Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress.
Doi: 10.5902/2179769216340Objetivo: estudo com o objetivo de compreender a percepção da família do recém-nascido hospitalizado em unidade neonatal em relação ao cuidado prestado pela equipe de saúde. Método: pesquisa qualitativa, descritiva, que utilizou como referencial teórico os pressupostos do Cuidado Centrado no Paciente e Família. A coleta de dados foi realizada por meio de entrevistas semiestruturadas com sete familiares de recém-nascidos internados em uma unidade neonatal de um hospital universitário em 2011. Resultados: Os dados foram analisados conforme a Análise Qualitativa de Conteúdo, emergindo duas categorias analíticas: satisfação com o cuidado na unidade e dificuldades enfrentadas em relação à equipe e à hospitalização. Conclusão: há uma distância entre a teoria e a prática, sendo o Cuidado Centrado no Paciente e Família um ideal a ser alcançado.
Parent's support group as a transforming experience for families at a neonatal unitGrupo de apoio aos pais como uma experiência transformadora para a família em unidade neonatal Grupo de apoyo a los padres como una experiencia transformadora para la familia en una unidad neonatal resumen Objetivo: Comprender el significado de la participación de la familia en el Grupo de Apoyo a los Padres en una unidad neonatal. Métodos:Estudio cualitativo descriptivo realizado en un Hospital Universitario de São Paulo. Los datos fueron recolectados a través de entrevistas semiestructuradas con las familias de los recién nacidos hospitalizados y después sometidas al análisis de contenido cualitativo. Resultados: El grupo de apoyo es una experiencia transformadora para la familia, ya que promueve la aclaración de dudas. Además de representar apoyo durante la hospitalización del recién nacido, promueve el intercambio de experiencias entre los padres y una mayor interacción entre el equipo de salud y amigos. Conclusión: Gracias al apoyo de un equipo multidisciplinario, se refuerza la importancia del grupo para fortalecer el vínculo afectivo entre padres e hijos, amenizar el sufrimiento de la familia y ampliar la autonomía de los padres en el cuidado de los niños.
Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources: Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis: Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes.
Objectives: To identify levels of sound pressure level (NPS) inside the incubator and the sources of noise in that microenvironment of the Neonatal Intensive Care Unit of a university hospital. Methods: Descriptive quantitative study, conducted in incubators for the Neonatal Intensive Care Unit of a university hospital in São Paulo. The records were obtained by NPS dosimeter, totaling 261 hours, 48 hours of records of the sources producing noise. Results: There were high NPS inside the incubators. Greater Leq levels were 79.7 dBA in room A, and 74.3 dBA in room B. The main sources of noise were: water circulation fan, maintaining open doors on the incubators during periods of care, equipment alarms, and conversation among professionals close to the incubator. Conclusions: The results showed that the NPS inside the incubator are far above those recommended by regulations. Based on these results, we developed a protocol and educational program. Keywords: Noise; Intensive care units, Neonatal; Neonatal nursing; Humanization of assistance RESUMOObjetivos: Identificar níveis de pressão sonora (NPS) no interior das incubadoras e as fontes geradoras de ruído nesse microambiente de Unidade de Terapia Intensiva Neonatal de um hospital universitário. Métodos: Pesquisa quantitativa, descritiva, conduzida nas incubadoras de Unidade de Terapia Intensiva Neonatal de um hospital universitário do Município de São Paulo. Os registros de NPS foram obtidos por meio de dosímetro, totalizando 261 horas, 48 horas de registros das fontes produtoras de ruídos. Resultados: Constataram-se elevados NPS no interior das incubadoras. Maiores Leq médios foram 79,7 dBA na sala A e 74,3 dBA na B. As principais fontes de ruído foram: barulho da água do ventilador, permanência das portinholas abertas da incubadora, durante os cuidados prestados, alarmes dos equipamentos e conversa entre profissionais próxima à incubadora. Conclusões: Os resultados evidenciaram que os NPS no interior das incubadoras estão distantes do recomendado pelos órgãos regulamentadores. Com base nesses resultados, foram desenvolvidos um protocolo e programa educativo. Descritores: Ruído; Unidades de terapia intensiva neonatal; Enfermagem neonatal; Humanização da assistência RESUMEN Objetivos: Identificar niveles de presión sonora (NPS) en el interior de las incubadoras y las fuentes generadoras de ruido en ese micro ambiente de Unidad de Cuidados Intensivos Neonatal de un hospital universitario. Métodos: Investigación cuantitativa, descriptiva, conducida en las incubadoras de una Unidad de Cuidados Intensivos Neonatal de un hospital universitario del Municipio de Sao Paulo. Los registros de NPS fueron obtenidos por medio de dosímetro, totalizando 261 horas, 48 horas de registros de las fuentes productoras de ruidos. Resultados: Se constataron elevados NPS en el interior de las incubadoras. Mayores Leq medios fueron 79,7 dBA en la sala A y 74,3 dBA en la B. Las principales fuentes de ruido fueron: bulla del agua del ventilador, permanencia de las portezuelas abiertas...
The aim of this study was to comprehend the meaning of using illness narratives to raise awareness among nursing students and healthcare professionals toward the family-centred care model. The adopted methodological framework was Qualitative Content Analysis based on the philosophy of Family-Centered Care. Data were collected by means of assessments provided by 29 participants at an event in 2013, in São Paulo. The resulting analytical category was "transformed by the family narrative", which consisted of three sub-categories: Favours a better understanding of the family's experience; facilitates learning of family issues; and triggers thought on family-centered care. Results showed that hearing the family narrative on experiences with illness and hospitalization raises awareness among nursing students and healthcare professionals toward the family-centered care model, and facilitates learning of this model of care.
RESUMO. Trata-se de um estudo que buscou meios para entender como lidar com a família que vivenciou a notícia de ter um recém-nascido mal-formado. A entrevista ocorreu em um hospital público de São Paulo, em novembro de 2002, utilizando-se o Modelo Calgary de Avaliação e Intervenção na Família (MCAF/MCIF). O estudo mostrou a necessidade de intervenções construídas com a família para minimizar o impacto da notícia e para favorecer espaço para expressão de sentimentos e resolução da crise. O papel do enfermeiro como membro da equipe interdisciplinar é tentar efetivar o trabalho de ajuda à família de forma precoce, quando esta vive a difícil experiência de ter uma criança especial. A intervenção visa atuar com a família a partir da detecção do problema, utilizando a escuta ativa da comunicação verbal e não-verbal na tentativa de compreensão da situação e atuar como facilitador do processo de resolutividade da crise vivenciada.Palavras-chave: Enfermagem Pediátrica, família, recém-nascido, má-formação congênita.ABSTRACT. Interviewing the families of sick newborn babies as a proposal of nursing assessment and intervention. This paper is based on a study that searched ways to understand how to deal with the family who experienced the news of a sick newborn. The interview was performed in a hospital located in São Paulo, Brazil, in November of 2002 and it used the Calgary Model of Assessment and Intervention in Family (CMAF/CMIF)). This study showed the need for intervention with the family to minimize the impact of receiving the news of a sick newborn, and to provide support through a conversation for resolution of the problem. The function of the nurse is to try to perform a precocious work with the family, facing the difficult experience of having a special child. The intervention aims to help the family to solve the problem, listening to the verbal and not verbal communication, searching to understand the situation with the family.Key words: pediatric nursing, family new born, congenital malformation. IntroduçãoAtualmente percebe-se o quanto o enfermeiro tem buscado evoluir na assistência prestada ao cliente, antes centrada no cliente/paciente (único indivíduo que necessitava e que recebia cuidados advindos da equipe multidisciplinar), ampliando para a família, considerando seus membros e também quem participa do cotidiano e de sua história. É importante destacar que, quando se fala em família, hoje entende-se que não inclui somente os membros co-sanguíneos (Neman, 2000).Apesar de vários estudos indicarem que a enfermagem na família existe desde os tempos pré-históricos, se fizéssemos uma retrospectiva na história iríamos perceber que, com a criação e com a supervalorização dos hospitais, o tratamento das doenças e o cuidado ao cliente passaram a ser desenvolvidos dentro desses centros e, com isso, a família foi afastada de tudo o que envolvia tratamento, recuperação e cura do cliente (Wright e Leahey, 2002).No decorrer dos séculos XVIII e XIX, durante a Repressão e a Segunda Guerra Mundial, houve uma transição do...
Objective:to develop and validate instruments to identify health professionals’ beliefs related to the presence of the child’s family in invasive procedures and in cardiopulmonary resuscitation. Method:study based on Psychometrics to conduct the theoretical, empirical and analytical stages, developed in a neonatal unit of a university hospital. The two instruments were constructed based on the literature and applied to 96 health professionals. Results:the Cronbach’s Alpha of the instrument related to the professionals’ beliefson invasive procedures was 0.863 and the instrument on cardiopulmonary resuscitation was 0.882. In both instruments, the tests performed indicated a correlation between the items. From the factorial analysis, four factors were generated: (1) benefits of the presence of the family; (2) impairment for professional practice; (3) strategies for the inclusion of the family; and (4) limitation of learning and decision making by the professional. Conclusion:the instruments analyzed obtained a good internal consistency and are indicators of the professionals’ beliefs with the potential to evaluate the quality of family care in this context.
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