Sarah Manns

Facilitators and Barriers to Engagement in Parenting Programs A Qualitative Systematic Review

Parenting programs have the potential to improve the health and well-being of parents and children. A challenge for providers is to recruit and retain parents in programs. Studies researching engagement with programs have largely focused on providers’, policy makers’, or researchers’ reflections of their experience of parents’ participation. We conducted a systematic review of qualitative studies where parents had been asked why they did or did not choose to commence, or complete programs, and compared these perceptions with those of researchers and those delivering programs. We used data-mining techniques to identify relevant studies and summarized findings using framework synthesis methods. Six facilitator and five barrier themes were identified as important influences on participation, with a total of 33 subthemes. Participants focused on the opportunity to learn new skills, working with trusted people, in a setting that was convenient in time and place. Researchers and deliverers focused on tailoring the program to individuals and on the training of staff. Participants and researchers/deliverers therefore differ in their opinions of the most important features of programs that act as facilitators and barriers to engagement and retention. Program developers need to seek the views of both participants and deliverers when evaluating programs.

Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England

Objective To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care. Design Before and after study, investigating the effects of the intervention during two 11-month periods before and after implementation. Setting Four local neonatal units (LNUs) in South West England. Participants Infants without major anomalies born at 27–33 weeks’ gestation admitted to participating units, and their parents. Train-to-Home intervention A family-centred discharge package to increase parents’ involvement and understanding of their babys needs, comprising a train graphic and supporting care pathways to facilitate parents’ understanding of their babys progress and physiological maturation, combined with improved estimation of the likely discharge date. Main outcome measures Perceived Maternal Parenting Self-Efficacy (PMP S-E) scores, infant length of stay (LOS) and healthcare utilisation for 8 weeks following discharge. Results Parents reported that the Train-to-Home improved understanding of their babys progress and their preparedness for discharge. Despite a lack of change in PMP S-E scores with the intervention, the number of post-discharge visits to emergency departments (EDs) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p<0.05) after discharge. In both study phases, over 50% of infants went home more than 3 weeks before their estimated date of delivery (EDD), though no reduction in LOS occurred. Conclusions Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach.

Patients’ perspectives on the educational preparation of cardiac nurses

Background: Over the last two decades the UK health service has endeavoured to place patient and public involvement at the heart of its modernisation agenda. Despite these aspirations the role of patients in the development of nursing curricula remains limited. Aim: A descriptive qualitative design was used to explore the views of cardiac patients about the educational preparation of cardiac nurses. Method: Eight participants attending an annual conference of a patient and carer support group were recruited to the study. A focus group was conducted to explore their views on how the educational preparation of cardiac nurses in the UK should develop. Tape-recorded data were transcribed and a thematic analysis was undertaken. Findings: Four themes were identified: contradictions around practice and education; demonstrating compassion; delivering rehabilitation expertise; leadership in practice. Participants perceived that they had a valuable role in the educational development of nurses, enhancing nurses’ understanding of how individuals live and adjust to living with cardiovascular disease. Conclusion: Cardiac patients believe that the education of cardiac nurses should be driven by experiences in practice, nevertheless they want nurses to be equipped to deliver care that is underpinned by a strong knowledge base and skills combined with an ability to engage, educate and deliver high quality care that is both compassionate and individualised.

Easy undressing with soft robotics

Dexterity impairments affect many people worldwide, limiting their ability to easily perform daily tasks and to be independent. Difficulty getting dressed and undressed is commonly reported. Some research has been performed on robot-assisted dressing, where an external device helps the user put on and take off clothes. However, no wearable robotic technology or robotic assistive clothing has yet been proposed that actively helps the user dress. In this article, we introduce the concept of Smart Adaptive Clothing, which uses Soft Robotic technology to assist the user in dressing and undressing. We discuss how Soft Robotic technologies can be applied to Smart Adaptive Clothing and present a proof of concept study of a Pneumatic Smart Adaptive Belt. The belt weighs only 68 g, can expand by up to 14% in less than 6 s, and is demonstrated aiding undressing on a mannequin, achieving an extremely low undressing time of 1.7 s.

“Giving us hope”: Parent and neonatal staff views and expectations of a planned family‐centred discharge process (Train‐to‐Home)

Preparing families and preterm infants for discharge is relatively unstructured in many UK neonatal units (NNUs). Family‐centred neonatal care and discharge planning are recommended but variable.