Peer support among parents of children with congenital heart defects: A qualitative analysis of written responses submitted via an online survey

Mothers' Internet Journeys Through Social, Health Care, and Virtual Systems When Congenital Anomalies Are Diagnosed In Utero

OBJECTIVE

To examine mothers' internet usage, in conjunction with social, health care, and virtual peer support navigations, when congenital anomalies were diagnosed in utero.

DESIGN

Qualitative descriptive, consisting of semistructured interviews.

SETTING

Interview data were collected over Zoom; mothers participated from locations of their choosing.

PARTICIPANTS

Mothers of neonates discharged postoperatively from NICUs for uterine-diagnosed congenital anomalies. The sample was purposefully recruited from private Facebook groups for parents of children with congenital anomalies.

INTERVENTION/MEASUREMENTS

Analysis was done with deductive coding using concepts from the third iteration of the systems engineering initiative for patient safety theory. The a priori codes were health care, social, journey-benefit, journey-risk, task, and technology.

RESULTS

Twenty-two mothers signed up for an interview; 12 completed an interview, and 10 did not. The majority (n = 8, 66%) were White, had a bachelor's or graduate degree (n = 7, 58%) and were between 24 and 33 years of age (n = 8, 66%). Nine themes emerged: (a) Providers cautioned searching for diagnosis information but encouraged private Facebook groups for peer support, (b) Mothers' inquiries for their own care are lacking, (c) Search for information while recognizing parent-partner's coping differences, (d) Pace information from friends and family with patience and appreciation, (e) Manage inquiries from friends and family with group sharing, (f) Private Facebook groups provide a means of receiving and giving peer support, (g) Exposure to difficult stories on Facebook is a risk of stress, (h) Select a NICU, learn about their children's diagnoses, participate in virtual peer support, and (i) Device features frame search strategies.

CONCLUSION

Mothers reflected on the internet as a burden and a source of support in their health care journeys. The ubiquity of internet access calls for mothers to include in their health care journeys the complexities of managing time spent on the internet.

Preferences for Peer Support Amongst Families Engaged in Paediatric Screening Programmes: The Perspectives of Parents Involved in Screening for Type 1 Diabetes in Children Aged 3-13

INTRODUCTION

This work describes a secondary analysis of a qualitative data set originally used to understand parent participants' preferences for the design and implementation of a screening programme for paediatric Type 1 diabetes (T1D). From this, their spontaneous preferences for peer support emerged, described here in the context of existing peer support programmes for the newly diagnosed alongside suggestions for their incorporation into screening programmes for T1D and a range of other conditions.

METHODS

Data were collected from semi-structured interviews conducted with parents of children aged 3-13 years to explore their expectations, perceptions and preferences of a T1D paediatric screening programme. A secondary analysis of interviews from participants who spontaneously raised preferences for peer support was used to populate a novel framework informed by NHS England's key principles for the same, namely, Shared experiences and reciprocated support, Accessibility and inclusivity and Person-centred and integrated peer support.

RESULTS

Parents in 29 of 33 interviews spontaneously described the potential value of peer support if receiving a result indicating a positive (presymptomatic T1D result) from a screening programme. Specifically, the value of 'Shared experiences and reciprocated support' in terms of emotional support and reassurance, and access to more directly interpretable and relevant information related to the condition; 'Accessibility and inclusivity' relating to access to a community of similar individuals, whether in person or online; 'Person-centred and integrated peer-support' and the need for support reflecting the changing need of the child and the integration of peer support with clinical care.

CONCLUSIONS

The needs of peer support described by parents involved in T1D paediatric screening appear to be shared with those of families with children diagnosed with a range of life-altering conditions. Although the needs of peer support for paediatric screening may differ across conditions, our findings are a valuable starting point for its design both in T1D and other examples of similar population screening programmes.

PATIENT OR PUBLIC CONTRIBUTION

Patients and the public have been involved throughout the design of the ELSA study and have worked with us to inform the study process. They contributed to the design and content of patient-facing materials, the content of our topic guides and the analysis and interpretation of our findings.

Parents' Experiences Caring for a Child after a Critical Illness: A Qualitative Study

Objectives  This article described parents' experience and identifies outcomes important to parents following their child's critical illness. Methods  Semistructured interviews with 22 female and 4 male parents representing 26 critically ill children with predominately neurologic and respiratory diagnoses. Most children were younger than 5 years at discharge with a median (interquartile range) of 2 (2.0-3.0) years from discharge to interview. Results  Many children returned home with life-altering physical and cognitive disabilities requiring months to years of rehabilitation. Parents remembered feeling unprepared and facing an intense, chaotic time when the child first returned home. They described how they suddenly had to center their daily activities around the child's needs amidst competing needs of siblings and partners, and in some cases, the medicalization of the home. They recounted negotiating adjustments almost daily with insurance agencies, medical doctors and therapists, employers, the child, and other family members to keep the family functioning. In the long term, families developed a new norm, choosing to focus on what the child could still do rather than what they could not. Even if the child returned to baseline, parents remembered the adjustments made to keep the child alive and the family functioning. Conclusion  Heightened awareness of family experiences after pediatric critical illness will allow health care providers to improve family preparedness for the transition from hospital to home.

Meeting Parents' Needs for Education and Preparation following Congenital Heart Disease Diagnosis: Recommendations from a Crowdsourced Study

OBJECTIVE

This article characterizes the educational needs of parents following fetal or neonatal congenital heart disease (CHD) diagnosis and generates recommendations for meeting these needs.

STUDY DESIGN

Online crowdsourcing methods were used to collect qualitative data from 95 parents of children with CHD regarding their needs for education and preparation following fetal or neonatal diagnosis. Data were analyzed using qualitative methods and themes were organized around the substructure of met and unmet needs.

RESULTS

Two themes represented consistently met needs, whereas 10 themes represented needs that were either inconsistently met or consistently unmet. Parents reported needing more information about social, emotional, and financial supports, preparation for long-term care, and guidance toward reputable online resources. Parents also provided recommendations for meeting these needs.

CONCLUSION

Parents' needs for education and preparation following CHD diagnosis are much broader in scope than what they currently receive. Addressing these may support parental coping and active participation in medical decision-making.

KEY POINTS

· CHD counseling after diagnosis may provide opportunities to promote parents' mental health.. · Guidelines recommend that this counseling should include emotional and decision-making support, however, it is unclear what parents actually receive.. · This study found that parents' needs for education and preparation following CHD diagnosis are much broader in scope than what they currently receive..

Receiving a Prenatal or Postnatal Diagnosis of (Dis)Ability: The Role and Importance of the Nurse

ABSTRACT

The phenomenon of carrying and birthing an infant with a (dis)ability is complex and emotionally driven for parents. Infants with (dis)abilities are at risk for long-term health and developmental challenges, which may cause fear and stress in families. Parents report dissatisfaction with their experience of learning of their infant's (dis)ability diagnosis. After unexpected news is given to expecting or new parents prenatally or postnatally, it is the nurse who is often left with parents during an extremely emotional and vulnerable time. Although nurses play a pivotal role in supporting parents through this vulnerable time, their specific role is not well defined. This narrative synthesis reviews the role of the nurse during complex family situations and applies findings to their role in supporting families through receiving the diagnosis of a (dis)ability for their infant either prenatally or postnatally. Nurses can assist parents through this process of adaptation by using a compassionate and empathetic approach in their care, facilitating opportunities for parent-infant bonding, speaking with person-first language, clarifying complex information, and assisting with allocation of various internal and external resources. Future research dedicated to the creation of best practice clinical guidelines on communicating with families during the diagnosis of (dis)ability would assist nurses and other health care professionals in meeting the multifaceted and sensitive needs of parents and families, ultimately contributing to improved health outcomes for the parents, family, and infant.

The Role of Congenital Heart Disease Patient Organizations in Advocacy, Resources, and Support Across the Lifespan

Congenital heart disease patient organizations, comprising experts with lived experience, and their families and supporters, have become an essential voice for patient advocacy, resources, and support. Thanks largely to the Internet, these organizations are growing in number worldwide. Their common voice can be used to influence research, be the catalyst for advocacy efforts for new programmes and supports, and connect patients and providers in endeavours beyond the clinical setting. The result has become more active engagement with how policy decisions, research directions, and laws are decided that will shape patients' lives. From advocating for much-needed mental health support, policies to combat discrimination and the lack of access to support services, and partnerships with clinicians and others to develop educational resources and tools, congenital heart disease patient organizations are having a considerable impact on patient lives and ultimately patient outcomes.

A Psychosocial Care Model for Families Affected by Congenital Heart Disease

OBJECTIVES

To develop a model of family-based psychosocial care for congenital heart disease (CHD).

DESIGN

Qualitative study using crowdsourced data collected from parents of young children with CHD who received care across 42 hospitals.

SETTING

Yammer, a social networking platform used to facilitate online crowdsourcing and qualitative data collection.

SUBJECTS

Geographically diverse sample of 100 parents (72 mothers and 28 fathers) of young children with CHD.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Parents joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process. Three broad themes corresponding to pillars of family-based psychosocial care were identified: pillar 1) parent partnership in family-integrated medical care, pillar 2) supportive interactions focused on parent and family wellbeing, and pillar 3) integrated psychosocial care and peer support for parents and families. Each pillar was supported by subthemes corresponding to specific intervention strategies. Most parents described the need for intervention strategies across multiple pillars, with almost half reporting needs across all three pillars of psychosocial care. Parents' preferences for psychosocial support changed over time with changes to their child's medical status and across care settings (e.g., hospital, outpatient clinic).

CONCLUSIONS

Results support a model of family-based psychosocial care that is multidimensional and flexible to meet the needs of families affected by CHD. All members of the healthcare team play an important role in providing psychosocial support. Future research incorporating components of implementation science is needed to promote uptake of these findings, with the goal of optimizing family-based psychosocial support in the hospital setting and beyond.

Peer Support Experienced by Mothers of Children With Congenital Heart Defects in Sweden

The aim of this study was to describe experiences of peer support among mothers of children with congenital heart defects. Ten mothers were interviewed through a semi-structured approach and interviews were analyzed with systematic text condensation. The respondents established various channels used for peer support and navigated between the channels depending on what type of information or support they needed. Through the channels, they found peers they developed strong friendships with and who they relied on for emotional support. Communicating with peers involved the reciprocal exchange of unique emotional support between peers who understand each other as well as the exchange of information derived from their collective knowledge, and thus, difficult to find without the help of peers. The findings illustrate the potential strengths of establishing reliable collaboration and liaisons between clinical units and peer support networks.

Belonging to a community of care: Mothers' experiences of online peer support groups for parents having lost a child with congenital heart defects

The aim was to study mothers' experiences of online peer support groups after the death of a child. Participants (N = 8) were recruited through a newsletter for the Swedish association for families/children with heart defects, and two closed support groups on Facebook (900 and 100 members) and interviewed by telephone. Transcripts were analyzed with qualitative content analysis. The groups were available around the clock, regardless of support need, and mothers joined both to receive and provide support. Participation in online peer support groups may provide a sense of belonging to a caring community and serve as a valuable complement to healthcare.

Peer support among parents of children with congenital heart defects: A qualitative analysis of written responses submitted via an online survey

AIM

To explore experiences of peer support among parents of children with congenital heart defects.

DESIGN

A study analysing written responses to open-ended questions about peer support, collected via an online survey distributed in Sweden.

METHODS

Respondents were recruited during 3 months in 2018 by means of convenience sampling, through ads via the Swedish foundation for families with children who have heart defects and two closed Facebook groups for peer support. An online survey containing open-ended questions was distributed and responses were analysed with systematic text condensation.

RESULTS

Peer support was grounded in a mutual understanding among parents and involved highly appreciated emotional support. Listening to the stories of peers meant an opportunity to gain useful insights about what life is like for parents of children with heart defects. Receiving and providing peer support was described as rewarding on a personal level. Negative aspects of peer support were also described, which sometimes led to psychological distress and withdrawal from peer support activities.

CONCLUSION

Peer support is emotionally relieving and appreciated among parents of children with congenital heart defects, who consider providing the support a rewarding responsibility. While peer support activities may have considerable benefits for individuals, it may also lead to psychological distress for some.

IMPACT

This study addressed peer support among parents of children with congenital heart defects. The main findings illustrate the potential impact peer support can have on individuals and calls attention to the experienced benefits related to peer support activities, while also providing some insights regarding potential negative aspects. The findings have relevance for nurses, midwives, and other health professionals working in settings providing care for these families.