Development of a parent experience measure for paediatric critical care transport teams.
parents
questionnaire design/survey
transport/transfer
Journal
Nursing in critical care
ISSN: 1478-5153
Titre abrégé: Nurs Crit Care
Pays: England
ID NLM: 9808649
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
16
03
2021
received:
30
11
2020
accepted:
20
04
2021
pubmed:
25
5
2021
medline:
11
5
2022
entrez:
24
5
2021
Statut:
ppublish
Résumé
A third of children admitted to paediatric intensive care units (PICUs) in the United Kingdom (UK) are transported by paediatric critical care transport services (PCCTs). Parents have described the transfer journey as particularly stressful. Critical care nurses have a key role in mitigating the impact of the journey on parents. Evaluating parents' experiences is important to inform service improvements. Our aim was to describe the development of a new measure of parents' experiences of PCCTs, derived from data collected in the Differences in access to Emergency Paediatric Intensive Care and care during Transport (DEPICT) study. A descriptive cross-sectional survey was used. As part of the DEPICT study, a 17-item transport experience questionnaire was developed and given to parents of children transported by PCCTs to 24 UK PICUs during a 12-month period. Analyses included exploratory factor analysis and a validation review by a PCCT stakeholder group. Families of 1722 children (1798 journeys) completed questionnaires. Five items were excluded from further analysis as correlation coefficients were <0.3. Two factors explained 53% of the variance and all 12 items loaded on one of these factors. Factor 1 (8 items) explained 47% of the variance, had excellent internal reliability and the clustered items were conceptually coherent with a specific relevance to PCCTs; these were offered for consideration, with other items possibly discarded. Twenty-eight PCCT clinicians reviewed the questions. Using a 70% agreement threshold, one additional, previously discarded, item was identified for inclusion, resulting in a nine-item experience measure. Our brief measure of parents' experience of critical care transport provides a standardized measure that can be used across all PCCTs, enabling national benchmarking of services and potentially increasing the collection and use of parent experience data to improve services. Being able to measure experience provides an opportunity to understand how to make services better to improve experience.
Sections du résumé
BACKGROUND
A third of children admitted to paediatric intensive care units (PICUs) in the United Kingdom (UK) are transported by paediatric critical care transport services (PCCTs). Parents have described the transfer journey as particularly stressful. Critical care nurses have a key role in mitigating the impact of the journey on parents. Evaluating parents' experiences is important to inform service improvements.
AIM AND OBJECTIVES
Our aim was to describe the development of a new measure of parents' experiences of PCCTs, derived from data collected in the Differences in access to Emergency Paediatric Intensive Care and care during Transport (DEPICT) study.
DESIGN
A descriptive cross-sectional survey was used.
METHODS
As part of the DEPICT study, a 17-item transport experience questionnaire was developed and given to parents of children transported by PCCTs to 24 UK PICUs during a 12-month period. Analyses included exploratory factor analysis and a validation review by a PCCT stakeholder group.
RESULTS
Families of 1722 children (1798 journeys) completed questionnaires. Five items were excluded from further analysis as correlation coefficients were <0.3. Two factors explained 53% of the variance and all 12 items loaded on one of these factors. Factor 1 (8 items) explained 47% of the variance, had excellent internal reliability and the clustered items were conceptually coherent with a specific relevance to PCCTs; these were offered for consideration, with other items possibly discarded. Twenty-eight PCCT clinicians reviewed the questions. Using a 70% agreement threshold, one additional, previously discarded, item was identified for inclusion, resulting in a nine-item experience measure.
CONCLUSION
Our brief measure of parents' experience of critical care transport provides a standardized measure that can be used across all PCCTs, enabling national benchmarking of services and potentially increasing the collection and use of parent experience data to improve services.
RELEVANCE TO CLINICAL PRACTICE
Being able to measure experience provides an opportunity to understand how to make services better to improve experience.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
367-374Subventions
Organisme : Health Services and Delivery Research Programme
ID : 15/136/45
Informations de copyright
© 2021 British Association of Critical Care Nurses.
Références
National Institute of Health Research. Themed Review: Improving Care by Using Patient Feedback. Southampton: NIHR Dissemination Centre; 2019.
de Silva D. Measuring Patient Experience. London: The Health Foundation; 2013.
Colville G, Orr F, Gracey D. "The worst journey of our lives": parents' experiences of a specialised paediatric retrieval service. Intensive Crit Care Nurs. 2003;19:103-108.
Watson RS, Choong K, Colville G, et al. Life after critical illness in children-toward an understanding of pediatric post-intensive care syndrome. J Pediatr. 2018;198:16-24.
Marsac ML, Kassam-Adams N, Delahanty DL, et al. Posttraumatic stress following acute medical trauma in children: a proposed model of bio-psycho-social processes during the peri-trauma period. Clin Child Fam Psychol Rev. 2014;17:399-411.
Bronner MB, Peek N, Knoester H, et al. Course and predictors of posttraumatic stress disorder in parents after pediatric intensive care treatment of their child. J Pediatr Psychol. 2010;35:966-974.
Alzawad Z, Lewis FM, Kantrowitz-Gordon I, et al. A qualitative study of parents' experiences in the pediatric intensive care unit: riding a roller coaster. J Pediatr Nurs. 2020;51:8-14.
NICE guideline [NG116]. Post-Traumatic Stress Disorder. London: National Institute for Health and Care Excellence; 2018.
Macnab AJ, Richards J, Green G. Family-oriented care during pediatric inter-hospital transport. Patient Educ Couns. 1999;36:247-257.
Colville G, Darkins J, Hesketh J, et al. The impact on parents of a child's admission to intensive care: integration of qualitative findings from a cross-sectional study. Intensive Crit Care Nurs. 2009;25:72-79.
NHS England. Overview of the Findings from the 2018 National Peer Review of Paediatric Critical Care Transport Services in England. England: NHS; 2019.
Ramnarayan P, Evans R, Draper ES, et al. Differences in access to emergency paediatric intensive care and care during transport (DEPICT): study protocol for a mixed methods study. BMJ Open. 2019;9:e028000.
NHS England. Friends and Family Test. Leeds: NHS England; 2020. https://www.england.nhs.uk/fft/. Accessed November 1, 2020.
Yong A, Pearce S. A beginner's guide to factor analysis: focusing on exploratory factor analysis. Tutor Quant Methods Psychol. 2013;9:79-94.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377-381.
Black N, Jenkinson C. Measuring patients' experiences and outcomes. BMJ. 2009;339:b2495.
Doyle C, Bell D, Lennox L. Experience as an aspect of quality: a review of the evidence. NHS Patient Exp J Meas Metrics. 2012;2:15-39.
Department of Health. Transparency in Outcomes-A Framework for the NHS. London: Department of Health; 2010.
Dahav P, Sjostrom-Strand A. Parents' experiences of their child being admitted to a paediatric intensive care unit: a qualitative study-like being in another world. Scand J Caring Sci. 2018;32:363-370.
Colville G. The psychologic impact on children of admission to intensive care. Pediatr Clin North Am. 2008;55:605-616.x.
Paediatric Intensive Care Audit Network (PICANet). Annual Report. Leeds: Universities of Leeds and Leicester; 2019.