جستجوی مقالات مرتبط با کلیدواژه "parents’ participation" در نشریات گروه "پزشکی"

Parental participation in decision-making for neonates with life-threatening conditions is morally and ethically approved. The health care team in the neonatal intensive care units is not prepared to involve parents in these decisions. Identifying factors affecting parental participation in decision-making can lead to removing the barriers and improving parents’ participation. The present study aimed to identify organizational factors influencing parents’ participation in decision-making for neonates with life-threatening conditions.

This study is part of a comprehensive project based on Corbin and Straus’s approach to grounded theory (GT) methodology (Corbin & Strauss, 2015) explored the process of parental participation in DM for neonates with LTC. Participants included 23 people (10 parents, 10 healthcare providers, 1 official in the Neonatal Health Office of the Ministry of Health and Medical Education, 1 professor of Jurisprudence and Principles of Islamic Law, and 1 insurance agent). The study field included level III neonatal intensive care units of 4 teaching hospitals. Data were collected using in-depth, semi-structured interviews and observation and simultaneously were analyzed through constant comparison utilizing the approach of Corbin and Strauss, 2015. The core category and the related categories reflecting contextual and structural factors, parents’ strategies, and the outcome of the adopted strategies were identified. The contextual and structural classification reflected various factors affecting parents’ participation in DM. Since it was impossible to publish all findings in one article, the current study focused on the organizational factors influencing parents’ participation in DM.

Organizational factors affecting the process of parental participation in decision-making consisted of 5 main categories, including 1) power imbalances, 2) ethics committees’ deficiencies, 3) hospital regulations deficiencies, 4) resource constraints, and 5) ongoing hospitalization, the only choice. 

Organizational factors play an important role in parental participation in decision-making. Providing parents of neonates with life-threatening conditions with accommodation and, developing instructions to encourage the presence of parents in the hospital, creating rules for selecting NICU nurses is necessary. Employing an interdisciplinary team of psychologists, social workers, and trained individuals to provide parents with spiritual care is recommended. Appointing hospital ethics committees to investigate cases of critically ill infants and employing experienced and knowledgeable ethicians about the end-of-life issues in these committees are also recommended. </div>

Nurses have important role in providing emotional support, decreasing stress and educating the parents to involve them in care for premature infant. The aim of this study was discovering the NICU Nurses’ perception about involving the parents in care for infants.

This qualitative study was carried out based on interpretative phenomenological approach.  The study setting was three separate NICUs of three teaching hospitals affiliated with Tabriz University of Medical Sciences. Eleven in-service NICU nurses were selected purposefully. Data collection was performed through semi-structured interviews and field notes and was analyzed using the seven-stage Diekelmann, Allen, and Tanner approach.

One of the important themes emerging in this study was “Patience to Progress” that included four subthemes of “Developing intellectual movement”, “Sending off the family to overpass the crisis”, “step by step until parents’ independency” and “help to correct decision making”.

Nurses’ experiences showed that there is developing intellectual movement on accepting the parents’ presence philosophy and their participation in the NICUs. This changing in nurses’ perception has occurred because of emphasis on family and NIDCAP importance. In nurses’ experiences involving parents in care for premature infant, is gradual and needs effort, patience, flexibility and continuous directing along with changing attitude.