scholarly journals Parents' Experiences of Support in NICU Single-Family Rooms

2019 ◽  
Vol 38 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Lisa Xiaoyang Liu ◽  
Maryam Mozafarinia ◽  
Anna Axelin ◽  
Nancy Feeley
Keyword(s):  
Decision Making ◽  
Preterm Infant ◽  
Nursing Care ◽  
Medical Staff ◽  
Single Family ◽  
Convenience Sample ◽  
Mothers And Fathers ◽  
Happy Life ◽  
Qualitative Descriptive ◽  
Parents Experiences

PurposeThis study aimed to explore support for mothers and fathers in single-family rooms (SFRs) of a NICU.DesignA qualitative descriptive design was employed.SampleA convenience sample of 15 parents (nine mothers, six fathers) were recruited from a Level III NICU.MethodDuring their infants' hospitalization, each parent recorded their thoughts and feelings regarding support whenever appropriate over a period of 48 hours using Handy Application to Promote Preterm infant happY-life (HAPPY), an android recording application.ResultsParents felt supported when staff facilitated their learning in a collaborative manner, fostered their optimism, and provided situational assistance. Continuity and consistency of care and presence were important characteristics of supportive nursing care. Though SFRs offered privacy for parents to learn and to be with their infants, the design limited parental access to nursing and medical staff, which sometimes prevented parents from receiving adequate support and partaking in decision making concerning their infants' care.

Patient and Provider Decision-Making Experiences: A Qualitative Study

2020 ◽  
pp. 019394592097747
Author(s):  
Elizabeth Kinchen ◽  
Bernadette Lange ◽  
David Newman
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Decisions ◽  
Convenience Sample ◽  
Face To Face ◽  
Telephone Interviews ◽  
Qualitative Descriptive ◽  
Primary Care Patients ◽  
Health Care Encounters ◽  
Implicit And Explicit

The purpose of this qualitative descriptive study was to explore patient and provider experiences in making health care decisions. A convenience sample of primary care patients and providers was engaged in face-to-face and telephone interviews, to elicit participants’ experiences in making health care decisions. Three main themes were identified in the data: Involvement, including being in control and accepting responsibility; seeking and confirming Information; and establishing communication and negotiating trust in the patient-provider Relationship. Themes identified in the data describe the elements involved in health care decision-making, and depict the relationship between patient and provider as being central to the making of health care decisions. In addition, the subthemes of control and negotiation merit additional in-depth exploration to illuminate the implicit and explicit expressions of hierarchy in the patient-provider relationship, as this hierarchy appears to hinder efforts at sharing decisions in health care encounters.

scholarly journals The decision-making process in families of terminal ICU patients

Psico-USF ◽  
2019 ◽  
Vol 24 (3) ◽  
pp. 437-448
Author(s):  
Mayla Cosmo Monteiro ◽  
Andrea Seixas Magalhães ◽  
Terezinha Féres-Carneiro ◽  
Cristina Ribeiro Dantas
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Medical Staff ◽  
Family Members ◽  
Decision Making Process ◽  
Qualitative Descriptive ◽  
End Of Life Decision ◽  
The Relationship ◽  
Life Decision

Abstract The objective of this research is to investigate family members’ perceptions as to the end-of-life decision-making process in an ICU. The authors conducted a qualitative descriptive study in which they interviewed six family members of critically ill patients admitted to the ICU of a private hospital. Five categories of analysis emerged from the examination of the material. This study will discuss two of those categories: the decision-making process and the relationship with the medical staff. The results indicate that family members were satisfied with communication with the medical staff, an important aspect for the decision-making process. Within this context, the shared model, prioritization of palliative care and identification of futile treatments prevailed, aimed at ensuring the patient’s comfort and dignity at the end of life. The results also reveal the need for integration of palliative care in ICUs, particularly in end-of-life situations.

Differences in Reward and Persistency characterise Behavior in Chronic Pain for the Iowa Gambling Task in a Web-based Lab-in-the-field study (Preprint)

2020 ◽  
Author(s):  
Lili Zhang ◽  
Himanshu Vashisht ◽  
Alekhya Nethra ◽  
Brian Slattery ◽  
Tomas Ward
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Chronic Pain ◽  
Iowa Gambling Task ◽  
Learning Curves ◽  
Self Report ◽  
Healthy Controls ◽  
Gambling Task ◽  
Convenience Sample ◽  
Pain Experiences

BACKGROUND Chronic pain is a significant world-wide health problem. It has been reported that people with chronic pain experience decision-making impairments, but these findings have been based on conventional lab experiments to date. In such experiments researchers have extensive control of conditions and can more precisely eliminate potential confounds. In contrast, there is much less known regarding how chronic pain impacts decision-making captured via lab-in-the-field experiments. Although such settings can introduce more experimental uncertainty, it is believed that collecting data in more ecologically valid contexts can better characterize the real-world impact of chronic pain. OBJECTIVE We aim to quantify decision-making differences between chronic pain individuals and healthy controls in a lab-in-the-field environment through taking advantage of internet technologies and social media. METHODS A cross-sectional design with independent groups was employed. A convenience sample of 45 participants were recruited through social media - 20 participants who self-reported living with chronic pain, and 25 people with no pain or who were living with pain for less than 6 months acting as controls. All participants completed a self-report questionnaire assessing their pain experiences and a neuropsychological task measuring their decision-making, i.e. the Iowa Gambling Task (IGT) in their web browser at a time and location of their choice without supervision. RESULTS Standard behavioral analysis revealed no differences in learning strategies between the two groups although qualitative differences could be observed in learning curves. However, computational modelling revealed that individuals with chronic pain were quicker to update their behavior relative to healthy controls, which reflected their increased learning rate (95% HDI from 0.66 to 0.99) when fitted with the VPP model. This result was further validated and extended on the ORL model because higher differences (95% HDI from 0.16 to 0.47) between the reward and punishment learning rates were observed when fitted on this model, indicating that chronic pain individuals were more sensitive to rewards. It was also found that they were less persistent in their choices during the IGT compared to controls, a fact reflected by their decreased outcome perseverance (95% HDI from -4.38 to -0.21) when fitted using the ORL model. Moreover, correlation analysis revealed that the estimated parameters had predictive value for the self-reported pain experiences, suggesting that the altered cognitive parameters could be potential candidates for inclusion in chronic pain assessments. CONCLUSIONS We found that individuals with chronic pain were more driven by rewards and less consistent when making decisions in our lab-in-the-field experiment. In this case study, it was demonstrated that compared to standard statistical summaries of behavioral performance, computational approaches offered superior ability to resolve, understand and explain the differences in decision- making behavior in the context of chronic pain outside the lab.

A qualitative descriptive inquiry of the influences on nurses’ missed care decision‐making processes in acute hospital paediatric care

2020 ◽  
Vol 28 (8) ◽  
pp. 1929-1939
Author(s):  
Annamaria Bagnasco ◽  
Nicoletta Dasso ◽  
Silvia Rossi ◽  
Fiona Timmins ◽  
Giuseppe Aleo ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Hospital ◽  
Paediatric Care ◽  
Decision Making Processes ◽  
Qualitative Descriptive ◽  
Missed Care ◽  
Care Decision

scholarly journals Factors associated with the decision to prescribe and administer antipsychotics for older people with delirium: a qualitative descriptive study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047247
Author(s):  
Emily J Tomlinson ◽  
Helen Rawson ◽  
Elizabeth Manias ◽  
Nicole (Nikki) M Phillips ◽  
Peteris Darzins ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Health Professionals ◽  
Acute Care Hospital ◽  
Nursing Workload ◽  
Care Hospital ◽  
Antipsychotic Medications ◽  
Factors Associated ◽  
Multiple Factors ◽  
Qualitative Descriptive

ObjectivesTo explore factors associated with decision-making of nurses and doctors in prescribing and administering as required antipsychotic medications to older people with delirium.DesignQualitative descriptive.SettingTwo acute care hospital organisations in Melbourne, Australia.ParticipantsNurses and doctors were invited to participate. Semi-structured focus groups and individual interviews were conducted between May 2019 and March 2020. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.ResultsParticipants were 42 health professionals; n=25 nurses and n=17 doctors. Themes relating to decisions to use antipsychotic medication were: safety; a last resort; nursing workload; a dilemma to medicate; and anticipating worsening behaviours. Nurses and doctors described experiencing pressures when trying to manage hyperactive behaviours. Safety was a major concern leading to the decision to use antipsychotics. Antipsychotics were often used as chemical restraints to ‘sedate’ a patient with delirium because nurses ‘can’t do their job’. Results also indicated that nurses had influence over doctors’ decisions despite nurses being unaware of this influence. Health professionals’ descriptions are illustrated in a decision-making flowchart that identifies how nurses and doctors navigated decisions regarding prescription and administration of antipsychotic medications.ConclusionsThe decision to prescribe and administer antipsychotic medications for people with delirium is complex as nurses and doctors must navigate multiple factors before making the decision. Collaborative support and multidisciplinary teamwork are required by both nurses and doctors to optimally care for people with delirium. Decision-making support for nurses and doctors may also help to navigate the multiple factors that influence the decision to prescribe antipsychotics.

Exploring parents’ experiences: Parent-focused intervention groups for communication needs

2021 ◽  
Vol 37 (2) ◽  
pp. 193-209
Author(s):  
Barbara Moseley Harris
Keyword(s):  
Individual Differences ◽  
Group Intervention ◽  
Peer Groups ◽  
Skills Training ◽  
Costs And Benefits ◽  
Personal Change ◽  
Convenience Sample ◽  
Safe Spaces ◽  
Communication Needs ◽  
Parents Experiences

Perceptions of a convenience sample of 10 parents (one father, nine mothers) who had completed one or more group-based, parent-focused interventions for their children’s communication needs were explored during semi-structured interviews. Nine different intervention groups (EarlyBird programmes, early communication skills training, or Makaton training) were discussed. Inductive and grounded theory approaches were used during thematic analysis to focus on parents’ priorities. Themes identified were: (1) intervention purposes, including initial session purposes; (2) groups as supportive/safe spaces; (3) personal change (behaviours and self-perception); (4) challenges of groups; (5) costs and benefits, including emotional costs. Parents supported previously reported findings about changes in knowledge, understanding, and perception of their role. Parents provided insights into how changes occurred, including helpful processes and professional strategies. They described emotional impacts of parent-focused intervention, particularly parental guilt. Participants perceived peer groups as contributing safe spaces and opportunities, but also challenges. Two parents experienced reduced benefits due to significant individual differences relating to their child’s more complex needs. Participants confirmed some speech and language therapists’ (SLTs’) perceptions about how interventions work and challenged others. Key findings were that (1) parents’ experiences during intervention facilitate personal change; (2) parents experience personal costs and benefits of intervention; (3) peer groups contribute to intervention effectiveness. These findings indicated that parents experience significant personal impacts from parent-focused intervention groups, and that groups provide a specific intervention type that differs from individual input. Clinical implications are that professionals need awareness of impacts on parents to support effective intervention and avoid harm; peer groups can facilitate learning and parental agency; dissimilarity to peers can make group intervention inappropriate. Study limitations included fewer perspectives from parents of children with primary communication needs. Further exploration of interventions’ emotional impacts, how group processes support parental confidence and agency, and effects of individual differences on suitability of group intervention are suggested.

Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making

2021 ◽  
pp. 089801012110627
Author(s):  
Elizabeth Kinchen
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Condition ◽  
Holistic Care ◽  
Special Focus ◽  
Free Text ◽  
Shared Decision ◽  
Convenience Sample

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.

Advanced Care Planning for Children With Special Health Care Needs: A Survey of Parental Attitudes

PEDIATRICS ◽  
1996 ◽  
Vol 97 (5) ◽  
pp. 682-687
Author(s):  
Robert H. Wharton ◽  
Karen R. Levine ◽  
Stephen Buka ◽  
Linda Emanuel
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Special Needs ◽  
Parental Attitudes ◽  
Best Interests ◽  
Children With Special Needs ◽  
Convenience Sample ◽  
Developmental Potential ◽  
Medical Needs ◽  
Life Decisions

Objectives. This study explored parental attitudes about their interactions with their children's providers when decision making involved critical life situations. We evaluated parents' attitudes regarding the following questions: What was the parents' understanding of their children's health care issues, and what was the parental perception of the professionals' understanding of their children and of themselves? Who should be the principal decision makers for the children? What was the parents' knowledge about advance directives? Did parents want to participate in a process of advance planning to assist with critical life decision making for their children? Methods. We surveyed all parents attending a conference sponsored by the Massachusetts Department of Public Health for parents of children with special needs. The questionnaire was provided to all parents attending the conference. An announcement was made at the conference requesting parental participation. The 76 respondents constitute a convenience sample of parents of children with special needs sufficient for this preliminary stage of investigation. Results. Of 177 parents attending the conference, 76 (43%) completed the questionnaire. Eighty-eight percent of the participants strongly agreed that they understood their children's conditions. Twenty-one percent stated that they had sufficient understanding of their children's future medical needs, and 21% thought that they had a sufficient understanding of their children's developmental potential. Ninety-nine percent of parents strongly agreed that physicians should share information with parents no matter how serious or potentially upsetting. Ninety-four percent of those parents who thought that their children's physicians understood their own needs also thought that the physicians understood their children's needs. In contrast, only half (55%) of those parents who thought the physicians did not understand their needs thought the physicians understood their children's needs. Ninety-two percent of parents who thought that the physicians understood their needs agreed that the physicians would make the best decisions in crises versus 60% of those who did not think the physicians understood their needs. Seventy-four percent stated that they would consider written guidelines for their children that dealt with critical life situations. All parents who thought their children's conditions were not understood wanted written guidelines. Of those parents who had thought their children would not survive (15 parents), 94% wanted written guidelines. All seven parents who had been told their children would not survive wanted written guidelines. Conclusions. Parents in this study were generally satisfied with care being provided to their children. Nevertheless, the results clearly suggest goals that could lead to improved capacity for parents and providers to make critical life decisions for and with children. First, physicians must understand the needs of parents to be able to make decisions that would be in the children's best interests. Second, parents should participate fully in critical life decisions for their children and should use written guidelines to assist with the process of these critical life decisions. Our findings strongly support the development of a longitudinal process, initiated early after the onset or discovery of illness and maintained longitudinally throughout the course of a child's illness, to help parents and providers work together in this vital area of health care to children.

scholarly journals Impact of Consumer Innovativeness on Shopping Styles: A Case-Study of Limkokwing University Students (Botswana)

2013 ◽  
Vol 1 (2) ◽  
pp. 107 ◽  
Author(s):  
Olumide Olasimbo Jaiyeoba ◽  
Frederick Odongo Opeda
Keyword(s):  
Decision Making ◽  
Structural Equation ◽  
Market Segment ◽  
Consumer Decision Making ◽  
Tertiary Institution ◽  
Convenience Sample ◽  
Consumer Innovativeness ◽  
Retail Outlets ◽  
Decision Making Processes ◽  
The Relationship

The unprecedented abundance of choice and retail outlets creates a massive array of choice for consumers most especially students. Innovative consumers are an important market segment. This paper seeks to investigate whether consumers’ innate innovativeness is associated with their shopping styles. Specifically, it aims to explore the relationship between two types of innovativeness (sensory innovativeness and cognitive innovativeness and consumer shopping styles). Indeed, the unprecedented abundance of choice and retail outlets creates a massive array of choice for consumers. Despite these significant changes in the commercial environment, very little is known about the decision making processes of consumers in developing countries, most especially in Botswana. Ostensibly, the paucity of research in this area hinders our understanding of consumer decision making processes. The paper integrates the consumer innovativeness and consumer shopping styles literature. A structural equation model was used to test the relationship between cognitive and sensory innovativeness and various shopping styles. Cognitive innovators are inclined to show shopping styles such as quality consciousness, price consciousness, and confusion by overchoice, while sensory innovators are inclined to have shopping styles such as brand consciousness, fashion consciousness, recreational orientation, impulsive shopping, and brand loyalty/habitual shopping. The research is based on a convenience sample of young consumers in Botswana. The findings of this research would hopefully help managers to develop a deeper insight into product development and marketing. Furthermore, since the youth market in Botswana represents an enormous opportunity for marketers, the paper provides valuable insights into this key market segment. It thus provides new insights into the shopping patterns of consumers who belong to different innovativeness types. It also makes a new contribution to the shopping styles literature by explicating potential antecedents to the various shopping styles among the largest private tertiary institution students in Botswana.

scholarly journals The Relationship between Soccer Club Coaches’ Decision-Making Style, Basic Psychological Needs, and Intention to Continue to Exercise: Based on Amateur Male Soccer Club Members in Korea

2018 ◽  
Vol 7 (10) ◽  
pp. 200 ◽  
Author(s):  
YongKoo Noh ◽  
Kyongmin Lee ◽  
Chul-Ho Bum
Keyword(s):  
Decision Making ◽  
Psychological Needs ◽  
Basic Psychological Needs ◽  
Convenience Sample ◽  
Exercise Participation ◽  
Sports Science ◽  
The People ◽  
Coaching Behavior ◽  
Intention To Continue ◽  
The Relationship

Numerous studies in sports science have investigated the relationships between coaching behavior, basic psychological needs, and intention to continue to exercise in sport participants in order to promote their continued exercise participation. However, little is known about the effect of the coach’s decision-making style on sport participants’ basic psychological needs and intention to continue to exercise. Thus, this study empirically investigated the relationship between these three variables. For this purpose, a survey was given to a convenience sample of 200 members of amateur male soccer clubs in Seoul and Gyeonggi, Korea. The results of multiple regression analysis showed that the type of coach that makes decisions based on a thorough analysis and reasonable evaluation of all possible solutions had a greater effect on the satisfaction of basic psychological needs and a greater effect on intention to continue to exercise in soccer club members than the types of coaches who use other styles of decision making in coaching. In addition, the intention to continue to exercise in soccer club members was higher when they voluntarily participated in soccer activities and when they made a strong emotional bond with the people they were exercising with. The findings of this study may provide the basic data on the coaches’ decision-making style needed to improve sport participants’ internal motivation and to stimulate their intention to continue to exercise.

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