CHILDREN WITH TRACHEOSTOMIES AND THE HOME ENVIRONMENT.

Description

This study was designed to describe the environments of children with tracheostomies cared for in the home. This descriptive exploratory study was based on an ecological framework, encompassing the home environment, the family, the mother-child interaction, and the child's sleep/activity patterns. A convenience sample of 27 families with children under the age of three years participated in the study. The study instruments included: the Feetham Family Functioning Survey (FFFS) and Family APGAR, the Caldwell Home Inventory for Measurement of the Environment (HOME), the Nursing Child Assessment Teaching Scale (NCATS), and A Sleep/Activity record which was kept for seven days by the child's caretakers. Descriptive data were reported using means and standard deviations. Relationships among environmental variables were determined by Pearson correlation. One way repeated measures analyses of variance were done to examine the differences on the subscale items for the measures of mother-child interaction. Subgroups of families and children emerged as the data were analyzed. These subgroups included single and two parent families, families who did or did not have nursing care in the home, children with or without prolonged hospital stays, and children who had premature or term birth. The subgroups were compared using t-tests for independent means. Significant differences were found on the subscales; opportunities for variety in stimulation for the HOME, sensitivity to cues, response to distress, and clarity of cues for the HOME and NCATS. Isolated significant findings were also found among the total sample and the subgroups for subscales of the HOME and FFFS. Many children did establish stable patterns of sleep, activity, and tracheostomy care. The longer the time that the child had a tracheostomy the more organized was the home environment. The findings of this study indicate that families are able to provide a growth fostering environment for their child with a tracheostomy. Implications for nursing and recommendations are included.

Subjects