PedsCCM: Pediatric Critical Care Nursing Literature Reviews

Article Reviewed:

Scott LD Perceived needs of parents of critically ill children. Journal of the Society of Pediatric Nurses 1998; 3; 4-12.

Reviewed by:

Jodi Rogers, BSN, RN,C, CCRN
The Children's Medical Center
Dayton, Ohio.
Jodibutton@aol.com

Posted 5/29/98

---

Study Purpose:

To identify the needs of parents of critically ill hospitalized children as perceived by the parents and critical care nurses. To identify any differences between the two groups.

Study Design:

Descriptive, comparative.

Participants:

Nonprobability convenience sample of female primary caregivers of critically ill children who had been hospitalized for 36 to 84 hours in the PICU (n=21), and the primary critical care nurses caring for each family (n=17). The caregivers were 18 years or older and spoke and understood English

Instrument:

Critical Care Family Needs Inventory (CCRNI) modified for pediatrics. The CCRNI is a 45-item instrument developed to quantify the significance of perceived family needs (Molter, 1979). The author reports internal consistency reliability of the modified version of the CCRNI for this study was .94 for the primary caregivers and .93 for the nurses.

Procedure:

Using a structured interview technique, the researcher collected data between 36 and 76 hours of admission of the child to the PICU. The pediatric critical care nurses assigned to the child whose caregiver participated in the study were interviewed immediately before or after the primary caregiver interview.

Results & Discussion:

The primary caregivers identified eight needs as priorities. These included the need to know the expected outcome and the medical treatment; to be given honest answers; to be assured that the best care was being given by caring personnel; to see and visit their child frequently; and to be notified of any changes in the condition of their child. The nurses identified similar needs as important, placing significance on child-related information and hopefulness.

There were significant differences in perceived importance for 10 needs statements identified by the caregivers and nurse pairs. Situational support, comfort, and self-care needs were perceived with significantly less importance by the caregivers than the critical care nurses.

Application to Clinical Practice:

Critical care nurses who have interactive roles with parents and their children can consistently incorporate the perceived needs identified by parents into the plan of care. Information, assurance, and proximity to the critically ill child were identified as priority needs by the caregivers in this study and the critical care nurses providing care. Nursing interventions must be developed and incorporated that will enhance parental participation and decision making regarding their child’s care.

Study Limitations:

This study was limited by sampling method, sample size, and inclusion of only female primary caregivers.

Further Study:

The author recommends investigation of specific nursing interventions designed to assist family members to adapt to the critical illness of one of their children. Also suggested is quantifying what primary caregivers and nurses perceive as demonstrations of caring behaviors.

References:

Molter N. Needs of relatives of critically ill patients: A descriptive study. Heart & Lung 1979: 8, 332-330.