Background: Being admitted to a paediatric intensive care unit is a stressful situation for the minor and their family, causing emotional alterations that generate changes in psychological, physical and social aspects, as well as on how to take care of the minor. Aim: The objective of this study was to explore the coping strategies experienced by families who have a minor admitted to the paediatric intensive care unit. Methods: Phenomenological qualitative research study. A sample of 12 participants was obtained from families who had a prolonged admission to the paediatric intensive care unit of a minimum duration of 3 months and who were not in an end-of-life situation. The data analysis was carried out by deepening the study theme during the data collection of the three group interviews conducted. Ethics Statement: This study is part of a predoctoral research project approved by the Ethics Committee of the Vall d'Hebrón University Hospital in Barcelona (approval code: PRAMI-273/2015). Results: Two main categories were identified that emerged from the families' perceptions related admission of their minors to the paediatric intensive care unit and their subsequent adaptation to the new situation: (1) Family self-perception: the families' own perceptions of different feelings and emotions experienced during admission and their interpretations are collected. (2) Role of the caregiver: understood as the families' perceptions of the capacity and willingness to face the new situation in the child's health-disease process; and 10 subcategories: training, comfort, confidence, fear, anxiety, impotence, loneliness, will, adaptability and reference family group. Conclusions: The findings show the need to carry out an integrative approach to families which coexist in a paediatric intensive care unit; through the training of these families to be able to cope with health changes. © 2025 The Author(s). Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Family-centered care (FCC) in pediatric intensive care units (PICUs) arises as a response to the need to humanize medical care, integrating families as active allies in the care of the hospitalized child. This approach seeks to improve the quality of care, the emotional well-being of caregivers, patient adaptation, and prioritizing principles such as respect, communication, participation, and mutual support. This review article highlights the positive impact of FCC on the reduction of stress, anxiety, and hospital stay, as well as on the satisfaction of family members. Strategies such as humanization of the environment through play activities, psychological support, and preparation for transition after PICUs are essential. However, their application is still uneven and faces institutional, organizational, and training barriers. Systematic implementation of the model requires the commitment of the healthcare team, continuous training, and tools to evaluate its real impact. The active involvement of families not only favors the recovery of the child but also improves the perception of the care received, becoming a key indicator of quality in pediatric intensive care.

Background

Healthcare professionals, especially professional nurses, experience various types of moral suffering due to inevitable ethical conflicts. Moral resilience is recently proposed as a resource to address moral suffering. However, there is no tool to measure moral resilience in Chinese professional nurses.

Aim

This study aimed to translate the Rushton Moral Resilience Scale (RMRS) into Chinese and evaluate the psychometric properties of the Chinese version of RMRS (Chi-RMRS).

Research design

A methodological and descriptive research design.

Participants and research context

A convenience sample of 411 Chinese professional nurses was recruited through an online survey platform between February and March 2023.

Ethical considerations

This study was approved by the Research Ethics Committees of the University and hospitals involved.

Results

The RMRS was translated and culturally adapted into a Chinese version. Neither floor nor ceiling effects were observed. The scale-level content validity index (CVI) was 0.922 with the item-level CVIs ranging from 0.833 to 1.000. The explanatory factor analysis (EFA) generated a three-factor structure for the Chi-RMRS, and the confirmatory factor analysis (CFA) demonstrated the three-factor structure with factor loadings for each item ranging from 0.42 to 0.80. The scale-level Cronbach’s α coefficient was 0.811 with each dimension ranging from 0.717 to 0.821, and composite reliability (CR) coefficient for the overall scale was 0.920, with each dimension varying from 0.739 to 0.824. The standard error of measurement (SEM) and smallest detectable change (SDC) were 3.522 and 9.763, respectively.

Discussion

The Chi-RMRS is able to measure moral resilience of Chinese professional nurses, and has good validity and reliability. It can be used in research and practice to determine the level of moral resilience, thus helping nursing managers to monitor the status of Chinese professional nurses, then develop interventions to maintain the well-being of professional nurses and to ensure quality of care.

Introduction: Non-adherence to treatments increases the probability of therapeutic failure and unnecessary complications. Objective: To explore the sources of support perceived by patients with chronic diseases that facilitate adherence to treatment. Method: Qualitative descriptive study with a phenomenological approach, in which eight complex chronic patients were recruited, without distinction of gender or age, residents of Barcelona, and who, after evaluating pharmacological adherence with the Morisky-Green test and the test of Batalla resulted in being adherent to the therapeutic regimen. After which, two open questions were asked that were recorded on an audio device and transcribed verbatim. For data analysis, the method Colaizzi was used. Results: Three thematic groups emerged: 1) Having family support; 2) Understanding of the disease and strategies that facilitate adherence to treatments; and 3) Relationship with reference professionals. Conclusions: The most important source of support perceived by the participants is the family, coinciding with other authors. The finding of this study is that shows medicine and nursing are evidenced as instigators that promote their empowerment and as a recognized source of influence that has allowed their assimilation and training to adopt measures that help them follow the pharmacotherapeutic guidelines.

Introducción: La falta de adherencia a los tratamientos aumenta la probabilidad de fracaso terapéutico y complicaciones innecesarias. Objetivo: Explorar las fuentes de apoyo percibidas por los pacientes con enfermedades crónicas que les facilitan la adherencia a los tratamientos. Método: Estudio cualitativo descriptivo con enfoque fenomenológico, en el que se reclutaron ocho pacientes crónicos complejos, sin distinción de género, ni edad, residentes en Barcelona, y que tras evaluar la adherencia farmacológica con los test de Morisky-Green y el test de Batalla diera como resultado ser adherente al régimen terapéutico. Tras lo cual se efectuaron dos preguntas abiertas que fueron grabadas en un dispositivo de audio y transcritas textualmente. Para el análisis de los datos, se utilizó el método Colaizzi. Resultados: Surgieron tres grupos temáticos: 1) Tener el apoyo familiar; 2) Comprensión de la enfermedad y estrategias que facilitan la adhesión a los tratamientos; y 3) Relación con los profesionales de referencia. Conclusiones: La fuente más importante de apoyo percibida por los participantes, es la familia, coincidiendo con otros autores. El hallazgo de este estudio, es que se evidencia a medicina y enfermería como instigadores que fomentan su empoderamiento y como fuente de influencia reconocida que ha permitido su asimilación y capacitación para adoptar medidas que les ayudan a seguir las pautas farmacoterapéuticas.