1
|
Grane FM. Down syndrome: Parental experiences of a postnatal diagnosis. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1032-1044. [PMID: 35698902 PMCID: PMC10647884 DOI: 10.1177/17446295221106151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Globally it is estimated that Down syndrome occurs in 1 in 800 live births (Bull 2020). It has also been estimated that the incidence of Down syndrome occurs in 1/444 live births in the Republic of Ireland. Given the prevalence of Down syndrome births in Ireland and the fact that care is provided by the majority of parents at home, this qualitative study aimed to explore the experiences of Irish parents receiving a postnatal diagnosis of Down syndrome. A qualitative research approach was used through semi structured interviews. Eight parents of a baby diagnosed postnatally with Down syndrome participated in this study sharing their stories of their postnatal diagnosis experiences. Five overarching themes emerged using a descriptive thematic analysis; 1. prenatal screening, pregnancy and delivery; 2. how the diagnosis was delivered; 3. setting and emotional experiences; 4. moving on with the postnatal diagnosis and 5. Future recommendations from parents' perspectives. This study highlighted the importance of the need for clinicians to ensure that partners are present at the time of the disclosure, that ample time is allocated and that verbal and written communications are provided to parents using less medical jargon when delivering the postnatal diagnosis of Down syndrome. These reasonable adjustments could alleviate parental anxiety at this critical juncture in their lives. Online resources and support forums were also identified as an integral support for families on discharge from the maternity centres and in the early months and years.
Collapse
Affiliation(s)
- Fiona Mc Grane
- School of Nursing and Midwifery, Queens University, Belfast, Ireland; Department of Paediatrics, Trinity College, Dublin, Ireland; Department of Neurodisability and Developmental Paediatrics, Children’s Health Ireland at Tallaght, Dublin, Ireland
| |
Collapse
|
2
|
Van Riper M, Cosgrove B, Fleming L. Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:324-347. [PMID: 37066798 PMCID: PMC10629249 DOI: 10.1177/10748407231163236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.
Collapse
|
3
|
Betancourt D, Canfield MA, Ethen MK, Shumate C, Drummond-Borg M, Kubenka C, Palacios J, Agopian AJ. Connecting children with birth defects to health and social service programs: A collaboration between the Texas Birth Defects Registry and agency social workers. Birth Defects Res 2023; 115:110-119. [PMID: 36373841 PMCID: PMC11218036 DOI: 10.1002/bdr2.2126] [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: 07/07/2022] [Revised: 10/14/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Timely referral to services for children born with birth defects can improve health outcomes. Birth defects surveillance registries may be a valuable data source for connecting children to health and social service programs. METHODS Population-based, state-wide data from the Texas Birth Defects Registry (TBDR) at the Texas Department of State Health Services (DSHS) were used to connect children 9-18 months old, born with select birth defects with DSHS social workers. The social workers reviewed developmental milestones and referred children and their families to various health and social service programs. We tabulated the proportions of children meeting milestones and referral characteristics by referral program type and type of birth defect. RESULTS Social workers reached 67% (909/1,362) of identified families. Over half of children (54%, 488/909) were not meeting the developmental milestones for their age. Social workers provided over 3,000 program referrals, including referring 21% (194/909) of children to Early Childhood Intervention (ECI) and 28% (257/909) to case management. CONCLUSION Our results illustrate a method of leveraging a birth defects surveillance system for referral services. Given the large number of referrals made, our findings suggest that birth defects registries can be a valuable source of data for referring children to programs.
Collapse
Affiliation(s)
- Dayana Betancourt
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Mary K. Ethen
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Charles Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Margaret Drummond-Borg
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Christina Kubenka
- Regional and Local Health Operations, Texas Department of State Health Services, Austin, Texas, USA
| | | | - A. J. Agopian
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| |
Collapse
|
4
|
Cosgrove B, Knafl K, Van Riper M. A Mixed Methods Analysis of Care Coordination Needs and Desirable Features of an M-Health Application to Support Caregivers of Children With Down Syndrome. J Pediatr Health Care 2023; 37:30-39. [PMID: 36257899 PMCID: PMC9772063 DOI: 10.1016/j.pedhc.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Care coordination is critical for the management of health care needs of children with Down syndrome by encompassing management of health information and linking of providers. This study was designed to identify caregiver and health care provider experiences of care coordination to inform the development of an m-health application. METHOD In this mixed methods study, caregivers completed survey materials addressing the child's health care needs, m-health use, and care coordination experiences. A sample of caregivers and health care providers were interviewed to further understanding. RESULTS Most caregivers reported having a primary health care provider but wanted increased communication and help with care coordination. Interview data identified themes related to care coordination challenges, including information management, information sharing, use of health care guidelines, tracking health data, resources, technology use, previous application use, and coordination of schedules. DISCUSSION Qualitative themes were linked to desired features of an m-health application to aid in development.
Collapse
Affiliation(s)
- Beth Cosgrove
- Beth Cosgrove, Assistant Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Kathleen Knafl, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marcia Van Riper, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Kathleen Knafl
- Beth Cosgrove, Assistant Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Kathleen Knafl, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marcia Van Riper, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Marcia Van Riper
- Beth Cosgrove, Assistant Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Kathleen Knafl, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marcia Van Riper, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
5
|
Kammes RR, Lachmar EM, Douglas SN, Schultheiss H. "Life-altering": A qualitative analysis of social media birth stories from mothers of children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:919-937. [PMID: 35898186 DOI: 10.1177/17446295211025960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Perinatal depression/anxiety is a significant concern for mothers of children with Down syndrome. This is influenced by the way the Down syndrome diagnosis is shared with parents. This study examined social media posts from mothers regarding experiences of the birth of their child with Down syndrome. Forty-three total stories were coded using thematic content analysis. Results highlighted the experiences of mother's who received a diagnosis of Down syndrome for their newborn. Two themes were found with relevant subthemes (i.e., receiving the diagnosis-mother's intuition, confirmation of the diagnosis, influence of potential health concerns, initial emotions, impact of the medical professional; Processing the diagnosis-life-altering, child not meeting expectations, reframing the diagnosis, impact of partner and others). Findings highlight the need for medical personnel to understand this identity-changing process, as perinatal depression/anxiety looks different for these mothers. There is also a need to help them engage in services accordingly.
Collapse
|
6
|
Skelton B, Knafl K, Van Riper M, Fleming L, Swallow V. Care Coordination Needs of Families of Children with Down Syndrome: A Scoping Review to Inform Development of mHealth Applications for Families. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8070558. [PMID: 34209506 PMCID: PMC8304112 DOI: 10.3390/children8070558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 01/13/2023]
Abstract
Care coordination is a critical component of health management aimed at linking care providers and health-information-involved care management. Our intent in this scoping review was to identify care coordination needs of families of children with Down syndrome (DS) and the strategies they used to meet those needs, with the goal of contributing to the evidence base for developing interventions by using an mHealth application (mHealth apps) for these families. Using established guidelines for scoping reviews, we searched five databases, yielding 2149 articles. Following abstract and full-text review, we identified 38 articles meeting our inclusion criteria. Studies incorporated varied in regard to research designs, samples, measures, and analytic approaches, with only one testing an intervention by using mHealth apps. Across studies, data came from 4882 families. Common aspects of families' care coordination needs included communication and information needs and utilization of healthcare resources. Additional themes were identified related to individual, family, and healthcare contextual factors. Authors also reported families' recommendations for desirable characteristics of an mHealth apps that addressed the design of a personal health record, meeting age-specific information needs, and ensuring access to up-to-date information. These results will further the development of mHealth apps that are tailored to the needs of families with a child with DS.
Collapse
Affiliation(s)
- Beth Skelton
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.K.); (M.V.R.); (L.F.)
- Correspondence: ; Tel.: +1-703-725-9194
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.K.); (M.V.R.); (L.F.)
| | - Marcia Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.K.); (M.V.R.); (L.F.)
| | - Louise Fleming
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.K.); (M.V.R.); (L.F.)
| | - Veronica Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK;
| |
Collapse
|
7
|
Family-Centered Management of Birth Defects Diagnosis and Referral in Hospital Settings in Florida. Matern Child Health J 2020; 24:777-786. [DOI: 10.1007/s10995-020-02914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|