Aims and objectives:To explore how parents and nurses experience partnership in neonatal intensive care units and to identify existing barriers and facilitators to a successful partnership.Background: Family-centred care is recommended as a frame of reference for treatment and care in neonatal intensive care units. A key element in family-centred care is partnership. Such partnerships are characterised by complex interpersonal relationships and interactions between nurses and parents/families. Partnerships therefore appear to present a significant challenge. Design:A qualitative review and meta-synthesis. Methods:Comprehensive searching in ten databases: CINAHL, PubMed (MEDLINE), EMBASE, PsycINFO, Scopus and SweMed+, OpenGrey, MedNar, Google Scholar and ProQuest Dissertations & Thesis Global. A total of 1,644 studies (after removal of duplicates) were critically assessed, and 21 studies fulfilled the inclusion criteria. A meta-aggregation was used to synthesise the findings from the studies and was methodically quality assessed with QUARI/SUMARI and PRISMA.Findings: Through a meta-aggregative approach, two synthesised findings were developed: (a) co-creation of mutual knowledge and (b) developing competencies and negotiating roles. The first synthesis embraced the categories: being respected and listened to, trust and sharing knowledge, and the second synthesis embraced the categories: space to learn with guidance, encouraging and enabling, being in control. In constructing the categories, findings were identified as characteristics, barriers and facilitators to application.
BackgroundAdequate self-management is the cornerstone of preventing type 1 diabetes mellitus (T1DM) complications. However, T1DM self-management is challenging for young people, who often struggle during the transition from childhood to adulthood. The mobile health (mHealth) app Young with Diabetes (YWD) was developed in collaboration with young people to enhance their T1DM self-management during this transition.ObjectiveThe purpose of this study was to explore the influence of YWD on young people’s self-management during a 12-month period.MethodsA qualitative explorative approach was used, comprising a purposive sample of 20 young people (11 females and 9 males, ages 15 to 23 years, with app use of 3 to 64 days) from 3 pediatric and 3 adult departments. Participants were interviewed individually using a semistructured interview guide. Data were collected from January to March 2017 and analyzed using thematic analysis.ResultsA total of 5 themes were identified: (1) not feeling alone anymore (“we are in this together”); (2) gaining competence by sharing experiences and practical knowledge (“they know what they are talking about”); (3) feeling safer (“it’s just a click away”); (4) breaking the ice by starting to share thoughts and feelings and asking for help (“it is an outstretched hand”); and (5) lack of motivating factors (“done with the app”). Young people reported that YWD promoted self-management by peer-to-peer social support, exchanging messages with health care providers, and sharing YWD with parents. Participants recommended YWD as a supplement to self-management for newly diagnosed young people with T1DM and suggested improvements in app content and functionality.ConclusionsThe mHealth app YWD has the potential to support self-management. In particular, peer-to-peer support reduced feelings of loneliness and helped young people to gain knowledge and skills for managing T1DM. A need exists for alternative ways to train health care providers in using YWD and to support collaboration between young people and their parents to further improve young people’s self-management of T1DM.
Our study was unable to demonstrate the effect of person-centred communication using the Guided Family-Centred Care intervention. It may be necessary to replicate the design to address the risk of contamination and add instruments sensitive to human interaction.
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