1인제대학교 대학원 간호학과 부산백병원
2인제대학교 간호학과·건강과학연구소
1Department of Nursing, Inje University, Nurse of Busan Paik Hospital, Busan, Korea
2Department of Nursing·Institute of Health Science, Inje University, Busan, Korea
Copyright © 2016 Korean Academy of Child Health Nursing
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
• 분석대상이 된 논문의 구체적인 선정 기준은 다음과 같다.
- 영어로 쓰인 논문
- 심사를 거친 학술지 논문
- 아동병동에서(NICU, PICU 포함) 가족중심 순회를 적용한 논문
- 가족중심 순회에 입원아동의 가족과 간호사가 포함된 논문
• 분석대상에서 제외한 구체적인 제외 기준은 다음과 같다.
- 사설, 편집자에게 보내는 편지
- 학술대회 프로시딩
- 아동병동이 아닌 곳에서 가족중심 순회를 적용한 논문
| Authors (Year)No | Research design | Participants | Team members | Timing/place | Findings |
|---|---|---|---|---|---|
| Aragona et al. (2016) [1] | Qualitative study | 2 residents, interim nurse manager, chief of the hospital medicine division, 2 hospitalists | Pediatric residents, two interns, three medical students | 8:45 am for 2 hours/bedside | • The rate of nurse attendance on FCR improved 30% to 59%. |
| • There was no correlation between nurse to patient ratio and nurse attendance on FCR. | |||||
| Xie et al. (2015) [2] | Qualitative study | Parents, medical administrator, nurse manager, nurses, attending physicians, resident | Parent, medical administrator, nurse manager, nurses, attending physicians, resident | Each morning/none | • A model of collaborative healthcare system was redesigned and defined in four phases; setup of the redesign team, preparation for meetings, collaboration in meetings, and two outcomes. |
| Beck et al. (2015) [3] | Qualitative study | 15 nurses, 13 family members | Physicians, nurses, resident | None | • Effective FCR teaching strategies, a framework for faculty development, and training to improve the educational value of FCR emerged. |
| Walker-Vischer et al. (2015) [4] | Mixed method | 20 parents | None | None | • Parents feel that their participation and input are valued in FCR and they are helped to understand the plan and facilitated communication when done in Spanish. |
| Palokas et al. (2015) [5] | Mixed method | 160 nurses, 150 attending physicians | None | None | • For excellent patient care and customer servke to be provided, patient rounds should be efficient, effective, and timely. |
| • Essential healthcare team members should be present in rounds to ensure interprofessional collaboration. | |||||
| Levin et al. (2015) | Mixed method | Families, physicians, nurses | Resident, nurses, pharmacist, respiratory therapist, case manager, consultants, fellows, physicians | None | • FCR is needed to increase the length of rounds. |
| • Non-English speaking families needed more support | |||||
| Carayon et al. (2014) [7] | Mixed method | 5 parents and 5 healthcare team member (nurses, physicians, resident) | Nurses, physicians, resident | None | • FCR is needed to allow a range of participants, including parents and children to participate in healthcare process improvement. |
| Subramony et al. (2014) [8] | Mixed method | 6 family members, 200 hours FCR observed | Attending physicians, senior residents, interns, medical students | None/patient’s room or hallway | . FCR provided a forum for information sharing. |
| • Medical teams approached families with practices intended to demonstrated respect. | |||||
| • Family members had the opportunity to participate in care. | |||||
| • FCR helped as a starting point for collaboration around plan making. | |||||
| Grzyb et al. (2013) [9] | Cross-sectional study | 81 parents, 67 medical trainees, 28 nurses | Staff neonatologists, residents, medical students, charge nurse, infant’s nurse, dietician. | 9:30 am for 2 hours/bedside | • Parents had positive experience such as reduced anxiety, increased confidence. |
| • Medical trainees had mixed views. | |||||
| Stickey et al. (2013) [10] | Cross-sectional study | 100 parents, 131 healthcare providers | Physician team (pediatric ICU attending and fellow, pediatric residents, pediatric physicians, and nurse practitioners, bedside nurse, respiratory therapist | Morning/bedside | • Parents preferred FCR especially satisfaction for caring. |
| • Healthcare providers had varied views and raised concerns regarding time, privacy, teaching, discussion. | |||||
| Lion et al. (2013) [11] | Prospective cohort study | 41 English proficient, 40 limited English proficiency | Faculty, residents, interpreter, | None | • Information filtering was common during FCR for families with limited English proficiency, |
| • Filtering might be associated with poorer diagnosis and comprehension. | |||||
| • Experience with a hospitalized child was associated with increased comprehension among families the limited English proficiency. | |||||
| Drago et al. (2013) [12] | Observational study | 431 patients were observed, 100 families | Attending physician, pediatric critical care, anesthesia, emergency medicine fellow, pediatrics residents, emergency or anesthesia residents, pharmacist, nutritionist, case manager, respiratory therapist, nurse | None/bedside or hallway | • FCR improved caring of their children. |
| • Family demographic characteristics were not associated with attending FCR. | |||||
| Ladak et al. (2013) [13] | Quasi-experimental study | 82 parents, 25 health professionals | Intensivist, surgeon, resident, nurse, technician, student nurse | Morning/ bedside | • FCR improved parents’ satisfaction and decreased length of stay. |
| Kuo et al. (2012) [14] | Prospective study | 97 families | General academic pediatrician or hospitalist, upper-level residents, interns, medial students, advance practice nurse, social worker, respiratory therapist, dietician, discharge planner | Weekday morning/none | • FCR was associated with improved family experiences, particularly in clarity of the care plan and overall satisfaction in care. |
| Subramony et al.(2012) [15] | Descriptive study | 118 families | Primarily outpatient based academic generalist, senior residents, interns, medical students. nurses, pharmacist | Weekday/patient’s room | • It helped to understand discharge goals. |
| • Spanish-speaking and Hispanic families had difficulty in understanding discharge plans compared with English speaking and other non-hispanic counterparts. | |||||
| Rappaport et al. (2011) [16] | Observation study | 295 patients, 257 staff members | Attending physician, interns, medical students, bedside nurse, pharmacist, dietician, social worker, interpreter. | None | • Families had high satisfaction and increasing knowledge of team member’s role. |
| • Physicians felt at ease in managing rounds with family present. | |||||
| • Senior resident decreased autonomy. | |||||
| McPherson et al. (2011) [17] | Mixed method | 68 health care professionals 32 parents | Physician, nurses, RT, allied health | None | • Consistent, reliable communication, issues of confidentiality, time constraints, policy and attention to the role of parents and care professionals were needed for successful FCR. |
| Voos et al. (2011) [18] | Descriptive study | 278 staff (NNP, fellows, physicians etc), 28 parents | Attending physician, medical resident or NNP, neonatal nurse, pharmacist, twice a week a dietitian | None | • NNPand Fellows enhanced collaboration among team members. |
| • Parents increased satisfaction especially communication. | |||||
| Seitz et al. (2011) [19] | Qualitative study | 28 families | Attending physician, resident physician, medical students, patient’s nurses | None | • Parents had positive opinion with Spanish interpreter, experience family-physician communication, lack of family empowerment. |
| -Parents preferred live interpreter rather than telephonic interpretation. | |||||
| Cameron et al. (2009) [20] | Mixed method | 48 patients, 186 HCP, 36 parents, 102 HCP | Bedside nurse, house staff member (resident, nurse practitioner, house doctor), critical care fellow, attending physician | None/outside the patients room (the doors to patients rooms were kept open) | • FCR improved families’ satisfaction. |
| • Medical team thought that FCR provides new and relevant information, and improves patient care. | |||||
| Rosen et al. (2009) [21] | Descriptive study | 27 patients, 53 staff members | Physician, senior resident, intern, medical student, nurses, care coordinator, social worker, and pharmacist, patient, family or legal guardian | Morning/none | • Staff members had better understanding of the patient’s medical plans, ability to help the families, greater sense of teamwork. |
| • 2.7 minutes required for FCR. | |||||
| • Families’opinion affected the mecHcal decision-making discussion in 90% of cases. | |||||
| Latta et al. (2008) [22] | Mixed method | 18 patients | Physician, several residents physicians and medical students, patient’s nurse, care coordinator, and team coordinator | None | • Parents acquired being able to communicate, understanding the plan, participating with decision making. |
| Phipps et al. (2007) [23] | Observational study | Total 105 admission, 81 family, 187 medical team staff for surveys | Resident, attending pediatric doctors, parent | Morning/none | • Length of rounds and time spent teaching are not associated with FCR. |
| • Parents thought that medical team spent appropriate time for discussing, privacy is not violated. | |||||
| • Medical team had a positive experience for FCR. | |||||
| Bramwell & Weindling (2005) [24] | Qualitative study | 86 family members | Junior medical staff, doctor, advanced neonatal nuBe practitioner, nuBe, social worker, nursing shift leader, medical students | 8:30-10:30am/none | • Overheard conversation during FCR, confidentiality was matter of concern for some. |
| Essential element | Contents | |
|---|---|---|
| Cognition | Description | Dignity and respect [4, 7, 8, 15, 17, 21, 22] |
| Empowerment and reinforcement [4, 5, 15, 17, 21, 22] | ||
| Obstacle | High expectation of family [9, 10, 13] | |
| Negative opinion of medical staff [9, 10, 13, 20] | ||
| Strategy | Leadership [14] | |
| Participation of family [17, 19] | ||
| Continuing support from staff [14, 17, 19, 22] | ||
| Communication | Description | Improving communication [3, 10, 15, 18] |
| Consideration for family [10, 18, 21] | ||
| Sharing care plan [3, 15, 21] | ||
| Obstacle | Language barrier [4, 7, 11, 15, 19] | |
| Poor understanding [10, 11, 15, 17] | ||
| Handing out bad news [9, 12] | ||
| Strategy | Using easy words [4, 15, 22] | |
| Interpreter training [19] | ||
| Mediative participation of nurse [1, 16, 25] | ||
| Understanding of culture [7, 15, 19] | ||
| Collaboration | Description | Supportive physical environment [7, 8, 17, 19, 27] |
| Active participation [2, 17, 19] | ||
| Obstacle | Inconsistent time [1, 2, 5, 9, 19] | |
| Limited space [8, 12] | ||
| Invasion of privacy [9, 10, 17, 24] | ||
| Strategy | Unified care planning [8, 17, 22] | |
| Cooperation of family [5, 10, 17, 23] | ||
| Regulation and guide [9, 14, 17] | ||
| Coaching | Description | Achievement of professionalism [3, 7, 16] |
| Improvement in communication skill [3, 7, 16] | ||
| Obstacle | Negative attitude of staff [9, 10] | |
| Embarrassment of students [7, 16] | ||
| Strategy | Learning goal setting of FCR [3, 16] | |
| Direct observation and experience [3, 16] | ||
| Teaching of therapeutic communication [3, 16] |
| Authors (Year)No | Research design | Participants | Team members | Timing/place | Findings |
|---|---|---|---|---|---|
| Aragona et al. (2016) [1] | Qualitative study | 2 residents, interim nurse manager, chief of the hospital medicine division, 2 hospitalists | Pediatric residents, two interns, three medical students | 8:45 am for 2 hours/bedside | • The rate of nurse attendance on FCR improved 30% to 59%. |
| • There was no correlation between nurse to patient ratio and nurse attendance on FCR. | |||||
| Xie et al. (2015) [2] | Qualitative study | Parents, medical administrator, nurse manager, nurses, attending physicians, resident | Parent, medical administrator, nurse manager, nurses, attending physicians, resident | Each morning/none | • A model of collaborative healthcare system was redesigned and defined in four phases; setup of the redesign team, preparation for meetings, collaboration in meetings, and two outcomes. |
| Beck et al. (2015) [3] | Qualitative study | 15 nurses, 13 family members | Physicians, nurses, resident | None | • Effective FCR teaching strategies, a framework for faculty development, and training to improve the educational value of FCR emerged. |
| Walker-Vischer et al. (2015) [4] | Mixed method | 20 parents | None | None | • Parents feel that their participation and input are valued in FCR and they are helped to understand the plan and facilitated communication when done in Spanish. |
| Palokas et al. (2015) [5] | Mixed method | 160 nurses, 150 attending physicians | None | None | • For excellent patient care and customer servke to be provided, patient rounds should be efficient, effective, and timely. |
| • Essential healthcare team members should be present in rounds to ensure interprofessional collaboration. | |||||
| Levin et al. (2015) | Mixed method | Families, physicians, nurses | Resident, nurses, pharmacist, respiratory therapist, case manager, consultants, fellows, physicians | None | • FCR is needed to increase the length of rounds. |
| • Non-English speaking families needed more support | |||||
| Carayon et al. (2014) [7] | Mixed method | 5 parents and 5 healthcare team member (nurses, physicians, resident) | Nurses, physicians, resident | None | • FCR is needed to allow a range of participants, including parents and children to participate in healthcare process improvement. |
| Subramony et al. (2014) [8] | Mixed method | 6 family members, 200 hours FCR observed | Attending physicians, senior residents, interns, medical students | None/patient’s room or hallway | . FCR provided a forum for information sharing. |
| • Medical teams approached families with practices intended to demonstrated respect. | |||||
| • Family members had the opportunity to participate in care. | |||||
| • FCR helped as a starting point for collaboration around plan making. | |||||
| Grzyb et al. (2013) [9] | Cross-sectional study | 81 parents, 67 medical trainees, 28 nurses | Staff neonatologists, residents, medical students, charge nurse, infant’s nurse, dietician. | 9:30 am for 2 hours/bedside | • Parents had positive experience such as reduced anxiety, increased confidence. |
| • Medical trainees had mixed views. | |||||
| Stickey et al. (2013) [10] | Cross-sectional study | 100 parents, 131 healthcare providers | Physician team (pediatric ICU attending and fellow, pediatric residents, pediatric physicians, and nurse practitioners, bedside nurse, respiratory therapist | Morning/bedside | • Parents preferred FCR especially satisfaction for caring. |
| • Healthcare providers had varied views and raised concerns regarding time, privacy, teaching, discussion. | |||||
| Lion et al. (2013) [11] | Prospective cohort study | 41 English proficient, 40 limited English proficiency | Faculty, residents, interpreter, | None | • Information filtering was common during FCR for families with limited English proficiency, |
| • Filtering might be associated with poorer diagnosis and comprehension. | |||||
| • Experience with a hospitalized child was associated with increased comprehension among families the limited English proficiency. | |||||
| Drago et al. (2013) [12] | Observational study | 431 patients were observed, 100 families | Attending physician, pediatric critical care, anesthesia, emergency medicine fellow, pediatrics residents, emergency or anesthesia residents, pharmacist, nutritionist, case manager, respiratory therapist, nurse | None/bedside or hallway | • FCR improved caring of their children. |
| • Family demographic characteristics were not associated with attending FCR. | |||||
| Ladak et al. (2013) [13] | Quasi-experimental study | 82 parents, 25 health professionals | Intensivist, surgeon, resident, nurse, technician, student nurse | Morning/ bedside | • FCR improved parents’ satisfaction and decreased length of stay. |
| Kuo et al. (2012) [14] | Prospective study | 97 families | General academic pediatrician or hospitalist, upper-level residents, interns, medial students, advance practice nurse, social worker, respiratory therapist, dietician, discharge planner | Weekday morning/none | • FCR was associated with improved family experiences, particularly in clarity of the care plan and overall satisfaction in care. |
| Subramony et al.(2012) [15] | Descriptive study | 118 families | Primarily outpatient based academic generalist, senior residents, interns, medical students. nurses, pharmacist | Weekday/patient’s room | • It helped to understand discharge goals. |
| • Spanish-speaking and Hispanic families had difficulty in understanding discharge plans compared with English speaking and other non-hispanic counterparts. | |||||
| Rappaport et al. (2011) [16] | Observation study | 295 patients, 257 staff members | Attending physician, interns, medical students, bedside nurse, pharmacist, dietician, social worker, interpreter. | None | • Families had high satisfaction and increasing knowledge of team member’s role. |
| • Physicians felt at ease in managing rounds with family present. | |||||
| • Senior resident decreased autonomy. | |||||
| McPherson et al. (2011) [17] | Mixed method | 68 health care professionals 32 parents | Physician, nurses, RT, allied health | None | • Consistent, reliable communication, issues of confidentiality, time constraints, policy and attention to the role of parents and care professionals were needed for successful FCR. |
| Voos et al. (2011) [18] | Descriptive study | 278 staff (NNP, fellows, physicians etc), 28 parents | Attending physician, medical resident or NNP, neonatal nurse, pharmacist, twice a week a dietitian | None | • NNPand Fellows enhanced collaboration among team members. |
| • Parents increased satisfaction especially communication. | |||||
| Seitz et al. (2011) [19] | Qualitative study | 28 families | Attending physician, resident physician, medical students, patient’s nurses | None | • Parents had positive opinion with Spanish interpreter, experience family-physician communication, lack of family empowerment. |
| -Parents preferred live interpreter rather than telephonic interpretation. | |||||
| Cameron et al. (2009) [20] | Mixed method | 48 patients, 186 HCP, 36 parents, 102 HCP | Bedside nurse, house staff member (resident, nurse practitioner, house doctor), critical care fellow, attending physician | None/outside the patients room (the doors to patients rooms were kept open) | • FCR improved families’ satisfaction. |
| • Medical team thought that FCR provides new and relevant information, and improves patient care. | |||||
| Rosen et al. (2009) [21] | Descriptive study | 27 patients, 53 staff members | Physician, senior resident, intern, medical student, nurses, care coordinator, social worker, and pharmacist, patient, family or legal guardian | Morning/none | • Staff members had better understanding of the patient’s medical plans, ability to help the families, greater sense of teamwork. |
| • 2.7 minutes required for FCR. | |||||
| • Families’opinion affected the mecHcal decision-making discussion in 90% of cases. | |||||
| Latta et al. (2008) [22] | Mixed method | 18 patients | Physician, several residents physicians and medical students, patient’s nurse, care coordinator, and team coordinator | None | • Parents acquired being able to communicate, understanding the plan, participating with decision making. |
| Phipps et al. (2007) [23] | Observational study | Total 105 admission, 81 family, 187 medical team staff for surveys | Resident, attending pediatric doctors, parent | Morning/none | • Length of rounds and time spent teaching are not associated with FCR. |
| • Parents thought that medical team spent appropriate time for discussing, privacy is not violated. | |||||
| • Medical team had a positive experience for FCR. | |||||
| Bramwell & Weindling (2005) [24] | Qualitative study | 86 family members | Junior medical staff, doctor, advanced neonatal nuBe practitioner, nuBe, social worker, nursing shift leader, medical students | 8:30-10:30am/none | • Overheard conversation during FCR, confidentiality was matter of concern for some. |
| Essential element | Contents | |
|---|---|---|
| Cognition | Description | Dignity and respect [4, 7, 8, 15, 17, 21, 22] |
| Empowerment and reinforcement [4, 5, 15, 17, 21, 22] | ||
| Obstacle | High expectation of family [9, 10, 13] | |
| Negative opinion of medical staff [9, 10, 13, 20] | ||
| Strategy | Leadership [14] | |
| Participation of family [17, 19] | ||
| Continuing support from staff [14, 17, 19, 22] | ||
| Communication | Description | Improving communication [3, 10, 15, 18] |
| Consideration for family [10, 18, 21] | ||
| Sharing care plan [3, 15, 21] | ||
| Obstacle | Language barrier [4, 7, 11, 15, 19] | |
| Poor understanding [10, 11, 15, 17] | ||
| Handing out bad news [9, 12] | ||
| Strategy | Using easy words [4, 15, 22] | |
| Interpreter training [19] | ||
| Mediative participation of nurse [1, 16, 25] | ||
| Understanding of culture [7, 15, 19] | ||
| Collaboration | Description | Supportive physical environment [7, 8, 17, 19, 27] |
| Active participation [2, 17, 19] | ||
| Obstacle | Inconsistent time [1, 2, 5, 9, 19] | |
| Limited space [8, 12] | ||
| Invasion of privacy [9, 10, 17, 24] | ||
| Strategy | Unified care planning [8, 17, 22] | |
| Cooperation of family [5, 10, 17, 23] | ||
| Regulation and guide [9, 14, 17] | ||
| Coaching | Description | Achievement of professionalism [3, 7, 16] |
| Improvement in communication skill [3, 7, 16] | ||
| Obstacle | Negative attitude of staff [9, 10] | |
| Embarrassment of students [7, 16] | ||
| Strategy | Learning goal setting of FCR [3, 16] | |
| Direct observation and experience [3, 16] | ||
| Teaching of therapeutic communication [3, 16] |
RT=respiratory therapist; NNP=neonatal nurse practitioner; HCP=health care practitioner; FCR=family centered rounds.
FCR=family-centered rounds.
