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LeGrow K, Cohen E, Espin S. Mother-nurse decision making practices for children with complex health care needs receiving homecare services: A qualitative descriptive study. Child Care Health Dev 2022; 48:605-612. [PMID: 35043429 DOI: 10.1111/cch.12966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 11/08/2021] [Accepted: 01/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many children with complex health care needs face chronic health and developmental issues that may include functional impairments, neurodevelopmental disabilities, and lifelong dependence on medical technology. Providing the necessary care and services for this unique group of children and youth places substantial demands on the health care system. Much of the focus on improvements has been in acute care settings even though homecare accounts for the largest proportion of health care utilization among children with complex health care needs. While parents assume great responsibility for their child's care at home, they indicate that the balance of power between themselves and their health care providers does not change when care shifts from the hospital to home. Given the expanding role of paediatric homecare and parents' concerns of their role in decisions related to their child's care, it is imperative to explore these practices in this unique setting. PURPOSE The purpose of this work is to explore mother-nurse decision making practices for children with complex health care needs receiving health care services in their home. METHODS A qualitative descriptive study design was used. Five mothers and five nurses participated. Twenty-six home observations with accompanying analytical memos and 10 semistructured interviews were conducted with five mothers and five homecare nurses. Thematic analysis of study data, using an iterative process, identified major themes. FINDINGS Data revealed the complex and relational nature of mother-nurse decision making practices within the home setting. Three major themes were identified: (1) core areas of decision making, (2) a dynamic and collaborative process, and (3) centrality of relationships. CONCLUSIONS Study findings enhanced our understanding of how decision making and relational care practices take place in the home for children with complex health care needs receiving homecare services, which has implications for child and family health.
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Affiliation(s)
- Karen LeGrow
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada
| | - Eyal Cohen
- Complex Care Program, Hospital for Sick Children, Professor, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Edward S. H. Leong Centre for Health Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sherry Espin
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada
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Carandang RR, Sakamoto JL, Kunieda MK, Shibanuma A, Yarotskaya E, Basargina M, Jimba M. Effects of the maternal and child health handbook and other home-based records on mothers' non-health outcomes: a systematic review. BMJ Open 2022; 12:e058155. [PMID: 35728908 PMCID: PMC9214383 DOI: 10.1136/bmjopen-2021-058155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/17/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This review aimed to investigate the effects of the maternal and child health (MCH) handbook and other home-based records on mothers' non-health outcomes. DESIGN Systematic review. DATA SOURCES PubMed, Web of Science, CINAHL, Academic Search Complete, PsycArticles, PsycINFO, SocINDEX, CENTRAL, NHS EED, HTA, DARE, Ichuushi and J-STAGE through 26 March 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Original research articles examining home-based records and mothers' non-health outcomes published in English or Japanese across various study designs. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted relevant data and assessed the risk of bias. We assessed the certainty of evidence for each study using the Grading of Recommendations Assessment, Development, and Evaluation approach. Due to the heterogeneity of the included studies, we conducted a narrative synthesis of their findings. RESULTS Of the 4199 articles identified, we included 47 articles (20 in Japanese) in the review. Among the different types of home-based records, only the MCH handbook provided essential information about the mother-child relationship, and its use facilitated the mother-child bonding process. Mothers reported generally feeling satisfied with the use of home-based records; although their satisfaction with health services was influenced by healthcare providers' level of commitment to using these records. While home-based records positively affected communication within the household, we observed mixed effects on communication between mothers/caregivers and healthcare providers. Barriers to effective communication included a lack of satisfactory explanations regarding the use of home-based records and personalised guidance from healthcare providers. These records were also inconsistently used across different health facilities and professionals. CONCLUSIONS The MCH handbook fostered the mother-child bond. Mothers were generally satisfied with the use of home-based records, but their engagement depended on how these records were communicated and used by healthcare providers. Additional measures are necessary to ensure the implementation and effective use of home-based records. PROSPERO REGISTRATION NUMBER CRD42020166545.
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Affiliation(s)
- Rogie Royce Carandang
- Department of Community and Global Health, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Public Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Jennifer Lisa Sakamoto
- Department of Community and Global Health, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Mika Kondo Kunieda
- Department of Community and Global Health, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Faculty of Policy Management, Keio University, Fujisawa-shi, Kanagawa, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ekaterina Yarotskaya
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Milana Basargina
- Department of Neonatal Pathology, National Medical Research Center for Children's Health, Moscow, Russian Federation
| | - Masamine Jimba
- Department of Community and Global Health, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
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LeGrow K, Cohen E, Espin S. Relational Aspects of Parent and Home Health Care Provider Care Practices for Children With Complex Care Needs Receiving Health Care Services in the Home: A Narrative Review. Acad Pediatr 2022; 22:196-202. [PMID: 34403801 DOI: 10.1016/j.acap.2021.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/16/2021] [Accepted: 08/10/2021] [Indexed: 11/01/2022]
Abstract
Children with medical complexity have ongoing health needs that may require dependence on medical technologies. While hospital admissions are an important focus of care delivery for these children, a majority of the time they are cared for in their own homes. Parents' report feeling overwhelmed and stressed by the scope of their responsibilities, but they become sophisticated care providers and assume greater authority when providing their children's care at home. Communication, decision-making, and dealing with conflict with members of health care teams have been central concerns in parents' reports of their home health care experiences. The objective is to review literature on relational aspects of parent and home health care provider care practices for children with medical complexity receiving home health care services. A narrative review was conducted. A search of MEDLINE, EMBASE, EBM Reviews, PsychINFO, ERIC, and CINAHL databases for English language studies published since database inception was carried out. Eligible studies focused on relational aspects of parent and home health care provider care practices for children with medical complexity receiving home health care services. Nine empirical studies were selected for this review. Literature describes parents' and providers' experiences managing a child with medical complexity in the home and the effects for the family and the parent-health care provider relationship. Parents want to be actively involved in all aspects of care that affects their child and ultimately their family. Further investigation is needed to better understand relational aspects of parent-home health care provider care practices to support child/family health and well-being in the home setting.
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Affiliation(s)
- Karen LeGrow
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University (K LeGrow and S Espin), Toronto, Ontario, Canada.
| | - Eyal Cohen
- Complex Care Program, Child Health Evaluative Sciences, Hospital for Sick Children, Edwin S.H. Leong Centre for Healthy Children, Department of Pediatrics, University of Toronto (E Cohen), Toronto, Ontario, Canada
| | - Sherry Espin
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University (K LeGrow and S Espin), Toronto, Ontario, Canada
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Aasen L, Johannessen AK, Ruud Knutsen I, Werner A. The work of nurses to provide good and safe services to children receiving hospital-at-home: A qualitative interview study from the perspectives of hospital nurses and physicians. J Clin Nurs 2021; 31:2495-2506. [PMID: 34570945 DOI: 10.1111/jocn.16062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
AIM To explore and describe the work performed by the nurses providing hospital-at-home care to children and their families from the perspectives of hospital nurses and physicians. BACKGROUND To reduce capacity pressure on hospitals, various ambulatory services combining hospital and home treatment have emerged. Studies have shown that children and their families are satisfied with hospital-at-home when the parents experienced the professionals possessed the necessary competences. Knowledge is limited about nurses and physicians' perspectives on the work performed and competence needed when children receive hospital treatment in the family's home. DESIGN A qualitative descriptive design with semi-structured interviews was used. Sixteen nurses and physicians from two hospitals in Norway working in hospital-at-home for children were recruited to interview. Data were analysed using systematic text condensation. In preparing the manuscript, we applied the COREQ guidelines. The theory on 'expert nursing' supported the discussion of results. RESULTS We identified three categories through analysis; building a trustful relationship with the family and the sick child; performing essential skills in paediatric nursing care in hospital-at-home; and nurses serving as the 'hub' between the different parties. CONCLUSION The results demonstrate the complexity of the work performed by hospital nurses when children received hospital-at-home. Building a trustful relationship and alliance with the child and the family formed the cornerstone of accomplishing good and safe paediatric care. The nurses became a coordinating and collaborating 'hub' for actors involved, taking care of patient safety on a daily basis. RELEVANCE TO CLINICAL PRACTICE The way the nurses approached the children and their families, was the core element of the paediatric nursing expertise and important for the service quality and patient safety. The importance of building a trustful relationship needs to be more acknowledged, and the services would benefit to organise this through continuity of care.
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Affiliation(s)
- Line Aasen
- Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anne-Kari Johannessen
- Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Ingrid Ruud Knutsen
- Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anne Werner
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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Chutiyami M, Wyver S, Amin J. Is Parent Engagement with a Child Health Home-Based Record Associated with Parents Perceived Attitude towards Health Professionals and Satisfaction with the Record? A Cross-Sectional Survey of Parents in New South Wales, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155520. [PMID: 32751668 PMCID: PMC7432040 DOI: 10.3390/ijerph17155520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 11/16/2022]
Abstract
We examined parent views of health professionals and satisfaction toward use of a child health home-based record and the influence on parent engagement with the record. A cross-sectional survey of 202 parents was conducted across New South Wales (NSW), Australia. Bivariate and multivariate logistic regressions were conducted to identify predictors of parent engagement with the record book using odds ratio (OR) at 95% confidence interval (CI) and 0.05 significance level. Parents reported utilizing the record book regularly for routine health checks (63.4%), reading the record (37.2%), and writing information (40.1%). The majority of parents (91.6%) were satisfied with the record. Parents perceived nurses/midwives as most likely to use/refer to the record (59.4%) compared to pediatricians (34.1%), general practitioners (GP) (33.7%), or other professionals (7.9%). Parents were less likely to read the record book if they perceived the GP to have a lower commitment (Adjusted OR = 0.636, 95% CI 0.429–0.942). Parents who perceived nurses/midwives’ willingness to use/refer to the record were more likely to take the record book for routine checks (Adjusted OR = 0.728, 95% CI 0.536–0.989). Both parent perceived professionals’ attitude and satisfaction significantly influenced information input in the home-based record. The results indicate that improvements in parent engagement with a child health home-based record is strongly associated with health professionals’ commitment to use/refer to the record during consultations/checks.
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Affiliation(s)
- Muhammad Chutiyami
- Faculty of Human Sciences, Macquarie University, Sydney 2109, Australia;
- Correspondence:
| | - Shirley Wyver
- Faculty of Human Sciences, Macquarie University, Sydney 2109, Australia;
| | - Janaki Amin
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney 2109, Australia;
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Samuelsson M, Wennick A. An Exploratory Study of the Everyday Life of Swedish Children on Home Parenteral Nutrition and Their Families. J Pediatr Nurs 2020; 52:e84-e89. [PMID: 32044196 DOI: 10.1016/j.pedn.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Improved survival rates of preterm infants and critically ill children has resulted in an increasing number of children growing up on HPN. However, how the child and the child's family experience HPN is sparsely studied. PURPOSE Thus, this study aims to elucidate the everyday life experiences of children with intestinal failure on HPN from the perspective of the child and the child's family. DESIGN AND METHODS We used a qualitative inductive study that included semi-structured interviews from 13 family members in six families, and we analyzed them using content analysis. RESULTS The family members' experiences had an overall theme, having to take on a full-time (nursing) responsibility, and fell into three categories: family restrictions, family adjustments, and family uncertainty. CONCLUSION Families on HPN had to shoulder an in-home round-the-clock (nursing) responsibility that came with a daily logistical challenge. The complexity of HPN complicates the possibility of external support, so the families choose to keep the burden within the family; consequently single-parent households have limited possibilities for relief and recovery. PRACTICE IMPLICATIONS To minimize the intrusion of the treatment in family's everyday life and, thereby, support the families, health care professionals might find it beneficial to obtain an inventory of the everyday life needs of each specific family when first introducing HPN. Further, by encouraging close kin to participate in the HPN education these families may be unburdened some more. In addition, it is essential that professionals follow the families protocol for management and not the other way around.
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Affiliation(s)
- Maria Samuelsson
- Skåne University Hospital, Malmö, Sweden; Department of Pediatrics, Malmö, Sweden; Malmö University, Faculty of Health and Society, Department of Care Science, Malmö, Sweden.
| | - Anne Wennick
- Malmö University, Faculty of Health and Society, Department of Care Science, Malmö, Sweden
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Church K, Campbell D, Halliday V. Impact of hospitalisation of children on parental dietary habits: a qualitative study. Arch Dis Child 2019; 104:967-971. [PMID: 31079071 DOI: 10.1136/archdischild-2018-316280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore how prolonged hospitalisation of a child with a neurological condition influences the dietary habits of parents, taking account of their attitudes and perceptions of this experience. DESIGN Qualitative study using semi-structured interviews and inductive thematic analysis. SUBJECTS Fifteen parents of children (aged 2-16 years) with a neurological condition resulting in prolonged periods of hospitalisation were recruited. RESULTS Mothers (n=13) and fathers (n=2) who were interviewed experienced frequent hospital visits brought about by their child's condition, or associated medical complications. Dietary habits of parents were affected throughout their time in hospital. Three key themes were identified relating to how hospitalisation influenced this: (1) access to food, (2) emotional and physical well-being and (3) impact on eating patterns and food choice. CONCLUSIONS Findings from this study suggest that parents in these circumstances need to be better supported within the hospital setting as a number of barriers exist when it comes to accessing food in hospital and making healthy food choices. Additionally, having a child in hospital has a considerable effect on a parent's emotional well-being, which further impacts on their dietary habits. The long-term physical and mental health implications of this may influence their ability to care for the sick child.
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Affiliation(s)
- Kirstyn Church
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - David Campbell
- Gastroenterology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Vanessa Halliday
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Petit-Steeghs V, Pittens CACM, Barnhoorn MJM, Broerse JEW. "The challenge of managing insecurities": Parents' experiences with the care for their child with congenital diaphragmatic hernia. J SPEC PEDIATR NURS 2019; 24:e12247. [PMID: 31025826 PMCID: PMC6767506 DOI: 10.1111/jspn.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/20/2019] [Accepted: 03/20/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE Last decennia remarkable advances have been made in decreasing the mortality rate of children with congenital diaphragmatic hernia (CDH), resulting in a relatively growing patient group with long-term complications and complex care needs. These consequences have a huge impact on the quality of life of both children and their families. To provide practical recommendations for improving the quality of care for this patient group, the present study sought to obtain insights into the experiences and needs of parents with a child with CDH. DESIGN AND METHODS A qualitative study was conducted on the experiences and needs of parents with a child with CDH living in the Netherlands. Data was obtained by means of a discourse analyses of 17 weblogs written by parents and three online focus groups with 8-12 parents per group (n = 29). The data was analysed thematically and structured by using the model of Lawoko (2007) on parental satisfaction with care. RESULTS Although parents were generally satisfied with the delivered care, they frequently encountered challenges in managing insecurities throughout the care process. Besides the unpredictable disease progress, insecurities were exacerbated by: (a) limited specialized knowledge of long-term consequences, (b) logistical problems, and (c) nontransparent communication. Providing security through, for instance, a clear care plan and by engaging parents in the decision-making process helped them feel more in control. PRACTICE IMPLICATIONS This study showed that parents' main challenge was to manage insecurities. Creating securities by providing a care plan and involving parents in the decision-making process helped parents to feel more in control. To improve quality of care for children with CDH, future measures should, therefore, focus on reducing insecurities by managing expectations, improving transparency and stimulating engagement.
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Schéle I, Ask I, Claeson AS. Prototype stories of life with Chemical Intolerance – when the environment becomes a threat to health and well-being. OPEN PSYCHOLOGY 2019. [DOI: 10.1515/psych-2018-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractWe aimed to explore how individuals living with Chemical Intolerance (CI) describe the onset and progression of CI, and how they live and cope with CI. The participants were recruited via Swedish websites hosted by CI support groups. A postal survey, including a Life history calender, was sent to potential participants. Eleven respondents fitted the consensus-based criteria for CI while not reporting comorbidity. A narrative analysis of their written replies resulted in five prototypical stories based on similarities in the onset and course of CI. All five stories contain descriptions of alienation from society and insufficient social support. Differences in participants’ perceptions of the symptom onset – with regard to suddenness, the point in life and the perceived cause of symptoms – partly corresponded to etiological theories of CI related to stress or inflammation. Further differences between the prototype stories mainly concern the possible effects on health and well-being related to social support and coping. Given these differences, we recommend that medical professionals and others apply a holistic, context-sensitive approach before discouraging or promoting a specific coping strategy in relation to CI.
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Affiliation(s)
| | - Ida Ask
- Department of Psychology, Umeå University and Byske Health Center
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Nygård C, Clancy A. Unsung heroes, flying blind-A metasynthesis of parents' experiences of caring for children with special health-care needs at home. J Clin Nurs 2018; 27:3179-3196. [PMID: 29754433 DOI: 10.1111/jocn.14512] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To aggregate, synthesise and interpret qualitative research studies of parents' experiences of caring for a child with special health-care needs at home. BACKGROUND Advances in the field of medical and nursing science have ensured better survival rates for children with chronic illnesses. Many of these children have significant special health-care needs. Today parents assume a caregiver role, undertaking tasks previously provided by nurses in hospitals. As the complexity of care delivered by parents continues to develop, synthesised knowledge can provide an evidence base that will support and guide nurses when caring for these families. DESIGN Metasynthesis. METHODS Based upon a systematic search protocol, a structured literature search, covering the years 2003-2016, was conducted in five electronic databases. Ten studies were included and appraised using the Critical Appraisal Skills Program assessment tool. A metasummary and a metasynthesis were undertaken guided by the metasynthesis methodology as described by Sandelowski and Barroso (Handbook for synthesizing qualitative research. New York, NY: Springer, 2007). RESULTS The results were interpreted and integrated under the overarching theme "unsung heroes, flying blind," supported by eight elucidating categories that illustrate aspects of the parents' life world. CONCLUSIONS The enormous burden of care can weaken the parents' will to carry on and result in a decreased ability to provide care. This can have an impact on the parents' health, family functioning and the sick child's potential health outcomes. Nurses are in a unique position to help these families and should be better prepared for the role. RELEVANCE TO CLINICAL PRACTICE Knowledge of how parents of children with special health-care needs experience their daily lives can promote trust in nurses and guide them in their efforts to support families with children living with chronic illness.
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Affiliation(s)
- Carina Nygård
- Faculty of Health Sciences, UiT The Arctic University of Norway, Harstad, Norway
| | - Anne Clancy
- Faculty of Health Sciences, UiT The Arctic University of Norway, Harstad, Norway
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Iranian mothers' Experiences with Children Undergoing Hemodialysis: A Hermeneutic Phenomenological Study. J Pediatr Nurs 2018; 42:e19-e25. [PMID: 29958764 DOI: 10.1016/j.pedn.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 06/16/2018] [Accepted: 06/17/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To describe Iranian mothers' perspectives regarding hemodialysis for their children. DESIGN AND METHODS This qualitative study was conducted using the hermeneutic phenomenological approach. The sample consisted of 11 mothers, among whom five were interviewed once and six were interviewed twice, for a total of 17 interviews. The data were then analyzed using van Manen's (1997) method. RESULTS Five themes emerged from the data: mothers enclosed by child care, emotional and psychological tension, acceptance and contrivance, the entire family being a victim of a sick child, and self-devotion. CONCLUSION The results indicated that the mothers of children undergoing hemodialysis experience multiple stresses in the physical, emotional-psychological, social, and economic dimensions. PRACTICAL IMPLICATIONS Nurses are the healthcare team members who most frequently interact with mothers of children undergoing hemodialysis. They are therefore positioned favorably to provide the information and emotional support needed by these mothers. Nurses are also among the frontline professionals who can provide services designed to assess the physical, psychological, and economic requirements of these mothers and their families.
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Reeder J, Morris J. The importance of the therapeutic relationship when providing information to parents of children with long-term disabilities: The views and experiences of UK paediatric therapists. J Child Health Care 2018; 22:371-381. [PMID: 29463110 DOI: 10.1177/1367493518759239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to understand the views and experiences of paediatric therapists working in the United Kingdom regarding the importance of the therapeutic relationship when providing information for parents of children with long-term disabilities. The aim was to develop new perspectives, to encourage dialogue and reflection for change and to identify practical suggestions for health professionals when developing therapeutic relationships. This study employed an interpretive phenomenological methodology. Semi-structured, in-depth interviews were carried out with seven health professionals from a single National Health Service trust in the United Kingdom (children's physiotherapists, occupational therapists and speech therapists). Resultant data were analysed using a systematic process of thematic content analysis. One main theme 'The Importance of the Therapeutic Relationship: Balancing a Positive Relationship with Professional Responsibility' is presented and discussed. Paediatric therapists recognize that fostering a positive therapeutic relationship is vital to facilitate parental engagement with the information they provide. Despite this it was felt that efforts to maintain a positive relationship needed to be carefully balanced with discharging professional responsibility to the child. A preliminary model 'The Therapeutic Relationship Continuum' is presented, aiming to help health professionals self-assess and reflect on the dynamic interface between the therapeutic relationship and information provision.
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Affiliation(s)
- Jim Reeder
- 1 School of Health Sciences, University of Brighton, Brighton, East Sussex, UK
| | - Jane Morris
- 1 School of Health Sciences, University of Brighton, Brighton, East Sussex, UK
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Aasen L, Ponton IG, Johannessen AKM. Being in control and striving for normalisation: A Norwegian pilot study on parents' perceptions of hospital-at-home. Scand J Caring Sci 2018; 33:102-110. [PMID: 30112773 DOI: 10.1111/scs.12606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 07/04/2018] [Indexed: 11/30/2022]
Abstract
In recent decades, there has been a shift from hospitalisation to home care throughout the Western world, even for children. Hospital-at-home for children is in a developmental phase and represents a new service model in Norway. The aim of this pilot study conducted in a Norwegian healthcare setting was to explore how parents with a sick child experienced early hospital discharge and further care at home. The qualitative data are drawn from nine interviews with parents with a child admitted to hospital-at-home. Transcripts of interviews were analysed using a method of qualitative content analysis. In the analysis, Antonovsky's salutogenic perspective on how people cope in demanding life situations was applied. The results show that the parents experienced hospital-at-home as providing a calmer, more predictable family life compared to hospitalisation. They argued that good information and training in medical procedures prior to hospital discharge made hospital-at-home easier to master. The participants pointed out the importance of the professionals' competence and their ability to interact with the child and the parent. The certitude that they could return to the hospital at any time made them feel safe and in control. The parents associated hospital-at-home with a kind of normalisation of their family life. They had a prominent need for normalisation, and this was probably a motivation for agreeing to the hospital-at-home arrangement. The findings indicate that hospital-at-home for children is a good solution if the parents are well prepared and feel in control. In addition, certain structural conditions must be in place before this type of health care is established; there must be a certain volume of patients and the distance to the hospital must be clearly limited. Norwegian policymakers should initiate more pilot testing of hospital-at-home for children. Users and clinicians should be involved in establishing and evaluating these services.
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Affiliation(s)
- Line Aasen
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Irene Gynnild Ponton
- Department of Youth and Adolescent Care, Akershus University Hospital, Lørenskog, Norway
| | - Anne-Kari Myrvold Johannessen
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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Amador DD, Marcílio AC, Soares JDSS, Marques FRB, Duarte AM, Mandetta MA. A força da informação sobre retinoblastoma para a família da criança. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Compreender a necessidade de informação da família da criança com retinoblastoma. Métodos: Estudo qualitativo fundamentado no Modelo do Cuidado Centrado no Paciente e na Família. Participaram famílias de crianças em tratamento em uma instituição referência em oncologia pediátrica. A Análise Qualitativa de Conteúdo guiou a coleta e análise dos dados. Resultados: “A força da informação sobre retinoblastoma para a família da criança” revela o valor que a família atribui à informação sobre a doença da criança, em um tempo de intenso sofrimento; os caminhos que realiza para obter as informações; e os elementos que considera essenciais para se sentir atendida em seu direito. Conclusão: Torna-se primordial que a oferta de informações respeite o tempo da família, seja honesta, contemple as perspectivas de futuro para a criança, em um espaço dialógico. Dessa maneira, promove-se uma prática fundamentada no Modelo do Cuidado Centrado no Paciente e na Família.
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Brooks S, Eckerli-Wäspi I, Händler Schuster D. In hospital with a hearing impaired child - How parents experience communication between nurses and their child. Pflege 2018; 31:63-73. [PMID: 29350077 DOI: 10.1024/1012-5302/a000603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: In daily communication, children with hearing impairment are restricted and dependent on their parents’ help. In case of a hospitalisation, the risk of insufficient information and resulting traumatisation for those children is high. The aim of this study is the investigation of the communicative needs of the children concerned in order to avoid negative consequences of a hospitalisation and of inappropriate communication by nursing staff. Aim: This study explores how parents of a child with hearing impairment experience the communication between the nursing staff and their hospitalised child. Method: The study was conducted together with an advisory centre for hearing-impaired children, where most of the parents could be recruited. Narrative, semi-structured interviews were conducted. The transcribed interviews were analysed according to the method of interpretative phenomenology. Results: The parents expressed their wish for affectionate verbal and nonverbal love and care for their child. They often experienced the nursing staff having little time, that there was no continuity and that the communicative needs of the child were not recognised. Since the parents did not think the nursing staff were capable of communicating with the child and because they wanted to protect him or her, they adopted a mediating role. Conclusions: Besides the sensitisation of the nursing staff, time resources, continuity, professional knowledge and benevolence in the nursing care of a child with hearing impairment play a fundamental role.
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Affiliation(s)
- Seraina Brooks
- 1 Kinder- und Jugendmedizin, Kantonsspital Graubünden, Chur, Schweiz
| | | | - Daniela Händler Schuster
- 3 Institut Pflege, Departement Gesundheit, Zürcher Hochschule für Angewandte Wissenschaften (ZHAW), Winterthur, Schweiz
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Masalha W, Auslander G. Coping strategies used by parents of children with traumatic brain injury: A cross-sectional study of Palestinians and Israelis. SOCIAL WORK IN HEALTH CARE 2017; 56:964-983. [PMID: 28762891 DOI: 10.1080/00981389.2017.1353568] [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: 06/07/2023]
Abstract
This study examined the use and helpfulness of coping strategies and patterns among parents of children with traumatic brain injury (TBI). Participants were 122 Arab-Israeli, Jewish-Israeli, and Palestinian parents of 65 children with TBI following their discharge from pediatric rehabilitation hospital. Family-focused strategies were highly prevalent and most helpful among both mothers and fathers. Jewish mothers reported that support coping pattern (but not medical or family) was more helpful than did Arab-Israeli and Palestinian mothers. The findings highlight the need to promote effective coping among mothers of children with TBI with low levels of income and education and underscore the need for continuous long-term professional support to parents of children with TBI after hospital discharge.
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Affiliation(s)
| | - Gail Auslander
- b Zena Harman Professor of Social Work, School of Social Work & Social Welfare , Hebrew University of Jerusalem , Jerusalem , Israel
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Popejoy E, Pollock K, Almack K, Manning JC, Johnston B. Decision-making and future planning for children with life-limiting conditions: a qualitative systematic review and thematic synthesis. Child Care Health Dev 2017; 43:627-644. [PMID: 28402040 DOI: 10.1111/cch.12461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 02/24/2017] [Accepted: 03/13/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND In the last decade, the number of children with life-limiting and life-threatening conditions in England has almost doubled, and it is estimated that worldwide, there are 1.2 million children with palliative care needs. Families and professionals caring for children with life-limiting conditions are likely to face a number of difficult treatment decisions and develop plans for future care over the course of the child's life, but little is known about the process by which these decisions and plans are made. METHODS The purpose of this review is to synthesize findings from qualitative research that has investigated decision-making and future planning for children with life-limiting conditions. A systematic search of six online databases was conducted and identified 887 papers for review; five papers were selected for inclusion, using predefined criteria. Reference list searching and contacting authors identified a further four papers for inclusion. RESULTS Results sections of the papers were coded and synthesized into themes. Nineteen descriptive themes were identified, and these were further synthesized into four analytical themes. Analytical themes were 'decision factors', 'family factors', 'relational factors' and 'system factors'. CONCLUSIONS Review findings indicate that decision-making and future planning is difficult and needs to be individualized for each family. However, deficits in understanding the dynamic, relational and contextual aspects of decision-making remain and require further research.
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Affiliation(s)
- E Popejoy
- University of Nottingham School of Health Sciences, Nottingham, UK
| | - K Pollock
- Nottingham Children's Hospital, Nottingham, UK
| | - K Almack
- University of Nottingham School of Health Sciences, Nottingham, UK
| | - J C Manning
- University of Nottingham School of Health Sciences, Nottingham, UK
| | - B Johnston
- University of Glasgow School of Medicine, Glasgow, UK
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Blomberg K, Carlsson AA, Hagberg L, Jonsson Ö, Leissner L, Eriksson MH. Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix® vaccination: protocol for a case-control study. BMC Pediatr 2017; 17:183. [PMID: 28835221 PMCID: PMC5569459 DOI: 10.1186/s12887-017-0935-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 08/15/2017] [Indexed: 11/15/2022] Open
Abstract
Background The extensive vaccination programme against swine flu resulted in an increased incidence of narcolepsy among children and adolescents. There is a need to explore if these young persons’ experiences have affected their trust in healthcare, their willingness to participate in future prevention programmes, and their contacts with the healthcare system. The overall aim is to identify factors important for the life-situation of children and adolescents with narcolepsy and their families, and factors that correlate with trust in healthcare. Methods/design Data will be collected via questionnaires from all available children with narcolepsy following the vaccination and their families, as well as a control group of children with diabetes and their families. Longitudinal descriptive interviews will also be conducted with a selection of 20–25 children and their families. Techniques from media research will be used for Internet-based data collection and analysis of information relating to narcolepsy from social media. Discussion This project will use the situation of young persons with narcolepsy after the swine flu vaccination as a case to build a model that can be used in situations where trust in healthcare is essential. This model will be based on findings from the included studies on how trust is influenced by support, quality of life, burden of disease, impact on family, and use of social media. The model developed in this project will be beneficial in future situations where trust in healthcare is essential, such as new pandemic outbreaks but also for “everyday” adherence to health advice.
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Affiliation(s)
- Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden.
| | - Agneta Anderzén Carlsson
- Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Lars Hagberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden.,Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Östen Jonsson
- Faculty of Medicine and Health, Department of Paediatrics, Örebro University, Örebro, Sweden
| | - Lena Leissner
- Faculty of Medicine and Health, Department of Neurology, Örebro University, Örebro, Sweden
| | - Mats H Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden
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Armstrong-Heimsoth A, Johnson ML, McCulley A, Basinger M, Maki K, Davison D. Good Googling: A Consumer Health Literacy Program Empowering Parents to Find Quality Health Information Online. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2017. [DOI: 10.1080/15398285.2017.1308191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | | | - Kelly Maki
- Northern Arizona University, Phoenix, Arizona, USA
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20
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Hinton D, Kirk S. Living with uncertainty and hope: A qualitative study exploring parents' experiences of living with childhood multiple sclerosis. Chronic Illn 2017; 13:88-99. [PMID: 27539955 DOI: 10.1177/1742395316664959] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There is growing recognition that multiple sclerosis is a possible, albeit uncommon, diagnosis in childhood. However, very little is known about the experiences of families living with childhood multiple sclerosis and this is the first study to explore this in depth. Objective Our objective was to explore the experiences of parents of children with multiple sclerosis. Methods Qualitative in-depth interviews with 31 parents using a grounded theory approach were conducted. Parents were sampled and recruited via health service and voluntary sector organisations in the United Kingdom. Results Parents' accounts of life with childhood multiple sclerosis were dominated by feelings of uncertainty associated with four sources; diagnostic uncertainty, daily uncertainty, interaction uncertainty and future uncertainty. Parents attempted to manage these uncertainties using specific strategies, which could in turn create further uncertainties about their child's illness. However, over time, ongoing uncertainty appeared to give parents hope for their child's future with multiple sclerosis. Conclusion Illness-related uncertainties appear to play a role in generating hope among parents of a child with multiple sclerosis. However, this may lead parents to avoid sources of information and support that threatens their fragile optimism. Professionals need to be sensitive to the role hope plays in supporting parental coping with childhood multiple sclerosis.
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Affiliation(s)
- Denise Hinton
- School of Health Sciences, University of Manchester, UK
| | - Susan Kirk
- School of Health Sciences, University of Manchester, UK
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21
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Aftyka A, Rozalska-Walaszek I, Wróbel A, Bednarek A, Dąbek K, Zarzycka D. Support provided by nurses to parents of hospitalized children - cultural adaptation and validation of Nurse Parent Support Tool and initial research results. Scand J Caring Sci 2017; 31:1012-1021. [DOI: 10.1111/scs.12426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Ilona Rozalska-Walaszek
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Aleksandra Wróbel
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Anna Bednarek
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Katarzyna Dąbek
- Chair and Clinic of Obstetrics and Gynaecology; Medical University of Lublin; Lublin Poland
- Neonatal Department with Neonatal Intensive Care Unit; Friderick Chopin Clinical Provincial Hospital No 1 in Rzeszów
| | - Danuta Zarzycka
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
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22
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von der Lippe C, Frich JC, Harris A, Solbraekke KN. Treatment of hemophilia: A qualitative study of mothers' perspectives. Pediatr Blood Cancer 2017; 64:121-127. [PMID: 27472376 DOI: 10.1002/pbc.26167] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND In Norway, boys with hemophilia usually begin treatment after their first bleeding episode. Boys with severe hemophilia usually start prophylactic treatment around 18-24 months. Health professionals administer factor concentrate initially, but when boys are around 4 years old most parents start treating their children at home. There is a lack of research on how parents, and especially how carrier mothers, experience the medical treatment for their sons' hemophilia. Our aim was to investigate how carrier mothers experience this treatment in the hospital setting and at home. METHODS In this qualitative study, we interviewed 16 mothers of boys or men with hemophilia A or B. Data were collected via semistructured interviews and analyzed using an inductive thematic analytical approach. RESULTS Mothers experienced both practical and emotional challenges in relation to their sons' treatment, and repeated venipuncture was especially difficult emotionally. Parents preferred home treatment to hospital treatment because it was less time-consuming, less disruptive to family life, and provided a greater sense of control. Encountering healthcare professionals who were unfamiliar with hemophilia was a second major stress factor, especially when parents felt that health professionals lacked competence and were unwilling to seek advice. CONCLUSION While home treatment for hemophilia enables freedom, flexibility, and autonomy for the boys as well as for the family, mothers may experience treatment of hemophilia as a burden. Health professionals should provide tailored practical and emotional support to parents by probing into their experiences with treating their sons' hemophilia.
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Affiliation(s)
| | - Jan C Frich
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anna Harris
- Department of Technology and Society Studies, Maastricht University, Maastricht, The Netherlands
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Sodi T, Kgopa B. Coping strategies of mother carers of children living with chronic illness and disease in a rural South African community. JOURNAL OF PSYCHOLOGY IN AFRICA 2016. [DOI: 10.1080/14330237.2016.1219546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Tholene Sodi
- Department of Psychology, University of Limpopo, South Africa
| | - Bontle Kgopa
- Department of Psychology, University of Limpopo, South Africa
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Nelson BB, Coller RJ, Saenz AA, Chung PJ, Kaplan A, Lerner CF, Klitzner TS. How Avoidable are Hospitalizations for Children With Medical Complexity? Understanding Parent Perspectives. Acad Pediatr 2016; 16:579-86. [PMID: 27142492 DOI: 10.1016/j.acap.2016.04.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Children with medical complexity (CMC) are a small group that utilizes large amounts of health care resources. Although parents are the primary healthcare decision-makers for their children, little is known from their perspective about why CMC are hospitalized. We sought to understand what parents think about factors leading to hospitalization and whether any recent hospitalizations might have been avoidable. METHODS We conducted qualitative, semistructured interviews with 35 parents of hospitalized CMC who receive care in the Pediatric Medical Home Program, a complex care program at University of California, Los Angeles. Interviews were conducted in English and in Spanish, audio-recorded, transcribed and translated, then coded in ATLAS.ti (Scientific Software Development Gmbh, Berlin, Germany) for qualitative analysis. We sorted qualitative codes into groups with shared concepts, to generate emergent themes. RESULTS Parents described their experiences leading up to their children's hospitalization, but no one suggested that the hospitalization was potentially avoidable. Most parents perceived their children as having higher susceptibility because of underlying conditions, perceived the symptoms they observed as high-risk, and described seeking emergent care only when they no longer were comfortable at home. Decisions about where to seek care were influenced by health care system factors such as accessibility and continuity of care. Most parents expressed a desire to learn more about their children's conditions and how best to care for them at home. CONCLUSIONS Parents of CMC believe that hospitalizations are largely unavoidable because of higher susceptibility and higher risk. Increasing parents' self-efficacy in caring for children at home might influence their decisions to seek emergent care.
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Affiliation(s)
- Bergen B Nelson
- Department of Pediatrics and Children's Discovery and Innovation Institute, Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Calif.
| | - Ryan J Coller
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Adrianna A Saenz
- Department of Pediatrics and Children's Discovery and Innovation Institute, Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Calif
| | - Paul J Chung
- Department of Pediatrics and Children's Discovery and Innovation Institute, Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Calif; Department of Health Policy and Management, Fielding School of Public Health at UCLA, University of California, Los Angeles, Calif; RAND Health, RAND Corporation, Santa Monica, Calif
| | - Avery Kaplan
- University of Southern California, Los Angeles, Calif
| | - Carlos F Lerner
- Department of Pediatrics and Children's Discovery and Innovation Institute, Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Calif
| | - Thomas S Klitzner
- Department of Pediatrics and Children's Discovery and Innovation Institute, Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Calif
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Pelentsov LJ, Fielder AL, Esterman AJ. The Supportive Care Needs of Parents With a Child With a Rare Disease: A Qualitative Descriptive Study. J Pediatr Nurs 2016; 31:e207-18. [PMID: 26651231 DOI: 10.1016/j.pedn.2015.10.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/17/2022]
Abstract
There are few studies that exist which focus specifically on parents with a child with a rare disease. The purpose of this study was to better understand the lived experiences and supportive care needs (SCN) of parents caring for a child across a spectrum of rare diseases. A qualitative descriptive approach was used to guide the research, and four semi-structured focus group interviews were conducted with 23 parents (17 mothers and 6 fathers). Participants described 'feeling boxed-in outside the box' due to a number of limitations unique to their child's disease, daily practical challenges in providing care and the various relational impacts of caring for a child with a rare disease were discussed. The results from this study help to give clearer direction for health professionals on where to focus future efforts in better meeting the supportive care needs of parents and their child with a rare disease.
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Affiliation(s)
- Lemuel J Pelentsov
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, Adelaide, SA, Australia.
| | - Andrea L Fielder
- Sansom Institute for Health Research and School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, Adelaide, SA, Australia.
| | - Adrian J Esterman
- Sansom Institute of Health Service Research and School of Nursing and Midwifery, Division of Health Sciences, University of SA, Centre for Chronic Disease Prevention, James Cook University, Cairns, QLD, Australia.
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Bray L, Shaw NJ, Snodin J. Living and managing with the long-term implications of neonatal chronic lung disease: The experiences and perspectives of children and their parents. Heart Lung 2015; 44:512-6. [DOI: 10.1016/j.hrtlng.2015.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/23/2015] [Accepted: 08/10/2015] [Indexed: 12/01/2022]
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Hayles E, Harvey D, Plummer D, Jones A. Parents' Experiences of Health Care for Their Children With Cerebral Palsy. QUALITATIVE HEALTH RESEARCH 2015; 25:1139-1154. [PMID: 25711842 DOI: 10.1177/1049732315570122] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although current health care service delivery approaches for children with cerebral palsy recognize the importance of including parents in the health care of their child, we do not yet understand how parents experience this phenomenon. In this study, we used grounded theory methodology to explore parents' experiences of health care for their children with cerebral palsy living in a regional area of Australia. Our findings indicate that parents experience health care for their child as a cyclical process of "making the most of their body and their life." Important aspects of care include "learning as you go," "navigating the systems," "meeting needs through partnership," "being empowered or disempowered," and "finding a balance." We suggest modifications to health care service delivery practices that might contribute to improved experiences of health care for this population.
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Affiliation(s)
- Emily Hayles
- James Cook University, Townsville, Queensland, Australia
| | - Desley Harvey
- James Cook University, Townsville, Queensland, Australia
| | | | - Anne Jones
- James Cook University, Townsville, Queensland, Australia
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Easter G, Sharpe L, Hunt CJ. Systematic Review and Meta-Analysis of Anxious and Depressive Symptoms in Caregivers of Children With Asthma. J Pediatr Psychol 2015; 40:623-32. [PMID: 25829528 DOI: 10.1093/jpepsy/jsv012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 02/02/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To provide a review of the literature comparing anxious and depressive symptoms in caregivers of children with asthma with caregivers of healthy children. METHOD A systematic search identified 25 studies from 17 articles, reporting outcomes on 4,300 caregivers of children with asthma and 25,064 caregivers of healthy children. RESULTS Overall, anxious (d = 0.50) and depressive symptoms (d = 0.44) were higher in caregivers of children with asthma compared with caregivers of healthy children. Age, site of recruitment, and whether the asthma diagnosis was medically confirmed were included as potential moderators. The relationship between parental psychopathology and asthma was stronger in those with medically confirmed asthma and participants recruited from clinical settings. Other moderators were not significant. CONCLUSIONS Caregivers of children with asthma appear to have greater anxious and depressive symptoms than caregivers of healthy children, but the reasons are unclear. More research that investigates modifiable factors that may moderate this association is urgently needed.
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Involving parents in managing their child's long-term condition-a concept synthesis of family-centered care and partnership-in-care. J Pediatr Nurs 2015; 30:143-59. [PMID: 25458112 DOI: 10.1016/j.pedn.2014.10.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 10/16/2014] [Accepted: 10/19/2014] [Indexed: 11/23/2022]
Abstract
UNLABELLED BACKGROUNG: Fostering effective engagement, collaboration and empowerment are central to supporting parents caring for children with long-term conditions. METHODS A concept synthesis was undertaken to identify the shared antecedents and attributes underpinning models of family-centered care and partnership-in-care. RESULTS Thirty studies were reviewed; antecedents of models related to unclear roles, entrenched professional practices, and lack of guidelines supporting their implementation; with central attributes being building trust, listening to parent concerns and valuing parents' knowledge of their child. CONCLUSION The key attributes are outlined in a practical framework of involvement which may promote parent-professional collaboration for families of children with long-term conditions.
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Nicholl H, Doyle C, Begley T, Murphy M, Lawlor A, Malone H. Developing an information leaflet on 22q11.2 deletion syndrome for parents to use with professionals during healthcare encounters. J SPEC PEDIATR NURS 2014; 19:238-46. [PMID: 24674229 DOI: 10.1111/jspn.12078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 03/03/2014] [Accepted: 03/03/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this project was to gather parents' expertise to inform an educational leaflet for parents to share with professionals caring for children with 22q11.2 deletion syndrome (22q11.2 DS). DESIGN AND METHODS A mixed-method design was adopted. Data were collected by one focus group interview (n = 8) and questionnaires with 92 other parents of children with 22q11.2 DS. RESULTS Quantitative and qualitative responses informed the development of an information leaflet. PRACTICE IMPLICATIONS Parents are well positioned to assist in development of information leaflets that can minimize "repeated storytelling" during professional encounters.
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Affiliation(s)
- Honor Nicholl
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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Sousa EFR, Costa EADO, Dupas G, Wernet M. Acompanhamento de familias de criancas com doenca cronica: percepcao da equipe de Saude da Familia. Rev Esc Enferm USP 2013; 47:1367-72. [DOI: 10.1590/s0080-623420130000600017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 03/26/2013] [Indexed: 11/22/2022] Open
Abstract
Este estudo objetivou caracterizar como a equipe da Estratégia Saúde da Família percebe sua dinâmica de acompanhamento de famílias que convivem com a doença crônica da criança. Trata-se de uma pesquisa qualitativa que teve como referencial teórico o Interacionismo Simbólico e como método a Análise de Conteúdo, técnica de análise categorial temática. Para a coleta de dados utilizou-se o grupo focal, que foi desenvolvido com três equipes de Saúde da Família, totalizando 32 sujeitos. Os resultados foram organizados em três categorias temáticas: Peculiaridades das famílias que convivem com a doença crônica da criança; Equipe, família e Estratégia Saúde da Família e Limitações para cuidar. A percepção da equipe é que o desenho da Estratégia Saúde da Família favorece o acesso à experiência familiar, permitindo o reconhecimento de suas especificidades. Os dados revelam ainda as limitações da equipe em sua capacidade de resolução e a necessidade de investimentos na articulação entre os distintos serviços, setores e equipamentos sociais.
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Schofield LM, Horobin HE. Growing up with Primary Ciliary Dyskinesia in Bradford, UK: exploring patients experiences as a physiotherapist. Physiother Theory Pract 2013; 30:157-64. [PMID: 24156703 DOI: 10.3109/09593985.2013.845863] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Primary Ciliary Dyskinesia (PCD) is a condition which causes impaired mucociliary clearance, resulting in sputum retention and recurrent respiratory tract infections. Physiotherapy, in the form of airway clearance techniques and exercise is recommended to patients with PCD to facilitate sputum clearance. As children diagnosed with PCD develop into adults, understanding their experiences of growing up with this long-term condition and undertaking physiotherapy may help to provide insight to clinicians. No previous research has been published which explores the lived experiences of children and young people with PCD. The prevalence of PCD in Bradford in the North of the UK is unusually high, signifying the importance of understanding the experiences of this patient population. This qualitative study used Interpretive Phenomenological Analysis to allow the researcher, as a physiotherapist, to investigate the lived experiences of five paediatric patients with PCD. While patients' experiences are all unique, three themes emerged across the analysis of the interviews: (1) the experiences of day to day life with the symptoms and treatment burden of PCD; (2) participants' awareness of their own symptoms and knowledge of PCD; and (3) the development of mastery skills and devolution of management from the family to the growing child. The results from this study suggested that facilitation of disease acceptance, strategies to increase patient empowerment, the use of patient-centred communication and understanding the contextualisation of patients' experiences may all help to guide clinical practice.
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Affiliation(s)
- Lynne M Schofield
- Department of Physiotherapy, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary , Duckworth Lane, Bradford , UK
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Mapping the information-coping trajectory of young people with long term illness. JOURNAL OF DOCUMENTATION 2013. [DOI: 10.1108/jd-10-2012-0133] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Smith J, Cheater F, Bekker H. Parents' experiences of living with a child with a long-term condition: a rapid structured review of the literature. Health Expect 2013; 18:452-74. [PMID: 23311692 DOI: 10.1111/hex.12040] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Living with a child with a long-term condition can result in challenges above usual parenting because of illness-specific demands. A critical evaluation of research exploring parents' experiences of living with a child with a long-term condition is timely because international health policy advocates that patients with long-term conditions become active collaborators in care decisions. METHODS A rapid structured review was undertaken (January 1999-December 2009) in accordance with the United Kingdom Centre for Reviews and Dissemination guidance. Three data bases (MEDLINE, CINAHL, PSYCINFO) were searched and also hand searching of the Journal of Advanced Nursing and Child: Care, Health and Development. Primary research studies written in English language describing parents' experiences of living with a child with a long-term condition were included. Thematic analysis underpinned data synthesis. Quality appraisal involved assessing each study against predetermined criteria. RESULTS Thirty-four studies met the inclusion criteria. The impact of living with a child with a long-term condition related to dealing with immediate concerns following the child's diagnosis and responding to the challenges of integrating the child's needs into family life. Parents' perceived they are not always supported in their quest for information and forming effective relationships with health-care professionals can be stressful. Although having ultimate responsibility for their child's health can be overwhelming, parents developed considerable expertise in managing their child's condition. CONCLUSION Parents' accounts suggest they not always supported in their role as manager for their child's long-term condition and their expertise, and contribution to care is not always valued.
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Affiliation(s)
- Joanna Smith
- School of Nursing, Midwifery and Social Work, University of Salford, Salford, Greater Manchester, UK
| | - Francine Cheater
- School of Nursing Science, University of East Anglia, Norwich, UK
| | - Hilary Bekker
- Institute of Health Sciences, University of Leeds, Leeds, UK
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Al-Akour NA, Gharaibeh M, Al-Sallal RAK. Perception of Jordanian mothers to nursing support during their children hospitalisation. J Clin Nurs 2012; 22:233-9. [DOI: 10.1111/j.1365-2702.2012.04278.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Nemeh A Al-Akour
- Maternal and Child Health Department; School of Nursing; Jordan University of Science and Technology (JUST); Irbid; Jordan
| | - Muntaha Gharaibeh
- Maternal and Child Health Department; Jordan University of Science and Technology; Irbid; Jordan
| | - Ranyah AK Al-Sallal
- School of Nursing; Jordan University of Science and Technology (JUST); Irbid; Jordan
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Oruche UM, Gerkensmeyer J, Stephan L, Wheeler CA, Hanna KM. The described experience of primary caregivers of children with mental health needs. Arch Psychiatr Nurs 2012; 26:382-91. [PMID: 22999034 DOI: 10.1016/j.apnu.2011.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
Abstract
About 10% of our nation's children have serious mental health needs that result in significant functional impairments. Although research has found that primary caregivers of children with mental health needs have high levels of depressive symptoms and distress, little is known about the challenges these caregivers face. Focus groups with 20 caregivers of children with mental health needs between 2 and 17 years of age revealed these themes: struggling with care systems, living in fear, being burdened and exhausted, worrying about the rest of the family, and having good things happen. Caregivers described extreme challenges and many unmet needs that are important to consider in efforts to improve both children's and caregivers' well-being.
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Bruce E, Sundin K. Experience of support for parents of adolescents with heart defects--supported to be supportive. J Pediatr Nurs 2012; 27:366-74. [PMID: 22703684 DOI: 10.1016/j.pedn.2011.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 04/13/2011] [Accepted: 04/20/2011] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to illuminate the meanings of the lived experience of support for parents of adolescents with heart defects. Narrative interviews were conducted with four mothers and two fathers of adolescents with heart defects. Interviews were interpreted using a phenomenological-hermeneutic method. The interpretation revealed that parents, themselves, attempt to be very supportive. They support their adolescent children, the rest of their families, the staffs of their children's schools, and others around their children. The sense of gratification and contentment that parents receive from fulfilling supportive functions is, in turn, influenced by the support that they, themselves, receive from care providers.
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Health-related quality of life in children and adolescents with celiac disease: from the perspectives of children and parents. Gastroenterol Res Pract 2012; 2012:986475. [PMID: 22548054 PMCID: PMC3324145 DOI: 10.1155/2012/986475] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 01/30/2012] [Indexed: 11/29/2022] Open
Abstract
Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children's self-valuation later in life. We also assessed the parents' valuation of their child's quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children's quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life.
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Kirk KD, Fedele DA, Wolfe-Christensen C, Phillips TM, Mazur T, Mullins LL, Chernausek SD, Wisniewski AB. Parenting characteristics of female caregivers of children affected by chronic endocrine conditions: a comparison between disorders of sex development and type 1 diabetes mellitus. J Pediatr Nurs 2011; 26:e29-36. [PMID: 21911316 DOI: 10.1016/j.pedn.2010.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 10/14/2010] [Accepted: 10/17/2010] [Indexed: 10/18/2022]
Abstract
Rearing a child with a chronic illness is stressful and can potentially affect parenting style, which may result in poorer outcomes for children. The purpose of this study was to compare parenting characteristics of female caregivers rearing children with a disorder of sex development (DSD) to female caregivers rearing children with type 1 diabetes mellitus (T1DM). Caregivers of both groups were matched according to age and compared on measures of stress and parenting practices. Both groups demonstrated significant levels of stress and negative parenting practices. Children with T1DM and male children with non-life-threatening DSD were perceived as more vulnerable by their caregivers. Better understanding of parenting experiences of female caregivers rearing children with DSD, particularly male children, will facilitate the development of individualized interventions to ameliorate negative parenting practices and stress, with the long-term goal of improved health outcomes for their children.
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Affiliation(s)
- Katherine D Kirk
- University of Oklahoma College of Nursing, Oklahoma City, OK, USA.
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Spiers G, Parker G, Gridley K, Atkin K. The psychosocial experience of parents receiving care closer to home for their ill child. HEALTH & SOCIAL CARE IN THE COMMUNITY 2011; 19:653-660. [PMID: 21623985 DOI: 10.1111/j.1365-2524.2011.01008.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Current health policy in England regarding the management of childhood illness advocates for care to be delivered as close to home as possible. The aim of this article is to report findings from a qualitative component of a larger study evaluating models of care closer to home (CCTH) for children and young people who are ill. The focus is on parents' psychosocial experience of receiving CCTH for their ill child. A qualitative case study design was used, with four Primary Care Trusts in England as the case study sites. In-depth, semi-structured interviews were conducted with 27 parents and one extended family caregiver of children using CCTH services within the case study sites. Interviews were conducted face-to-face and audio-recorded with permission. Data were collected in 2009. There was an overall preference for CCTH over hospital-based care where possible. The parents in this study experienced differing levels of responsibility as part of this care, and responded to this in different ways. Being supported emotionally and socially by practitioners was an important part of receiving CCTH for parents, especially when they had increased responsibility as part of this care. Developing relationships with practitioners appeared to be a medium through which parents received support. If the provision of CCTH continues to expand in line with current policy, provision of support for parents should be considered a fundamental aspect of service development.
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Affiliation(s)
- Gemma Spiers
- Social Policy Research Unit, University of York, Heslington, UK.
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McCullough C, Price J. Caring for a child with cystic fibrosis: the children's nurse's role. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2011; 20:164-7. [PMID: 21378637 DOI: 10.12968/bjon.2011.20.3.164] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article presents a narrative literature review of the psychosocial impact on family life of caring for a child diagnosed with cystic fibrosis. Diagnosis of long-term illness in a child causes major upheaval in the lives of both the child and family. Normal family life is often emotionally, socially, physically and financially disrupted. Amid such disruption, parents attempt to cope by creating a semblance of order in their lifestyle. Within an interdisciplinary approach to caring, the children's nurse plays a pivotal role in supporting families to establish such order and reconstruct their lives, while coming to terms with the knowledge that their child could die prematurely. In addition, the nurse, in his/her role as teacher and educator, empowers parents, children and young people with the knowledge to make informed decisions and assists parents in developing the skills (often technical) to care for their child. Cystic fibrosis is one such condition in childhood, and this article explores the main psychosocial issues experienced by families caring for their child following diagnosis of CF, as raised in the literature.
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Fisher MJ, Broome ME. Parent-provider communication during hospitalization. J Pediatr Nurs 2011; 26:58-69. [PMID: 21256413 DOI: 10.1016/j.pedn.2009.12.071] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 12/02/2009] [Accepted: 12/02/2009] [Indexed: 11/26/2022]
Abstract
Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended.
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Affiliation(s)
- Mark J Fisher
- University of Oklahoma Health Sciences Center College of Nursing, Oklahoma City, OK, USA.
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Aein F, Alhani F, Mohammadi E, Kazemnejad A. Struggling to create new boundaries: a grounded theory study of collaboration between nurses and parents in the care process in Iran. J Adv Nurs 2010; 67:841-53. [PMID: 21105897 DOI: 10.1111/j.1365-2648.2010.05515.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To develop a substantive grounded theory of nurse-mother interaction in the care of chronically ill children in hospital setting. BACKGROUND Interaction between nurses and parents is critical in paediatric hospital settings. This area of practice in developing countries has been under-researched. METHOD The qualitative research design of grounded theory methodology was used to develop a theory of nurse-parent interaction within the child care. Registered Nurses (n=17) and mothers of chronically ill children (n=14) from two central paediatric hospital in Iran participated in this study. In-depth interviews with nurses and mothers were conducted using theoretical sampling between July 2007 and August 2008. The data were analysed using constant comparative analysis. FINDINGS 'Struggling to create new boundaries' as a core variable was a dominant socio-psychological process that was manifesting itself within three stages: facing up to and perceiving the environmental pressures, balancing nurse's duties, and controlling the nurse-parent boundary in the care. CONCLUSION It is concluded that nurses and parents need a care model, which addresses their collaboration and improved interpersonal relationship and clearly defines the boundary of their roles based on the needs of both sides while allowing parents to choose their role in these defined boundaries and providing parent education with aim to empower them for care at home.
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Affiliation(s)
- Fereshteh Aein
- Nursing Department, Tarbiat Modares University, Tehran, Iran
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Jönsson L, Hallström I, Lundqvist A. A multi-disciplinary education process related to the discharging of children from hospital when the child has been diagnosed with type 1 diabetes--a qualitative study. BMC Pediatr 2010; 10:36. [PMID: 20507611 PMCID: PMC2889941 DOI: 10.1186/1471-2431-10-36] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 05/27/2010] [Indexed: 11/24/2022] Open
Abstract
Background Worldwide, insulin-dependent type 1 diabetes is one of the most frequently diagnosed long-term endocrine disorders found in children and the incidences of this diseased is still increasing. In Sweden the routines are, according to national guidelines, when the child is diagnosed with type 1 diabetes, the child and its family remains at the hospital for about two weeks. There is limited knowledge about how a diabetes team handles a child and its family from admission to discharge, therefore the purpose of this study was to seek a deeper understanding of how the diabetes team's parent/child education process works, from admission to discharge, among families with a child newly diagnosed with type 1 diabetes. Methods Qualitative data collection was used. Four focus-group interviews, with a sample of three diabetes teams from different paediatric hospitals in the south western part of Sweden, were conducted and the data recorded on tape and then analysed using qualitative content analysis. Results The results indicate that achieving a status of self-care on the part of the patient is the goal of the diabetes education programme. Part of the programme is aimed at guiding the child and its parents towards self-help through the means of providing them with knowledge of the disease and its treatment to enable the whole family to understand the need for cooperation in the process. To do this requires an understanding, by the diabetes team, of the individualities of the family in order to gain an overall picture. Conclusion The results of this study show that the diabetes education programme is specifically designed for each family using the internationally recommended clinical practice guidelines with its specific aims and objectives. Achieving the families' willingness to assist in the self-care of the child care is the goal of the parent education process. To achieve this, the paediatric diabetes specialist nurse and the diabetes specialist paediatrician immediately and deliberately start the process of educating the family using a programme designed to give them the necessary knowledge and skills they will need to manage their child's type 1 diabetes at home.
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Affiliation(s)
- Lisbeth Jönsson
- Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden.
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Rose RA, Parish SL, Yoo J, Grady MD, Powell SE, Hicks-Sangster TK. Suppression of racial disparities for children with special health care needs among families receiving Medicaid. Soc Sci Med 2010; 70:1263-70. [PMID: 20185219 DOI: 10.1016/j.socscimed.2009.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 09/24/2009] [Accepted: 12/14/2009] [Indexed: 10/19/2022]
Abstract
This study examines whether the US public health insurance program Medicaid suppresses racial disparities in parental identification of service needs of their children with special health care needs (CSHCN). We analyze data from the 2001 US National Survey of CSHCN (n = 14,167 children). We examine three outcomes which were parental identification of (a) the child's need for professional care coordination, (b) the child's need for mental health services, and (c) the family's need for mental health services. A suppression analysis, which is a form of mediation analysis, was conducted. Our results show a disparity, reflected in a negative direct effect of race for all three outcomes: Black parents of CSHCN are less likely to report a need for services than White parents of CSHCN and Medicaid coverage was associated with reduced racial disparities in reporting the need for services. These analyses suggest receipt of Medicaid is associated with a suppression of racial disparities in reported need for services.
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Affiliation(s)
- Roderick A Rose
- University of North Carolina, School of Social Work, 325 Pittsboro Street, CB 3550, Chapel Hill, NC 27599-3550, United States
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Finnvold JE. In their own words: early childhood asthma and parents' experiences of the diagnostic process. Scand J Caring Sci 2010; 24:299-306. [PMID: 20230513 DOI: 10.1111/j.1471-6712.2009.00720.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This paper explores the experiences of parents of asthmatic children in the period leading up to their child receiving a formal medical diagnosis. To what extent did the parents face difficulties in obtaining this diagnosis? How did they describe their encounters with the healthcare professionals? In particular, did parents portray themselves as passive and dominated or active and participating during the prediagnosis phase? In-depth interviews with individuals and participants in a focus group exposed the prediagnosis phase as a distinct and memorable phase of the disease, often recalled as a period of frustration and uncertainty. Results show that instead of accepting the authority of the professional, parents eventually acquire knowledge elsewhere about the diagnosis and the healthcare system, and act according to that knowledge. As a fundamental uncertainty appears involved in the diagnostic process, parents dealing with this uncertainty use a number of strategies to gain control of the process of alleviating their child's disease. The paper discusses the status of the information that the researcher obtained from parents. Lay narratives cannot be treated as simple reports of an external reality. As the parental role is rooted in normative conceptions about what constitutes 'responsible parenthood', information given to the observer may therefore be influenced by the informants' concern with their appearance as moral persons or adequate parents. Although a research strategy based on one-sided interviews has limitations, using parents as a source of information offers a rare glimpse into the realities of patient-physician encounters.
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Aein F, Alhani F, Mohammadi E, Kazemnejad A. Parental participation and mismanagement: A qualitative study of child care in Iran. Nurs Health Sci 2009; 11:221-7. [DOI: 10.1111/j.1442-2018.2009.00450.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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You just have to ask…*. Crit Care Med 2009; 37:2136-7. [DOI: 10.1097/ccm.0b013e3181a5c293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Information management in families who have a child with a genetic condition. J Pediatr Nurs 2009; 24:194-204. [PMID: 19467432 PMCID: PMC2735554 DOI: 10.1016/j.pedn.2008.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Revised: 07/17/2008] [Accepted: 07/19/2008] [Indexed: 11/20/2022]
Abstract
In families with children with genetic conditions, information management may influence how parents view their child; their reproductive decision making; and how, when, what, and why they communicate about the condition to other family members. The purpose of this study was to identify unique patterns of information management and to explore the relationship between these patterns and individual and family characteristics and functioning. The sample was composed of 142 parents in 86 families in which a child had a single-gene condition. Four distinct information management patterns were identified that varied in the parents' understanding of the genetic aspects of the condition: accurate understanding-open (35%, n = 30), accurate understanding-selective (24%, n = 21), discrepant understanding (15%, n = 13), and confused understanding (26%, n = 22). In two patterns, accurate understanding-open and accurate understanding-selective (59%), parents had an accurate understanding of the genetic aspects of the condition, and the patterns were differentiated from one another by parents' views about sharing information. In the discrepant understanding pattern, which included only two-parent families, one parent had an accurate understanding and one parent a confused understanding of the genetic aspects of the condition. In the confused understanding pattern, parents had an inaccurate understanding of one or more of the genetic aspects of the condition. Statistically significant differences were found between information management patterns and parents' education, family annual income, and health insurance coverage. These information management patterns reflect how parents access, interpret, and convey genetic information and can influence the effectiveness of health care providers' interactions with these families.
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