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Suonpera E, Gallagher K, Marlow N, Lanceley A. 'I don't want him to always be so far behind': Parental perceptions of child independence in the context of extreme prematurity; a qualitative study. J Child Health Care 2024:13674935241256545. [PMID: 38798176 DOI: 10.1177/13674935241256545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
This study addresses the paucity of research on parents of extremely preterm adolescents (born <27 weeks of gestation) and their experiences within the framework of parental determinism. We conducted semi-structured interviews with twenty-two mothers and one father. Data were analysed thematically, revealing three overarching themes and eight subthemes shaping parental accounts. These themes centred on parental ambitions for their children, their perceptions of their child's abilities, and the parenting behaviours employed to support parental aspirations. Parents' actions were influenced by their ambitions and the belief that they could impact their child's future independence. While some parents adopted 'trusting', non-intensive parenting behaviours, those anticipating challenges for their child's future independence resorted to intensive parenting practices. These findings align with the concept of parental determinism, emphasising the perceived causal link between present parental actions and future child outcomes. In the context of extreme prematurity, a nuanced understanding of parental perceptions regarding their child's future independence aligned with a delicate balance between hope and realistic aspiration is crucial for enhancing parental support and well-being.
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Affiliation(s)
- Emmi Suonpera
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Katie Gallagher
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Neil Marlow
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- UCL EGA Institute for Women's Health, University College London, London, UK
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Suonpera E, Lanceley A, Ni Y, Marlow N. Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study. Arch Dis Child Fetal Neonatal Ed 2024; 109:253-260. [PMID: 37879883 DOI: 10.1136/archdischild-2023-325429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To determine whether extremely preterm (EP) birth exerts persisting effects on parents in early adolescence. DESIGN Cross-sectional survey conducted between March 2017 and October 2018. SETTING Evaluation of a longitudinal population-based birth cohort in England at 11 years of age (EPICure2@11 Study). PARTICIPANTS Parents of EP (<27 weeks of gestation) adolescents and control parents of term born (≥37 weeks of gestation) classmates of similar age and sex. MAIN OUTCOME MEASURES The Parenting Stress Index Short Form (PSI-4-SF) and the Short Form Health Survey (SF-12v1). RESULTS The 163 EP and 125 comparison respondents were most commonly mothers in their mid-40s. EP parents reported higher total parenting stress scores compared with controls, overall (adjusted difference in means: 14 (95% CI 9 to 20)) and after exclusion of moderate and severe child disability and multiples (9 (95% CI 3 to 15). Average physical and mental health-related quality of life scores were similar in the two groups (adjusted difference in means physical health: -2 (95% CI -4 to 1) and mental health: -1 (95% CI -4 to 1)). Among EP parents, 12% (20/164) reported the combination of high parenting stress and low mental health scores. With increasing child age, parenting stress scores for preterm parents were lower in contrast to controls who reported increasing parenting stress. CONCLUSIONS In early adolescence, compared with parents of term-born children, EP parents experience increased levels of parenting stress that are particularly high among a proportion of parents and associated with lower mental health-related quality of life. Practitioner awareness of this continuing risk throughout childhood is important to support parental abilities and well-being.
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Affiliation(s)
- Emmi Suonpera
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Yanyan Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Neil Marlow
- EGA UCL Institute for Women's Health, University College London, London, UK
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Laporte G, Sergerie-Richard S, Genest C, Aita M. Family Resilience as an Emerging Concept in Neonatology: Evidence From a Metasummary Review. J Perinat Neonatal Nurs 2023:00005237-990000000-00014. [PMID: 37582182 DOI: 10.1097/jpn.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
BACKGROUND Family resilience can be observed through specific resilience-promoting processes, namely, shared belief systems, communication, and organizational processes, but the concept remains mostly unstudied in neonatology. This metasummary aims to evaluate the frequency of family resilience processes in qualitative scientific literature to illustrate how family resilience is exhibited in the neonatal intensive care unit (NICU) setting. METHODS A search among 4 databases yielded 7029 results, which were reviewed for inclusion. Following Sandelowski and Barroso's qualitative metasummary method, findings from each study were independently coded and frequency effect size was calculated. RESULTS Forty-six primary qualitative studies published between 2016 and 2022 conducted with parents of preterm infants who discussed their NICU hospitalization experience were included in this metasummary. All 9 of Walsh's family resilience processes were identified in the literature, and their frequency effect size ranged from 4% to 91%. Four additional themes emerged pertaining to specific family resilience behaviors exhibited by NICU families. CONCLUSION This analysis sheds new light on the most recent qualitative evidence of parents' experiences in the NICU by analyzing it through the lens of family resilience and posits family resilience as a promising concept in relation to the predominance of the family-centered care philosophy in neonatal units.
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Affiliation(s)
- Geneviève Laporte
- Faculty of Nursing, Université de Montréal, Montreal, Canada (Ms Laporte and Drs Genest and Aita); CHU Sainte-Justine Research Centre, Montreal, Canada (Ms Laporte and Dr Aita); Nursing Excellence Center, CIUSSS-EMTL, Montreal, Canada (Ms Sergerie-Richard); Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices (CRISE), and Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM), Université du Québec à Montréal, Montreal, Canada (Dr Genest); and Quebec Network on Nursing Intervention Research (RRISIQ), Montreal, Canada (Dr Aita)
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Bayrami N, Rassouli M, Shirinabadi Farahani A, Heidarzadeh M, Khademi F, Tajlli S, Babaie M, Masoum Poor A, Hatamipour K. Validation of post-traumatic growth inventory in mothers with the experience of having the NICU-Hospitalized newborns "validation of post-traumatic growth inventory". Nurs Open 2023. [PMID: 37147889 PMCID: PMC10333864 DOI: 10.1002/nop2.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/15/2023] [Accepted: 04/16/2023] [Indexed: 05/07/2023] Open
Abstract
AIMS Investigating post-traumatic growth (PTG) in mothers with the experience of having a preterm newborn hospitalized in the NICU requires a valid tool. This study aims to determine the validity and reliability of the Farsi version of the post-traumatic growth inventory (PTGI) in mothers with the experience of having their newborns hospitalized in the NICU. DESIGN This study was methodological research. METHODS In this study, 250 mothers who had newborns with a history of NICU hospitalization during the last 3 to 12 months and had visited paediatric clinics of the selected hospitals in Tehran with the aim of having their children's condition examined were selected through convenience sampling. The data were collected using a demographic information questionnaire and PTGI. The face validity, the construct validity (confirmatory factor analysis), and the internal consistency reliability of the inventory were measured using SPSS V22 and LISREL V8.8. RESULTS According to appropriate values for factor analysis fit indices (FI = 0.94, RMSEA = 0.07, IFI = 0.94, NFI = 0.93, RFI = 0.91, NNFI = 0.93, SRMR = 0.07), 21 items and 5 factors were confirmed for this inventory. Furthermore, Cronbach's alpha coefficient of this inventory was measured as α = 0.94. CONCLUSION According to favourable psychometric properties, the Farsi version of PTGI is a suitable tool for studying PTG in mothers with the experience of having preterm newborns in the NICU. Using PTGI can help nurses in planning family-centered care interventions to reduce the impact of the mental trauma caused by the preterm newborn's hospitalization in parents. PATIENT OR PUBLIC CONTRIBUTION Mothers who had newborns with a history of NICU hospitalization during the last 3-12 months.
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Affiliation(s)
- Nahid Bayrami
- Department of Pediatrics and Neonatal Intensive Care, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Shirinabadi Farahani
- Department of Pediatric & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Heidarzadeh
- Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fatemeh Khademi
- Department of Nursing, School of Nursing & Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Salehe Tajlli
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadese Babaie
- Cancer Research Center, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Masoum Poor
- Department of Pediatric & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khadijeh Hatamipour
- Department of Nursing, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
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Lafrenaye S, Dumas M, Gosselin É, Duhamel A, Bourgault P. Parents living with a child afflicted by a life-limiting medical condition: Typology of their narrative identity. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2021. [DOI: 10.4081/qrmh.2021.9174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Parents of children suffering from a life-limiting medical condition struggle with difficult existential questions. Our objective was to understand why those parents’ interactions with the medical world were so different, ranging from hostile to collaborative, with the themes of identity, spirituality and serenity. A grounded theory design based on the narrative identity framework was used to interview sixteen parents. Three categories emerged: i) Parents in the Almighty category delegate all their power to God or medicine and are the most suffering parents as they do not author their life; ii) Parents in the Me category make every decision on their own causing much anxiety, and they become rebarbative to the medical world; iii) Parents in the Guide category take advice from others, while remaining the authors of their stories and are the most serene parents. Understanding and recognizing these categories can have a major impact on communication with those families.
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Scanferla E, Gorwood P, Fasse L. Familial experience of acute bacterial meningitis in children: a transversal qualitative study using interpretative phenomenological analysis. BMJ Open 2021; 11:e047465. [PMID: 34285009 PMCID: PMC8292830 DOI: 10.1136/bmjopen-2020-047465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To capture the subjective experience of close family ascendants of acute bacterial meningitis survivors and to explore how they give meaning to this specific experience. DESIGN A qualitative study of indepth interviews using interpretative phenomenological analysis. PRIMARY OUTCOME Main meaning-making processes of participants' experience. SETTINGS Participants were recruited through two associations of people affected by meningitis and their family ascendants. PARTICIPANTS Convenience sampling of 11 women whose children or grandchildren were between 0.2 and 20 years old at the time of their meningitis diagnosis (M=4.06, SD=7.3). On average, 9.39 (SD=5.4) years had passed between the onset of illness and the interview. RESULTS Six superordinate themes (meningitis disease; healthcare services and professionals; knowledge/ignorance; repercussions of the meningitis experience: 'life afterwards'; sick child attitudes/behaviour; and sibling attitudes/behaviour) and two main meaning-making processes in relation to participants' experience of meningitis were identified: (1) the sick child becoming a 'hero': comparison with other children; and (2) engaging action/attitude: finding the 'positive' of the traumatic experience and engaging action to improve the care system. These two processes underpin the psychological adjustment to meningitis and its consequences. CONCLUSIONS This study provides a unique insight into close family members' first-hand experience with acute bacterial meningitis. Findings highlighted factors characterising the disease experience, the psychological adjustment of meningitis survivors' families and their meaning-making processes. These findings are important for research and clinical practice, demonstrating the multidimensional impact of the disease on family ascendants, their need for professional psychological support and the importance of direct involvement of parents in identifying key aspects of care.
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Affiliation(s)
- Elisabetta Scanferla
- CMME (Clinique des Maladies Mentales et de l'Encéphale), GHU Paris psychiatrie et neurosciences, Paris, France
- ED 450, Université de Paris, Paris, France
| | - Philip Gorwood
- CMME (Clinique des Maladies Mentales et de l'Encéphale), GHU Paris psychiatrie et neurosciences, Paris, France
- U1266, INSERM, Institute of Psychiatry and Neuroscience of Paris (IPNP), Université de Paris, Paris, France
| | - Léonor Fasse
- LPPS, EA4057, Université de Paris, Paris, France
- Département de Soins de Support, Gustave Roussy Institute, Villejuif, France
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Krick JA, Weiss EM, Snyder A, Haldar S, Campelia GD, Opel DJ. Living with the Unknown: A Qualitative Study of Parental Experience of Prognostic Uncertainty in the Neonatal Intensive Care Unit. Am J Perinatol 2021; 38:821-827. [PMID: 31899927 DOI: 10.1055/s-0039-3402722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study aims to characterize the experience of prognostic uncertainty for neonatal intensive care unit (NICU) parents. STUDY DESIGN We conducted a qualitative interview study of current and former NICU parents regarding their experience with prognostic uncertainty in the NICU. Interviews were transcribed and analyzed using a grounded theory methodology. RESULTS Twenty-four parents were interviewed before achieving thematic saturation. Three phases of the parental experience of prognostic uncertainty emerged: shock, gray daze, and looking forward. These phases often, but not always, occurred sequentially. In shock, parents felt overwhelmed by uncertainty and were unable to visualize a future for their family. In gray daze, parents felt frustrated by the continued uncertainty. While accepting the possibility of a future for their family, they could not conceptualize a path by which to achieve it. In looking forward, parents accepted uncertainty as inevitable and incorporated it into their vision of the future. CONCLUSION While each parent experienced the prognostic uncertainty in the neonatal intensive care unit in their own way, we found three common experiential phases. By understanding how a parent experiences prognostic uncertainty in these phases, providers may become better able to communicate and form therapeutic relationships with parents.
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Affiliation(s)
- Jeanne A Krick
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington
| | - Elliott Mark Weiss
- Treuman Katz Center for Pediatric Bioethics, Seattle, Washington.,Division of Neonatology, University of Washington, Seattle, Washington
| | - Anna Snyder
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Shefali Haldar
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington
| | - Georgina D Campelia
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | - Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington.,Department of Bioethics and Humanities, University of Washington, Seattle, Washington
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Van Haeken S, Braeken MAKA, Nuyts T, Franck E, Timmermans O, Bogaerts A. Perinatal Resilience for the First 1,000 Days of Life. Concept Analysis and Delphi Survey. Front Psychol 2020; 11:563432. [PMID: 33224056 PMCID: PMC7670043 DOI: 10.3389/fpsyg.2020.563432] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Abstract
Background The ability to cope with challenges and stress in life is generally understood as resilience. Pregnancy and parenthood are challenging times. The concept of resilience is receiving increasing interest from researchers, clinicians, and policy staff because of its potential impact on health, well-being, and quality of life. Nevertheless, the concept is less studied during the perinatal period. Objectives The aim of this study is to understand the concept of perinatal resilience, including the underlying processes and more specifically for the first 1,000 days of life. Methods A concept analysis according to the Walker and Avant (2011) framework was used, to investigate the basic elements of the concept. Concurrently, a two-round Delphi survey involving researchers, clinicians, epidemiologists, mothers, and fathers (N = 21), was conducted to prioritize the terms associated with perinatal resilience. Data collection took place between January and April 2019. Results Through concept analysis and Delphi survey, five defining attributes for perinatal resilience were identified: social support, self-efficacy, self-esteem, sense of mastery and personality. The additional terms, rated important by the Delphi survey, were linked to the consequences of being resilient during the perinatal period for the individual and his/her family. Specifically, highlighted were the experiences of families in personal growth and achieving family balance, adaptation, or acceptance. Conclusion Based on the results of the concept analysis and Delphi survey, we describe perinatal resilience for the first 1,000 days as a circular process towards a greater well-being in the form of personal growth, family balance, adaptation or acceptance, when faced with stressors, challenges or adversity during the perinatal period. The presence of resiliency attributes such as social support, sense of mastery, self-efficacy, and self-esteem enhance the capacity to be resilient and probably prevent mental health problems.
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Affiliation(s)
- Sarah Van Haeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Marijke A K A Braeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Tinne Nuyts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Erik Franck
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
| | - Olaf Timmermans
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Professorship Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Annick Bogaerts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
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Early for Everyone: Reconceptualizing Palliative Care in the Neonatal Intensive Care Unit. Adv Neonatal Care 2020; 20:109-117. [PMID: 31990696 DOI: 10.1097/anc.0000000000000707] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Palliative care (PC) in the neonatal intensive care unit (NICU) is often provided exclusively to infants expected to die. Standards of care support providing PC early after diagnosis with any condition likely to impact quality of life. PURPOSE To determine the state of early PC practice across populations to derive elements of early PC applicable to neonates and their families and demonstrate their application in practice. SEARCH STRATEGY Multiple literature searches were conducted from 2016 to 2019. Common keywords used were: palliative care; early PC; end of life, neonate; NICU; perinatal PC; pediatric PC; family-centered care; advanced care planning; palliative care consultant; and shared decision-making. FINDINGS Early PC is an emerging practice in adult, pediatric, and perinatal populations that has been shown to be helpful for and recommended by families. Three key elements of early PC in the NICU are shared decision-making, care planning, and coping with distress. A hypothetical case of a 24-week infant is presented to illustrate how findings may be applied. Evidence supports expansion of neonatal PC to include infants and families without terminal diagnoses and initiation earlier in care. IMPLICATIONS FOR PRACTICE Involving parents more fully in care planning activities and decision-making and providing structured support for them to cope with distress despite their child's prognosis are essential to early PC. IMPLICATIONS FOR RESEARCH As early PC is incorporated into practice, strategies should be evaluated for feasibility and efficacy to improve parental and neonatal outcomes. Researchers should consider engaging NICU parent stakeholders in leading early PC program development and research.
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Widding U, Hägglöf B, Farooqi A. Parents of preterm children narrate constructive aspects of their experiences. J Clin Nurs 2019; 28:4110-4118. [DOI: 10.1111/jocn.14948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/24/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Bruno Hägglöf
- Department of Clinical Sciences: Child and Adolescent Psychiatry Umeå University Hospital Umeå Sweden
| | - Aijaz Farooqi
- Department of Neonatology: Child and Adolescent Medicine Umeå University Hospital Umeå Sweden
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