ÇOCUK KLİNİKLERİNDE AİLE MERKEZLİ BAKIM UYGULAMALARININ İNCELENMESİ

Amaç: Çocuk kliniklerinde aile merkezli bakım uygulamalarını incelemektir. Yöntem: Araştırma, Erzurum’da, bir üniversite ve bölge eğitim ve araştırma hastanesinin çocuk kliniklerinde, Ocak-Eylül 2013 tarihleri arasında tanımlayıcı olarak gerçekleştirilmiştir. Araştırmada belirtilen hastanelerin çocuk kliniklerinde, Haziran-Temmuz 2013 tarihleri arasında en az üç gün çocuğuna refakat eden 186 anne ile çalışılmıştır. Örnekleme yöntemine gidilmemiştir. Veriler benzer bir çalışmanın anne ve çocukların özelliklerini belirleyen, aile merkezli bakımı inceleyen sorularına dayanılarak hazırlanan bir soru formu ile elde edilmiştir. Veriler, bilgisayar ortamında yüzdelik ve ortalama ile analiz edilmiştir. Araştırmada, etik ilkelere uyulmuştur. Bulgular: Araştırmada, annelerin çoğunluğunun çocukları ile ilgili kararlara dahil edildiği ve yapılacak tıbbi işlemler için yazılı izin alındığı belirlenmiş, ancak; yaklaşık %15’inin bu durumlardan yoksun bırakıldığı saptanmıştır. Ayrıca, annelerin yaklaşık %10’unun tıbbi işlemler sırasında çocuğunun yanında kalmasına izin verilmediği, tedavi edici ve temel bakım uygulamalarına katıldıkları, çoğunluğunun çocuklarının bakımına katılmaları için desteklendiği ve çocukları ile ilgili endişelerini hemşireler ile paylaşabildikleri tespit edilmiştir. Annelerin bir kısmı endişelerini paylaşamadıklarını ve kendi gereksinimlerini karşılayamadıklarını, çoğunluğu aynı hemşirenin bakım vermediğini ifade etmişlerdir. Sonuç: Araştırmada, hastanede çocuklarına refakat eden anneler için aile merkezli bakım uygulamaları istendik düzeyde değildir. Kurum politikası olarak aile merkezli bakımın benimsenmesi ve buna yönelik düzenlemelerin yapılması önemlidir. Türkiye genelinde çocuk kliniklerinin aile merkezli bakım yönünden incelenmesi ve yeni politikalar geliştirilmesi önerilebilir.

Anahtar Kelimeler:

Aile merkezli bakım, çocuk, hemşire

The Examination of Family Centered Care Practices in Pediatric Clinics Aim: To examine the family centered care practices in pediatrics clinics. Method: The study has been carried out as a complementary project in the pediatric clinics of a university and a regional training and research hospital in Erzurum between January-September 2013. In the study, 186 mothers, who sat up with their children in the pediatric clinics of the aforementioned hospitals at least for three days, have been worked with between June-July 2013. Sampling method has not been used. The data have been obtained from a question form including questions that are exactly the same in the literature and that determine the characteristics of mothers and children and examining the family-centered care. The data have been analyzed within percentage and average values. Ethical issues have been prioritized in the study. Results: In the study, it has been ascertained that mothers were involved in the decisions related to their children and written permissions were taken from them, however it has also been determined that approximately %15 of the mothers have been left short of those situations. Besides, it has been found out that approximately %10 of mothers were not allowed to be with their children during medical treatments, that they attended medical and primary care applications, most of them were supported to participate in their children’s care and that they were able to share their concerns about their children with the nurses. Some of the mothers mentioned that they could not share their concerns and meet their needs, and most of them said that the care has not been carried out by the same nurse. Conclusion: It has been found out in the study that family-centered care applications for the attendant mothers are not satisfactory. It is important to adopt the family-centered care as an institutional policy and regulations for that situations should be carried out.It can also be suggested that pediatric clinics all over Turkey could be investigated in terms of family-centered care and new policies could be developed

Keywords:

Family centered care; child; nurse,

PDF

___

Ahmann E, Johnson B. New Guidance Promote Family Centered Change in Health Care Institution. Pediatric Nursing 2001; 27 (2): 173-5.
Alderson P.European charter of childrensrights. Bulletin of Medical Ethics October;1993.p.13-5.
Alexander D, White M, Powell G. Anxietylevels of rooming-in andnon-rooming-in parents of young hospitalized children. Maternal Child NursingJournal1988;17 (2):79-99.
Aitken M, Mele N, Barrett K. Recovery of injuredchildren: parentperspectives on family needs. Archives of Physical Medicine and Rehabilitation 2004; 85 (4): 567-73.
Balling K, McCubbin M. Hospitalized children with chronic illness: parental care giving needs and valuing parental expertise. Journal of Pediatric Nursing 2001;16 (2):110-9
Bauchner H. Parental presence during procedures in an emergency room: Results from 50 observations. Pediatrics 1991;87(4): 544-8.
Bauchner H, Winci R, Waring C. Pediatric procedures: Do parents want to stay? Pediatrics 1989; 84 (3):907-9.
Blower K, Morgan E. Great expectations? Parental participation in care. Journal of Child Health Care 2000;4 (2): 60-5.
Boztepe, H. Pediatri hemşireliğinde aile merkezli bakım. Türkiye Klinikleri Journal of Nursing Science 2009;1 (2): 88-93.
Brennan A. Caring for children during procedures: A review of theliterature. Pediatric Nursing 1994; 20 (5):451-8.
Brown K, Mace SE, Dietrich AM, Knazik S, Schamban NE. Patient and family-centred care for pediatric patients in the emergency department. Canadian Journal of Emergency Medicine 2008; 10 (1):38-43.
Byers J, Lowman L, Francis J, Kaigle L, Lutz N, Waddell T. A quasi-experimental trial on individualized, developmentally supportive family-centered care. Journal of Obstet Gynecol Neonatal Nursing 2006;35(1):105-15.
Carson D, Council J, Gravley J.Temperament and family characteristics as predictors of childrens reactions to hospitalization. Developmental and Behavioral Pediatrics 1991;12(3):141-7.
Challery P. Caring for parents of hospitalized children: a hidden area of nursing work. Journal of Advanced Nursing 1997;26(5):992-8.
Cooper LG, Gooding JS, Gallagher J, Sternesky L, Ledsky R, Berns SD. Impact of a family-centered care initiative on neonatal intensive care units, staff and families. Journal of Perinatol 2007;27(2):32-7.
Contro N, Sounkers B. Family perspectives on the quality of pediatric palliative care. Archives Pediatric and Adolescent Medicine 2002;156 (1):14-8.
Çavuşoğlu H. Çocuk Sağlığı Hemşireliği, 11. Baskı, Ankara, Cilt 1, Sistem Ofset; 2013. p.5.
Demirhan EA, Oğuz Y, Elcioğlu O, Doğan H. Klinik Etik, İstanbul, Nobel Tıp Kitabevi, 2001:46.
Desy P. Family presence during cardiopulmonary resuscitation and invasive procedures: Practices of critical careand emergency nurses. Journal of Emergency Nursing 2003;29(3):208-21.
Er M. Çocuk, hastalık, anne-babalar ve kardeşler. Çocuk Sağlığı ve Hastalıkları Dergisi 2006;49(2):155- 68.
Evagelou E. Parental participation in their hospitalized childs physical and psychological care: nurses perceptions. Intensive Care Units and Nursing Web Journal 2003;13(3):13-8.
Griffin T. Facing challenges to family centered care II.: Anger in the clinical setting. Pediatric Nursing 2003;29(3): 212-6.
Harrison TM. Family-centered pediatric nursing care: state of the science. Journal of Pediatric Nursing 2010;25 (5):335-43.
Hockenberry JM, Wilson D, WinkelsteinML, Kline NE. Wongs Nursing Care of Infants and Children. 7th ed. Elsevier Press; 2003.p.39.
İşler A, Conk Z. Pediatride aile merkezli bakım. Ege Pediatri Bülteni 2006;13 (3):137-204.
Kain Z, Caldwell-Andrews A, Mayes L, Weinberg M, Wang S, MacLaren J, et al. Family-centered preparation for surgery improves perioperative outcomes in children. Anesthesiology 2007;106(1): 65- 74.
Kristensson-Hallstrom I. Parental participation in pediatric surgical care. AORN Journal 2000;71(5): 1021-9.
Lam L, Anne M, Chang J. Parents experiences of participation in the care of hospitalised children: A qualitative study. International Journal of Nursing Studies 2006;43(5):535-45.
Lindeke, L, Leonard, Presler B, Garwick, A. Family-centered care coordination for children with special needs a cross multiple sertting. Journal Pediatirc Health Care 2002;16(6):290-7.
Maclean SL, Guzzetta CE, White C, Fontaine D, Eichhorn DJ, Meyers TA, Ygge B, Lindholm C, Arnetz J. Hospital staff perceptions of parental involvement in pediatric hospital care. Journal of Advanced Nursing 2006;53(5):534-42.
Mantha S, Davies B, Moyer A, Crowe K. Providing responsive nursing care to new mothers with high and low confidence. The American Journal of Maternal Child Nursing 2008;33 (5):307-14.
Melnyk M, Feinstein F. Mediating functions of maternal anxiety and participation in care on young childrens post hospital adjustment. Research in Nursing and Health 2001;24(1):18-26.
Ocakcı, A. Çocuğun Aile Merkezli Bakımı, 2. Baskı, Zonguldak, Dökel Matbaası; 2006.p.11-26.
Oktay H. Bir üniversite hastanesinin çocuk servislerinde verilen bakımın aile merkezli bakım yönünden incelenmesi ve anne görüşlerinin belirlenmesi. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2009;16(1):1124.
Palmer J. Care of sick children by parents: a meaningful role. Journal of Advanced Nursing 1993;18 (2):185-91.
Peterson M, Cohen J, Parsons V. Family centered care: Do we practice what wep reach ? Journal of Obstetric Gynecologic and Neonatal Nursing 2004;33 (4):421-7.
Piskosz Z. One pediatric emergencydepartments successful approach to family centered care. Journal of Emergency Nursing 2007;33(2):169-71.
Power N, Franck L. Parent participation in thecare of hospitalized children: a systematic review. Journal of Advanced Nursing 2008;62(6):622-41.
Pölkki T, Pietila AM, Vehvilainen- Julkunen K, Laukkala H, Ryhanen P. Parental views on participation in their childs pain relief measures and recommendations to health care providers. Journal of Pediatric Nursing 2002;17(4):270-8.
Roden J. The involvement of parents and nurses in the care of acutely-ill children in a non-specialist paediatric setting. Journal of Child Health Care 2005; 9 (3):222-40.
Sarajarvi A, Haapamaki M, Paavilainen E. Emotional and informational support for families during their childs illness. International Nursing Review 2006;53(3):205-10.