Abstract:Background:
Sepsis is a time critical disease and outcomes strongly depend on time to initiation of appropriate treatment in hospital. A range of studies have assessed sepsis recognition in hospital settings, whereas little is known about sepsis recognition in the community. The decision-making of parents in seeking medical care may substantially impact survival of children with sepsis. An improved understanding of the parental perspective in recognizing sepsis is urgently needed to inform the desig… Show more
“…Prior to the COVID-19 pandemic, our team of parents and healthcare professionals developed a parent decision-making and risk assessment leaflet (10) for parents to identify early deterioration of a seriously ill child, including parental concern as a trigger to escalate care (11). Due to the decrease in pediatric emergency department (PED) attendances at the early stages of the COVID-19 pandemic, we published our leaflet on the hospital website in February 2020 to support parents in the community.…”
“…Prior to the COVID-19 pandemic, our team of parents and healthcare professionals developed a parent decision-making and risk assessment leaflet (10) for parents to identify early deterioration of a seriously ill child, including parental concern as a trigger to escalate care (11). Due to the decrease in pediatric emergency department (PED) attendances at the early stages of the COVID-19 pandemic, we published our leaflet on the hospital website in February 2020 to support parents in the community.…”
“…While there is little change from 2016 to 2018, data reinforce the commitment to implementing long-term community-based programs in the St. Louis Metropolitan region that give parents the ability to be active participants in the health care of their children. 7-11…”
Section: Discussionmentioning
confidence: 99%
“…6 Health systems encourage parents to be active participants in the health care of their children and recognizes the need to assess parents on their ability to identify health needs of their children. [7][8][9][10][11] Parents often express concern for the physical, behavioral, and developmental aspects of their child's health. [12][13][14] Studies of parents' primary health concerns for their child are frequently related to psychosocial issues, such as their child's behavior or even their own parenting.…”
Population health includes medical conditions and social determinants of health, and it can be measured through community health needs assessments (CHNAs). A pediatric hospital utilized a survey to ask parents to rank different health topics based on the severity they present to children in the St. Louis Metropolitan for 2 installments of a CHNA (2016 and 2019). Between November 2015 and April 2016, 1156 parents and, between May 2018 and September 2018, 1022 parents responded to the Parent Health Concerns Survey. Respondents were most likely to be 25 to 44 years old, white, educated, have an income of at least $60 000, and work-related insurance. The top needs identified in 2016 and 2018 were lack of exercise and bullying, respectively. Depression saw the largest increase. Emerging topics in 2018 include tobacco/smoking, depression, and health insurance access. Our findings suggests that pediatricians should be prepared to address concerns across a wide variety of topics.
“…Families of hospitalised preterm/low-birthweight neonates experience stress, insecurity and alienation. 1 2 However, sepsis in the baby-a time-critical, devastating bloodstream infection with an unpredictable clinical courseposes different challenges for a family compared with babies who are not seriously ill. [3][4][5][6] It can range from a localised infection to life-threatening manifestations. 3 4 Complications (eg, septic shock and cardiopulmonary arrest) can progress suddenly and rapidly leading to multiorgan dysfunction and death, despite corrective measures.…”
Section: Introductionmentioning
confidence: 99%
“…3 This situation can be frightening for parents, with stressors affecting different fronts of their lives. [4][5][6] Families of infected/seriously ill babies are subject to health inequalities, face acute stressors, worry constantly about devastating consequences and continually have feelings of inadequacy. 5 7 8 Moreover, neonates of stressed parents are at the greatest risk of cognitive and behavioural problems compared with healthy neonates.…”
ObjectiveTo explore stressors and support system for families with a neonate admitted with a systemic infection.DesignQualitative study using in-depth interviews (IDIs), based on principles of grounded theory.SettingA busy level III neonatal unit of a tertiary care teaching hospital in coastal Karnataka, India, between May 2018 and January 2019.ParticipantsParents and accompanying attendants of neonates admitted to the neonatal unit with one or more systemic infections.MethodsUsing purposive sampling, semi-structured IDIs were audio recorded, transcribed verbatim and a thematic analysis was performed.ResultsThirty-eight participants were interviewed, lasting between 30 and 59 min. Babies’ hospitalisation with sepsis was an unprecedented, sudden and overwhelming event. Stressors related to uncertainties due to the information gap inherent to the nature of illness, cultural rituals, financial constraints, barriers to bonding and others. Parents reported experiencing insomnia, gastric disturbances and fatigue. Support (emotional and/or financial) was sought from families and friends, peers, staff and religion. Availability and preference of emotional support system differed for mothers and fathers. In our context, families, peers and religion were of particular importance for reinforcing the available support system. Participant responses were shaped by clinical, cultural, financial, religious and health service contexts.ConclusionDesigning a family-centred care in our context needs consideration of stressors that extend beyond the immediate neonatal intensive care unit environment and interactions. Understanding the influence of the nature of illness, financial, familial and cultural contexts helps identify the families who are particularly vulnerable to stress.
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