A new viral illness called coronavirus disease 2019 (COVID-19) is currently spreading throughout the world at an alarming rate (Dong et al., 2020). As family nursing practitioners, educators, and researchers, we work from a guiding assumption that health and “illness is a family affair” (Wright & Bell, 2009, p. ix). Patients, clients, residents, and their families are inextricably connected. The science and practice of Family Nursing is based on a systemic premise offered by Wright and Leahey (2013) that serious illness and life challenges impact the family unit, and reciprocally, the functioning of the family unit (including their structure, development, and function) influences the health and well-being of each family member. This especially holds true for the current coronavirus pandemic which is creating unique hardships and suffering in an alarmingly large number of patients and their families around the world.
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AIM: The purpose of this study was to describe how nurses apply the components of family nursing conversations in their home healthcare practice.METHOD: A qualitative content analysis with a deductive approach was conducted. Home healthcare nurses conducted family nursing conversations with families from their practice. Families were selected based on three nursing diagnoses: risk of caregiver role strain, caregiver role strain or interrupted family processes. Nurses audio-recorded each conversation and completed a written reflection form afterwards. Transcripts of the audio-recorded conversations were analysed in Atlas.ti 8.0 to come to descriptions of how nurses applied each component. Nurses' reflections on their application were integrated in the descriptions.RESULTS: A total of 17 conversations were audio-recorded. The application of each component was described as well as nurses' reflections on their application. Nurses altered or omitted components due to their clinical judgment of families' needs in specific situations, due to needs for adjustment of components in the transfer from theory to practice or due to limited skill or self-confidence.CONCLUSION: All of the components were applied in a cohesive manner. Nurses' application of the components demonstrates that clinical judgment is important in applying them. Further training or experience may be required to optimise nurses' skill and self-confidence in applying the components. This study demonstrates the applicability of the family nursing conversations components in home health care, allowing exploration of the working mechanisms and benefits of family nursing conversations for families involved in long-term caregiving in future studies.
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Background: Caregiving by family members of elderly with chronic conditions is currently intensifying in the context of an aging population and health care reform in the Netherlands. It is essential that nurses have attention for supporting roles of family caregivers of older patients and address family caregiving aspects on behalf of the continuity of care. This study aims to explore what aspects of family caregiving were addressed during planned discussions between nurses, patients and family caregivers in the hospital.Methods: Qualitative descriptive research was conducted using non-participant observation and audio-recordings of planned discussions between nurses, older patients and their family caregivers as they took place in the hospital.Through purposive sampling eligible patients (≥ 65 years) with one or more chronic conditions were included. These patients were admitted to the hospital for diagnostics or due to consequences of their chronic illness.Retrospective chart review was done to obtain patient characteristics. Data were collected in November/December 2013 and April/May 2014 in four hospitals. Qualitative content analysis was performed using the inductive approachin order to gain insight into addressed aspects of family caregiving.Results: A total of 62 patients (mean age (SD) 76 years (7.2), 52% male) were included in the study, resulting in 146 planned discussions (62 admission and discharge discussions and 22 family meetings). Three themes were identifiedregarding addressed aspects of family caregiving. Two themes referred to aspects addressing the patients’ social network, and included ‘social network structure’ and ‘social network support’. One theme referred to aspectsaddressing coordination of care issues involving family caregiving, referred to as ‘coordination of care’.Conclusions: During discussions nurses mostly addressed practical information on the patients’ social network structure. When specific family caregiving support was addressed, information was limited and nurses did not seem toexplore the nature of the family support. Patients discharge and after care needs were addressed occasionally as aspects of coordination of care. Current nursing policies could be evaluated on nursing and family oriented theories.Implications for education could include mirroring study findings with nurses in a group discussion to enhance their awareness on family caregiving aspects.
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Background: The outbreak of the COVID-19 pandemic influenced family-centred care dramatically due to restricting visiting policies. In this new situation, nurses were challenged to develop new approaches to involve family members in patient care. A better understanding of these changes and the experiences of nurses is essential to make an adaptation of procedures, and to secure a family-centred approach in care as much as possible. Objectives: The aim of this study was to investigate how family involvement had taken place, and to explore the experiences of nurses with family involvement during the COVID-19 outbreak. In addition, we aimed to formulate recommendations for the involvement of family. Methods: We conducted a qualitative study using patient record review and focus-group interviews between April and July 2020. We reviewed records of patients with confirmed COVID-19, who were admitted to the COVID-19 wards at two affiliated university hospitals in the Netherlands. All records were searched for notations referring to family involvement. In two focus-groups, nurses who worked at the COVID-19 wards were invited to share their experiences. The Rigorous and Accelerated Data Reduction (RADaR) method was used to collect, reduce and analyse the data. Results: In total, 189 patient records were reviewed and nine nurses participated in the focus-group meetings. Patient records revealed infrequent and often unstructured communication with focus on physical condition. Nurses confirmed that communication with family was far less than before and that the physical condition of the patient was predominant. The involvement of family in care was limited to practicalities, although more involvement was described in end-of-life situations. Nurses experienced moral distress due to the visiting restrictions, though some acknowledged that they had experienced the direct patient care so intense and burdensome, that family contact simply felt too much. Conclusion: The communication with and involvement of family in hospital care changed enormously during the COVID-19 outbreak. Based on the identified themes, we formulated recommendations that may be helpful for family-centered care in hospitals during periods of restricted visiting policy.
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Artikel van Judith Huis in het Veld, docent onderzoeker van de Hogeschool Inholland verschenen in Research in Gerontological Nursing ABSTRACT The current article discusses how and by whom family caregivers want to be supported in selfmanagement when managing changes in behavior and mood of relatives with dementia and whether family caregivers consider eHealth a useful tool for self-management support. Four asynchronous online focus groups were held with 32 family caregivers of individuals with dementia. Transcripts of the online focus groups were analyzed using qualitative thematic analysis. Family caregivers need support from professionals or peers in the form of (a) information about dementia and its symptoms, (b) tips and advice on managing changes in behavior and mood, (c) opportunities to discuss experiences and feelings, and (d) appreciation and acknowledgement of caregiving. The opinions of family caregivers about self-management support through eHealth were also reported. Findings suggest a personal approach is essential to self-management support for family caregivers managing changes in behavior and mood of relatives with dementia. In addition, self-management support can be provided to some extent through eHealth, but this medium cannot replace personal contacts entirely.
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Several interventions have been developed to support families living with parental mental illness (PMI). Recent evidence suggests that programmes with whole-family components may have greater positive effects for families, thereby also reducing costs to health and social care systems. This review aimed to identify whole-family interventions, their common characteristics, effectiveness and acceptability. A systematic review was conducted according to PRISMA 2020 guidelines. A literature search was conducted in ASSIA, CINAHL, Embase, Medline, and PsycINFO in January 2021 and updated in August 2022. We double screened 3914 abstracts and 212 papers according to pre-set inclusion and exclusion criteria. The Mixed Methods Appraisal Tool was used for quality assessment. Quantitative and qualitative data were extracted and synthesised. Randomised-control trial data on child and parent mental health outcomes were analysed separately in random-effects meta-analyses. The protocol, extracted data, and meta-data are accessible via the Open Science Framework (https://osf.io/9uxgp/). Data from 66 reports—based on 41 independent studies and referring to 30 different interventions—were included. Findings indicated small intervention effects for all outcomes including children’s and parents’ mental health (dc = −0.017, −027; dp = −0.14, −0.16) and family outcomes. Qualitative evidence suggested that most families experienced whole-family interventions as positive, highlighting specific components as helpful, including whole-family components, speaking about mental illness, and the benefits of group settings. Our findings highlight the lack of high-quality studies. The present review fills an important gap in the literature by summarising the evidence for whole-family interventions. There is a lack of robust evidence coupled with a great need in families affected by PMI which could be addressed by whole-family interventions. We recommend the involvement of families in the further development of these interventions and their evaluation.
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The research presented examines how pervasive technology can support intra-family communication, supporting existing practices and complimenting them by addressing communication needs currently unmet by current communication media like mobile phones, social networking systems, and so forth. Specifically the investigation focused on busy families, understood here to be families with two working parents and at least one child sharing the same roof. The class of technologies the authors consider are awareness systems, defined as communication systems that support individuals to maintain, with low effort, a peripheral awareness of each other's activities and whereabouts. This research combined a variety of research methods including interviews, web surveys, experience sampling, and field testing of functional prototypes of mobile awareness systems. It also involved the development of several applications, which were either seen as research tools in support of the methods applied or as prototypes of awareness systems that embody some of the envisioned characteristics of this emerging class of technologies. The contribution of this research is along two main dimensions. First in identifying intra-family communication needs that drive the adoption of awareness systems and second in providing directions for the design of such systems.
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ObjectiveWe designed a Patient and Family Participation Education Program (PFEP) with the aim of fostering a positive attitude and enhancing the competencies of hospital nurses required for effective patient and family participation in care.MethodsIn a Dutch university hospital, we conducted a before-after study. The PFEP comprising three courses: family conversation, supporting shared decision-making, and health literacy. We assessed nursing attitudes using the FINC-NA questionnaire and competencies with a separate questionnaire before and three months after the program. Changes in attitudes and competencies were analyzed using regression analysis.ResultsTwenty-two nurses participated in the education group, and 58 participated as controls.After three months, the change scores for the education group were statistically significantly higher on the total attitude score (FINC-NA) compared to the control group. Moreover, in six out of twelve competencies, the education group demonstrated significantly higher scores than the control group.ConclusionThe educational program appeared effective in promoting nurses' attitudes and feelings of competencies towards patient and family-centered care.InnovationA blended education program focusing on patient and family has potential value for implementation in hospital care settings, especially for hospitals aiming to cultivate a more patient- and family-centered environment.
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Parents who grew up without digital monitoring have a plethora of parental monitoring opportunities at their disposal. While they can engage in surveillance practices to safeguard their children, they also have to balance freedom against control. This research is based on in-depth interviews with eleven early adolescents and eleven parents to investigate everyday negotiations of parental monitoring. Parental monitoring is presented as a form of lateral surveillance because it entails parents engaging in surveillance practices to monitor their children. The results indicate that some parents are motivated to use digital monitoring tools to safeguard and guide their children, while others refrain from surveillance practices to prioritise freedom and trust. The most common forms of surveillance are location tracking and the monitoring of digital behaviour and screen time. Moreover, we provide unique insights into the use of student tracking systems as an impactful form of control. Early adolescents negotiate these parental monitoring practices, with responses ranging from acceptance to active forms of resistance. Some children also monitor their parents, showcasing a reciprocal form of lateral surveillance. In all families, monitoring practices are negotiated in open conversations that also foster digital resilience. This study shows that the concepts of parental monitoring and lateral surveillance fall short in grasping the reciprocal character of monitoring and the power dynamics in parent-child relations. We therefore propose that monitoring practices in families can best be understood as family surveillance, providing a novel concept to understand how surveillance is embedded in contemporary media practices among interconnected family members.
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