Qualitative Research On The Real Experience Of Transition Nursing For High-risk Infants In Different Groups

Purpose1.To reveal the real experience and the need for the parents of high-risk infants during the transition period;to uncover the current situation of transitional nursing and the experience of NICU and community nurses in using transitional care for high-risk infants;to know the related doctors’ opinions on the transition nursing of high-risk infants.2.In order to construct the nursing mode of hospital-community-family for high-risk infants during transition period and to provide theoretical basis for the scientific management system of high-risk children,this study will start from four different roles to investigating the real experience on the four characters facing the same problem,then analyze the related factors influencing the implementation of high-risk infants and the existing problems in the transition period of high-risk infants through.3.To explore reference for clinical and community nurses to implement more targeted nursing interventions,and to improve the quality of nursing during the transition period.4.This research is a holistic study.It is not limited to the psychological experience of the subjects,but for the different perspectives of the four subjects.MethodIn this research,a qualitative study was used to describe the true experiences and perceptions of different groups related to transition nursing for high-risk infants according to the explanatoryphenomenological characteristics of Phenomenology.Through purposive sampling,16 parents of high-risk infants,12 neonatal clinical nurses,7 community nurses,8 doctors related to were selected and interviewed respectively.To understand the subjects of the true inner thoughts in depth,semi-structured in-depth interviews were used.Through the interaction between the researcher and the respondents,we recorded words of the respondents,observed the behavior of the respondents and carried on the analysis to get a conclusion,collected and analyzed data.Finally,as the basis of Colaizzi’sphenomenological data of 7 step,combined with the use of NVivo 10,the data were collected for encoding,storage,retrieval and non intelligence analysis.ResultPart 2 A qualitative study on the real experience of parents of high-risk infants in transition nursingFour main themes were abstracted and divided into 11 sub themes1.Emotional experienceThe performance pressure from parents of children hospitalized was mainly manifested in the uncertainly in illness,due to limited visitation anxiety;negative emotion after discharge was mainly manifested in fatigue and depression in emotion.But some of them have showed a positive and optimistic attitude.2.Behavior experience of nursing difficulties in transition periodIt was observed seeking help from various channels and two kinds of behaviors including positive coping and negative coping.3.Cognition experienceThe infants’ s parents were lack of knowledge about the transition nursing,cannot correctly treat the outcome of diseases,had little experience in child care and disease care,and were not metedby community care.4.Demand for transitional careParents of infants with diseases had requirements in information,health education,professional care skills,community care and other aspects.Part 3 Qualitative study of clinical nurses’ real experience in transitional nursing careThree main themes were abstracted and divided into 8 sub themes1.Emotional experienceThere were three kinds of emotional experience including negative,positive,and mixed feelings of negative and positive for clinical nurses in nursing of high-risk infants during transition period.Exactly,it was shown a feeling of accomplishment for the child and family,a sense of accomplishment for the child to reach the transition period successfully,a sense of burnout and stress,a contradiction feeling between the expectation of the community care and worrying about post discharge care,and the contradiction between presenting support and assuming unsolicited support.Among them,negativeemotion was influenced by working environment,workload,nurse patient relationship,information security and other factors.2.Cognition experienceThe clinical nursing staff thought that the parents of high-risk infants had little capacity of home care,faced the feeding difficulties,were lack of care ability,and had problems such as lack of knowledge.And they also suggested that the emphases of transitional nursing was on basic nursing,health education,and personalized management etc.3.The main problems of current transition careThe form of nursing was single and the nursing training was insufficient.Part 4 Qualitative study of community nurses’ real experience in transitional nursing careThree main themes were abstracted and divided into 6 sub themes1.Emotional experienceCommunity nurses had a sense of busyness and fear of work,and a sense of ambivalence caused by the difficult of nursing and their own conditions in the management of high-risk infants.2.Cognition experienceIt was relatively insufficient that the relative theory and skills of community nurses in high-risk transition period.And it was also considered that the difficulties of the parents after the discharge of the infants mainly focused on feeding,injury prevention,and disease treatment.3.Behavior experienceCommunity nurses suggested that there were barriers between hospitals and communities after high-risk infants were discharged from hospitals.Part 5 Qualitative study of doctors in relevant departments real experience in transitional nursing careThree main themes were abstracted and divided into 5 sub themes1.Cognition experienceThere was one sidedness and limitation in the understanding of the concept of the transitional nurse among doctors in relevant departments.Moreover,the emphases of transitional nursing concerned by different professional doctors were not the same.Finally,the role of the nurses in the transition period was unclear.The role of the transitional nurse was equivalent to the role of the clinical nurse in the hospital when the child was about to leave the hospital.2.Evaluation of transitional careDoctors in the relevant departments suggested that there were still some shortcomings in the transition period nursing care,which were due to the busy work,insufficient attention,knowledge reserve and related skills etc.3.Ability requirements for nursing staffRelevant department doctors put forward that nurses should be professional and technical ability,communication and coordination ability,lack of clinical thinking and judgment,decision-making ability,and so on.Conclusion1.Although parents of high-risk infants faced great pressure and ideological burden,different parents had diverse sources of stress in different periods.During the transition period,the focus of support for parents was emotional support,parent-child communication,decision support,early education,family support and network support when the infants were hospitalized.And the support after discharge was focused on health education,specialist technologies,early intervention,peer support,and family visit.2.The nursing of transitional period should pay more attention to the form and connotation of nursing.Firstly,setting up individualized discharge plan was the guarantee of transition nursing.Then we should carry out family centered care,pay attention to the development of other transitional nursing services,and establish effective link mechanism between community nursing and clinical nursing.From the point of view of nursing management,we should fully understand the negative emotion experience of nurses and the work requirements of all aspects of nurses,take various measures,such as building an effective information support platform,improving the working environment,rational allocation of human resources,and building a harmonious relationship between nurses and patients,strengthening the training of nurses to meet the needs of staff,to promote the clinical nurses to implement the transition period nursing work in order to improve the quality of nursing services.3.Simple hospital or community model was difficult to meet the needs of high-risk infants in transition care,so we should establish hospital-community-family transitionalnursing model for high-risk infants according to the regional features in order to play their respective advantages,to ensure the community and clinical nursing working together effectively,to support the community care strongly,to pay attention to the contraction of community quality evaluation system,and to improve the compliance of parents during transition nursing period.4.In clinical and community nursing training,the clinical nurses should pay attention to professional skills,to ability of thinking and communication.The management of high-risk infants should conform to the development of the times,change concepts and break the closed management mode.High-risk infants entering the family ward after NICU will be the future trend.