The first year: the support needs of parents caring for a child with an intellectual disability

Exploring Psychosocial Distress in Caregivers of Children and Youth With Special Health Care Needs

PURPOSE

Caring for a child or youth with special health care needs (CYSHCN) can be overwhelming. Parents and caregivers may experience psychosocial distress, such as depression, frustration, and hopelessness. The purpose of the current study was to gain further insight into families' perspectives on the psychosocial impacts of caring for CYSHCN to identify gaps in health care systems and strengthen systems of support.

METHOD

A qualitative descriptive design was used in 16 parents and caregivers. Colaizzi's method of analysis and semi-structured interviews were used.

RESULTS

Six themes emerged from this study: (1) Stigma and Isolation, (2) Religion as a Coping Mechanism, (3) Financial Challenges, (4) Bearing the Burden, (5) Familial Denial, and (6) System-Related Concerns.

CONCLUSION

Psychiatric-mental health nurses (PMHNs) are in a pivotal position to use their knowledge, skills, and experiences to guide families. PMHNs can also engage communities and enhance mental health promotion to break the stigma associated with having a CYSHCN. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 37-46.].

Motivation in caregiving among mothers of children with intellectual and developmental disabilities in Iran: A qualitative study

BACKGROUND

The motivation of caregivers plays a crucial role in the treatment, follow-up, and care of children with intellectual and developmental disabilities. Previous studies have focused on the older people and end-stage diseases, while giving less attention to the motivation of mothers caring for children with special needs. This study aimed to explore the motivations of mothers caring for children with intellectual and developmental disabilities in Iran.

METHODS

This study employed a qualitative approach, guided by the Self-Determination Theory. Purposeful sampling was initially used, followed by theoretical sampling until data saturation was achieved. Data were collected through semi-structured interviews with 26 mothers of children with intellectual and developmental disabilities. Mayring's seven-step directed content analysis approach was utilized for coding and categorization. The research adhered to ethical standards and ensured data trustworthiness through credibility, dependability, confirmability, and transferability measures.

RESULTS

The findings revealed that mothers' caregiving motivations could be classified into four main categories: (I) intrinsic, (II) identified-extrinsic, (III) introjected-extrinsic, and (IV) external-extrinsic. Additionally, twelve sub-categories were identified within these four main categories.

CONCLUSION

The findings revealed that mothers demonstrated varying levels of intrinsic and extrinsic motivations in caring for children with intellectual and developmental disabilities. By recognizing and enhancing the diverse sources of motivation, healthcare providers and policymakers can better support mothers in their caregiving roles, ultimately contributing to improved outcomes for both the mothers and their children.

Immediate Caregiving Environment of Young Children with Autism: Findings from the U.S. National Survey of Children's Health

Autism spectrum disorder (ASD) is a complex neurodevelopmental disability that negatively affects children's learning, motor behavior, social communication, and interaction. It was estimated that, in 2020, 1 in 36 children aged 8 years in the United States had ASD. Caring for children with ASD might exert significant psychological and emotional distress on parents. Receiving parental emotional support and fostering positive parent-child interactions at home have been identified as beneficial for the immediate caregiving environment for children with ASD. The current secondary analysis of the 2019-2020 National Survey of Children's Health examined parent-child interactions and accessible sources of emotional support for parents caring for 3-5-year-old children diagnosed with ASD (N = 243). Children with the following characteristics had higher odds of having ASD: male gender; having no private insurance or uninsured; and having less than excellent general health. Among parents, higher odds of caring for children with ASD were associated with accessing emotional support from various sources, especially from healthcare professionals and peers, and spending more time telling stories and/or singing to their children. Given these significant health disparities, educational interventions and strategies are needed to foster a positive home caregiving environment for young children with ASD, including equitable access to parent resources.

Supporting Parents Throughout the Genetic Testing Process and New Diagnosis

Receiving a genetic diagnosis can be challenging for parents as they learn to cope and adapt to this news. They often experience a myriad of emotions ranging from shock to relief. Yet overwhelmingly, parents report a negative experience with this process. Factors that improve parental satisfaction include being provided written information, emotional and psychosocial support, and connections with other parents. Genetics care providers are particularly equipped to solicit parental needs and provide support before, during, and after receiving a diagnosis. This review will provide suggestions and recommendations for supporting parents throughout the diagnostic testing experience and receiving a genetic diagnosis.

Support needs around the time of diagnosis of parents caring for an infant with visual impairment or blindness in Denmark: a qualitative study

OBJECTIVE

The whole family is affected when an infant is diagnosed with visual impairment or blindness. We aimed to describe the support needs of parents around the time of diagnosis.

DESIGN

We used a descriptive qualitative method based on the theory of critical psychology and conducted five semistructured interviews with a total of eight parents of children under the age of 2 years who had been diagnosed with blindness or visual impairment before the age of 1 year. Thematic analysis was used to extract primary themes.

SETTING

The study was initiated by a tertiary hospital centre specialised in the ophthalmic management of children and adults with visual impairment.

PARTICIPANTS

Eight parents representing five families caring for a child under the age of 2 years with visual impairment or blindness participated in the study. The parents were recruited from the Department of Ophthalmology at Rigshospitalet, Denmark in relation to appointments in the clinic or by phone or email.

RESULTS

We identified three themes: (1) recognition and reactions during the time of diagnosis; (2) family, network and struggles; and (3) interaction with healthcare professionals.

CONCLUSION

The main lesson for healthcare professionals is to bring hope at a time when all hope may seem to be lost. Second, a need to direct attention to families with no or sparse supportive networks. Third, coordinating appointments between hospital departments and at-home therapies and reducing the number of appointments to allow parents time to establish a family relation with their child. Parents respond well to competent healthcare professionals who keep them informed and who see their child as an individual rather than as a diagnosis.

Parents' experience of family-centred care in the post-anaesthetic care unit during non-clinical delays: A qualitative study

The qualitative exploratory descriptive study explored parents' experience of family-centred care during delayed transfer from a paediatric post-anaesthetic care unit to an inpatient ward. Data were collected in a tertiary children's hospital in Melbourne, Australia, using in-depth, semi-structured interviews. Participants (n = 15) were parents of children (n = 10, aged 6 months to 16 years) delayed in a Stage 1 post-anaesthetic care unit for longer than 30 min. Elements of the family-centred care framework guided thematic analysis, the core concepts of which are respect and dignity, information sharing, participation and collaboration. Respect and dignity was most often identified, expressed in three subthemes: (1) the caring behaviour of staff, (2) being present with their child and (3) a journey shared with other families. Information sharing was also common, illustrated through (1) being told information and (2) being heard. Participation, the third element of the framework, was infrequently identified by participants; however, parents of children under 6 years of age alluded to contributing to their child's care. The final element, collaboration, was not identified in the study data. Only two of four elements of the family-centred care framework were common in parents' experiences: respect and dignity, and information sharing. 'Being with' their child emerged as a central concern for parents' perceptions of family-centred care.

Challenges and support needs of parents of children with developmental disabilities (DD) in Accra, Ghana

BACKGROUND

Parents of children with developmental disabilities (DD) have diverse challenges and needs. If met, these parents are able to provide adequate care for their children. Unfulfilled needs like information about their child's diagnosis, counselling, and poor access to informal and formal supports increase parental stress and hinder their potential to provide optimal care for their children and themselves.

AIMS

This study explores the unique challenges and needs of parents caring for children with DD in the Accra metropolis. This is the first study exploring the needs of parents in a Lower-middle income (LMIC) country like Ghana.

METHODS AND PROCEDURES

A qualitative research design was adopted for this study. Data was collected using semi-structured interviews from 9 parents of children with DD.

RESULTS

Findings from thematic analysis revealed five themes including; Emotional needs; Informational needs; Financial needs; Informal Support, and Formalized Support. Parents indicated their great need for information on their children's condition, support from family, religious groups, and other formalized institutions and how to provide better care.

CONCLUSIONS AND IMPLICATIONS

Parents have several expectations and needs which must be addressed. Findings have the potential of influencing the design and development of appropriate interventions to meet the needs and improve the quality of life of parents of children with DD in the Ghanaian context.

The experiences of new mothers accessing feeding support for infants with down syndrome during the COVID-19 pandemic

Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8-17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey, (2) There's no point asking, they won't know, (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing.

Meanings Assigned by Primary Care Professionals to Male Prenatal Care: A Qualitative Study

Background:

Considering recent strategies used in prenatal care, the involvement of fathers has been considered an important factor in ensuring that pregnancy and delivery are successful.

Objective:

The aim of this study is to identify the meanings assigned by primary health care professionals to male prenatal care.

Methods:

This is a descriptive study with a qualitative approach. A total of 19 interviews were conducted with primary health care professionals registered in the City Health Department of Teresina, Piauí, Brazil. Data were collected through semi-structured interviews and analyzed according to the Collective Subject Discourse methodology.

Results:

Three themes emerged from the reports’ analysis: The importance of the role of fathers in the gestational process, attitudes of men toward male prenatal care and formal education and training in primary health care. Health practitioners understand the importance of male prenatal care but reported they lack proper training to provide effective care.

Conclusion:

The expansion of continuing education strategies focusing on male prenatal care and directed to primary health care professionals is recommended to promote greater adherence on the part of fathers in prenatal care, with the purpose of strengthening bonds and improving the care provided to the entire family. The humanized care can facilitate the approach of the paternal figure during male prenatal care.

Family Sense-Making After a Down Syndrome Diagnosis

The script of parenting shifts when parents learn of their child's Down syndrome diagnosis. To build a theory of the diagnostic experience and early family sense-making process, we interviewed 33 parents and nine grandparents living in the United States who learned prenatally or neonatally of their child's diagnosis. The core category of rescuing hope for the future encompassed the social process of sense-making over time as parents managed their sorrow, shock, and grief and amassed meaningful messages that anchored them as they looked toward the future. Application of the theory to practice underscores the import of early professional support offered to parents at key points in the sense-making process: Early as they disclose the news of the diagnosis to family and friends, and later close friends and kin assimilate meaningful messages about what the diagnosis means as they recalibrate expectations for a hopeful future.

Ecuadorian mothers of preschool children with and without intellectual disabilities: Individual and family dimensions

BACKGROUND

Approximately 71,454 children younger than 5 years old have a disability in Ecuador.

AIMS

Our objective was to compare and relate family cohesion, adaptability, coping, perceived stress, and control with family satisfaction of Ecuadorian mothers of preschool children with and without intellectual disabilities (ID).

METHOD

Participants were 384 Ecuadorian mothers: 111 had a child with ID and 273had a child without ID. The FACES II, Family Satisfaction Scale and Moos Coping Response Inventory were used.

RESULTS

No significant differences were found between mothers of children with and without intellectual disabilities on their perceptions of family cohesion, adaptability or family satisfaction. Mothers of children with ID perceived less stress and more control over their children and adopted more approach coping strategies compared to mothers of children without ID. The mothers 'family satisfaction was positively related to approach coping strategies and to family cohesion and adaptability, and negatively related to avoidant coping strategies-regardless of whether their children had a disability or not.

CONCLUSIONS AND IMPLICATIONS

These data are in accordance with an adaptive approach to disability and emphasise the capacity of individuals and families to cope.

Health information seeking and people with disability: A systematic search and scoping review

BACKGROUND

Health information and access to it are important aspects of maintaining health. There are 61 million people with disability in the U.S., many of whom experience health disparities. However, it may not be clear to health professionals how people with disability seek health information.

OBJECTIVE

Assess the breadth, examine the characteristics, and evaluate the risk of bias in the existing literature related to health information seeking and people with disability.

METHODS

The authors conducted a systematic search across five databases (Pubmed, Scopus, PsycINFO, HealthSTAR, and CINAHL) to identify empirical journal articles related to health information seeking among people with disability. Analysis of data items and a quality assessment were completed.

RESULTS

Forty-two articles met the criteria for inclusion and were assessed. The articles primarily used survey methodology (50%), and primarily focused on ten disability types, including MS (19%), CP (17%) and general disability (17%). The articles primarily investigated the internet (88%), and healthcare providers (71%) as sources of health information. Trustworthiness (31%), accuracy (29%), and accessibility (29%) were also commonly assessed. The overall quality was high, with room for improvement in minimizing bias.

CONCLUSIONS

The literature addressing health information seeking among people with disability is heterogeneous, but generally of high quality. Future research may benefit from an inclusive definition of disability and a more consistent definition of health information. Focused research on best practices and interactions among sources of health information would be valuable additions.