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Walkowiak D, Domaradzki J, Mozrzymas R, Kałużny Ł, Walkowiak J. Navigating the Unique Challenges of Caregiving for Children with Rare Diseases: Are the Care Experiences of All Caregivers the Same? A Focus on Life-Limiting Rare Diseases. J Clin Med 2024; 13:4510. [PMID: 39124776 PMCID: PMC11313382 DOI: 10.3390/jcm13154510] [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: 06/03/2024] [Revised: 07/19/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Caregiving experiences in rare diseases (RDs) vary based on factors such as specific clinical entity, disease severity, the child's age, and available support and resources, leading to challenges that significantly impact caregivers' lives. This study investigates whether caregivers of children with different RDs encounter varied aspects of care. Methods: This study was conducted as a self-administered, anonymous, computer-assisted online survey, focusing on the challenges of caregiving for children with RDs. Questions covered aspects such as information availability on RDs, diagnostic processes, modern treatment accessibility, family physicians and specialists, the impact of caregiving on personal life, family dynamics, and financial challenges. To achieve our study objectives, we categorized caregivers of children with RDs into two groups to compare various aspects of caregiving: caregivers of children with phenylketonuria (PKU) (n = 175) and those caring for children with life-limiting rare diseases (LLRD) (n = 226). Results: Caregivers of children with LLRD reported greater emotional challenges, personal sacrifices, and financial burdens compared to caregivers of children with PKU. Significant differences included heightened emotional distress, more frequent conflicts, and lower assessments of healthcare support among LLRD caregivers. Although family support ratings were similar between the groups, perceptions of financial concerns and interactions with the healthcare system varied significantly. Conclusions: This study, representing the inaugural systematic comparison of specific caregiver cohorts overseeing children with RDs across a substantial sample size, provides valuable insights. The findings lay a crucial foundation for precisely tailoring assistance and support initiatives to meet the unique needs of caregivers facing various RDs in diverse contexts.
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Affiliation(s)
- Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, 60-356 Poznań, Poland
| | - Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, 60-356 Poznań, Poland;
| | - Renata Mozrzymas
- Research and Development Center, Regional Specialist Hospital, 53-413 Wrocław, Poland
| | - Łukasz Kałużny
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-356 Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-356 Poznań, Poland
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Harlow AB, Ledbetter L, Brandon DH. Parental presence, participation, and engagement in paediatric hospital care: A conceptual delineation. J Adv Nurs 2024; 80:2758-2771. [PMID: 38037504 DOI: 10.1111/jan.15996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
AIM To delineate between the concepts of parental presence, participation, and engagement in paediatric hospital care. DESIGN The concepts' uses in the literature were analysed to determine attributes, influences, and relationships. METHODS Delineations of each concept are established and conceptual definitions are proposed following Morses' methods. DATA SOURCES MEDLINE (PubMed); CINAHL, PsycINFO, Sociology Source Ultimate (EBSCOhost); Embase, Scopus (Elsevier); Google Scholar. Search dates October 2021, February 2023. RESULTS Multinational publications dated 1991-2023 revealed these concepts represent a range of parental behaviours, beliefs, and actions, which are not always perceptible to nurses, but which are important in family-integrated care delivery. Parental presence is the state of a parent being physically and/or emotionally with their child. Parental participation reflects parents' performing caregiving activities with or without nurses. Parental engagement is a parents' state of emotional involvement in their child's health and the ways they act on their child's behalf. CONCLUSION These concepts' manifestations are important to parental role attainment but may be inadequately understood and considered by healthcare providers. IMPLICATIONS Nurses have influence over parents' parental presence, participation, and engagement in their child's care but need support from healthcare institutions to ensure equitable family-integrated care delivery. IMPACT Problem: Lack of clear definition among these concepts results in incomplete and at times inequitable family-integrated care delivery. FINDINGS Parental presence is an antecedent to parental participation, and parental presence and participation are elements of parental engagement. The concepts interact to influence one another. IMPACT Hospitalized children, their families, nurses, and researchers will benefit through a better understanding of the concepts' attributes, interactions, and implications for enhanced family-integrated care delivery.
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Affiliation(s)
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Debra H Brandon
- Duke University School of Nursing, Durham, North Carolina, USA
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Widyaratne A, Bally JMG. Utilization of the Keeping Hope Possible Toolkit with parents of children with life limiting and life threatening illnesses during the COVID-19 pandemic: Exploring pediatric nurses and allied healthcare provider opinions. J Pediatr Nurs 2024; 77:e177-e186. [PMID: 38627171 DOI: 10.1016/j.pedn.2024.04.008] [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: 02/02/2023] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND For families with children diagnosed with complex illnesses, the COVID-19 pandemic added many challenges. In order to mitigate inevitable disruptions in pediatric care settings, caregivers may need added supports and resources. The Keeping Hope Possible (KHP) Toolkit is a self-administered intervention intended to enhance caregiving experiences of parents with a child with multiple needs. However, little is known about effectively disseminating the Toolkit. PURPOSE AND METHODS A qualitative, thematic analysis was conducted to explore the opinions and perceptions of pediatric nurses and allied healthcare providers (HCPs) in relation to the dissemination and use of the KHP Toolkit for use by families with complex medical needs. Structured interview data were analyzed from a sample of seven pediatric HCPs working in various care settings in one Canadian province. FINDINGS Five themes were developed including: Recognising Importance of the KHP Toolkit; Needing Support and Direction; Implementation and Use of the KHP Toolkit; Realizing Important Considerations for Success; and, Emphasizing Connection through Isolated Times. DISCUSSION Participants recognized the importance of the KHP Toolkit for parents and extended family in a variety of settings to encourage self-care, daily structure, and connectedness. Thus, pediatric nurses' awareness and openness to the initial dissemination of the Toolkit is essential, and a subsequent interprofessional team approach will ensure consistent reminders and support for families. APPLICATION TO PRACTICE Careful assessment of family readiness for learning about and using the KHP Toolkit is essential, along with an interprofessional approach to consistent inquiry and support at each family encounter.
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Affiliation(s)
- Amaya Widyaratne
- College of Arts & Science, University of Saskatchewan, 9 Campus Drive, Saskatoon, SK S7N 5A5, Canada.
| | - Jill M G Bally
- College of Nursing, University of Saskatchewan, 104 Clinic Drive, Saskatoon, SK S7N 2Z4, Canada
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P P, A R, E B, Z M, Z D, M H, R H, C F. Initiatives for promoting educator wellbeing: a Delphi study. BMC Psychol 2024; 12:220. [PMID: 38649952 PMCID: PMC11036615 DOI: 10.1186/s40359-024-01724-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Growing demands on educators have resulted in increased levels of burnout and stress and decreasing wellbeing. This study aimed to establish expert consensus on the key characteristics required in prospective educator wellbeing initiatives. METHODS The Delphi approach is a process of forecasting that is based on the aggregated opinion of panel members (or experts) within a field of study. Using a Delphi approach, academic and practitioner expertise were sought over a two-rounds, with 17 and 14 participants in each round respectively. The study aimed to identify how systemic factors (e.g., leadership) could be utilised to promote educator wellbeing. The study also sought expert consensus on enablers and barriers for engagement in educator wellbeing initiatives. RESULTS Findings highlighted the importance of fostering positive relationships with colleagues, communities and families, and the active role of wellbeing teams to promote wellbeing initiatives. The need for leaders to address their own wellbeing and build trust within teams was also identified. Panel members identified the need for prospective funding to prioritise wellbeing initiatives. There was also a preference for ongoing initiatives rather than stand-alone wellbeing events that conveyed the ongoing importance of managing one's wellbeing. CONCLUSIONS This paper presents practical recommendations that can be used to inform the development and evaluation of future initiatives and policy. Applying the consensus derived from this study is likely to make wellbeing initiatives more viable and facilitate uptake amongst educators.
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Affiliation(s)
- Patrick P
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo, VIC 3800, Clayton, Australia.
| | - Reupert A
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo, VIC 3800, Clayton, Australia
| | - Berger E
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo, VIC 3800, Clayton, Australia
- Monash Rural Health, Monash University, Warragul, Australia
| | - Morris Z
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo, VIC 3800, Clayton, Australia
| | - Diamond Z
- School of Education, Culture & Society, Faculty of Education, Monash University, Clayton, Australia
| | - Hammer M
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo, VIC 3800, Clayton, Australia
| | - Hine R
- Monash Rural Health, Monash University, Warragul, Australia
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Bally JMG, Burles M, Spurr S, McGrath J. Exploring the Use of Arts-Based Interventions and Research Methods in Families of Seriously Ill Children: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:395-416. [PMID: 37128884 PMCID: PMC10629247 DOI: 10.1177/10748407231165119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family care is essential to pediatric nursing practice, as the entire family is affected by childhood illness. However, little is known about art making for therapeutic purposes and how art is used to better understand families' experiences. Our purpose was to examine the nature of arts-based interventions and research methods used with, and the experiences of families of children facing life-limiting and life-threatening illnesses, and those families who are bereaved. Academic peer-reviewed sources published between January 1999 and May 2022 were retrieved via four databases using key search terms. Twenty-five articles were analyzed, resulting in three multifaceted categories including Social, Emotional, and Family Health. Critical strengths and limitations were also identified. Art making has been incorporated into interventions and research studies due to its benefits for family well-being. Understanding the potential of art making can inspire nurses to implement such activities to enhance family nursing practice and research.
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Engel M, Brouwer MA, Jansen N, Leget C, Teunissen SCCM, Kars MC. The spiritual dimension of parenting a child with a life-limiting or life-threatening condition: A mixed-methods systematic review. Palliat Med 2023; 37:1303-1325. [PMID: 37461310 PMCID: PMC10548770 DOI: 10.1177/02692163231186173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND Spirituality refers to the dynamic dimension of human life that relates to the way that persons experience meaning, purpose, and transcendence. The complex task of parenting a child with a life-limiting condition may raise existential questions, which are easily overlooked by healthcare professionals. AIM We explored how the spiritual dimension becomes manifest in parents of children in pediatric palliative care. DESIGN A mixed-methods systematic review was conducted, registered in Prospero (2021 CRD42021285318). DATA SOURCES PubMed, CINAHL, Embase, PsycInfo, and Cochrane were searched for articles published between January 1, 2015 and January 1, 2023. We included original empirical studies that reported on spirituality of parents of seriously ill children, from parents' perspectives. RESULTS Sixty-three studies were included: 22 North-American, 19 Asian, 13 European, 9 other. Studies varied in defining spirituality. We identified five different aspects of spirituality: religion, hope, parental identity, personal development, and feeling connected with others. All aspects could function as source of spirituality or cause of spiritual concern. Sources of spirituality helped parents to give meaning to their experiences and made them feel supported. However, parents also reported struggling with spiritual concerns. Several parents highlighted their need for professional support. CONCLUSIONS Although studies vary in defining spirituality, reports on spirituality focus on how parents connect to their faith, others, and themselves as parents. Healthcare professionals can support parents by paying attention to the spiritual process parents are going through. More research is needed into how healthcare professionals can support parents of seriously ill children in this process.
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Affiliation(s)
- Marijanne Engel
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marije A Brouwer
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nienke Jansen
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Carlo Leget
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Saskia CCM Teunissen
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marijke C Kars
- Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
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Witt S, Schuett K, Wiegand-Grefe S, Boettcher J, Quitmann J. Living with a rare disease - experiences and needs in pediatric patients and their parents. Orphanet J Rare Dis 2023; 18:242. [PMID: 37568186 PMCID: PMC10422846 DOI: 10.1186/s13023-023-02837-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND A rare disease (RD) diagnosis and therapy can affect the family's quality of life and mental health. A lack of information and missing care options lead to helplessness and psychological stress within families. This work aims to identify patients' and parents' experiences in daily life and with the health care system as well as their needs and current pathways to psychosocial care to develop implementation strategies adapted to the families' needs. METHODS The present analysis is part of the national multicenter study "Children Affected by Rare Disease and Their Families-Network (CARE-FAM-NET)." We conducted semi-structured telephone interviews with children, adolescents, and young adults with RD (aged 12 to 21 years) and parents of children with RD (aged 0 to 17 years). We analyzed the transcribed and anonymized interviews using the method of focused interview analyses to identify previous experiences with medical and psychosocial care and possible needs for improvement and support. RESULTS Seventy-four parents of children with RD and 15 children, adolescents, and young adults with RD participated. Five main themes emerged. Daily life with an RD: RD affects the everyday and social life of the respondents, negatively impacting mental well-being. Experiences with the health care system: The long diagnostic path is stressful for families. Professionals' lack of information/education leads to inadequate care for those affected. Psychosocial support: Families do not know about psychosocial care services. In some cases, the families take advantage of psychosocial support services (such as support groups or advocacy groups), which are predominantly very helpful. Difficulties and barriers: Time, socio-legal and organizational problems burden families and lead to advantages in using psychosocial services. Improvements for patient-oriented support: Those affected wished for timely, preventive support (especially in administrative and socio-legal matters) and education regarding psychosocial care services. CONCLUSION RD represent a great challenge for all family members - patients, parents, and siblings. The patients' and parents' previous experiences in daily life, medical and psychosocial care show a need for target-group specific support, including training of health care professionals and low-threshold access care services and practical help for all family members.
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Affiliation(s)
- Stefanie Witt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52 W 26, Hamburg, 20246, Germany.
| | - Katharina Schuett
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52 W 26, Hamburg, 20246, Germany
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Quitmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52 W 26, Hamburg, 20246, Germany
- Faculty of Business and Social Sciences, University of Applied Sciences Hamburg, Hamburg, Germany
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Nogueira AJ, Ribeiro MT. "The Key Is to Value Every Little Achievement": A Qualitative Study of the Psychological Experience of Parent Caregivers in Paediatric Palliative Care. Clin Pract 2023; 13:670-683. [PMID: 37366931 DOI: 10.3390/clinpract13030062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
In Europe, Portugal has been identified as the country with the most rapid evolution of paediatric palliative care provision, which is a highly complex experience for families. The present descriptive-exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting conditions in parent caregivers. A total of 14 families completed a sociodemographic and clinical data sheet and answered a structured online interview based on an incomplete narrative resulting from the Unwanted Guest Metaphor. A thematic analysis of the various narratives was performed through an inductive-deductive process. The results provide a holistic view of 10 essential dimensions in the parental psychological experience and contribute to the design of intervention methodologies in an eco-systemic approach. The importance of clear communication with health professionals, an awareness of the unpredictability of the disease, the desire for more self-care, the difficulty in understanding their children's needs and the threat implicit in everyday life are some of the main findings. This research emphasizes the importance of having opportunities of emotional expression and psychoeducation about anxiety' management, enhancing the perception of positive characteristics in children with palliative needs and creating time for the couple. The study has some limitations, such as the small sample size, and suggests that further research should explore the father's experience.
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Patrick PM, Reupert AE, McLean LA, Berger E. Developing a Support Program for Adult Children of Parents with Mental Illness: A Delphi Study. Community Ment Health J 2023; 59:209-221. [PMID: 35778634 PMCID: PMC9859908 DOI: 10.1007/s10597-022-00999-7] [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: 08/07/2021] [Accepted: 06/09/2022] [Indexed: 01/25/2023]
Abstract
Parental mental illness can have long-lasting impacts on a child's life. Although programs exist in supporting the needs of young children, there remains a paucity in programs that address the needs of adult children. A two-round Delphi study with adult children, academics and clinicians who have experience with parental mental illness was employed. A total of 45 and 24 participants participated in rounds one and two respectively. Open-ended questions in round one around program design and content were thematically analysed, and subsequently rated in round two. Adult children specifically identified four topics of need: (i) managing multiple roles, (ii) emotional regulation, (iii) setting relational boundaries and (iv) transition to parenthood. Current results provide the foundation for the development of modular programs that could be pilot tested with adult children who grew up with parents with mental illness.
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Affiliation(s)
- Pamela M Patrick
- Faculty of Education, School of Educational Psychology & Counselling, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia.
| | - Andrea E Reupert
- Faculty of Education, School of Educational Psychology & Counselling, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
| | - Louise A McLean
- Faculty of Education, School of Educational Psychology & Counselling, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
| | - Emily Berger
- Faculty of Education, School of Educational Psychology & Counselling, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
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Wu MH, Lee TY, Lin MH. The parental experience of participating in surgical decision-making regarding one's child with a congenital heart disease in Taiwan. J Pediatr Nurs 2023; 68:e103-e108. [PMID: 36437130 DOI: 10.1016/j.pedn.2022.11.020] [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: 08/02/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study explores how parents experienced the surgical decision-making process for their child with a congenital heart disease (CHD). DESIGN AND METHODS Purposive sampling was used in this qualitative descriptive study at a medical center in Northern Taiwan. Twelve parents whose children had cardiac corrective surgery participated in one-to-one in-depth interviews. The interview content subsequently was transcribed verbatim and analyzed by content analysis. RESULTS Five themes, with 2 to 3 subthemes, were identified: 1) accumulating medical knowledge in a short time, 2) trusting the medical teams but parents needing clear communication, 3) feeling pervasive uncertainty, 4) using self-talk to calm down, and 5) looking for positive energy from various sources. CONCLUSIONS For the parents of these children with CHD, participating in surgical decision-making can be a difficult and stressful experience. When explaining the disease and treatment procedures, it is important for medical professionals to make sure of the individual parent's information needs, to use plain language and encourage parents to ask questions. PRACTICE IMPLICATIONS Although the surgery is imperative and inevitable, understanding the parents' worries and providing adequate support can help them reduce feelings of uncertainty during the decision-making and surgical processes.
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Affiliation(s)
- Mei-Hua Wu
- Department of Nursing, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd, Taipei 10002, Taiwan, ROC.
| | - Tzu-Ying Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Rd. Beitou 11219, Taipei, Taiwan, ROC.
| | - Mei-Hsiang Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Rd. Beitou 11219, Taipei, Taiwan, ROC.
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Oakley S, Dunbar H, de Vries K. Parent-led strategies supporting personal well-being when caring for a child with a life-limiting condition: A scoping review. J Child Health Care 2022; 26:648-667. [PMID: 34372722 DOI: 10.1177/13674935211026122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The objectives of this review were to identify strategies initiated by parents of children with life-limiting conditions to support their own well-being at home and to describe the impact of these strategies on parental well-being. A systematic scoping review was performed using PRISMA-ScR guidelines, identifying 15 relevant studies that fit the inclusion and exclusion criteria. There were no studies that specifically assessed how parents support their own well-being; however, the 15 identified studies did provide pertinent data secondary to the primary aims of each study. This resulted in the identification of 14 parent-initiated strategies which were grouped thematically into 4 categories: (i) social experience and peer support, (ii) information and management techniques, (iii) reframed perspectives and (iv) prioritising own needs. Overall, there was some evidence of parents initiating specific, individualised and useful strategies to supporting their well-being. Notably lacking was any empirical evaluation as to the effectiveness of these strategies and the wider factors associated with them. Further research is required to assess how parents support their personal well-being in daily life and how these strategies can be implemented alongside service-initiated support to ensure full parental well-being.
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Affiliation(s)
- Sarah Oakley
- Leicester School of Nursing and Midwifery, 4487De Montfort University, Leicester, UK
| | - Helena Dunbar
- Leicester School of Nursing and Midwifery, 4487De Montfort University, Leicester, UK
| | - Kay de Vries
- Leicester School of Nursing and Midwifery, 4487De Montfort University, Leicester, UK
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Burles M, Bally JMG, Holtslander L, Zimmer M, Hodgson-Viden H. Supporting parental caregivers of seriously ill children: findings from a feasibility and acceptability study of a hope intervention. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2119975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Meridith Burles
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jill M. G. Bally
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Lorraine Holtslander
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Heather Hodgson-Viden
- Department of Pediatrics, Saskatchewan Health Authority, Saskatoon, SK, Canada
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Krantz M, Malm E, Darin N, Sofou K, Savvidou A, Reilly C, Boström P. Parental experiences of having a child with CLN3 disease (juvenile Batten disease) and how these experiences relate to family resilience. Child Care Health Dev 2022; 48:842-851. [PMID: 35233790 PMCID: PMC9541062 DOI: 10.1111/cch.12993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/08/2022] [Accepted: 02/20/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND CLN3 disease is a neurodegenerative condition presenting in the first decade of life typically leading to death in the third decade. The earliest symptom is rapidly progressive visual impairment followed by intellectual and motor impairments, epilepsy and behavioural disturbances. There are limited data on how the condition affects the family system or the role of family resilience in paediatric neurodegenerative diseases. METHODS Semi-structured interviews were conducted with eight parents (five mothers and three fathers) of five children with CLN3. Interview questions focused on the experience of having a child with CLN3, its impact on the family system as well as the concept of family resilience. Data were analysed via thematic analysis. RESULTS The thematic analysis resulted in four main themes. The theme 'recurring losses' included the feeling of losing a healthy child, the child's loss of abilities and loss of relationships. The theme 'disruption to the family system' included that siblings could be 'side-lined', the potential negative impact on romantic relationships and difficulties finding time to oneself. The theme 'Society is not developed for a progressive disease' highlighted the difficulties parents faced with respect to contacts with the health and/or social insurance system. The paediatric health care system was seen as supportive, but the adult health care system was not seen as fit for the purpose. Regarding family resilience, parents felt that the disease forced them to reconsider what was important in life. Several parents described that they learned to value small moments of joy and create deep connections through involvement in family routines and rituals. CONCLUSIONS CLN3 places a very significant burden on the family system including parental feelings of loss, impact on family relationships and lack of understanding within the health/social insurance systems. The concept of family resilience may be useful in understanding the experiences of families affected by paediatric neurodegenerative conditions.
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Affiliation(s)
- Mattias Krantz
- Department of PsychologyUniversity of GothenburgGothenburgSweden
| | - Emma Malm
- Department of PsychologyUniversity of GothenburgGothenburgSweden
| | - Niklas Darin
- Department of PediatricsInstitute of Clinical SciencesUniversity of GothenburgGothenburgSweden,Queen Silvia Children's Hospital, Sahlgrenska University HospitalGothenburgSweden
| | - Kalliopi Sofou
- Department of PediatricsInstitute of Clinical SciencesUniversity of GothenburgGothenburgSweden,Queen Silvia Children's Hospital, Sahlgrenska University HospitalGothenburgSweden
| | - Antri Savvidou
- Department of PediatricsInstitute of Clinical SciencesUniversity of GothenburgGothenburgSweden,Queen Silvia Children's Hospital, Sahlgrenska University HospitalGothenburgSweden
| | - Colin Reilly
- Department of PediatricsInstitute of Clinical SciencesUniversity of GothenburgGothenburgSweden,Queen Silvia Children's Hospital, Sahlgrenska University HospitalGothenburgSweden
| | - Petra Boström
- Department of PsychologyUniversity of GothenburgGothenburgSweden
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Chong L, Khalid F, Abdullah A. Compassionate Healthcare for Parents of Children with Life-limiting Illnesses: A Qualitative Study. Indian J Palliat Care 2021; 28:266-271. [PMID: 36072248 PMCID: PMC9443155 DOI: 10.25259/ijpc_50_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: Premature death of a child from a serious illness is probably one of the most painful experiences for a parent. This study examined the clinical experiences of bereaved parents of children with a life-limiting illness to provide recommendations for quality care. Materials and Methods: Data were collected using semi-structured in-depth interviews with bereaved parents whose children had died at least 3 months before the interview. Parents were purposively sampled from two institutions offering end-of-life care to children with life-limiting illnesses. Data were analysed using thematic analysis. Results: Data analysis revealed three main themes: (1) Clinical communication, (2) Healthcare infrastructure and (3) Non-physical aspects of healthcare. The seven subthemes uncovered were as follows: (1) Honesty and clarity, (2) empathy, (3) interdisciplinary communication, (4) inconveniences in hospital, (5) home palliative care, (6) financial burden of illness and (7) psychosocial and spiritual support. Conclusion: Strategies to improve healthcare for children and their families are multifold. Underlying the provision of quality care is compassion; a child and family-friendly healthcare system with compassionate providers and compassionate institutional policies are vital components to achieving quality healthcare. Culturally sensitive psychosocial, emotional and spiritual support will need to be integrated as standard care.
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Affiliation(s)
- Leeai Chong
- Department of Paediatrics University of Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan, Malaysia,
| | - Farah Khalid
- Department of Paediatrics University of Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan, Malaysia,
| | - Adina Abdullah
- Department of Primary Care Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan, Malaysia,
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Bally JMG, Burles M, Spurr S, Holtslander L, Hodgson-Viden H, Sinha R, Zimmer M. Keeping Hope Possible Toolkit: The Development and Evaluation of a Psychosocial Intervention for Parents of Infants, Children and Adolescents with Life Limiting and Life Threatening Illnesses. CHILDREN (BASEL, SWITZERLAND) 2021; 8:218. [PMID: 33808999 PMCID: PMC8000730 DOI: 10.3390/children8030218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Globally, many infants and children are diagnosed with illnesses that impose limitations on their well-being and life course trajectory. Children's care becomes the central focus of family life. Inadequate support for parents is detrimental to their well-being and management of their child's care and support needs. METHODS The second phase of this evaluation study followed a quasi-experimental crossover design to test a theory-based psychosocial intervention, the Keeping Hope Possible Toolkit. Fifty-nine participants were randomly assigned to one of two sequence groups, with measures of hope, feelings of control, distress, and uncertainty completed pre- and post-intervention, and at a three-month follow-up. Qualitative interviews sought to assess participant experiences with the intervention, along with acceptability and feasibility. RESULTS Significant influence on parental distress was found, and the qualitative findings reveal benefits of the intervention for parental wellbeing. The intervention effectively offered practical and emotional support to diverse family caregivers. CONCLUSIONS The evidence-informed KHP intervention can be used by healthcare providers to intervene with family caregivers to support their dynamic emotions including hope, need to live in the moment and remember self, and social preferences. In doing so, parents' critical caregiving activities can be sustained and their child's health and wellbeing optimized.
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Affiliation(s)
- Jill M. G. Bally
- College of Nursing, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.B.); (S.S.); (L.H.)
| | - Meridith Burles
- College of Nursing, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.B.); (S.S.); (L.H.)
| | - Shelley Spurr
- College of Nursing, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.B.); (S.S.); (L.H.)
| | - Lorraine Holtslander
- College of Nursing, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.B.); (S.S.); (L.H.)
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Heather Hodgson-Viden
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.H.-V.); (R.S.)
| | - Roona Sinha
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.H.-V.); (R.S.)
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16
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Ringnér A, Olsson C, Eriksson E, From I, Björk M. A moment just for me - parents' experiences of an intervention for person-centred information in paediatric oncology. Eur J Oncol Nurs 2021; 51:101923. [PMID: 33618229 DOI: 10.1016/j.ejon.2021.101923] [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: 07/26/2020] [Revised: 01/02/2021] [Accepted: 02/07/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Information can help parents of children with cancer by reducing uncertainty and giving them a sense of control in a chaotic situation. Although providing information to parents is a core activity of paediatric oncology nursing, few studies focus on interventions for informing parents. Thus, the aim of this study is to evaluate parents' experiences after participating in a person-centred information intervention for parents of children with cancer. METHOD This study is part of a process evaluation of a person-centred informational intervention in paediatric oncology for patients' parents. Qualitative semi-structured interviews with 13 parents who had taken part in the intervention were analysed using qualitative content analysis. RESULTS An opening for healing emerged as the overarching theme, consisting of three categories. Gaining a deeper understanding of the entire situation describes how parents benefitted from processing current topics and moving forward by learning. Caring reflections in a safe space describes how parents appreciated having a moment just for themselves and feeling better by venting their feelings. Meeting a competent and compassionate nurse describes how parents experienced trust and being listened to. CONCLUSION Having individual information meetings integrated as a primary nursing responsibility, mediated by competent and compassionate nurses also responsible for the care of the child, could enhance person-centred care and individualise parental education.
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Affiliation(s)
- Anders Ringnér
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden.
| | - Cecilia Olsson
- Karlstad University, Department of Health Sciences, Karlstad, Sweden
| | - Emma Eriksson
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden
| | - Ida From
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden
| | - Maria Björk
- Jönköping University, CHILD Research Group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden
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17
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Gill FJ, Hashem Z, Stegmann R, Aoun SM. The support needs of parent caregivers of children with a life-limiting illness and approaches used to meet their needs: A scoping review. Palliat Med 2021; 35:76-96. [PMID: 33103579 DOI: 10.1177/0269216320967593] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Provision of paediatric palliative care is complex and optimally covers meeting the individual needs of a heterogenous population of children and their parent caregivers throughout a life-limiting illness. It is unclear whether existing approaches comprehensively address parent caregivers' needs. AIM To examine support needs of parents caring for children with life limiting illnesses and identify specific approaches used to identify and address needs. DESIGN A scoping review. DATA SOURCES MEDLINE, EMBASE, PsycINFO, CINAHL and ProQuest Central, were searched for peer reviewed English language full text research published from 2008 to 2019. Study quality appraisal was undertaken. Fourteen quantitative, 18 qualitative and 12 mixed methods studies were synthesised and themed using summative content analysis and mapped to the Parent Supportive Care Needs Framework (PSCNF). RESULTS Themes were communication, choice, information, practical, social, psychological, emotional and physical. Communication and choice were central and additional to domains of the PSCNF. Unmet were needs for supporting siblings, for respite care, out of hours, psychological, home and educational support. Six articles reported using instruments to identify parent carer support needs. CONCLUSION Support needs of parent caregivers of children with life limiting illnesses are substantial and heterogenous. While studies report evidence of burden and distress in parent caregivers, this rarely translates into improvements in practice through the development of interventions. A systematic and regular assessment of individual parent caregiver support needs is required by using instruments appropriate to use in clinical practice to move the focus to palliative care interventions and improved services for parents.
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Affiliation(s)
- Fenella J Gill
- Perth Children's Hospital, Child and Adolescent Health Service, Nedlands, Western Australia, Australia.,School of Nursing, Midwifery and Paramedicine, Faculty Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Zahraa Hashem
- School of Nursing, Midwifery and Paramedicine, Faculty Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Roswitha Stegmann
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Samar M Aoun
- School of Psychology and Public Health, La Trobe University, Victoria, Australia.,Perron Institute for Neurological and Translational Science, Western Australia, Australia
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Brimble MJ, Anstey S, Davies J. Long-term nurse-parent relationships in paediatric palliative care: a narrative literature review. Int J Palliat Nurs 2020; 25:542-550. [PMID: 31755830 DOI: 10.12968/ijpn.2019.25.11.542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Paediatric palliative care (PPC) is an active, total approach to the holistic care of the child and family. Close, long-lasting relationships between healthcare professionals and parents in paediatric palliative care enhance quality, provide emotional support and can influence how parents manage their role in the face of uncertainty. AIM To present a narrative literature review of long-term relationships between children's nurses and parents in PPC settings. METHODS Six databases (CINAHL, PsycINFO, ASSIA, Scopus, Medline and BNI) were searched, identifying 35 articles. A grey literature search produced seven additional relevant items. FINDINGS Four themes were identified: bonds; attachments and trust; sharing the journey; going the extra mile; and boundaries and integrity. All themes revealed an element of tension between closeness and professionalism. CONCLUSION Gaining a greater understanding of how closeness and professionalism are successfully managed by children's palliative care nurses could positively influence pre- and post-registration nurse education.
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Affiliation(s)
- Mandy J Brimble
- Senior Lecturer and Professional Doctorate Student, Cardiff University, School of Healthcare Sciences
| | - Sally Anstey
- Senior Lecturer, Cardiff University, School of Healthcare Sciences
| | - Jane Davies
- Senior Lecturer, Cardiff University, School of Healthcare Sciences
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