Support provided by nurses to parents of hospitalized children – cultural adaptation and validation of Nurse Parent Support Tool and initial research results

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Child's illness and hospitalisation are difficult and stressful situations both for the patients themselves and for their parents. The literature of the subject shows numerous examples that prove negative effect of child hospitalisation on parents’ biopsychosocial condition. Prevalence of headaches, insomnia, loss of appetite and tachyarrhythmia is reported in the mothers. Psychological changes include getting easily irritated, nervousness, problems with concentration, depression, fear, grief, anxiety, lack of self‐confidence, emotional chaos and high levels of stress 1. The sense of lack of control and suspension between hope and despair are also typical 2. Since hospitalisation changes the functioning of the whole family, not only the patient but also their relatives should be in the centre of the therapeutic team's attention.
The term family‐focused care (FFC) is not new and well‐being of the family as an entity is fundamental to this approach. Family‐focused care involves various forms of support that is provided to the whole family experiencing illness and hospitalisation of a child. It includes not only a therapy and care provided to the child, but also engaging the family to caring for the child and making decisions. The support given to the parents of hospitalised children has become an essential element of caring for the child 3. Bruns and Klein report that according to the parents, family‐focused care means the support of the medical staff and ability to take active part in caring for the child 4. Professional nursing care should encompass psychological and health care, education, activation, help with solving problems and playing a role of a temporary replacement 5.
Social support provided during child's hospitalisation not only reduces the level of stress in parents, but also improves their comfort 10. Other authors point out protective effect of support in relation to the risk of post‐partum depression and anxiety disorders in mothers as well as positive impact on building relationship between the child and their parents 12. Social support also affects health condition and duration of hospital stay of the young patients, quality assessment of care provided in the intensive care unit as well as well‐being of the entire family 10. Meert et al. 20 show that professional support provided by family counsellors to parents who have experienced their child's death facilitated their return to normal life and overcoming the accompanying grief. Researchers also indicate that the parents not only reported subjective need for and value of the support but also insufficiency of it, which they experienced during their child's hospitalisation 10. Lack of support evoked frustration and hindered yet hard situation which the family had faced 16. Low level of social support is also described as the main risk factor of depression and fear 24.
In order to objectivise the assessment of social support, including the support given by the nurses, numerous research tools have been developed among others The Nurse‐Parent Support Tool (NPST). This was created by Margaret S. Miles who relied on house's conceptual model of social support comprising four elements of support, namely emotional, appraisal, informational and instrumental 28. Emotional support provided to the parents of hospitalised children encompasses listening, showing care, interest in ways of dealing with the child's illness and other aspects of their lives. Appraisal support is creating, enhancing and supporting the role of a parent in relation to the child. Informational support described in the model is aimed at supportive communication and constant improving the parents’ knowledge on the child's illness and treatment, development and care as well as the child's behaviour, their emotional reactions, needs, laws and obligations during hospitalisation.
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