Problem: The literature states that it is not unusual for health care professionals to show reservations towards family presence during resuscitation on the pediatric patient. Underlying this view are the feelings aroused by the sensation of being observed by subjects emotionally involved in the situation. The major doubts are related to the possible negative influence that the context could have on the work of professionals, and the traumatic consequences that could arise in a family member who observes. Individual perceptions exert a strong influence on the decision making process of healthcare professionals regarding whether or not to allow family members to attend resuscitation operations. Aim: The aim of the study is to determine whether the perceptions expressed by a sample of health workers, in an Italian hospital setting, are in line with what is stated in the literature. By analyzing the positive and negative opinions of health workers, based on direct experience or on the idea of being able to experience the family presence, we try to highlight the strengths and implications related to this controversial practice. Materials and Methods: The descriptive study is oriented to identify the perceptions, positive and negative, of nurses and physicians with respect to family presence during cardiopulmonary resuscitation on the pediatric patient, and the approach towards the family in case of death of the child. An online questionnaire was administered, authorized and conducted according to the respect of privacy, to nurses and physicians of the Pediatric Emergency Department of Padua and of the Emergency Department of Treviso. Data analysis was performed by simple descriptive statistics using Microsoft excel program. Results: The main themes that characterize the questionnaire are: the experience of family presence during CPR on the pediatric patient; positive and negative perceptions about the practice and how these may affect the work of health care providers; the existence or not of a specific support figure and in case of negative outcome (death); the approach of health care providers towards parents through grief processing meetings. It was found that more than half of the operators who returned the questionnaire had witnessed the family presence during resuscitation and, in many cases, expressed negative feelings such as anxiety, inadequacy, insecurity and discouragement. At the same time, positive aspects inherent in the practice of family presence emerged such as, for example, a more efficient processing of grief by family members who witnessed the efforts. The results highlighted: the lack of a figure in charge of the emotional and psychological support of the family, the family facilitator; and the absence of structured meetings between health professionals and family members in case of bereavement. Conclusion: The comparison between the survey and the literature review showed that there is still resistance related to family presence. The healthcare professionals in the study reported feelings of discomfort with family presence, which, in addition to the absence of a support figure, can be a barrier to performing this practice.
Problema: La letteratura afferma che non è inusuale che gli operatori sanitari mostrino riserve nei confronti della presenza familiare durante la rianimazione sul paziente pediatrico. Alla base di questa visione vi sono i sentimenti suscitati dalla sensazione di essere osservati da soggetti emotivamente coinvolti dalla situazione. I dubbi maggiori si ricollegano alla possibile influenza negativa che il contesto potrebbe avere sull’operato dei professionisti, e dalle conseguenze traumatiche che potrebbero insorgere in un familiare che osserva. Le percezioni individuali esercitino una forte influenza sul processo di decision making degli operatori sanitari in merito al permettere o meno ai familiari di assistere alle operazioni rianimatorie. Scopo: Il fine dello studio è determinare se le percezioni espresse da un campione di operatori sanitari, in un contesto ospedaliero italiano, siano in linea con ciò che è dichiarato in letteratura. Analizzando le opinioni positive e negative dei sanitari, basate sull’esperienza diretta o sull’idea di poter sperimentare la family presence, si cerca di evidenziare i punti di forza e le implicazioni legati a questa controversa pratica. Materiali e metodi: Lo studio descrittivo è orientato ad identificare le percezioni, positive e negative, di infermieri e medici rispetto alla presenza familiare durante la rianimazione cardiopolmonare sul paziente pediatrico, e l’approccio nei confronti della famiglia in caso di decesso del bambino. È stato somministrato un questionario online, autorizzato e condotto secondo il rispetto della privacy, agli infermieri e medici del Pronto Soccorso pediatrico di Padova e del Pronto soccorso di Treviso. L’analisi dei dati è avvenuta mediante statistica descrittiva semplice utilizzando il programma di Microsoft excel. Risultati: Le tematiche principali che caratterizzano il questionario sono: l’esperienza della presenza familiare durante la RCP sul paziente pediatrico; le percezioni positive e negative rispetto la pratica e su come queste possano andare ad influire sull’operato dei sanitari; l’esistenza o meno di una figura specifica di supporto e in caso di esito negativo (decesso); l’approccio dei sanitari nei confronti di genitori attraverso incontri di elaborazione del lutto. Si è riscontrato che più della metà degli operatori che hanno restituito il questionario ha assistito alla presenza familiare durante la rianimazione e, in molti casi, hanno espresso sentimenti negativi come ansia, inadeguatezza, insicurezza e sconforto. Al contempo sono emersi aspetti positivi inerenti alla pratica della family presence come, ad esempio, una più efficiente elaborazione del lutto da parte dei familiari che hanno assistito agli sforzi. I risultati hanno evidenziato: la mancanza di una figura deputata al supporto emotivo e psicologico della famiglia, il family facilitator; e l’assenza di incontri strutturati tra i sanitari e i familiari in caso di lutto. Conclusione: Il confronto tra l’indagine e la revisione letteraria, ha permesso di evidenziare che esistono ancora delle resistenze legate alla family presence. I sanitari in studio hanno riferito sentimenti di disagio alla presenza familiare che, in aggiunta all’assenza di una figura di supporto, può rappresentare un ostacolo all’esecuzione di questa pratica.
La presenza dei familiari durante la rianimazione cardiopolmonare sul paziente pediatrico: analisi descrittiva.
DIAO, ASSE PENDA
2020/2021
Abstract
Problem: The literature states that it is not unusual for health care professionals to show reservations towards family presence during resuscitation on the pediatric patient. Underlying this view are the feelings aroused by the sensation of being observed by subjects emotionally involved in the situation. The major doubts are related to the possible negative influence that the context could have on the work of professionals, and the traumatic consequences that could arise in a family member who observes. Individual perceptions exert a strong influence on the decision making process of healthcare professionals regarding whether or not to allow family members to attend resuscitation operations. Aim: The aim of the study is to determine whether the perceptions expressed by a sample of health workers, in an Italian hospital setting, are in line with what is stated in the literature. By analyzing the positive and negative opinions of health workers, based on direct experience or on the idea of being able to experience the family presence, we try to highlight the strengths and implications related to this controversial practice. Materials and Methods: The descriptive study is oriented to identify the perceptions, positive and negative, of nurses and physicians with respect to family presence during cardiopulmonary resuscitation on the pediatric patient, and the approach towards the family in case of death of the child. An online questionnaire was administered, authorized and conducted according to the respect of privacy, to nurses and physicians of the Pediatric Emergency Department of Padua and of the Emergency Department of Treviso. Data analysis was performed by simple descriptive statistics using Microsoft excel program. Results: The main themes that characterize the questionnaire are: the experience of family presence during CPR on the pediatric patient; positive and negative perceptions about the practice and how these may affect the work of health care providers; the existence or not of a specific support figure and in case of negative outcome (death); the approach of health care providers towards parents through grief processing meetings. It was found that more than half of the operators who returned the questionnaire had witnessed the family presence during resuscitation and, in many cases, expressed negative feelings such as anxiety, inadequacy, insecurity and discouragement. At the same time, positive aspects inherent in the practice of family presence emerged such as, for example, a more efficient processing of grief by family members who witnessed the efforts. The results highlighted: the lack of a figure in charge of the emotional and psychological support of the family, the family facilitator; and the absence of structured meetings between health professionals and family members in case of bereavement. Conclusion: The comparison between the survey and the literature review showed that there is still resistance related to family presence. The healthcare professionals in the study reported feelings of discomfort with family presence, which, in addition to the absence of a support figure, can be a barrier to performing this practice.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/11515