Log in | Register

A qualitative study exploring the experiences of parents of children admitted to seven Dutch pediatric intensive care unitsOpen access

Jos M. Latour| Johannes B. van Goudoever| Beatrix Elink Schuurman| Marcel J. I. J. Albers| Nicolette A. M. van Dam| Eugenie Dullaart| Marc van Heerde| Carin W. M. Verlaat| Elise M. van Vught| Jan A. Hazelzet
Pediatric Original
Volume 37, Issue 2 / February , 2011

Pages 319 - 325

Abstract

Purpose

To explore parents' experiences during the admission of their children to a pediatric intensive care unit (PICU).

Method

Qualitative method using in-depth interviews. Thematic analysis was applied to capture parents’ experiences. Thirty-nine mothers and 25 fathers of 41 children admitted to seven of the eight PICUs in university medical centers in The Netherlands were interviewed.

Results

Parents were interviewed within 1 month after their child’s discharge from a PICU. Thematic analysis identified 1,514 quotations that were coded into 63 subthemes. The subthemes were categorized into six major themes: attitude of the professionals; coordination of care; emotional intensity; information management; environmental factors; parent participation. Most themes had an overarching relationship representing the array of experiences encountered by parents when their child was staying in a PICU. The theme of emotional intensity was in particular associated with all the other themes.

Conclusions

The findings provided a range of themes and subthemes describing the complexity of the parental experiences of a PICU admission. The subthemes present a systematic and thematic basis for the development of a quantitative instrument to measure parental experiences and satisfaction with care. The findings of this study have important clinical implications related to the deeper understanding of parental experiences and improving family-centered care.

Keywords

References

  1. Shudy M, de Almeida ML, Ly S, Landon C, Groft S, Jenkins TL, Nicholson CE (2006) Impact of pediatric critical illness and injury on families: a systematic literature review. Pediatrics 118:S203–S218
    • View reference on publisher's website
    • View reference on PubMed
  2. Romer LH, Nichols D, Woods BH, Latour JM, Mesman J (2008) Impact of pediatric critical care on the family, community, and society. In: Nichols D (ed) Roger′s textbook of pediatric intensive care, 4th edn. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia, pp 24–35
  3. Board R, Ryan-Wenger N (2000) State of the science on parental stress and family functioning in pediatric intensive care units. Am J Crit Care 9:106–122
    • View reference on PubMed
  4. Farrell MF, Frost C (1992) The most important needs of parents of critically ill children: parents’ perceptions. Intensive Crit Care Nurs 8:130–139
    • View reference on publisher's website
    • View reference on PubMed
  5. Fisher MD (1994) Identified needs of parents in a pediatric intensive care unit. Crit Care Nurse 14:82–90
    • View reference on PubMed
  6. Scott LD (1998) Perceived needs of parents of critically ill children. J Soc Pediatr Nurs 3:4–12
    • View reference on publisher's website
    • View reference on PubMed
  7. Noyes J (1998) A critique of studies exploring the experiences and needs of parents of children admitted to paediatric intensive care units. J Adv Nurs 28:134–141
    • View reference on publisher's website
    • View reference on PubMed
  8. Carter MC, Miles MS (1989) The parental stressor scale: pediatric intensive care unit. Matern Child Nurs J 18:187–198
    • View reference on PubMed
  9. Leske JS (1991) Internal psychometric properties of the critical care family needs inventory. Heart Lung 20:236–244
    • View reference on PubMed
  10. Latour JM, van Goudoever JB, Hazelzet JA (2008) Parent satisfaction in the pediatric ICU. Pediatr Clin North Am 55:779–790
    • View reference on publisher's website
    • View reference on PubMed
  11. Meyer EC, Snelling LK, Myren-Manbeck LK (1998) Pediatric intensive care: the parents’ experience. AACN Clin Issues 9:64–74
    • View reference on publisher's website
    • View reference on PubMed
  12. Wagner D, Bear M (2009) Patient satisfaction with nursing care: a concept analysis within a nursing framework. J Adv Nurs 65:692–701
    • View reference on publisher's website
    • View reference on PubMed
  13. Heyland DK, Rocker GM, Dodek PM, Kutsogiannis DJ, Konopad E, Cook DJ, Peters S, Tranmer JE, O’Callaghan CJ (2002) Family satisfaction with care in the intensive care unit: results of a multiple center study. Crit Care Med 30:1413–1418
    • View reference on publisher's website
    • View reference on PubMed
  14. Latour JM, Haines C (2007) Families in the ICU: do we truly consider their needs, experiences and satisfaction? Nurs Crit Care 12:173–174
    • View reference on publisher's website
    • View reference on PubMed
  15. Rusinova K, Pochard F, Kentish-Barnes N, Chaize M, Azoulay E (2009) Qualitative research: adding drive and dimension to clinical research. Crit Care Med 37:S140–S146
    • View reference on publisher's website
    • View reference on PubMed
  16. Creswell JW (2003) Research design: qualitative, quantitative, and mixed methods approaches. SAGE Publications, Thousand Oaks
  17. De PICE werkgroep (2009) Pediatric Intensive Care Evaluatie. Jaarrapport 2006&2007 Rotterdam, Stichting PICE [The PICU working group (2009) Pediatric Intensive Care Evaluation, Year Report 2006&2007, Rotterdam, PICE foundation]
  18. Creswell JW (1998) Qualitative inquiry and research design: choosing among five traditions. SAGE Publications, Thousand Oaks
  19. Guest G, Bunce A, Johnson L (2006) How many interviews are enough? An experiment with data saturation and variability. Field Methods 18:59–82
    • View reference on publisher's website
  20. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101
    • View reference on publisher's website
  21. Pope C, Ziebland S, Mays N (2000) Qualitative research in health care. Analysing qualitative data. BMJ 320:114–116
    • View reference on publisher's website
    • View reference on PubMed
  22. Colville G, Darkins J, Hesketh J, Bennett V, Alcock J, Noyes J (2009) The impact on parents of a child’s admission to intensive care: integration of qualitative findings from a cross-sectional study. Intensive Crit Care Nurs 25:72–79
    • View reference on publisher's website
    • View reference on PubMed
  23. Avis M, Reardon R (2008) Understanding the views of parents of children with special needs about the nursing care their child receives when in hospital: a qualitative study. J Child Health Care 12:7–17
    • View reference on publisher's website
    • View reference on PubMed
  24. Roden J (2005) The involvement of parents and nurses in the care of acutely-ill children in a non-specialist paediatric setting. J Child Health Care 9:222–240
    • View reference on publisher's website
    • View reference on PubMed
  25. Graham RJ, Pemstein DM, Curley MA (2009) Experiencing the pediatric intensive care unit: perspective from parents of children with severe antecedent disabilities. Crit Care Med 37:2064–2070
    • View reference on publisher's website
    • View reference on PubMed
  26. Diaz-Caneja A, Gledhill J, Weaver T, Nadel S, Garralda E (2005) A child’s admission to hospital: a qualitative study examining the experiences of parents. Intensive Care Med 31:1248–1254
  27. Keogh S (2001) Parent’s experiences of the transfer of their child from the PICU to the ward: a phenomenological study. Nurs Crit Care 6:7–13
  28. Van Waning NR, Kleiber C, Freyenberger B (2005) Development and implementation of a protocol for transfers out of the pediatric intensive care unit. Crit Care Nurs 25:50–55
  29. Gallant MH, Beaulieu MC, Carnevale FA (2002) Partnership: an analysis of the concept within the nurse-client relationship. J Adv Nurs 40:149–157
    • View reference on publisher's website
    • View reference on PubMed
  30. Latour JM, van Goudoever JB, Duivenvoorden HJ, van Dam NAM, Dullaart E, Albers MJIJ, Verlaat CWM, van Vught EM, van Heerde M, Hazelzet JA (2009) Perceptions of parents on satisfaction with care in the pediatric intensive care unit: the EMPATHIC study. Intensive Care Med 35:1082–1089
  31. Latour JM, Hazelzet JA, van der Heijden AJ (2005) Parent satisfaction in pediatric intensive care: a critical appraisal of the literature. Pediatr Crit Care Med 6:578–584
    • View reference on publisher's website
    • View reference on PubMed
  32. Antonelli M, Azoulay E, Bonten M, Chastre J, Citerio G, Conti G, De Backer D, Lemaire F, Gerlach H, Hedenstierna G, Joannidis M, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Preiser JC, Pugin J, Wernerman J, Zhang H (2010) Year in review in Intensive Care Medicine 2009. Part III: mechanical ventilation, acute lung injury and respiratory distress syndrome, pediatrics, ethics, and miscellanea. Intensive Care Med 36:567–584
  33. Board R (2004) Father stress during a child’s critical care hospitalization. J Pediatr Health Care 18:244–249
    • View reference on PubMed
  34. Board R, Ryan-Wenger N (2003) Stressors and stress symptoms of mothers with children in the PICU. J Pediatr Nurs 18:195–202
    • View reference on publisher's website
    • View reference on PubMed
  35. Balluffi A, Kassam-Adams N, Kazak A Tucker M, Dominguez T, Helfaer M (2004) Traumatic stress in parents of children admitted to the pediatric intensive care unit. Pediatr Crit Care Med 5:547–553
  36. Colville G, Cream P (2009) Post-traumatic growth in parents after a child’s admission to intensive care: maybe Nietzsche was right? Intensive Care Med 35:919–923
  37. Paediatric Intensive Care Audit Network National Report 2006–2008: Universities of Leeds and Leicester, 2009
  38. Australian and New Zealand Intensive Care Society (ANZICS) (2009) Report Australian and New Zealand Paediatric Intensive Care Registry 2007. ANZPIC Registry, Royal Children’s Hospital, Herston
  39. Lam LW, Chang AM, Morrissey J (2006) Parents’ experiences of participation in the care of hospitalised children: a qualitative study. Int J Nurs Stud 43:535–545
    • View reference on publisher's website
    • View reference on PubMed
  40. Latour JM (2008) Parental needs during end-of-life care: one room for improvement. Pediatr Crit Care Med 9:661–662
    • View reference on publisher's website
    • View reference on PubMed
  41. Meert KL, Thurston CS, Briller SH (2005) The spiritual needs of parents at the time of their child’s death in the pediatric intensive care unit and during bereavement: a qualitative study. Pediatr Crit Care Med 6:420–427
    • View reference on publisher's website
    • View reference on PubMed

Sign In

Connect with ICM

Top 5 Articles Editors Picks Supplement