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Koneru S, Bhavsar S, Pugazenthi S, Koller GM, Karuparti S, Kann MR, Strahle JM. A qualitative analysis of patient and caregiver experiences with myelomeningocele through online discussion boards. Childs Nerv Syst 2024; 40:1783-1790. [PMID: 38578480 DOI: 10.1007/s00381-024-06331-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Patients and caregivers impacted by myelomeningocele (MMC) use online discussion board forums to create community and share information and concerns about this complex medical condition. We aim to identify the primary concerns expressed on these forums with the goal of understanding gaps in care that may merit investment of resources to improve care received by this population. METHODS Anonymous posts from online MMC discussion boards were compiled using internet search engines. Posts were then analyzed using an adaptation of the Grounded Theory Method, a three-step system involving open, axial, and selective coding of the data by two independent researchers to identify common themes. RESULTS Analysis of 400 posts written primarily by parents (n = 342, 85.5%) and patients (n = 45, 11.25%) yielded three overarching themes: questions surrounding quality of life, a lack of support for mothers of children with MMC, and confusion with a complex healthcare system. Many posts revealed concerns about management and well-being with MMC, including posts discussing symptoms and related conditions (n = 299, 75.75%), treatments (n = 259, 65.75%), and emotional aspects of MMC (n = 146, 36.5%). Additionally, families, especially mothers, felt a lack of support in their roles as caregivers. Finally, in 118 posts (29.5%), patients and families expressed frustration with navigating a complex healthcare system and finding specialists whose opinions they trusted. CONCLUSIONS MMC is a complex medical condition that impacts patients and families in unique ways. Analysis of online discussion board posts identified key themes to be addressed in order to improve the healthcare experiences of those impacted by MMC.
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Affiliation(s)
- Shriya Koneru
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sanjeevani Bhavsar
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sangami Pugazenthi
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Gretchen M Koller
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sasidhar Karuparti
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael R Kann
- Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jennifer M Strahle
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
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Yavari S, Vahidi M, Namdar Areshtanab H, Lotfi M, Jafarzadeh Kohneloo A. The Perceived Informational Needs of Family Caregivers of Children Hospitalized in a Burn Department: A Cross-sectional Study. J Burn Care Res 2024; 45:692-699. [PMID: 38315624 DOI: 10.1093/jbcr/irae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Indexed: 02/07/2024]
Abstract
Children are most vulnerable to burn injuries, and their families are their most important source of support. Therefore, it is necessary to identify the information needs of such parents and support them to help children adapt to the new situation, recover to pre-accident conditions, and reintegrate into school and society. This study aimed to investigate the perceived information needs of family caregivers of children admitted to the burn wards of hospitals. This cross-sectional study was conducted on 200 family caregivers of children admitted to the burn ward of a hospital in Tabriz, Iran. Participants were selected through convenience sampling, and the required data were collected by using questionnaires on socio-demographic information, information needs, information resources, and information acquisition methods. The obtained data were analyzed statistically using descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistics (Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests). Results indicated that the greatest informational need among family caregivers was related to the child's condition. The treatment team was identified as the most important source of information for them. It was found that information should be provided in a comprehensive and understandable manner, while maintaining honesty and human dignity. The study findings contribute to our understanding of the specific information needs of family caregivers in managing the medical care of children with burns. These findings can serve as a basis for interventions and support services aimed at meeting the needs of these families and improving the quality of care for children with burns.
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Affiliation(s)
- Sima Yavari
- Department of Mental Health and Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Maryam Vahidi
- Department of Pediatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Hossein Namdar Areshtanab
- Department of Mental Health and Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Mojgan Lotfi
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz 5138947977, Iran
| | - Aarefeh Jafarzadeh Kohneloo
- Department of Biostatistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz 5165665931, Iran
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Engel M, Brouwer MA, Jansen N, Leget C, Teunissen SCCM, Kars MC. The spiritual dimension of parenting a child with a life-limiting or life-threatening condition: A mixed-methods systematic review. Palliat Med 2023; 37:1303-1325. [PMID: 37461310 PMCID: PMC10548770 DOI: 10.1177/02692163231186173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND Spirituality refers to the dynamic dimension of human life that relates to the way that persons experience meaning, purpose, and transcendence. The complex task of parenting a child with a life-limiting condition may raise existential questions, which are easily overlooked by healthcare professionals. AIM We explored how the spiritual dimension becomes manifest in parents of children in pediatric palliative care. DESIGN A mixed-methods systematic review was conducted, registered in Prospero (2021 CRD42021285318). DATA SOURCES PubMed, CINAHL, Embase, PsycInfo, and Cochrane were searched for articles published between January 1, 2015 and January 1, 2023. We included original empirical studies that reported on spirituality of parents of seriously ill children, from parents' perspectives. RESULTS Sixty-three studies were included: 22 North-American, 19 Asian, 13 European, 9 other. Studies varied in defining spirituality. We identified five different aspects of spirituality: religion, hope, parental identity, personal development, and feeling connected with others. All aspects could function as source of spirituality or cause of spiritual concern. Sources of spirituality helped parents to give meaning to their experiences and made them feel supported. However, parents also reported struggling with spiritual concerns. Several parents highlighted their need for professional support. CONCLUSIONS Although studies vary in defining spirituality, reports on spirituality focus on how parents connect to their faith, others, and themselves as parents. Healthcare professionals can support parents by paying attention to the spiritual process parents are going through. More research is needed into how healthcare professionals can support parents of seriously ill children in this process.
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Affiliation(s)
- Marijanne Engel
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marije A Brouwer
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nienke Jansen
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Carlo Leget
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Saskia CCM Teunissen
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marijke C Kars
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
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Thomas S, Ryan NP, Byrne LK, Hendrieckx C, White V. Unmet supportive care needs of families of children with chronic illness: A systematic review. J Clin Nurs 2023; 32:7101-7124. [PMID: 37353963 DOI: 10.1111/jocn.16806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/12/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND AND AIMS Unmet supportive care needs (SCN) refer to perceived gaps in the support parents want to manage caregiving activities for children with chronic health conditions (CHC) and the support received. This review aims to systematically identify the unmet SCN of families with children living with five common paediatric CHC and characterise the assessment tools used to measure SCN. DESIGN Systematic review methodology with narrative synthesis of data. Reporting followed the PRISMA statement guidelines. METHOD Literature searches were conducted in electronic databases Medline complete, PsycINFO, CINHAL and EMBASE to retrieve relevant articles published between 1990 and July 2022. Eligible studies involved (i) children aged 0-18 years diagnosed with either of cancer, congenital heart disease (CHD), diabetes, asthma, renal disease and (ii) assessment of unmet SCN. Studies involving children with genetic or developmental conditions were excluded. The methodological quality of studies was assessed using JBI assessment tool. RESULTS Of 6223 articles screened, 34 papers were included (25 quantitative, 5 qualitative and 4 mixed design). Most papers explored unmet needs of families with cancer (n = 26). The remaining articles concerned CHD (n = 5), asthma (n = 2) and mixed CHC (n = 1, renal failure, and diabetes). Information (e.g. treatment, lifestyle, etc.) and health care (e.g. emotional support, practical services, etc.) were the most common unmet need domains across health conditions. A variety of methods and need assessments hampered comparisons between studies both across and within CHC. CONCLUSION Irrespective of illness, addressing unmet informational or health care needs may help to optimise outcomes and care for children and families living with common CHC. There was considerable variation in reporting styles, study design and need assessments both within and across conditions. RELEVANCE TO CLINICAL PRACTICE Health care professionals must routinely evaluate the type, quality and quantity of psychoeducation and support that families of children with CHC want and receive. Providing nurses with more effective strategies to assess child and family needs across a broad range of domains may help to increase understanding of where further support for families is required. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution to this study as it involved a systematic review of existing literature.
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Affiliation(s)
- Sangeetha Thomas
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Nicholas P Ryan
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Linda K Byrne
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Christel Hendrieckx
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
- Institute of Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Victoria White
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Smith NDW, Boone DM, Schimmel-Bristow A, Rawlins J, Ellingham L, Sobalvarro S, Faith MA. The mediating role of caregiver hope in relations among caregivers' coping and emotional socialization beliefs in pediatric oncology. J Psychosoc Oncol 2023; 42:271-285. [PMID: 37589450 DOI: 10.1080/07347332.2023.2241855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
The purpose of this study is to identify links between caregiver hope, caregiver coping behaviors, and caregivers' coaching versus dismissing emotion socialization (ES) beliefs in a pediatric cancer sample. Self-report measures. Caregivers (N = 183, 80.20% mothers; 58.5% white; 32.2% Hispanic) of youth undergoing cancer treatment (51.10% hematological malignancy, 15.30% brain or spinal [CNS] tumor, and 25.14% non-CNS solid tumor) for at least six weeks. We used a series of mediation models to examine links between caregivers' coping behaviors, hope, and ES beliefs. Caregivers' hope significantly mediated a positive relation between caregivers' coping and their emotion coaching beliefs, as well as an inverse relation between caregivers' maladaptive coping and their emotion dismissing beliefs. Enhancing caregivers' hope or adaptive coping may support caregivers' beliefs during the pediatric cancer experience. Our findings support future research to evaluate whether enhancing caregivers' hope or adaptive coping may help support evidence-based interventions that target ES beliefs and behaviors.
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Affiliation(s)
- Nicholas David W Smith
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida Health System, Tampa, Florida, USA
| | - Dianna M Boone
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Allison Schimmel-Bristow
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Jonathan Rawlins
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Lauren Ellingham
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Sarah Sobalvarro
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Melissa A Faith
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
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Tsimicalis A, Arora RS, Bagai P, Ranasinghe N, Zubieta M. Patient‐led research and Advocacy Efforts. Cancer Rep (Hoboken) 2022; 5:e1657. [PMID: 35703915 PMCID: PMC9199502 DOI: 10.1002/cnr2.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing and Gerald Bronfman Department of Oncology Faculty of Medicine and Health Sciences, McGill University Quebec Canada
| | | | - Poonam Bagai
- Department of Medical Projects and Social Support Program Cankids Kidscan New Delhi India
| | - Neil Ranasinghe
- SIOP GLobal Health Network, International Society of Paediatric Oncology SIOP Global Health Network London UK
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Nagabushan S, Rao PJ, Ganta R, Chaturvedi S. Building a Foundation for the Care of Children with Cancer in Rural North India. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1742444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractOne of India's biggest challenges is to improve its global standing by increasing healthcare access and outcomes for children with cancer, with inferior overall survivorship compared with its Western counterparts. In conjunction with the government's efforts, private enterprise is crucial in delivering optimal cancer care consistently to its vast and diverse pediatric population, despite existing limitations. This article describes the successful implementation of a value-based, collaborative clinical and research framework by a philanthropic foundation in a rural Northern Indian city to establish and run a local childhood cancer service. It is proof of concept that substantial change could be brought about at grass roots level through resourceful partnerships and reduce prevailing imbalance in pediatric oncology service provision.
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Affiliation(s)
- Sumanth Nagabushan
- Department of Oncology and Bone Marrow Transplant, Perth Children's Hospital, Nedlands, Western Australia
| | - Prashanth J. Rao
- University of New South Wales, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Roopa Ganta
- Department of Head and Neck Oncology, Hanuman Prasad Poddar Cancer Hospital, ChildCan Cancer Foundation, Gorakhpur, Uttar Pradesh, India
| | - Shailja Chaturvedi
- Penrith Psychiatry Clinic, Sydney, New South Wales, Australia
- ChildCan Cancer Foundation, Gorakhpur, Uttar Pradesh, India
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