Family-Centered Pediatric Emergency Care: A Framework for Measuring What Parents Want and Value
Family-Centered Pediatric Emergency Care: A Framework for Measuring What Parents Want and Value
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DOI：
10.1016/j.acap.2015.08.011
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发表时间：
2016-05-01
影响因子：
3.1
通讯作者：
Alessandrini, Evaline A.
中科院分区：
文献类型：
--
作者：
Byczkowski, Terri L.;Gillespie, Gordon L.;Alessandrini, Evaline A.
目的：识别和描述在儿科急诊护理中对父母重要的以家庭为中心的护理维度，并将其与目前文献中定义的维度进行比较。方法：进行了一项定性研究，涉及8个焦点小组，父母陪同他们的孩子到一个大型三级保健儿科卫生系统的急诊科就诊。使用有目的的抽样来确定参与者，以实现人口统计学特征的代表性，包括儿童的种族，保险状况，严重程度以及参与者与儿童的关系。焦点小组按患者年龄和是否患有慢性疾病进行分组。会议由一位在卫生相关专题方面经验丰富的主持人主持。一个6人的多学科团队完成了内容分析。结果：68名家长参与。女性占77%；20 ~ 29岁（19%）、30 ~ 39岁（47%）、40岁以上（31%）；黑人（44%），白人（52%）；已婚（50%）。他们的孩子的特点是：公共保险（52%）；黑人（46%），白人（46%）；并作为住院病人入院（46%）。分析得到8个维度：1)情感支持；2)协调;3)引导和尊重患者的偏好，让患者和家属参与护理决策；4)及时周到的护理；5)信息、传播和教育；6)疼痛管理；7)安全和以儿童为中心的环境；8)连续性和过渡。与已发表的文献相比，最显著的差异是将涉及家庭和尊重偏好合并为一个维度，并将身体舒适分为两个维度：疼痛管理和安全/以儿童为中心的环境。结论：所得维度为衡量和改善以家庭为中心的儿科急诊服务提供了一个框架。
OBJECTIVE: To identify and describe dimensions of family centered care important to parents in pediatric emergency care and compare them to those currently defined in the literature.METHODS: A qualitative study was conducted involving 8 focus groups with parents who accompanied their child to an emergency department visit at a large tertiary-care pediatric health system. Participants were identified using purposive sampling to achieve representation across demographic characteristics including child's race, insurance status, severity, and participant's relationship to child. Focus groups were segmented by patient age and presence of a chronic condition. They were moderated by a facilitator experienced in health related topics. A 6-member multidisciplinary team completed a content analysis.RESULTS: Sixty-eight parents participated. They were female (77%); aged 20 to 29 years (19%), 30 to 39 years (47%), more than 40 years (31%); black (44%), white (52%); and married (50%). Their child's characteristics were: public insurance (52%); black (46%), white (46%); and admitted as an inpatient (46%). The analysis resulted in 8 dimensions: 1) emotional support; 2) coordination; 3) elicit and respect preferences, and involve the patient and family in care decisions; 4) timely and attentive care; 5) information, communication, and education; 6) pain management; 7) safe and child-focused environment; and 8) continuity and transition. Compared to those published in the literature, the most notable differences were combining involving family and respect for preferences into a single dimension, and separating physical comfort into 2 dimensions: pain management and safe/child-focused environment.CONCLUSIONS: The resulting dimensions provide a framework for measuring and improving the delivery of family centered pediatric emergency care.