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Background: One in five households has a child with special health care needs (SHCN). Such parents report poorer mental health, greater depressive symptoms, and more restrictions in instrumental activities of daily living (IADL). The quality of mental and physical health of all family members' continuingly declines. Objectives: To evaluate the effects of the current ITK Healing Retreat Week program on familial well-being via introduction of CAM methods through assessment of 1) mood based on affect 2) self-efficacy 3) changes in coping skills 4) growth over time in parents/caregivers who have children with SHCN. Methods: A secondary analysis of data from sixteen parents/caregivers who participated in the ITK Healing Retreat Week July 13-19, 2014. Scores from Positive and Negative Affect Schedule (PANAS) with Serenity subscale, Post Traumatic Growth Inventory (PTGI), and Self-Efficacy Scale (SES) were analyzed using SPSS. Content analysis was performed on open-ended questions from post, three and six-month post retreat questionnaires. Results: Before to immediately after the retreat week there was a statistically significant decrease in negative emotions and increase in positive mood state, ability to feel calm/at peace, relate to others, see new possibilities, and confidence in ability to perform certain care needs (<.001). From post to three-month post retreat the families' confidence in ability to perform certain care needs did not change (<.001), but declined from three to six month post retreat in a statistically significant manner (.044). Content analysis indicated that the biggest benefit for the families was being in a supportive community and having an increase in positive emotional states. At six-months post retreat an increase in receptivity was additionally reported. Conclusion: The ITK Healing Retreat Week program positively impacted families who have children with SHCN in multiple positive ways: increased mood, more confidence, ability to relate better to others and ability to see new possibilities. In effort to make this program generalizable or even replicable, further research needs to be done on the mechanism of change, the structure that creates this change, and how to make such a change sustainable by investigating a new retreat format and alternative research tools, questions, and scales.

Este estudo objetivou identificar na literatura de saúde textos que abordassem aspectos do desenvolvimento de crianças dependentes de ventilador; caracterizar ações de cuidado realizadas ou propostas para a promoção do desenvolvimento dessas crianças, assim como, analisá-las, segundo o referencial de necessidades essenciais da infância proposto por Brazelton e Greenspan (2002). O processo de busca bibliográfica realizado nas bases de dados PubMed, Lilacs, Embase e Cinahl e a leitura dos resumos, possibilitaram a organização dos artigos localizados em 17 grupos temáticos, sendo eleitos para a análise temática de conteúdo somente os que potencialmente continham informações relacionadas às perguntas da pesquisa. O corpus da análise constituiu-se de 35 artigos internacionais que pertenciam aos seguintes grupos temáticos: (1) processo de transição do hospital para casa/comunidade, (2) experiência da criança e da família, (3) interação criança-cuidador, (4) qualidade de vida, (5) proteção e segurança e (6) artigos de revisão. Os critérios para seleção dos documentos e análise pautaram-se no modelo metodológico de análise de Bardin (1977). A análise temática possibilitou a construção de duas categorias sobre o ambiente de cuidados e o desenvolvimento de crianças dependentes de ventilador. A categoria Concepções e práticas que resultam em cuidado desigual agrupou as diferentes concepções sobre infância e dependência de tecnologia ventilatória, e, como conseqüência, os contextos de assistência diversos, ou mesmo, opostos aos quais as crianças em ventilação prolongada foram submetidas. Revelou as ações, pensamentos, experiências e situações que dão existência ao contexto desfavorável ao atendimento das necessidades integrais da criança ou do adolescente dependente de ventilador, assim como aquelas que proporcionam condições mais favoráveis ao desenvolvimento. Sinalizou tanto as oportunidades como os desafios que estavam presentes em todos os cenários de atenção à saúde da criança e estabeleciam-se nas interações entre criança, ambiente e cuidador, resultando em maior ou menor desenvolvimento do potencial de cada criança. A categoria Potenciais de desenvolvimento efetivados versus potenciais de desenvolvimento comprometidos forneceu evidências sobre a competência da criança dependente de ventilador nas tarefas esperadas do desenvolvimento, tais como a socialização e o aprendizado, favorecidas no contexto de cuidados integrais. Ainda, descreveu distúrbios físicos, comportamentais e de desenvolvimento, potencialmente associados a contextos desfavoráveis, marcando os prejuízos a que seu potencial foi submetido. Notaram-se, nos artigos analisados, a preocupação e o empenho dos pais, profissionais e instituições para melhorar o contexto de atenção às necessidades de saúde das crianças dependentes de ventilador. No entanto, destacaram-se as ações que privilegiam a necessidade de proteção física e segurança em detrimento das demais necessidades essenciais para o desenvolvimento / This study aimed to identify in health literature papers that dealt with developmental aspects of ventilator-dependent children, to characterize care actions proposed or given so as to promote these childrens development, and at the same time to analyze such actions according to the Irreducible Needs of Children framework proposed by Brazelton and Greenspan (2002). Search for bibliography in PubMed, Lilacs, Embase and Cinahl and abstract reading made it possible to organize articles in 17 theme groups. However, theme analysis was carried out using only the articles that potentially contained information related to the research questions. Analysis corpus is made up of 35 articles from foreign sources belonging to the following group themes: (1) transition process from hospital to home/community, (2) childs and familys experience, (3) child-care giver interaction, (4) life quality, (5) protection and safely and (6) review articles. Criteria to select documents and analysis followed Bardins (1977) methodological model analysis. Theme analysis enabled the construction of two categories about care settings and ventilator-dependent children. The category Concepts and practices resulting in unequal care encompassed different concepts about childhood and ventilation technology dependence and thus the different or even opposite settings concerning care to which prolonged ventilator-dependent children are submitted. This concept also revealed actions, thoughts, experiences and situations that bring about both the unfavorable setting of providing for the comprehensive needs of ventilator-dependent child or adolescent and those that provide more favorable conditions for their development. It also pointed to opportunities and challenges present in all settings pertaining to the childs health care that are established in the interactions between child, environment and caregiver, resulting in higher or lower level of development of each childs full potential. The category Effective developmental potentials vs. Compromised developmental potentials provided evidences about competences of the ventilator-dependent child to perform developmental tasks, such as socializing and learning, which a comprehensive care setting favors. It also described physical, behavioral and developmental disorders potentially associated with unfavorable settings which compromise the childs and adolescents full potential. The analyzed studies showed that parents, health care professionals and institutions are concerned and making efforts to improve the health care setting of ventilator-dependent children. However, actions aimed at providing physical protection needs and safety are more favored to the detriment of other essential needs for their full development

ObjectiveWe examined the self-reported preparedness of hospitalized adolescents and young adults (AYA) for transition from pediatric to adult-oriented health care with regard to: 1) previous health care transition (HCT) preparation, 2) Self-Determination Theory (SDT) constructs of health self-management autonomy and competence, and 3) their perception of medical knowledge, attitudes, and concerns.MethodsFrom 2013 to 2015, 139 hospitalized patients aged 15 to 21 years completed a 40-item survey on HCT preparation, attitudes, concerns, and perception of knowledge adapted in part from validated questionnaires of the Department of Health and Human Services, Maternal and Child Health Bureau, and SDT Treatment Self-Regulation Study.ResultsFewer than 40% of all respondents endorsed previous HCT preparation such as providers discussing taking responsibility for their health, transitioning to adult providers, and only 20% had discussed future health insurance needs. Of our AYA population, 84% had 1 or more special health care needs. Older patients, female patients, and those with increased HCT preparation scores had increased autonomous motivation, positive attitudes toward transition, yet also increased transition concerns. Higher autonomous motivation and perceived competence correlated with increased perception of knowledge (P = .002, < .001 respectively) and more positive attitudes toward transition planning (P < .001, .054 respectively). Multivariate regression analysis revealed those with increased HCT preparation and those with increased perceived competence had increased perception of knowledge (β = .25, P = .005 and β = .35, P < .001).ConclusionsOur findings suggest that hospitalized AYA received limited education and preparation regarding key elements of HCT to adult-oriented health care. Moreover, those previously exposed to transition preparation efforts were more likely to have motivation and a sense of competence in HCT skills.

Este estudo objetivou identificar na literatura de saúde textos que abordassem aspectos do desenvolvimento de crianças dependentes de ventilador; caracterizar ações de cuidado realizadas ou propostas para a promoção do desenvolvimento dessas crianças, assim como, analisá-las, segundo o referencial de necessidades essenciais da infância proposto por Brazelton e Greenspan (2002). O processo de busca bibliográfica realizado nas bases de dados PubMed, Lilacs, Embase e Cinahl e a leitura dos resumos, possibilitaram a organização dos artigos localizados em 17 grupos temáticos, sendo eleitos para a análise temática de conteúdo somente os que potencialmente continham informações relacionadas às perguntas da pesquisa. O corpus da análise constituiu-se de 35 artigos internacionais que pertenciam aos seguintes grupos temáticos: (1) processo de transição do hospital para casa/comunidade, (2) experiência da criança e da família, (3) interação criança-cuidador, (4) qualidade de vida, (5) proteção e segurança e (6) artigos de revisão. Os critérios para seleção dos documentos e análise pautaram-se no modelo metodológico de análise de Bardin (1977). A análise temática possibilitou a construção de duas categorias sobre o ambiente de cuidados e o desenvolvimento de crianças dependentes de ventilador. A categoria Concepções e práticas que resultam em cuidado desigual agrupou as diferentes concepções sobre infância e dependência de tecnologia ventilatória, e, como conseqüência, os contextos de assistência diversos, ou mesmo, opostos aos quais as crianças em ventilação prolongada foram submetidas. Revelou as ações, pensamentos, experiências e situações que dão existência ao contexto desfavorável ao atendimento das necessidades integrais da criança ou do adolescente dependente de ventilador, assim como aquelas que proporcionam condições mais favoráveis ao desenvolvimento. Sinalizou tanto as oportunidades como os desafios que estavam presentes em todos os cenários de atenção à saúde da criança e estabeleciam-se nas interações entre criança, ambiente e cuidador, resultando em maior ou menor desenvolvimento do potencial de cada criança. A categoria Potenciais de desenvolvimento efetivados versus potenciais de desenvolvimento comprometidos forneceu evidências sobre a competência da criança dependente de ventilador nas tarefas esperadas do desenvolvimento, tais como a socialização e o aprendizado, favorecidas no contexto de cuidados integrais. Ainda, descreveu distúrbios físicos, comportamentais e de desenvolvimento, potencialmente associados a contextos desfavoráveis, marcando os prejuízos a que seu potencial foi submetido. Notaram-se, nos artigos analisados, a preocupação e o empenho dos pais, profissionais e instituições para melhorar o contexto de atenção às necessidades de saúde das crianças dependentes de ventilador. No entanto, destacaram-se as ações que privilegiam a necessidade de proteção física e segurança em detrimento das demais necessidades essenciais para o desenvolvimento / This study aimed to identify in health literature papers that dealt with developmental aspects of ventilator-dependent children, to characterize care actions proposed or given so as to promote these childrens development, and at the same time to analyze such actions according to the Irreducible Needs of Children framework proposed by Brazelton and Greenspan (2002). Search for bibliography in PubMed, Lilacs, Embase and Cinahl and abstract reading made it possible to organize articles in 17 theme groups. However, theme analysis was carried out using only the articles that potentially contained information related to the research questions. Analysis corpus is made up of 35 articles from foreign sources belonging to the following group themes: (1) transition process from hospital to home/community, (2) childs and familys experience, (3) child-care giver interaction, (4) life quality, (5) protection and safely and (6) review articles. Criteria to select documents and analysis followed Bardins (1977) methodological model analysis. Theme analysis enabled the construction of two categories about care settings and ventilator-dependent children. The category Concepts and practices resulting in unequal care encompassed different concepts about childhood and ventilation technology dependence and thus the different or even opposite settings concerning care to which prolonged ventilator-dependent children are submitted. This concept also revealed actions, thoughts, experiences and situations that bring about both the unfavorable setting of providing for the comprehensive needs of ventilator-dependent child or adolescent and those that provide more favorable conditions for their development. It also pointed to opportunities and challenges present in all settings pertaining to the childs health care that are established in the interactions between child, environment and caregiver, resulting in higher or lower level of development of each childs full potential. The category Effective developmental potentials vs. Compromised developmental potentials provided evidences about competences of the ventilator-dependent child to perform developmental tasks, such as socializing and learning, which a comprehensive care setting favors. It also described physical, behavioral and developmental disorders potentially associated with unfavorable settings which compromise the childs and adolescents full potential. The analyzed studies showed that parents, health care professionals and institutions are concerned and making efforts to improve the health care setting of ventilator-dependent children. However, actions aimed at providing physical protection needs and safety are more favored to the detriment of other essential needs for their full development

Background: Every year in the United States approximately half a million youth with special health care needs (SHCN) turn 18. Little is known about how this population fares during the transition to adulthood. Purpose: To examine transitions to adulthood for young adults with SHCN. Methods: Using data from two national longitudinal surveys: the Panel Study of Income Dynamics and the Survey of Adult Transitions and Health, I built linear and logistic regression models to evaluate the relationship between having a history of SHCN during childhood and key transitional outcomes during young adulthood (e.g., mental health status, educational attainment, employment, financial independence and subjective indicators of adulthood). A second set of logistic models examined associations between hypothesized risk and protective factors during childhood (e.g. family financial burden, care in a medical home and access to adequate insurance) and physical health outcomes during young adulthood for youth with SHCN. Multivariate models were adjusted for key confounders. Results: The majority of youth with a history of SHCN were doing well during the transition to adulthood. That said, compared to young adults without a history of SHCN, young adults with a history of SHCN were in significantly worse mental health (adjusted OR of experiencing a non-specific psychological disorder 3.90, 95% CI 1.78-8.53) and had significantly lower odds of graduating from high school (adjusted OR 0.55, 95% CI 0.32-0.96), attending college (adjusted OR 0.61, 95% CI 0.38-0.96), and receiving financial assistance from their families (adjusted OR 0.56, 95% CI 0.38-0.83). Amongst young adults with a history of SHCN, family financial burden during childhood significantly decreased the odds of being in good physical health during the transition to adulthood. There was limited evidence that receipt of care in a medical home or access to adequate insurance during childhood increased the odds of being in good physical health for young adults with a history of SHCN. Conclusions: These findings have important policy implications for programs serving youth with SHCN. Specifically, mental health and educational services may need to be expanded and more emphasis placed on addressing the non-medical determinants of health, like family financial burden.

Made available in DSpace on 2016-01-26T12:51:44Z (GMT). No. of bitstreams: 1 josivazdelimapaschoal_dissert.pdf: 1330092 bytes, checksum: d120bcabf80ff477cd1a550207e2b2b9 (MD5) Previous issue date: 2012-04-09 / Introduction: The increasing complexity of nursing work demands fast and accurate decision-making skills about patients care needs. Assessment is one of the tools professional use to identify these needs and guides care actions. Aims: This descriptive and exploratory study aimed to: 1. analyze agreement and disagreement between assessments made through clinical reasoning and application of a patient classification instrument and, 2. investigate the association between the agreement and the professionals personal (age) and professional characteristics (function, professional experience and time on the job, professional and academic qualification, working at an Intensive Care Unit or another hospitalization unit). Method: 105 adult patients were investigated, hospitalized at a teaching hospital in the interior of São Paulo State between May and January 2011). Each patient was assessed by three nurses active at six hospitalization units or not and using a classification instrument or not. To verify the inter-rater agreement level, weighted kappa statistics were used 95% CI and, to investigate the association between agreement and personal characteristics, the Bootstrap method. Results: Inter-rater agreement indicated: kw 0.87 very good level (instrument x internal evaluator), Kw 0.78 (instrument x external evaluator) and Kw 0.76 (among evaluators), considered a good level. The main care areas the nurses identified were Research and Monitoring, Locomotion and Activity and Bodily Care and Eliminations. The mean number of care areas identified in the assessments by the internal evaluator was 2.8 (1.8), against 3.5 (1.6) by the external evaluator. The personal and professional characteristics that influenced inter-rater agreement were: age &#8805; 30 years 0.73(0.08), professional experience &#8805; 5 years 0.73 (0.08), professional qualification 0.83 (0.08) and working at an Intensive Care Unit 0.80 (0.11) for the internal evaluator. As for the external evaluator, the following results were observed: academic qualification 0.19 (0.26) and time on the job &#8805; 2 years 0.14 (0.13). Conclusion: The assessments based on clinical reasoning and the classification instrument similarly identified patients nurse care demand and care categories (care profile), although many areas were not addressed in the nurses clinical assessment. / Introdução: A crescente complexidade do trabalho do enfermeiro demanda habilidade de tomada de decisões rápidas e acuradas sobre as necessidades cuidativas dos pacientes. A avaliação é uma das ferramentas utilizadas pelos profissionais para a identificação dessas necessidades e norteia as ações assistenciais. Objetivos: Este estudo descritivo exploratório teve por objetivos: 1. analisar a concordância e discordância entre as avaliações realizadas por raciocínio clínico e aplicação de instrumento de classificação de pacientes e, 2. investigar a associação entre a concordância e características pessoais (idade) e profissionais dos avaliadores (função, tempo de atuação profissional e na unidade, qualificação profissional e acadêmica, ser profissional atuante em Unidade de Terapia Intensiva ou em outra unidade de internação). Casuística e Método: Foram investigados 105 pacientes adultos internados em um hospital de ensino do interior do Estado de São Paulo no período de maio a janeiro de 2011. Cada paciente foi avaliado por três enfermeiros alocados dentro e fora de seis unidades de internação com e sem instrumento de classificação. Para aferição do grau de concordância entre as avaliações foi utilizada a estatística Kappa ponderado IC 95% e, para investigar a associação entre a concordância e as características pessoais, o método Bootstrap. Resultados: A concordância entre as avaliações apontou: kw 0,87- nível muito bom (instrumento x avaliador interno), Kw 0,78 (instrumento x avaliador externo) e Kw 0,76 (entre os avaliadores), consideradas nível bom. As principais áreas de cuidados identificadas pelos enfermeiros foram Investigação e Monitoramento, Locomoção e Atividade e Cuidado Corporal e Eliminações. A média de áreas de cuidados identificadas nas avaliações realizadas pelo avaliador interno foi de 2,8 (1,8) e do externo de 3,5 (1,6). As características pessoais e profissionais que apresentaram influência na concordância entre as avaliações foram: idade &#8805; 30 anos - 0,73(0,08), tempo de atuação profissional &#8805; 5 anos - 0,73 (0,08), ter qualificação profissional - 0,83 (0,08) e estar lotado em Unidade de Terapia Intensiva 0,80 (0,11) para o avaliador interno. Em relação ao avaliador externo observaram-se os seguintes resultados: ter qualificação acadêmica - 0,19 (0,26) e tempo de atuação na unidade &#8805; 2 anos - 0,14 (0,13). Conclusão: As avaliações conduzidas através de raciocínio clínico e mediante instrumento de classificação identificaram de forma similar a demanda de atenção dos pacientes em relação à enfermagem e categorias de cuidados (perfil assistencial) embora muitas áreas não tenham sido contempladas na avaliação clínica dos enfermeiros.

Background: There is considerable evidence that physicians lack sufficient training in facilitating transition from pediatric to adult care systems for adolescents and young adults (A/YA). While several primary care residency programs have introduced health care transition (HCT) curricula in recent years, there are few studies that assess the effectiveness of HCT teaching models. Purpose: To assess the impact of a residency education program that uses electronic health records (EHR) and other methods to teach residents how to prepare A/YA for transition to adult care. Methods: In a mixed methods, quasi-experimental research design, quantitative methods were used to measure change in knowledge, confidence and experience among 67 Pediatrics and Med-Peds residents who participated in the program. All residents and a comparison group were invited to complete a 35-item pre/post-survey; a retrospective chart review provided documentation of age-specific HCT preparation tasks completed by residents during well visits for A/YA aged 12-21. Descriptive and correlational analyses were conducted to compare differences between resident and control test scores for 5 outcome variables, and to measure resident utilization of the HCT tool in the EHR. Using the Reach Effectiveness-Adoption Implementation Maintenance (RE-AIM) evaluation model as a guide, semi-structured interviews were conducted concurrently with residents and faculty to assess program acceptability, feasibility, and other important attributes. Interviews were transcribed and analyzed using a constant comparative, iterative process. Results: Survey results showed residents (11 matched pairs) scored significantly higher than controls (13 matched pairs) in 2 of 5 outcomes: exposure to HCT learning activities (p=.0005) and confidence in providing primary care for YSHCN (p=.0377). Overall utilization of the EHR tool among 51 residents was 52.8% (57 of 108 patient visits). In interviews conducted with 16 residents and 6 faculty, both groups said that HCT training is a highly relevant need. Residents said they had little knowledge or experience in HCT prior to the intervention but felt more confident in their abilities afterwards. The HCT tool in the EHR was the only intervention element among multiple modalities that reached all study participants, with more than 80% of residents interviewed reporting they used the HCT tool "usually" or "always." Factors that influenced program adoption included accessibility of educational materials, ease of use, time constraints, patient age and health condition, and attending physicians' enforcement of the protocol. Conclusion: This study contributes to the body of knowledge concerning HCT by increasing our understanding of ways to effectively educate residents about transition preparation. Results show a positive intervention effect on selected dimensions of resident knowledge, confidence, and practice in HCT, highlighting program strengths and weaknesses. The program is distinctive in educating residents to prepare all A/YA for HCT, as recommended by major medical associations for pediatric and adult care physicians, and in its use of the EHR as a primary teaching tool, a consideration for reducing time-intensive didactic instruction. It provides a model that can be adapted by other residency and provider training programs, and suggests a need to integrate acquisition of health care self-management skills more broadly in child and adolescent health preventive care tools and policies.

It is estimated that one out of every five household with children in the United States includes a Child with Special Health Care Needs (CSHCN). Families of CSHCN face many challenges including financial burdens beyond that of other families and difficulty accessing much needed pediatric specialty care. Telemedicine provides a potential solution or, at the least, an alternative to the traditional system of care, for health care providers and communities to address access and financial concerns of families of CSHCN. A quasi-experimental research design was used in this study to examine the differences in cost, caring, and family-centered care in relation to pediatric specialty services utilizing telemedicine technology compared to traditional face-to-face care. The study sample included a convenience sample of 222 parents/ guardians of CSHCN residing in rural, remote and medically underserved areas of Southeast Florida enrolled in the Children's Medical Services (CMS) program. The sample was comprised of two study groups: traditional (n = 110) which included families receiving traditional face-to-face pediatric specialty care; and the telemedicine group (n = 112) which included families who have received telemedicine visits along with traditional face-to-face pediatric specialty care. Measures of cost, caring, and family-centered care were obtained using three instruments including a Family Cost Survey, Caring Professional Scale (CPS), and Measure of Processes of Care- 20 Item Scale (MPOC-20). Results indicated that there were no significant differences in family costs when telemedicine was available locally compared to traditional face-to-face care in the local community. Family costs were anticipated to be significantly higher if telemedicine was not available in their communities. There were no differences in the families' perceptions of care as caring for the telemedicine and traditional groups. Results indicated significant differences between the groups in regards to family-centered care, with telemedicine group parents/ guardians reporting more positive perceptions of the system of care as family-centered compared to families receiving traditional face-to-face pediatric specialty care. These results together underscore the importance of assuring and facilitating access to pediatric specialty care for CSHCN and their families by further reducing their burdens and costs. The use of innovative systems of care such as telemedicine has promise to promote caring, family-centered systems of care in their home communities. Future research is recommended to further examine nursing roles and interventions in telemedicine programs, measurement tools, and family perceptions of systems of care across different populations.

Children with complex health problems who are dependent upon medical technology require frequent hospitalizations, during which parents must make difficult decisions regarding their child’s care. Although principles of “family-centred care” have been widely adopted by paediatric hospitals, studies indicate that many parents are dissatisfied with their roles in decisions about their child’s care. Pierre Bourdieu’s Logic of Practice, specifically his concepts of field, capital, and habitus, as they relate to cultural and symbolic capital within the field of pediatric medicine, were used to guide the design of a parent briefing intervention aimed at improving parents’ satisfaction with decision making. Briefings were conducted during daily hospital rounds. Physicians and nurses were asked to sit while using a checklist as a communication guide. A two-part study was conducted to determine feasibility of a randomized controlled trial of a parent briefing. One component was a psychometric evaluation of an instrument to measure parents’ satisfaction with decision making. The other was a phase I single group, post-test study of the parent briefing. Eighty-two parents of children admitted to an in-patient unit in a large metropolitan pediatric health centre, with an expected length of stay ≥ 3 days, completed the Family Satisfaction with Decision Making (FS/DM) subscale and the Decisional Conflict Scale (DCS) prior to discharge. A subgroup of parents participated in the parent briefing study. The Cronbach’s alpha reliability coefficient of the FS/DM was 0.87, and it was inversely correlated with the DCS (r2= -0.635, p<0.0001). Eighteen physicians, 25 nurses, and 31 parents participated in the phase I trial of the briefing intervention. Sixty-eight out of an expected 93 briefings were carried out as per study protocol. Nineteen parents did not receive the required “dose” of the study intervention. Mean time to complete the intervention was 11.9 minutes (SD = 6.9). Parents and nurses rated the acceptability and usefulness of the intervention favourably, whereas physicians’ ratings were mixed. The FS/DM instrument is a suitable primary outcome measure for an RCT. However, more work needs to be done, to ensure the feasibility of the intervention, including more intensive clinician training.