title: Parental perceptions of transition from intensive care following a child's cardiac surgery.
abstract: BACKGROUND
  Children with congenital heart disease (CHD) who undergo cardiac surgery are hospitalized in a paediatric intensive care unit (PICU) prior to being transferred to a surgical ward. This is a challenging transition for parents of children with CHD who experience high levels of stress related to their child's illness.
  
  
  OBJECTIVE
  To explore parents' perceptions of the transition from the PICU to the surgical ward following their child's cardiac surgery.
  
  
  METHODS
  A qualitative descriptive design using semi-structured interviews was used to explore parents' perceptions of the transfer experience.
  
  
  METHODS
  All parents of children with CHD who met inclusion criteria were approached to participate. Parents were recruited until data saturation was achieved (n = 9). Interviews were audiotaped and transcribed verbatim. Transcripts were coded and thematically analysed concurrently with data collection.
  
  
  RESULTS
  Parents described having mixed feelings of happiness and uncertainty upon learning that their child would be transferred to the surgical ward (theme 1). Parents' uncertainty prompted a need to rally for the upcoming transfer, a process in which the nurse was perceived to play an important role (theme 2). Once transferred to the surgical ward, parents described having to come to terms with a new care experience in which they encountered new role expectations and a challenging new environment (theme 3).
  
  
  CONCLUSIONS
  Emotional reactions to transfer were generally consistent with the literature, although parents in our study did not describe feelings of isolation related to transition as reported elsewhere. We also identified the timing of transfer as a potential source of stress for parents. Parents identified key nursing interventions that helped them to prepare for transfer and come to terms with challenges in their new environment.
  
  
  CONCLUSIONS
  A deeper understanding of parents' transfer experience will facilitate the development of effective nursing interventions to support parents at this time.
authors.affiliation: Department of Nursing, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada.
authors.forename: Katrina A
authors.initials: KA
authors.lastname: Obas
authors.affiliation: Department of Nursing, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Leal
authors.affiliation: Department of Nursing, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.
authors.forename: Michele
authors.initials: M
authors.lastname: Zegray
authors.affiliation: Department of Nursing, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.|Ingram School of Nursing and Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Canada.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Rennick
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010290:Parents / Q000523:psychology*; D010360:Patient Transfer; D036301:Qualitative Research
keywords: Cardiac surgery; Congenital heart disease; Paediatric intensive care; Transfer; Transition