilton, Canada;3. School of Nursing, McMaster University, Hamilton, Canada;1. General Intensive Care Unit, Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, SE-17176 Stockholm, Sweden;2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden;3. Red Cross University College, SE-141 21 Stockholm, Sweden
Abstract:Withdrawal assessment in critically ill children is complicated by the reliance on non-specific behaviours and compounded when the child’s typical behaviours are unknown. The existing approach to withdrawal assessment assumes that nurses elicit the parents’ view of the child’s behaviours.Objective and research methodologyThis qualitative study explored parents’ perspectives of their child’s withdrawal and preferences for involvement and participation in withdrawal assessment. Parents of eleven children were interviewed after their child had completed sedation weaning during recovery from critical illness. Data were analysed using thematic analysis.SettingA large children’s hospital in the Northwest of England.FindingsParents experienced varying degrees of partnership in the context of withdrawal assessment and identified information deficits which contributed to their distress of parenting a child with withdrawal syndrome. Most parents were eager to participate in withdrawal assessment and reported instances where their knowledge enabled a personalised interpretation of their child’s behaviours. Reflecting on the reciprocal nature of the information deficits resulted in the development of a model for nurse-parent collaboration in withdrawal assessment.ConclusionFacilitating nurse-parent collaboration in withdrawal assessment may have reciprocal benefits by moderating parental stress and aiding the assessment and management of withdrawal syndrome.
Keywords:Critical care  Decision-making  Family-centred care  Iatrogenic withdrawal syndrome  PICU
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