Mother–nurse decision making practices for children with complex health care needs receiving homecare services: A qualitative descriptive study
Bibliographic record
Abstract
BACKGROUND: Many children with complex health care needs face chronic health and developmental issues that may include functional impairments, neurodevelopmental disabilities, and lifelong dependence on medical technology. Providing the necessary care and services for this unique group of children and youth places substantial demands on the health care system. Much of the focus on improvements has been in acute care settings even though homecare accounts for the largest proportion of health care utilization among children with complex health care needs. While parents assume great responsibility for their child's care at home, they indicate that the balance of power between themselves and their health care providers does not change when care shifts from the hospital to home. Given the expanding role of paediatric homecare and parents' concerns of their role in decisions related to their child's care, it is imperative to explore these practices in this unique setting. PURPOSE: The purpose of this work is to explore mother-nurse decision making practices for children with complex health care needs receiving health care services in their home. METHODS: A qualitative descriptive study design was used. Five mothers and five nurses participated. Twenty-six home observations with accompanying analytical memos and 10 semistructured interviews were conducted with five mothers and five homecare nurses. Thematic analysis of study data, using an iterative process, identified major themes. FINDINGS: Data revealed the complex and relational nature of mother-nurse decision making practices within the home setting. Three major themes were identified: (1) core areas of decision making, (2) a dynamic and collaborative process, and (3) centrality of relationships. CONCLUSIONS: Study findings enhanced our understanding of how decision making and relational care practices take place in the home for children with complex health care needs receiving homecare services, which has implications for child and family health.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".