满足家长健康素养需求——儿童癫痫三步干预的设计与可行性检验。

IF 3.6 3区 医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2025-01-28 DOI:10.1111/jocn.17652
Merete K. Tschamper, Astrid K. Wahl, Rita Jakobsen, Marie H. Larsen
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引用次数: 0

摘要

目的:(1)在专业医疗机构内共同设计一项健康素养干预措施,以帮助癫痫患儿的父母获取、理解、使用和沟通信息;(2)通过探讨利益相关者对干预措施的有用性、试验方法的易用性和影响其执行的环境因素的观点,评估干预措施的可行性。设计:采用共同设计的参与式方法,然后采用可行性方法,其灵感来自优化卫生知识普及和获得卫生服务(Ophelia)进程,以促进卫生知识普及干预措施的发展。方法:(1)共同设计方法包括与(a)多学科人员(n = 9)和(b)家长(n = 12)的研讨会,以及(c)与一名地区癫痫专科护士(n = 1)的访谈。与会者在小插曲的基础上讨论了家长的健康素养需求,并集思广益地改进了服务。随后设计了一个三步干预方案。(2)通过对6名家长(n = 6)的访谈、对研究护士的焦点小组访谈、对医生的简短调查和对干预措施进行测试的时间记录来评估干预措施的可行性。结果:(1)以癫痫专科医院首次住院患儿家长为干预对象。护士-家长咨询是干预的核心,激活家长共同制定和执行量身定制的教育计划。(2)可行性:家长(n = 6)经历了有利于提高其管理孩子病情的自我效能感的咨询和教育计划。研究护士(n = 3)承认在简化患者教育方面取得了积极成果,但认为他们在干预方法方面的培训不足。家长和护士都认为有限的人力资源是实施干预的重大障碍。结论:尽管存在制度障碍,但共同设计的干预措施使护士和家长参与了HL的发展。父母在管理孩子的情况时体验到增强的自我效能感。但是,在今后实施之前,需要进行进一步的改进和可行性测试。报告方法:采用2010年Consort声明扩展报告非随机试验和可行性研究,以确保研究的方法学质量。作为附加文件提供了2010年配偶声明清单。患者或公众贡献:在共同设计和评估这一三步干预措施的过程中,目标群体内的家长、相关提供者和项目指导委员会的合作至关重要。家长和多学科提供者通过研讨会、访谈和讨论会议积极贡献。测试干预的研究护士在确定共同制定的教育计划的文件编制过程中发挥了关键作用。对专业护理的影响:这三步健康素养干预可以积极影响父母在管理孩子病情方面的自我效能感。提高护士的沟通技巧对于提高父母的健康素养至关重要,因此为此类培训分配资源至关重要。满足家长健康素养需求的干预内容和战略需要改进,需要更多的提供者参与,以便更好地适应具体情况。今后的研究应集中于进一步的可行性测试,考虑更灵活的时间框架。试验注册:开放科学框架:https://osf.io/fg9c7/。
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Meeting Parents' Health Literacy Needs—Designing and Feasibility Testing of a Three-Step Intervention in the Childhood Epilepsy Context

Aims

(1) To codesign a health literacy intervention within a specialist healthcare setting to help the parents of children with epilepsy access, comprehend, use and communicate information and (2) to assess the intervention's feasibility by exploring stakeholders' perspectives on its usefulness, ease of use of trial methods and contextual factors impacting its execution.

Design

A codesign participatory approach followed by a feasibility approach inspired by the OPtimising HEalth LIteracy and Access to Health Services (Ophelia) process for health literacy intervention development.

Methods

(1) The codesign approach included workshops with (a) multidisciplinary personnel (n = 9) and (b) parents (n = 12), along with (c) an interview with one regional epilepsy specialist nurse (n = 1). The participants discussed parents' health literacy needs on the basis of vignettes and brainstormed service improvements. A three-step intervention was subsequently designed. (2) The intervention's feasibility was assessed via interviews with six parents (n = 6), a focus group interview with study nurses, a short doctors survey and a log of time spent testing the intervention.

Results

(1) The parents of first-time admitted children to a specialist epilepsy hospital were targeted for the intervention. Nurse–parent consultations were central to the intervention, activating parents in codeveloping and executing a tailored education plan. (2) Feasibility: parents (n = 6) experienced consultations and education plans that were beneficial for enhancing their self-efficacy in managing the child's condition. The study nurses (n = 3) acknowledged positive outcomes in streamlining patient education but felt that their training on the intervention methods was insufficient. Both parents and nurses identified limited personnel resources as a significant barrier to executing the intervention.

Conclusion

The codesigned intervention engaged nurses and parents in HL development despite system barriers. The parents experience enhanced self-efficacy in managing their child's condition. However, needs refinements and further feasibility tests are needed before future implementation.

Reporting Method

The Consort Statement 2010 extension for reporting non-randomised pilot and feasibility studies was used to ensure the methodological quality of the study. A Consort Statement 2010 checklist is provided as an additional file.

Patient or Public Contribution

The collaboration of parents within the target group, the providers involved and the project's steering committee was crucial in codesigning and evaluating this three-step intervention. Parents and multidisciplinary providers actively contributed through workshops, interviews and in discussion meetings. The study nurses testing the intervention played a key role in defining the documentation process for the codeveloped education plan.

Implications for Professional Care

This three-step health literacy intervention can positively impact parents' self-efficacy in managing their child's condition. Enhancing nurses' communication skills is essential for improving parents' health literacy, making it crucial to allocate resources for such training. The intervention content and strategies to meet parents' health literacy needs require refinement, with more provider involvement to better adapt it to the context. Future studies should focus on further feasibility testing by considering a more flexible time frame.

Trial Registration

Open Science Framework: https://osf.io/fg9c7/

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来源期刊
CiteScore
6.40
自引率
2.40%
发文量
0
审稿时长
2 months
期刊介绍: The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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