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AnteayerInternacionales

Parents' Lived Experiences of Their Child's Undergoing Emergence Delirium During Anaesthesia Recovery: A Descriptive Phenomenological Study

ABSTRACT

Aim

To explore parents' experience when their children underwent emergence delirium during anaesthesia recovery.

Design

A descriptive phenomenological qualitative study.

Methods and Setting

This descriptive phenomenological study was conducted at a medical center in Taiwan. Purposive sampling was employed, and a semi-structured interview guide was used to conduct in-depth interviews. Twelve parents whose children experienced emergence delirium were recruited after data saturation was reached. Data were collected between January and July 2024 and analysed using Colaizzi's seven-step method.

Findings

Parents underwent an unexpected journey characterised by emotional ups and downs when witnessing their child's emergence delirium. Four major themes were generated, including ‘unexpected chaos’, describing the disorienting situation parents experienced when confronted with their child's unfamiliar behaviours; ‘help beyond reach’, reflecting their inability to provide comfort despite being physically present; ‘a day of suffering’, highlighting the emotional overwhelm during the emergence delirium episode; and ‘appreciation after recovery’, illustrating their relief and gratitude once their child returned to baseline. These themes reveal the intense emotional fluctuations parents experience during this critical phase.

Conclusions

This study highlights the complex emotional fluctuations parents experience when facing their child's emergence delirium. The findings emphasise the need for anticipatory guidance and support strategies to better prepare parents and inform family-centred nursing practices.

Impact

This study addresses a gap regarding the emotional challenges experienced by East Asian parents when their child undergoes emergence delirium. The findings reveal complex parental distress shaped by internal worry and external social pressure in shared recovery spaces. These insights inform culturally sensitive care models, emphasising the importance of private environments and communication strategies that reduce parental stress and improve clinical support.

Patient or Public Contribution

Two parents reviewed and provided feedback on the interview content and results, improving cultural relevance and clarity.

Reporting Method

The study followed COREQ guidelines.

Child and Family Centred Care: A Three‐Phased Principle‐Based Concept Analysis

ABSTRACT

Introduction

Despite a growing multidisciplinary interest in the Child and Family Centred Care approach, its meaning remains unclear in extant literature. It is, therefore, crucial to explore, analyse, describe, and clarify the concept of the Child and Family Centred Care approach and its associated terms.

Method

A three-phased principle-based concept analysis approach was used to analyse the concept of Child and Family Centred Care. A systematic search of literature was completed using the CINAHL, PsycINFO, Medline, Scopus, and Web of Science databases. Peer-reviewed articles on Child and Family Centred Care, published from inception to 2023 were included if they were available in English and discussed children aged zero to 17 years, healthcare providers, and/or caregivers. A systematic screening of articles was undertaken to remove duplicates and articles that did not meet the inclusion criteria. A concept quality criteria assessment was performed independently based on a recommended appraisal tool.

Results

Full texts of the retained 23 titles were included in the deductive thematic analysis. Guided by the three-phased principle-based concept analysis approach, data were grouped into epistemological, pragmatic, linguistic, and logical principles. The study revealed various characteristics of the concept of interest to highlight the common terms associated with the concept, primarily being collaboration, participation, communication, and respect/dignity.

Conclusions and Implications

This concept analysis provides a theoretical definition of the Child and Family Centred Care approach. The definition emphasises the child as an individual and an active collaborator with healthcare providers and their family. Standardised language improving health outcomes, patient satisfaction, and healthcare systems.

No Patient or Public Contribution.

Conceptualisation and Measurement of Resilience of Adults With Cancer: An Umbrella Review

ABSTRACT

Aims

To (1) clarify the key components of resilience of adults with cancer; (2) summarise and analyse the resilience measures used in this population; and (3) discuss future evaluation directions.

Design

An umbrella review.

Data Sources

MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane library and Epistemonikos were searched in December 2023.

Methods

The Joanna Briggs Institute (JBI) guidelines were followed for undertaking this umbrella review. Systematic and narrative reviews that defined resilience of adults with cancer and reported resilience measures, published in English, were included. The methodological quality was assessed using the JBI appraisal tool.

Results

Fourteen eligible reviews were included. Four key resilience components from various resilience conceptualisations were identified. Twenty resilience measures were used among cancer patients, with the 25-item Connor-Davidson Resilience Scale providing a relatively comprehensive assessment of individual resilience. Recommended future research with cancer patients includes assessing these resilience components: (1) available individual resources—key psychological factors that enhance individual resilience; (2) access to social resources—close interpersonal relationships, family cohesion and social support; (3) adaptive coping ability—problem-solving skills, emotional management strategies and experiences in managing adversity; (4) ability to regain mental health and well-being—the capacity to recover a relatively stable psychological state and promote positive psychological functioning.

Conclusion

The findings provide evidence for refining future resilience measurement in the adult cancer population. Examining the four key components of resilience with this population across cultures is warranted.

Impact

Understanding the key components of resilience of cancer patients can help healthcare professionals identify individuals who may need further support and facilitate early intervention or referral to psychosocial support services. The 25-item Connor-Davidson Resilience Scale is recommended over other tools for use in the cancer population.

Patient or Public Contribution

Patient or public involvement is not applicable in this study.

Nursing practices to optimise rheumatic fever prevention in a high‐risk country: An integrative review

Abstract

Background

New Zealand is one of the last high-income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this.

Aim

To explore nursing practices that optimise rheumatic fever prevention.

Design

An integrative review.

Methods

Four electronic databases (CINAHL, SCOPUS, Medline via, and Ovid) were searched for peer-reviewed empirical articles published from 2013 to 2023. Grey literature (guidelines/reports) was also sourced. Critical appraisal was applied using the Mixed-Methods Appraisal Tools and the Joanna Briggs Critical Appraisal checklist. Qualitative Research in Psychology, 3(2), 77–101, thematic analysis method was used to generate themes.

Results

Seven research articles and three national reports were included. Four themes—in-depth nursing knowledge and improving prophylaxis adherence, cultural competency, and therapeutic nurse–patient relationships—were found.

Conclusion

While nursing knowledge and ways to improve injection adherence are essential, being culturally receptive and developing therapeutic relationships are equally important. Without strong and trusting relationships, it is difficult to deliver care required for prevention success.

Implications to care

When working with vulnerable populations it is important to be culturally receptive in all interactions with patients and their families.

Impact

New Zealand has high rates of rheumatic fever, especially among vulnerable populations such as Pacific Islanders and Māori. Nurses are often frontline primary care providers who, when skilled with the right tools, can help reduce the prevalence of this disease.

Reporting method

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow chart.

Patient or public contribution

No Patient or Public Contribution was required for this research.

Oral intake of solid medications in patients with post‐stroke dysphagia. A challenge for nurses?

Abstract

Aim

To provide a comprehensive overview of how stroke nurses manage solid medication (SM) delivery to patients with post-stroke dysphagia.

Design

Cross-sectional study.

Methods

A self-administered online survey was carried out among nurses in German-speaking countries between September and December 2021.

Results

Out of a total of 754 responses, analysis was conducted on 195 nurses who reported working on a stroke unit. To identify swallowing difficulties in acute stroke care, 99 nurses indicated routinely administering standardised screenings, while 10 use unvalidated screenings, and 82 are waiting for a specialist evaluation. Regardless of whether screening methods are used or not, most preferred a non-oral route of medication administration for patients with suspected dysphagia. None of the respondents reported administering whole SMs orally to patients. If screening methods indicate dysphagia, approximately half of the respondents would modify SMs. Participants who stated to use the Gugging Swallowing Screen managed the SM intake guided by its severity levels. One-third of the group who awaited assessment by the dysphagia specialist provided modified medication before the consultation.

Conclusion

Most of the nurses on stroke units use swallowing screens and avoid the administration of whole SMs in post-stroke dysphagia. In addition to the non-oral administration, SMs are modified if dysphagia is suspected. Precise guidance on the administration of SM is needed, based on screening tests and prior to expert consultation.

Trial and Protocol Registration

ClinicalTrials.gov: Registration ID: NCT05173051/ Protocol ID: 11TS003721.

Implications for the profession and/or patient care

The present paper serves to alert nurses to the issue of patient safety when administering medication for acute stroke-induced dysphagia.

Impact

SM delivery after acute stroke-induced dysphagia is often neglected. While nurses are aware of the risk associated with dysphagia and would not give whole SMs to patients, the modification of tablets and their administration with semisolids are common.

Reporting Method

This study was reported according to the Checklist for Reporting of Survey Studies (CROSS).

Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery

Abstract

Aim(s)

To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery.

Design

This scoping review was conducted according to the JBI scoping review framework.

Methods

Review included systematic reviews that evaluated any nurse-initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a ‘certainty (quality) of evidence’ according to the Grading of Recommendations, Assessment, Development and Evaluations criteria.

Data Sources

Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023.

Results

A total of 428 articles were identified; following screening, 81 reviews underwent full-text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%).

Conclusions

This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice.

Implications for the profession and/or patient care

Implementing up-to-date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes.

Patient or public contribution

No patient or public involvement in this scoping review.

The long‐term impact of COVID‐19 on nursing: An e‐panel discussion from the International Network for Child and Family Centred Care

Abstract

Aim

To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce.

Background

On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread.

Design

Discursive paper.

Methods

A web-based survey was e-mailed to 63 INCFCC members from 28 March to 30 April 2022, as an invitation to share their experience concerning the long-term impact of COVID-19 on their role as a nurse educator, clinician or researcher.

Results

Sixteen members responded, and the responses were grouped under the themes stress and anxiety, safe staffing and pay, doing things differently, impact on research, impact on teaching and learning, impact on clinical practice, nursing made visible and lessons for the future.

Conclusion

The INCFCC members provided their views and highlighted the impact on their role in nursing education, administration, research and/or practice. This discussion of international perspectives on the similarities and differences imposed by COVID-19 found that the impact was wide-ranging and prolonged. The overarching theme revealed the resilience of the participating members in the face of COVID-19.

Relevance to Clinical Practice

This study highlights the importance of all areas of nursing, be it in academia or in clinical practice, to work together to learn from the present and to plan for the future. Future work should focus on supporting organizational and personal resiliency and effective interventions to support the nursing workforce both during a disaster and in the recovery phase. Nursing workforce resilience in the face of COVID-19.

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