Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies
Humans; Health Facilities; Observational Studies as Topic; Pediatrics; Power (Psychology); Parents/psychology
BACKGROUND: Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established. OBJECTIVE: The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. ELIGIBILITY CRITERIA: The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies. INFORMATION SOURCES: We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists. INCLUDED STUDIES: Forty-four articles met the inclusion criteria. SYNTHESIS OF RESULTS: We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation. STRENGTHS AND LIMITATIONS OF EVIDENCE: Non-English articles were excluded. INTERPRETATION: Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents. CLINICAL REGISTRATION NO: PROSPERO 2017:CRD42017059478.
Ashcraft LE; Asato M; Houtrow AJ; Kavalieratos D; Miller E; Ray KN
Patient
2019
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s40271-018-0336-2" target="_blank" rel="noreferrer noopener">10.1007/s40271-018-0336-2</a>
Complications and mortality of venovenous extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure: a systematic review and meta-analysis
Humans; Infant Newborn; Survival Rate; Pneumothorax/etiology; Systematic reviews; Meta-analysis; Neonate; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation/adverse effects/mortality; Hypertension/etiology; Observational Studies as Topic; Respiratory Distress Syndrome Newborn/mortality/therapy; Respiratory failure
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. To systematically evaluate the complications and mortality of venovenous ECMO (VV ECMO) in the treatment of neonatal respiratory failure, we performed a systematic review and meta-analysis of all the related studies. METHODS: PubMed, Embase, and Cochrane Library were searched. The retrieval period was from the establishment of the database to February 2019. Two investigators independently screened articles according to the inclusion and exclusion criteria. The quality of article was assessed by the Newcastle-Ottawa scale (NOS). The meta-analysis was performed by Stata 15.0 software. RESULTS: Four observational studies were included, with a total of 347 newborns. VV ECMO was used for neonates with refractory respiratory failure unresponsive to maximal medical therapy. Median ages of the newborns at cannulation were 43.2 h, 23 h, 19 h, and 71 h in the included four studies, respectively. The overall mortality at hospital charge was 12% (5-18%) with a heterogeneity of I(2) = 73.8% (p = 0.01). Two studies reported mortality during ECMO and after decannulation, with 10% (0.8-19.2%) and 6.1% (2.6-9.6%), respectively. The most common complications associated with VV ECMO were: pneumothorax (20.6%), hypertension (20.4%), cannula dysfunction (20.2%), seizure (14.9%), renal failure requiring hemofiltration (14.7%), infectious complications (10.3%), thrombi (7.4%), intracranial hemorrhage or infarction (6.6%), hemolysis (5.3%), cannula site bleeding (4.4%), gastrointestinal bleeding (3.7%), oxygenator failure (2.8%), other bleeding events (2.8%), brain death (1.9%), and myocardial stun (0.9%). CONCLUSION: The overall mortality at discharge of VV ECMO in the treatment of neonatal respiratory failure was 12%. Although complications are frequent, the survival rate during hospitalization is still high. Further larger samples, and higher quality of randomized controlled trials (RCTs) are needed to clarify the efficacy and safety of this technique in the treatment of neonatal respiratory failure.
Xiong J; Zhang L; Bao L
BMC Pulmonary Medicine
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s12890-020-1144-8" target="_blank" rel="noreferrer noopener">10.1186/s12890-020-1144-8</a>