Effective Interventions to Support Self-management for Parents of Children with a Chronic Condition: A Systematic Review.

INTRODUCTION: This systematic review aims to determine the efficacy of interventions to support the self-management for parents of children with a chronic condition. An overview of prior research, regardless of the children's diagnosis, is lacking. Therefore, this systematic review provides an overview of the most recent available scientific literature that describes interventions to support self-management for parents of children with a chronic condition. METHODS: A systematic search of Randomised Controlled Trials (RCTs) was conducted in CENTRAL, CINAHL, EMBASE, MEDLINE and PsychInfo. Studies that describe any type of self-management intervention or a combination of self-management interventions that support parents of children with a chronic condition between 0 and 18 years were included. The interventions and results were reported, hence categorized in the four areas of self-management: medical management, adjustment of lifestyle, shared decision-making and managing the consequences of a chronic condition. RESULTS: The study included 23 RCTs. Due to the heterogeneity of the included studies a meta-analysis was impossible. Twenty studies showed statistically significant effects in favour of the intervention on at least one of the outcomes. Twenty-two studies showed risk of bias. The results indicate that disease management, (parent) group training, psycho-education and the Triple P intervention are effective interventions to support self-management. There were limited studies found in the areas lifestyle adjustment and shared decision making. DISCUSSION: Effective interventions to support self-management for parents of children with a chronic condition are described, but the moderate quality of the studies hampers firm conclusions.

Participation of Parents of Hospitalized Children in Medical Rounds: A Qualitative Study on Contributory Factors.

PURPOSE: Factors that promote parents' participation during medical rounds on their hospitalized child have not been fully addressed. The aim of this study was to identify factors that promote the participation of family members during medical rounds. DESIGN AND METHODS: This was a descriptive qualitative study using elements of analysis from the grounded theory method. Semi-structured interviews and non-participant observations were performed from December 2015 until June 2016 and took place on a general academic pediatric ward where the age of children did not exceed 12 months. RESULTS: In total 20 participants were interviewed: 10 pediatric nurses, 4 pediatricians and 6 parents. In addition, five medical rounds were videotaped. Five themes emerged from the analyses of the interviews and videotapes: "conditions", "structure of medical rounds", "cast", "adaptive professionals" and "parents' participation as a process". CONCLUSION: Contextual factors, such as the room and seating arrangement, as well as the willingness of healthcare professionals to work together with the parents are important in enabling parents' participation. To promote active participation, professionals have to communicate in layman's terms and information given by parents has to be taken seriously. Support and coaching of parents during the medical rounds and evaluating the rounds are meaningful factors. PRACTICE IMPLICATIONS: These findings help healthcare professionals to restructure the traditional medical rounds to enable parents' participation. The identified communication skills and attitudes can enhance the competencies of nurses and doctors as communicators and collaborators. This urge the need for more specific education for professionals to promote parents' participation.