Dataset Information

Children's own perspectives demonstrate the need to improve paediatric perioperative care.

ABSTRACT:

Aim

To explore children's perspectives when facing anaesthesia and surgery.

Design

Interpretative qualitative design.

Methods

Children undergoing outpatient surgery were interviewed in three different phases, before and after anaesthesia and surgery (phase 1 and 2) and 1 month after the hospitalization (phase 3). Twenty-two children (4-15 years) were interviewed in phase 1 and 2 and six children (5-13 years) in phase 3. Data were analysed using manifest and latent qualitative content analysis.

Results

Two contrasting themes were identified: Fearful in association with anaesthesia and surgery and Confident in association with anaesthesia and surgery. Comprehension of the perioperative procedures, continuous information and interaction with the healthcare providers were decisive factors for children's expressions of confidence or fearfulness. Events considered as major from a healthcare perspective may be of no importance to the child, while events considered as less important by healthcare providers may be significant to the child. Understanding children's perspectives and awareness of their need to process the information provided are significant factors for establishment of trust and confidence in a highly technological perioperative environment.

SUBMITTER: Loof G

PROVIDER: S-EPMC6805266 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Children's own perspectives demonstrate the need to improve paediatric perioperative care.

Lööf Gunilla G Andersson-Papadogiannakis Nina N Silén Charlotte C

Nursing open 20190718 4

<h4>Aim</h4>To explore children's perspectives when facing anaesthesia and surgery.<h4>Design</h4>Interpretative qualitative design.<h4>Methods</h4>Children undergoing outpatient surgery were interviewed in three different phases, before and after anaesthesia and surgery (phase 1 and 2) and 1 month after the hospitalization (phase 3). Twenty-two children (4-15 years) were interviewed in phase 1 and 2 and six children (5-13 years) in phase 3. Data were analysed using manifest and latent qualitati ...[more]

PMID: 31660163

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Project description:BackgroundPerioperative medicine services for older surgical patients are being developed across several countries. This qualitative study aims to explore geriatricians' perspectives on challenges and opportunities for developing and delivering integrated geriatrics perioperative medicine services.MethodsA qualitative phenomenological semi-structured interview design. All geriatric medicine departments in acute public hospitals across Australia and New Zealand (n = 81) were approached. Interviews were conducted with 38 geriatricians. Data were analysed thematically using a framework approach.ResultsGeriatricians identified several system level barriers to developing geriatrics perioperative medicine services. These included lack of funding for staffing, encroaching on existing consultative services, and competing clinical priorities. The key barrier at the healthcare professional level was the current lack of clarity of roles within the perioperative care team. Key facilitators were perceived unmet patient needs, existing support for geriatrician involvement from surgical and anaesthetic colleagues, and the unique skills geriatricians can bring to perioperative care. Despite reporting barriers, geriatricians are contemplating and implementing integrated proactive perioperative medicine services. Geriatricians identified a need to support other specialties gain clinical experience in geriatric medicine and called for pragmatic research to inform service development.ConclusionsGeriatricians perceive several challenges at the system and healthcare professional levels that are impacting current development of geriatrics perioperative medicine services. Yet their strong belief that patient needs can be met with their specialty skills and their high regard for team-based care, has created opportunities to implement innovative multidisciplinary models of care for older surgical patients. The barriers and evidence gaps highlighted in this study may be addressed by qualitative and implementation science research. Future work in this area may include application of patient-reported measures and qualitative research with patients to inform patient-centred perioperative care.

Project description:BackgroundPatient Reported Experience Measures (PREMs) are recognized as an important indicator of high quality care and person-centeredness. PREMs are increasingly adopted for paediatric care, but there is little published evidence on how to administer, collect, and report paediatric PREMs at scale.MethodsThis paper describes the development of a PREMs questionnaire and administration system for the Meyer Children's University Hospital in Florence (Meyer) and the Children's Clinical University Hospital in Riga (CCUH). The system continuously recruits participants into the electronic administration model, with surveys completed by caregivers or adolescents at their convenience, post-discharge. We analyse 1661 responses from Meyer and 6585 from CCUH, collected from 1st December 2018 to 21st January 2020. Quantitative and qualitative experience analyses are included, using Pearson chi-square tests, Fisher's exact tests and narrative evidence from free text responses.ResultsThe large populations reached in both countries suggest the continuous, digital collection of paediatric PREMs described is feasible for collecting paediatric PREMs at scale. Overall response rates were 59% in Meyer and 45% in CCUH. There was very low variation in mean scores between the hospitals, with greater clustering of Likert scores around the mean in CCUH and a wider spread in Meyer for a number of items. The significant majority of responses represent the carers' point of view or the perspective of children and adolescents expressed through proxy reporting by carers.ConclusionsVery similar reported scores may reflect broadly shared preferences among children, adolescents and carers in the two countries, and the ability of both hospitals in this study to meet their expectations. The model has several interesting features: inclusion of a narrative element; electronic administration and completion after discharge from hospital, with high completion rates and easy data management; access for staff and researchers through an online platform, with real time analysis and visualization; dual implementation in two sites in different settings, with comparison and shared learning. These bring new opportunities for the utilization of PREMs for more person-centered and better quality care, although further research is needed in order to access direct reporting by children and adolescents.

Dataset Information

Children's own perspectives demonstrate the need to improve paediatric perioperative care.

Aim

Design

Methods

Results

Publications

Children's own perspectives demonstrate the need to improve paediatric perioperative care.

Similar Datasets

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