13 “Don’t Want to Be in the Room? Never. Can’t Be in the Room? Yes”: A Mixed Methods Analysis of Barriers and Facilitators to Parental Presence at the Bedside in a Paediatric Intensive Care Unit
Notice bibliographique
Résumé
Abstract Background Though a paediatric intensive care unit (PICU) admission is overwhelming for families, bedside parental presence improves child comfort, reduces parental anxiety, and enables family engagement. Previous research has focused on parental presence during events (rounds, resuscitation, and procedures), but little is known about factors influencing parental presence at their child’s bedside for routine PICU care. Objectives To identify factors that parents perceive as impacting their capability, opportunity, and motivation to be at the bedside in PICU, and explore parental perceptions about the quality and value of time spent at the bedside. Design/Methods This mixed methods study used semi-structured interviews based on the Theoretical Domains Framework (TDF). Participants were parents of children admitted to a Canadian PICU. Participants completed a demographics form and the Medical Term Recognition Test (METER) to assess health literacy. Interviews were coded independently by two researchers using a directed content approach based on the TDF. Once consensus was reached, themes and subthemes were identified inductively within each domain to generate barriers and enablers. Factors were examined for trends based on dichotomized demographics. Results Fourteen primary caregivers participated in 11 interviews. Participants were 8 mothers and 6 fathers, of children with both planned (n=4) and unplanned (n=7) admissions. METER scores ranged from 4 to 40, with a mean of 31. Seventy-six barriers and enablers were identified within 13 domains. Factors were most commonly in the ‘environmental context and resources’ domain (n=13) and included “comfortable and functional physical environment”, “medicalization of the child”, and “PICU technology”. Parents emphasized the importance of self-care which, although requiring parents to leave the bedside, allowed them to be fully engaged when they were present. A ubiquitous factor was “maintenance of the parent role”. Parents felt responsible to be present, but recognized alterations in the parental role while in PICU. Parents who were <25 years old, fathers, or those who had first and unplanned PICU admissions identified relatively fewer skills and capabilities supporting their presence. Multiple factors, particularly in the domains of social influence and environmental context, are potentially modifiable to better support parental presence and engagement at the bedside. Conclusion Parents perceive multiple factors influencing their capability, opportunity, and drive to be present with their critically ill child in PICU, some of which are amenable to direct intervention by healthcare professionals and hospital policy. Healthcare professionals may maximize parental engagement by attempting to optimize quality, rather than quantity, of time at the bedside.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,036 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,004 | 0,004 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».