Perceptions and expectations of parents regarding their position in a French NICU: quantitative and qualitative approaches.
Ontology highlight
ABSTRACT: Objectives
To assess perceptions, expectations, and concerns of parents of preterm infants regarding their position during hospital admission in the neonatal intensive care unit.Design
Data were analysed from two studies, using complementary methods (quantitative and qualitative). Study I surveyed parents via a questionnaire, and study II was a reanalysis of interviews with fathers, collected in a previous study.Setting
Neonatology department in a French tertiary care university hospital that promotes the Newborn Individualised Care and Assessment Program (NIDCAP).Participants
In both studies, participants had a premature child admitted for any level of care in the neonatal intensive care unit.Results
For study I, about half (33) of eligible families participated in the questionnaire survey, and for study II, we reanalysed interviews with 20 fathers. In both analyses, parents were satisfied overall with their involvement in the care of their child. In both studies, however, they expressed that they had expected to be better informed about their child's condition and more involved in medical decision-making. Parents also reported relational issues with some healthcare practitioners who made them feel judged, unheard or not competent to discuss their child's case. These concerns were not reported for NIDCAP staff. Respondents in both studies also described insufficient contact with physicians and an inability to obtain rest in the room with their child.Conclusion
Provision of training to healthcare practitioners regarding information that parents request and doing so respectfully might be keys to fulfilling parent-reported needs. Such improvements could facilitate parental empowerment and involvement.
SUBMITTER: Thebaud V
PROVIDER: S-EPMC9272115 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:ObjectivesDextropropoxyphene (DXP), a step 2 analgesic commonly prescribed in France, was withdrawn from the French market in 2011 following a European decision due to its poor risk-benefit ratio. The purpose of this study was to explore the perceptions of French general practitioners (GPs) and patients regarding DXP withdrawal.DesignQualitative study based on 26 individual semi-structured interviews.SettingRhône-Alpes region of France.ParticipantsThirteen patients and 13 GPs.MethodsInterviews were conducted to collect data concerning the status of DXP, its efficacy and safety, the conditions of DXP's withdrawal and its potential impact. The transcripts were analysed using NVivo software.ResultsDXP was a very popular drug among both patients and GPs. Its withdrawal was a bad experience for patients and many GPs; these misunderstood the reasons for its withdrawal and several contested them. They generally recognised more benefits than risks of DXP and considered alternative drugs unsatisfactory. In the same period, a French court case regarding another drug led to distrust towards the pharmaceutical industry and healthcare institutions, which contributed to the negative feelings reported. However, the experience was positive for the GPs who had been alerted to the poor DXP risk-benefit ratio well before its withdrawal.ConclusionsApart from physicians who were previously informed of its poor risk-benefit ratio, DXP withdrawal was not a good experience for patients and GPs. Better anticipation by the health authorities, in terms of pharmacoepidemiological surveillance and communication to healthcare professionals as well as the general public, should provide better acceptance of such a decision in the future.
| S-EPMC6157533 | biostudies-literature
Project description:BackgroundAcute bleeding is an omnipresent challenge for all physicians. Uncontrolled hemorrhage is the most common preventable cause of death after trauma worldwide. In different surgical disciplines, hemorrhage represents an independent risk factor for increased postoperative morbimortality, directly affecting patients' outcomes. This study asked anesthesiologists about their personal perceived challenges when treating bleeding patients.MethodsThis investigator-initiated, prospective, international, dual-center, mixed qualitative and quantitative study interrogated anesthesiologists about what they found easy and what difficult in treating acutely bleeding patients. Following the template approach for qualitative research, we identified major and minor topics through free inductive coding and word count. In a second step, we derived ten statements from the participants' answers. Using a field survey, we then asked the participants to rate their level of agreement with the derived statements. We analyzed the answers using one sample Wilcoxon test and the Mann-Whitney test.ResultsWe included a total of 84 physicians in the qualitative interrogations and a different group of 42 anesthesiologists in the quantitative part. We identified 11 major topics and 19 associated subtopics. The main topics and the degree of agreement (here as agree or strongly agree) were as follows: "Complexity of the topic" (52.4% agreed to find the topic complex), "Cognitive aids" (92.9% agreed to find them helpful), "Time management" (64.3% agreed to feeling time pressure), "Human factors" (95.2% agreed that human factors are essential), "Resources" (95.2% agreed that resources are essential), "Experience" and "Low frequency of cases" (57.1% agreed to lack practice), "Diagnostic methods" (31.0% agreed that the interpretation of test results is difficult), "Anticoagulation" (85.7% agreed to it being difficult), "Treatment" (81.0% agreed to knowing the first therapeutic steps), and "Nothing".ConclusionsAnesthesiologists in two large tertiary care facilities in different parts of the world found coagulation management, especially in anticoagulated patients, complex. We identified the delayed diagnostic test results and their interpretation as challenges. Resources, treatment protocols and human factors such as team communication were perceived to facilitate management. Future studies should explore the challenges in smaller hospitals and other parts of the world and test new technologies addressing the identified difficulties.
| S-EPMC7874660 | biostudies-literature
Project description:BackgroundPrior to the COVID-19 pandemic, parents of infants in the Neonatal Intensive Care Unit (NICU) frequently reported high levels of stress, uncertainty, and decreased parenting confidence. Early research has demonstrated that parents have had less access to their infants in the hospital due to restrictions on parental presence secondary to the pandemic. It is unknown how parents have perceived their experiences in the NICU since the beginning of the COVID-19 pandemic. The purpose of this study was to describe the lived experience of parents who had an infant in the NICU in the context of the COVID-19 pandemic to inform healthcare providers and policy makers for future development of policies and care planning.MethodsThe study design was a qualitative description of the impact of the COVID-19 pandemic on parents' experiences of having an infant in the NICU. Free-text responses to open-ended questions were collected as part of a multi-method study of parents' experiences of the NICU during the first six months of the pandemic. Participants from the United States were recruited using social media platforms between the months of May and July of 2020. Data were analyzed using a reflexive thematic approach.FindingsFree-text responses came from 169 parents from 38 different states in the United States. Three broad themes emerged from the analysis: (1) parents' NICU experiences during the COVID-19 pandemic were emotionally isolating and overwhelming, (2) policy changes restricting parental presence created disruptions to the family unit and limited family-centered care, and (3) interactions with NICU providers intensified or alleviated emotional distress felt by parents. A unifying theme of experiences of emotional distress attributed to COVID-19 circumstances ran through all three themes.ConclusionsParents of infants in the NICU during the first six months of the COVID-19 pandemic experienced emotional struggles, feelings of isolation, lack of family-centered care, and deep disappointment with system-level decisions. Moving forward, parents need to be considered essential partners in the development of policies concerning care of and access to their infants.
| S-EPMC8655088 | biostudies-literature
Project description:PurposeThe probability of detecting radiologically evident metastatic disease in asymptomatic women with newly diagnosed operable breast cancer is low. Despite the recommendations of most practice guidelines imaging is still frequently performed. Relatively little is known about what patients believe is important when it comes to radiologic staging.MethodsPatients with early stage breast cancer who had completed their definitive breast surgery were surveyed about their personal experiences, perceptions, and expectations on the issue of perioperative imaging for distant metastatic disease.ResultsOver a 3 month period, 245 women with primary operable breast cancer completed the questionnaire (87.0% response rate) and 80.8% indicated having had at least one imaging test for distant metastatic disease. These were either of the thorax (72.2%), abdomen (55.9%) or skeleton (65.3%) with a total of 701 imaging tests (average of 3.5 tests per patient imaged) performed. Overall, 57.1% indicated that they would want imaging done if the chance of detecting metastases was ?10%. Although 80.0% of patients indicated that, "doing whatever their doctor recommended" was important to them, 70.4% also noted that they would be uncomfortable if their physician did not order imaging, even if this was in keeping with practice guidelines.ConclusionsMost patients with early stage breast cancer recall having imaging tests for distant metastases. Given the choice, most would prefer having imaging performed, even if this is not in line with current guidelines. If patient expectations are, in part, driving excessive imaging, new strategies addressing this are required.
| S-EPMC4000356 | biostudies-literature
Project description:BackgroundInfancy appears to be a critical period for establishing a person's weight set point. It remains unclear which interventions during infancy may be most effective in preventing later obesity and which ones are most acceptable to parents. The aim of this study was to examine the attitudes of parents of children aged 2 years and under toward different obesity prevention messages and their preferences with regard to these messages.MethodsUsing a qualitative research design, we conducted semistructured interviews followed by a focus group. Parents of children under 2 years of age were purposively recruited from 2 communities in British Columbia, Canada, and asked for their opinions about various health promotion messages relating to obesity prevention. A theoretical thematic analysis was used to analyze the data.ResultsThirty-three parents participated in the study. Participants reported that many of the current recommendations (no screen time, no sugary beverages) are unrealistic, unclear and inconsistent, making them difficult to follow and causing parents to feel guilty; they had a more positive response to the feeding roles message. Parents noted the importance of starting education early and targeting the broader community.InterpretationSeveral important and interesting themes were identified in this study, which increases our understanding of parents' attitudes toward and preferences for the messages presented. Obesity prevention information for today's busy parents needs to be realistic, supportive and timely.
| S-EPMC6380902 | biostudies-literature
Project description:ObjectiveAs part of an update of feeding benchmarks targeting children aged 0-3 years, this study aimed to explore parental perceptions, information-seeking practices and needs concerning infant and young child feeding (IYCF) to design an efficient communication strategy.DesignParticipants were recruited using the quota sampling to complete an online survey. Effects of parity, child age, prematurity, parental education and financial situation on parents' responses were evaluated separately.SettingFrance.ParticipantsA nationally representative sample of 1001 parents of children <4 years.ResultsParents whose child had any medical condition affecting feeding (children with medical condition (CMC), 17 %) were considered separately from healthy children's parents. All the healthy children's parents recognised the importance of IYCF for children's health and growth; however, one-third considered the available advice contradictory and not guilt-free. The most used information sources were healthcare professionals (HCP, 81 %), internet (72 %) and parental networks (63 %). The most influential sources (mean influence ± sd) included HCP (7·7 ± 1·7/10), childcare professionals (7·3 ± 1·8/10) and parental networks (6·9 ± 1·8/10). Parents searched for practical tips for implementing IYCF starting when their child was 5 months old. Differences regarding the type of source used by parents with higher v. lower educations were small. Search strategies differed according to parity or child age but not to prematurity. The CMC parents reported slightly different practices and needs.ConclusionsParents receive information from multiple sources, which can lead to confusion when deciding which advice to follow. A public health communication strategy adapted to the current parental needs should target these various sources.
| S-EPMC9991613 | biostudies-literature
Project description:Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents' and pediatricians' perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children's healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents' needs and pediatricians' perceptions of those needs with regard to CoF information.
| S-EPMC8308433 | biostudies-literature
Project description:BackgroundFor unclarified reasons, parents tend to be cautious about administering analgesics to their children, potentially leading to suboptimal management of AOM symptoms. We aim to understand parents' views and expectations of pain management in acute otitis media (AOM) in children.MethodsQualitative study alongside a cluster-randomised controlled trial (PIM-POM study) aimed at optimising pain management in childhood AOM. We purposefully sampled 14 parents of children diagnosed with AOM by their GP, who were recruited to the trial between November 2017 and May 2018. Semi-structured interviews were held at home in the first two weeks after trial enrollment. Interviews were audio-recorded, transcribed and analyzed thematically.ResultsParents experienced difficulties in recognising earache and other symptoms of an ear infection. They consulted the GP for a diagnosis, for reassurance and for management advice. Parents shared that, prior to consultation, they had insufficient knowledge of the benefits of correctly dosed pain medication at regularly scheduled intervals. Parents valued the GP's advice on pain management, and were happy to accept pain medication as standalone therapy, provided that the GP explained why antibiotics would not be needed. Parents' views and expectations of pain management in AOM were shaped by previous experiences of AOM within their family; those with a positive experience of pain medication are more likely to use it in subsequent AOM episodes.ConclusionsParents of children with AOM consult the GP to help cope with uncertainties in recognising symptoms of AOM, and to receive management advice. It is important that GPs are aware of parents' lack of understanding of the role of pain medication in managing AOM, and that they address this during the consultation.Trial registrationNetherlands Trial Register, identifier NTR4920 (registration date: 19 December 2014).
| S-EPMC6343236 | biostudies-literature
Project description:Introduction: A pandemic with the severity of COVID-19 affects people's lives physically, as well as their daily routines, views of the world, and emotional balance. Lockdown is often an unpleasant experience due to a separation from loved ones, loss of freedom, and uncertainty over the disease status. To adjust, individuals and groups have had to adapt their perceptions of the event to the current scenario. This study aims to describe the perceptions of confined people on the changes occurring in their lives in the aftermath of the COVID-19 lockdown. Methods: A total of 1,534 individuals (26.6% men; 73.4% women; mean age 41.6) responded to the questionnaire comprising 19 closed and five open-ended questions about the changes they anticipated in their lives in the immediate post-confinement era. Results: Two definite groups appeared in the results: those who lived the confinement pleasantly, and those for which it was painful. They differ according to their confinement conditions and perceived degree of exposure to the virus. There seems to be a link for those who had a pleasant experience to a lower perceived exposure to the virus and less burdensome confinement conditions (young children, surface area, etc.). Lockdown conditions seem to influence the respondents' perceptions: a pleasant experience is associated with a vision of the society's evolution at large, and the care about its economic and professional progress; a painful one is associated more with focusing on the immediate needs of social support and personal well-being. Discussion: Emotional experience during lockdown impacts the perception of its aftermath, with hope and anxiety becoming two ways of coping with uncertainty.
| S-EPMC8273336 | biostudies-literature
Project description:Current medical school education focuses on acquiring appropriate knowledge with relatively little interest in developing the career selection skills of medical students. We investigated medical students' perceptions of career problems and the required types of career counseling programs. Five focus group discussions were held with 23 medical students. The consensual qualitative study method was used to analyze the recorded discussion process. The medical students were more influenced by parents and grades than by subjective choices when deciding on admission to medical school. In future career choices, medical students considered the stability and feasibility of the career and expected quality of life. However, there were several opinions that it is essential to understand oneself. Objective and specific career information was lacking, and meeting with the professor was not very helpful for career counseling. Most medical students expected the effectiveness of the career counseling program but hoped the program would proceed with voluntary participation. Medical students wanted a variety of concrete and objective information, such as specialty information for choosing residency training, trainee hospital information, and post-residency training information in the career counseling program. Most medical students are not ready for career-related problems, therefore making it necessary to develop a career counseling program suitable for them.
| S-EPMC7277443 | biostudies-literature