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AnteayerInternacionales

Co‐Designing a Cultural Informed Framework to Promote the Well‐Being of Black Canadian Parents With Preterm Infants: A Qualitative Study Protocol

ABSTRACT

Aim

To explore the experiences and support needs of Black Canadian parents with preterm infants and to engage them in co-creating a culturally informed framework to inform nurses, healthcare providers and community organisations to better serve this population.

Background

Preterm birth (PTB) is a traumatic experience that places significant physical and emotional strain on families and other caregivers. Despite research showing that Black mothers are at risk of PTB, little is known about their experiences of giving birth to a preterm infant and the challenges they encounter caring for these children in Canada. This lack of research specifically on Black parents in Canada makes it difficult to identify their psychosocial needs and develop intervention programmes to address their unique challenges.

Design

A two-phase qualitative exploratory design informed by a community engagement lens will be used.

Methods

In Phase 1, five focus groups (n = 48) and 6–8 in depth interviews will be conducted with Black parents of preterm infants. Questions will explore experiences in the NICU, transition home, access to support, coping strategies and mental well-being. One focus group will be conducted with the parent advisory council of the Canadian Premature Babies Foundation, our community partner to explore gaps in services. The data from Phase 1 will be analysed and findings will be used to informed Phase 2 concept mapping exercise. This research was approved by the Toronto Metropolitan University Research Ethics Board.

Discussion

There is a paucity of research addressing the experiences and needs of Black parents with preterm infants. Thus, this study is well positioned to generate the much-needed Canadian empirical knowledge on the unique experiences and stressors face by Black parents with preterm infants and inform the design of programmes and services to better support them.

Patient or Public Contribution

This study is in collaboration with the Canadian Premature Babies Foundation, our community partner.

Siblings of Children With Cancer and Their Challenges Across Everyday Life Contexts: A Two‐Phase Qualitative Study in Denmark

ABSTRACT

Aim

To explore the familial, emotional, social and school-related challenges experienced by school-aged siblings of children with cancer, focusing on how these challenges intersect across hospital, home and school in their everyday lives.

Design

Qualitative, two-phase, multi-site study.

Methods

Fieldwork was conducted at two distinct paediatric oncology wards, followed by semi-structured interviews with 11 siblings (aged 7–19 years) and 20 parents, recruited through criterion-based sampling. The data were analysed using reflexive thematic analysis.

Results

Analysis showed that siblings were often marginalised in hospital life due to (1) family logistics; (2) hospital-induced restrictions, rules and physical spaces and (3) perceptions of their presence as ‘problematic’, ultimately limiting their access. In family life, siblings experienced peripheral roles because (1) they were cared for by others, (2) had their needs subordinated and (3) faced shifting expectations. At school, siblings encountered (1) limited understanding from classmates and teachers and (2) insufficient support resources.

Conclusions

Siblings of children with cancer face significant, interconnected challenges, often amplified by the structural frameworks of healthcare, family and school contexts.

Impact

Siblings of children with cancer are often marginalised in their own lives. In healthcare, a family-centred approach to care should formally and actively include siblings. Nurses are well-positioned to promote this, ensuring whole-family support. Siblings would benefit from coordinated support bridging hospital, home and school.

Reporting Method

This study adheres to the SRQR Checklist.

Patient or Public Contribution

Parents helped shape the study focus by discussing preliminary observations and potential support needs.

Peer‐Mentor Support for Older, Vulnerable Patients With Ischemic Heart Disease: A Mixed Methods Process‐Outcome Evaluation

ABSTRACT

Aim

To achieve a deeper understanding of the results of a primary randomised controlled trial to clarify the potential effective mechanisms and barriers of a peer-mentor intervention.

Design

Mixed methods process-outcome evaluation of the intervention.

Method

Qualitative and quantitative data were collected during the intervention in a during-trial set-up, that is, a convergent design.

Results

The qualitative and quantitative findings mostly confirmed and expanded each other, identifying several mechanisms that facilitate the effectiveness of peer-mentor support during cardiac rehabilitation, such as mentors' experience-based knowledge and motivation. However, barriers related to lifestyle changes among older, vulnerable patients (e.g., mentee concerns about heart-healthy diets) and psychological outcomes (e.g., mentees' resilience) may minimise the effectiveness.

Conclusion

Peer-mentoring holds potential for supporting older, vulnerable patients during cardiac rehabilitation. However, ensuring that peer-mentors are well-suited for their role and capable of providing motivational, experience-based support is crucial, as is the need for tailored mentorship and consideration of specific patient populations needing mentor-supported cardiac rehabilitation.

Implications and Impact

Cardiac rehabilitation faces challenges due to high drop-out rates, particularly among older individuals, females, and vulnerable patients. Peer mentoring, a low-cost intervention, holds promise for supporting these groups in cardiac rehabilitation programmes.

Reporting Method

The study adheres to the ‘Systematic Development of Standards for Mixed Methods Reporting in Rehabilitation Health Sciences Research’, ‘Good Reporting of A Mixed Methods Study’ and ‘Template for Intervention Description and Replication’.

Patient and Public Contribution

A group of patients with cardiovascular disease actively contributed to developing and implementing the intervention.

Trial and Protocol Registration

ClinicalTrials.gov Identifier: NCT04945486—prospectively registered before the first participant was recruited

Qualitative Exploration of Black Canadian Parents' Experiences of Having a Preterm Infant and Navigating Racism in the NICU

ABSTRACT

Aim

The study aims to explore the experiences of Black Canadian parents following a preterm birth and their perspectives of being in the NICU.

Design

A qualitative design guided by principles of community engagement was used to explore the experiences of Black Canadian parents.

Methods

Focus groups and in-depth interviews were conducted with 40 Black parents of preterm infants. A thematic analysis approach was used to organize the data into meaningful themes.

Results

Five major themes were identified through the data analysis: encountering racism and discrimination in the NICU, bearing the emotional weight of staying in the NICU, enduring the feeling of bodily betrayal and guilt, grappling with the turmoil of uncertainty and seeking peer and mental health support programs.

Conclusion

This study provides in-depth understanding of the unique experiences of Black Canadian parents after a preterm birth and the challenges they face navigating the NICU.

Implications for Professional and/or Patient

Developing a targeted training program for health care providers is critical to address racism and discriminatory practices and enhance parents' sense of belonging in the NICU. Creating Black-focused peer support and accessible mental health care during and after the NICU is critical to address the gaps in programs and services and to promote effective coping.

Impact

Addressing racism and discriminatory practice requires urgent attention to promote equity within the NICU environment. Scaling up access to Black peer support and mental health programs will contribute to improving parental wellbeing in Canada and beyond.

Patient or Public

This study was in partnership with the Canadian Premature Babies Foundation, our community collaborator.

THE Effect of Mentoring Programmes on Newly Graduated Nurses' Retention and Turnover: An Umbrella Review

ABSTRACT

Aim

To summarise the effect of mentoring within mentoring programmes on the retention and turnover of newly graduated nurses in healthcare settings.

Design

An umbrella review.

Methods

Two independent reviewers screened the titles, abstracts and full texts for eligibility and critically appraised the included reviews using the JBI critical appraisal. The findings were tabulated and synthesised.

Data Sources

The search was conducted in five electronic databases (CINAHL, OvidMedline, ProQuest, Scopus, Cochrane and Medic) in November 2023.

Results

Out of 450 Papers, 13 systematic and integrative reviews were included. Thirteen mentoring programmes were identified and categorised into three groups based on their content: didactic mentoring programmes, interaction-based mentoring programmes and combined mentoring programmes. Across these programme types, retention among newly graduated nurses ranged from 72% to 100% at the 1-year mark and 70% to 98% at 2 years. Turnover rates showed consistent reductions, with post-intervention rates ranging from 3.5% to 20% compared to pre-intervention rates of up to 50%. Several studies reported statistically significant improvements in retention and turnover, particularly in programmes integrating structured education and preceptorship models.

Conclusions

Several different mentoring programmes have been developed to support the transition of newly graduated nurses. Mentoring programmes that provide ongoing support and structured guidance increase retention and reduce turnover among newly graduated nurses.

Implications for the Profession and/or Patient Care

Effective mentoring programmes are key to ensuring high-quality patient care and a sufficient supply of qualified nurses in the future.

Impact

The findings can provide information for developing transition support and mentoring programmes for newly graduated nurses.

Reporting Method

This umbrella review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Patient or Public Contribution

No patient or public contribution.

Trial and Protocol Registration

The umbrella review protocol was registered in PROSPERO: CRD42023478044.

The Effectiveness of Family Health Conversations Delivered by Nurses: A Systematic Review

ABSTRACT

Aim

To extract and interpret quantitative data exploring the effectiveness of family health conversations (FHCs) on family functioning, perceived support, health-related quality of life, caregiver burden and family health in families living with critical or chronic health conditions.

Background

Addressing the health of families affected by critical or chronic illnesses requires focused attention. The effective integration of FHCs is hampered by a scarcity of rigorous quantitative studies that provide solid evidence on best practices and outcomes.

Design

A systematic review following the Joanna Briggs Institute guidelines.

Methods

The review is reported according to the PRISMA 2020 checklist. Appropriate studies were searched in PubMed, CINAHL, PsycINFO, Scopus and Cochrane Databases. Results of the search were imported into the Covidence web-based program. Included were studies with a quantitative research design, delivered to families with critical or chronic health conditions, describing FHCs based on the Calgary Family Assessment Model and/or the Calgary Family Intervention Model, and/or the Illness Beliefs Model, using reliable and validated instruments, published between 2008 and 2023, and written in English.

Results

In total, 24 papers met the inclusion criteria. Sixteen papers used a quasi-experimental design, eight of which included a control group. Two papers used a mixed methods design, and six papers were randomised controlled trials (RCTs). A statistically significant effect of FHCs on family functioning was reported in two RCTs and three quasi-experimental papers. We also found that a statistically significant effect of FHCs was reported on perceived support in 9 of 15 papers, quality of life in 4 of 11 papers and caregiver burden in 1 of 3 papers.

Conclusion and Implications for Clinical Practice

The interventions reviewed revealed variability and partial results concerning the effectiveness of FHCs on family functioning. More rigorous research about short-term, intermediate- and long-term effectiveness is needed before conclusions can be drawn.

Reporting Method

The study is reported according to the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses) (File S1).

Patient or Public Contribution

No patient or public contribution. Data were gathered from previously published studies.

Best Practices in Supporting Inpatient Communication With Technology During Visitor Restrictions: An Integrative Review

imageBackground Since the onset of the COVID-19 pandemic, healthcare workers around the world have experimented with technologies to facilitate communication and care for patients and their care partners. Methods Our team reviewed the literature to examine best practices in utilizing technology to support communication between nurses, patients, and care partners while visitation is limited. We searched four major databases for recent articles on this topic, conducted a systematic screening and review of 1902 articles, and used the Johns Hopkins Nursing Evidence-Based Practice for Nurses and Healthcare Professionals Model & Guidelines to appraise and translate the results of 23 relevant articles. Results Our evaluation yielded three main findings from the current literature: (1) Virtual contact by any technological means, especially video visitation, improves satisfaction, reduces anxiety, and is well-received by the target populations. (2) Structured video rounding provides effective communication among healthcare workers, patients, and offsite care partners. (3) Institutional preparation, such as a standardized checklist and dedicating staff to roles focused on facilitating communication, can help healthcare workers create environments conducive to therapeutic virtual communication. Discussion In situations that require healthcare facilities to limit visitation between patients and their care partners, the benefits of virtual visitation are evident. There is variance in the types of technologies used to facilitate virtual visits, but across all of them, there are consistent themes demonstrating the benefits of virtual visits and virtual rounding. Healthcare institutions can prepare for future limited-visitation scenarios by reviewing the current evidence and integrating virtual visitation into modern healthcare delivery.
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