In-hospital interventions to promote relational practice with families in acute care settings: A scoping review

Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families' needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions. Contribution: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused.

Incidences de la présence des garde-malades sur la prise en charge médicale des patients. Etude menée au Centre Hospitalier Universitaire de Brazzaville

La gestion du malade dans l?univers hospitalier implique non seulement le personnel soignant, mais aussi d?autres acteurs sociaux encore moins connus des gestionnaires des structures hospitalières et des catégories socio professionnelles y évoluant. Parmi ces acteurs encore moins connu, il y a le garde-malade faisant partie du personnel hospitalier en charge de la prise en charge des patients en milieu hospitalier. Cependant au Centre Hospitalier et Universitaire de Brazzaville en République du Congo, les garde-malades sont constitués des parents, amis et connaissances dont la représentation est importante dans cet univers hospitalier. Cette représentation aussi remarquable soit ­ elle, interpelle plus d?un observateur au point de s?interroger sur les raisons à l?origine de cette présence. Notre étude répond à la logique qui est celle de tenter de comprendre et d?analyser ce phénomène devenu très inquiétant. Ce phénomène est donc à lire dans la perspective de la complexité des réalités sociales qui s?expliquent à partir des déterminants socio culturels, fondements de la vie sociale. Aussi, la faiblesse des services sous tutelle du C.H.U-B et la culture bantoue, laquelle repose sur la solidarité mécanique qui, appelle à la cohésion sociale, constituent des facteurs qui expliquent ce phénomène. A cet effet, une observation participante a été effectuée dans cette structure hospitalière. Celle-ci a permis de relever une influence importante qui, pour diverses raisons réponde aux préoccupations des malades. Cette étude présente trois intérêts : scientifique, social et personnel. D?abord, elle montre la difficulté en ressources humaines qui se traduit par la sous représentativité des catégories socio professionnelles qui, contribueraient à résoudre la question de l?effectivité de prise en charge du malade. Ensuite, l?étude présente un autre intérêt qui met en exergue la cohésion sociale qui, s?exprime à travers la chaine de solidarité dont la famille est le maillon. Le dernier centre d?intérêt est personnel. Il met en relief un aspect culturel très intéressant, celui de l?homogénéité et de la dynamique des rapports des acteurs impliqués dans la gestion du malade. Quoi qu?il en soit, le garde-malade joue un rôle de premier plan dans la gestion du malade. Il accompagne le personnel soignant, car partageant le même environnement social que le malade. Aussi, sa visibilité nécessite un encadrement juridique pour lui donner une véritable identité.

The management of the patient in the hospital word involves not only the nursing staff, but also other social actors even less known to the manager of hospital structures and socio-professional categories. Among these actors even less known, there is the nurse who is part of the hospital staff in charge of the care of patients in hospital environment. Howerver at the Brazzaville Hospital and University Center in the Republic of Congo, the nurses are made up of relatives, friends and acquaintanees whose representation is important in this hospital environment. This representation, as remarkable as it is, calls out to more than one observer to the point of questioning the reasons behind this presence.Our study reponds to the logic of trying to understand and analyze this phenomenon, which has become very worrying. This phenomenon should therefore be read in the perspective of the complexity of social realities which can be explained on the basis of socio-cultural determinants, the foundations of social life. Also, the weakness of the services under the supervision of the C.H.U-B and of the Bantu culture, which is based on mechanical solidarity, which, calls for social cohesion, are factors that explain this phenomenon. To this end, a participant observation was carried out this hospital structure. This made it possible to identify an important influence which, for various reasons, responds to the concerns of patients. This study has three interests: scientific, social and personal. First, it shows the difficulty in human resources which result in the representativeness of the socio-professional categories which would help to resolve the issue of effectiveness of patient care. The study presents another interest which highlights the social cohesion which is expressed through the chain of solidarity of which the family is the link. The last area of interest is personal. It highlights a very interesting cultural aspect, that of the homogeneity and dynamics of relationships of the actors involved in the management of the patient. In any case, the nurse plays a leading role in management of the patient. He supports the nursing staff, because they share the same social environment as the patient. Also, its visibility requires a legal framework to give it a real identity

Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa

Background: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. Objectives: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Method: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Results: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences.Recommendations: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU.Conclusion: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships

Problématique de garde-malade au Centre Hospitalier et Universitaire de Brazzaville (CHU-B) / NA

Le Centre Hospitalier et Universitaire de Brazzaville (C.H.U-B), est l'une des grandes structures sanitaires en République du Congo. Dans ce centre hospitalier, on constate une présence massive des gardes ­ malades, qui interpelle plus d'un observateur au point de s'interroger sur leur nécessité. Celle-ci serait ­ elle l'expression de la solidarité ou du dysfonctionnement des services sous tutelle du C.H.U-B? Pour vérifier nos hypothèses, nous nous sommes parvenus au résultat selon lequel, cette présence des gardes ­ malades dans ce centre hospitalier résulte de la conjonction de ces deux (02) facteurs, c'est ­ à ­ dire la solidarité mécanique et le dysfonctionnement du C.H.U-B. À cela s'ajoute l'inadéquation entre les nouvelles attentes des malades et l'état actuel des structures de ce centre.

The Brazzaville Hospital and University Center (C.H.U-B) is one of the largest health facilities in the Republic of Congo. In this hospital, there is a massive presence of sick keepers, which challenges more than one observer to question the reason of their existence. Would this be the expression of the solidarity or the dysfunction of the services under the supervision of the C.H.U-B? To verify our hypotheses, we arrived at the result according to which, this presence of the sick keepers in this hospital center results from the conjunction of these two (02) factors, that is to say the mechanical solidarity and the dysfunction of the CHU-B. Added to this is the mismatch between the new expectations of the patients and the current state of the structures of this center.

Role de l'accompagnant de malade : a propos de 100 cas colliges a l'unite d'hospitalisation du Service PPH de Cocody

De cette etude prospective; transversale et descriptive dont l'objectif principal etait d'identifier le role de l'accompagnant de malade; il ressort que l'accompagnement de malade dans le service PPH est une realite.Les activites de ces accompagnants sont nombreuses. Les plus frequentes sont :*surveillance de la perfusion : 100pour cent*toilette generale du malade 81pour cent*habillement du malade : 79pour centBien que non formalisee; la presence de l'accompagnant dans notre contexte parait pour Le moment indispensable. Cependant; compte tenu des difficultes d'ordre relationnel avec le personnel soignant et du risque infectieux probable; il est souhaitable que des solutions efficaces soient apportees dans l'interet des malades