Developing a Family-Centered Care Model for Critical Care After Pediatric Traumatic Brain Injury.
Developing a Family-Centered Care Model for Critical Care After Pediatric Traumatic Brain Injury.
复制标题
DOI：
10.1097/pcc.0000000000000494
复制
发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Vavilala MS
中科院分区：
文献类型：
--
作者：
Moore M;Robinson G;Mink R;Hudson K;Dotolo D;Gooding T;Ramirez A;Zatzick D;Giordano J;Crawley D;Vavilala MS
本研究考察了儿童创伤性脑损伤后重症监护的家庭经验，以建立一个与以家庭为中心的护理相关的特定因素模型。采用半结构化访谈的定性方法。两个一级创伤中心。我们对15位在过去5年内因创伤性脑损伤而急性住院的儿童母亲进行了访谈，了解她们的重症监护经历和出院计划。主要讲英语、西班牙语或广东话的受访者也包括在内。内容分析用于对访谈记录进行编码，并开发以家庭为中心的护理模型。三个主要主题出现了：1)彻底、及时、富有同情心的沟通；2)家庭、提供者和机构的能力建设；3)护理过渡的协调。参与者报告说，他们重视详细、频繁的沟通，这种沟通设定了现实的期望，并为他们的决策和结果做好了准备。能力建设领域包括提高提供者文化谦逊、家长参与护理和机构灵活性的战略。强调了协调的护理过渡，包括信息的连续性和维持与家庭和护理小组的伙伴关系。主要不讲英语的参与者报告在沟通、文化理解和协调过渡方面特别困难。本研究提出一种基于家庭视角的以家庭为中心的创伤性脑损伤护理模式。除了沟通和协调策略外，该模型还提供了解决文化和结构障碍的方法，以满足非英语家庭的需求。考虑到创伤性脑损伤儿童家庭所经历的压力，仔细考虑本文确定的模型主题可能有助于提高创伤性脑损伤住院儿童家庭的整体护理质量。
This study examined the family experience of critical care after pediatric traumatic brain injury in order to develop a model of specific factors associated with family-centered care. Qualitative methods with semi-structured interviews were utilized. Two level 1 trauma centers. Fifteen mothers of children who had an acute hospital stay after TBI within the last 5 years were interviewed about their experience of critical care and discharge planning. Participants who were primarily English, Spanish or Cantonese speaking were included. None Content analysis was used to code the transcribed interviews and develop the family-centered care model. Three major themes emerged: 1) thorough, timely, compassionate communication, 2) capacity building for families, providers and facilities, and 3) coordination of care transitions. Participants reported valuing detailed, frequent communication that set realistic expectations and prepared them for decision-making and outcomes. Areas for capacity building included strategies to increase provider cultural humility, parent participation in care and institutional flexibility. Coordinated care transitions, including continuity of information and maintenance of partnerships with families and care teams were highlighted. Participants who were not primarily English speaking reported particular difficulty with communication, cultural understanding and coordinated transitions. This study presents a family-centered traumatic brain injury care model based on family perspectives. In addition to communication and coordination strategies, the model offers methods to address cultural and structural barriers to meeting the needs of non-English speaking families. Given the stress experienced by families of children with TBI, careful consideration of the model themes identified here may assist in improving overall quality of care to families of hospitalized children with traumatic brain injury.