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Ay A, Semerci R, Savaş EH, Sarıdağ KNK. Development and psychometric analysis of care needs scale for mothers of children with congenital heart disease. J Pediatr Nurs 2024; 78:51-59. [PMID: 38865825 DOI: 10.1016/j.pedn.2024.06.002] [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: 12/14/2023] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE This cross-sectional study aimed to create and evaluate a care needs scale for mothers of children with congenital heart disease (CHD) to determine its psychometric properties. DESIGN AND METHODS This methodological research was conducted with 155 mothers whose children were diagnosed with CHD and were treated at a university hospital. The study's methodology included scale development, specialist opinions, and a pilot test. Data analysis involved descriptive statistics, exploratory and confirmatory factor analyses, and reliability assessments. RESULTS The 11-item scale was created using component analysis, expert comments, and pilot testing. It was divided into two categories: Information Needs Regarding Disease and Treatment and Needs Regarding Care. The Exploratory Factor Analysis revealed a 2-factor structure, explaining 41.5% of the variance. Reliability analysis showed reliable dimensions, and Tukey's scalability test indicated the scale requires separate dimension evaluation. The model fit indices were obtained as CMIN/DF (72.751/41) = 1.774, GFI = 0.925, IFI = 0.923, TLI = 0.893, CFI = 0.920, RMSEA = 0.071, SRMR = 0.063. The Cronbach's alpha coefficient for subdimension 1 was 0.758, and for subdimension 2 was 0.678, indicating reliable dimensions. CONCLUSION The developed scale provides a valuable tool for assessing the care needs of mothers of children with CHD, contributing to enhancing maternal support programs in pediatric cardiology clinics. PRACTICE IMPLICATIONS Assessment of the care needs of mothers who have children with CHD is promising for the development of educational programs on this subject and to ensure the competence of mothers for care.
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Affiliation(s)
- Ayşe Ay
- Nursing Department, Faculty of Health Sciences, Başkent University, Ankara, Turkey.
| | - Remziye Semerci
- Child and Disease Nursing Department, Nursing Faculty, Koç University, İstanbul, Turkey
| | - Eyşan Hanzade Savaş
- Child and Disease Nursing Department, Nursing Faculty, Koç University, İstanbul, Turkey
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Gaskin KL, Barron D, Wray J. Parents' Journeys of Mastery and Knowledge Construction After Their Infant's First Stage of Surgery for Complex Congenital Heart Disease. Compr Child Adolesc Nurs 2024; 47:68-81. [PMID: 38090784 DOI: 10.1080/24694193.2023.2293993] [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: 05/15/2023] [Accepted: 12/05/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND A growing body of conceptual evidence over the last decade has increased our understanding of parents' experiences of having an infant with complex congenital heart disease. These concepts include parents' feelings of uncertainty, fear, excitement, and mastery. However, little is known about parents' experiences, confidence, and knowledge acquisition during transition from hospital to home with their infant after the first stage of complex cardiac surgery. A theoretical framework to assess, plan and implement child and family centered care would assist children's cardiac nurses responsible for parental education, discharge planning and coordination. AIM To explore parents' experiences of the transition from hospital to home with their infant, following the first stage of cardiac surgery. DESIGN A prospective mixed methods longitudinal design. Semi-structured interviews were undertaken, including administration of the Maternal Confidence Questionnaire at four timepoints: before discharge following stage one cardiac surgery (T0), 2 weeks' post discharge (T1), 8 weeks' post discharge (T2) and after stage two surgery (T3). Qualitative data were thematically analyzed. Descriptive statistics were used to characterize the sample and non-parametric repeated measures analysis of variance was used to analyze changes over time in maternal confidence scores. RESULTS Sixteen parents of 12 infants participated. Four "patterns of transition experience" emerged, the fourth "Mastery", is discussed in this paper. Mastery can be contextualized in terms of the parents' journeys of knowledge construction, gaining confidence and reflection. Learning was dynamic and transformational, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. Confidence at T0 was significantly lower than at T1 (p = .011), T2 (p = .018) and T3 (p = .012). There were no significant differences between scores at T1, T2 and T3. Liminality, as a concept, described the between and betwixt time that parents experienced as they were preparing for discharge from hospital; excitement to be going home balanced with the fear of being alone and confidence in looking after their fragile infant. CONCLUSION Parents of infants with complex congenital heart disease obtain knowledge, confidence, and mastery dependent upon their transition experience and their personal journey through pre-liminal, liminal, and post-liminal phases of discharge from hospital to home. A conceptual framework "Parenting through Transitions - hospital to home" emerged that could assist in structuring assessment of parents' knowledge and support needs within a coordinated discharge process. Identifying individualized support would promote adaptation and adjustment during transition from the pre to post liminal phase, following their infant's first stage of complex cardiac surgery.
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Affiliation(s)
- Kerry L Gaskin
- Children's Cardiac Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham Children's Hospital, Birmingham, UK
- Three Counties School of Nursing and Midwifery, University of Worcester, Worcester, UK
| | - David Barron
- Children's Cardiac Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham Children's Hospital, Birmingham, UK
- Division Head Cardiac Surgery, Hospital for Sick Children, Toronto, Canada
- CIT Endowed Chair, Professor of Surgery, University of Toronto, Toronto, Canada
| | - Jo Wray
- Health Psychology, Heart and Lung Directorate, Great Ormond Street Hospital for Children, London, UK
- Heart and Lung Directorate, NIHR Great Ormond Street Biomedical Research Centre, London, UK
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Rodrigues MG, Rodrigues JD, Moreira JA, Clemente F, Dias CC, Azevedo LF, Rodrigues PP, Areias JC, Areias ME. A randomized controlled trial to assess the impact of psychoeducation on the quality of life of parents with children with congenital heart defects-Quantitative component. Child Care Health Dev 2024; 50:e13199. [PMID: 37967565 DOI: 10.1111/cch.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/30/2023] [Accepted: 10/19/2023] [Indexed: 11/17/2023]
Abstract
PURPOSE To develop, implement and assess the results of psychoeducation to improve the QoL of parents with CHD newborns. METHODS Participants were parents of inpatient newborns with the diagnosis of non-syndromic CHD. We conducted a parallel RCT with an allocation ratio of 1:1 (intervention vs. control), considering the newborns, using mixed methods research. The intervention group received psychoeducation (Parental Psychoeducation in CHD [PPeCHD]) and the usual routines, and the control group received just the regular practices. The allocation concealment was assured. PI was involved in enrolling participants, developing and implementing the intervention, data collection and data analysis. We followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. RESULTS Parents of eight newborns were allocated to the intervention group (n = 15 parents) and eight to the control group (n = 13 parents). It was performed as an intention-to-treat (ITT) analysis. In M2 (4 weeks), the intervention group presented better QoL levels in the physical, psychological, and environmental domains of World Health Organization Quality of Life instrument (WHOQOL-Bref). In M3 (16 weeks), scores in physical and psychological domains maintained a statistically significant difference between the groups. CONCLUSIONS The PPeCHD, the psychoeducational intervention we developed, positively impacted parental QoL. These results support the initial hypothesis. This study is a fundamental milestone in this research field, adding new essential information to the literature.
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Affiliation(s)
- Marisa Garcia Rodrigues
- Department of Pediatric Cardiology, University Hospital Center of São João (CHUSJ), Porto, Portugal
- Department of Gynecology-Obstetrics and Pediatrics, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS) - EvidenS&HTA, FMUP, Porto, Portugal
| | - José Daniel Rodrigues
- Center for Health Technology and Services Research (CINTESIS) - EvidenS&HTA, FMUP, Porto, Portugal
| | - Jorge Antunes Moreira
- Department of Pediatric Cardiology, University Hospital Center of São João (CHUSJ), Porto, Portugal
| | - Fátima Clemente
- Department of Gynecology-Obstetrics and Pediatrics, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
- Neonatal Intensive Care Unit, Neonatology Department, CHUSJ, Porto, Portugal
- São João Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Training Center, CHUSJ, Porto, Portugal
| | - Cláudia Camila Dias
- Knowledge Management Unit and Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), FMUP, Porto, Portugal
- RISE@CINTESIS, FMUP, Porto, Portugal
| | - Luís Filipe Azevedo
- RISE@CINTESIS, FMUP, Porto, Portugal
- Department of Community Medicine, MEDCIDS, FMUP, Porto, Portugal
- Clinical and Health Services Research (PDICSS), FMUP, Porto, Portugal
| | - Pedro Pereira Rodrigues
- RISE@CINTESIS, FMUP, Porto, Portugal
- Department of Community Medicine, MEDCIDS, FMUP, Porto, Portugal
- Health Data Science (PDCDS), FMUP, Porto, Portugal
| | | | - Maria Emília Areias
- Cardiovascular R&D Unit (UnIC), FMUP, Porto, Portugal
- University Institute of Health Sciences (IUCS), Gandra, Portugal
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McKechnie AC, Elgersma KM, Iwaszko Wagner T, Trebilcock A, Damico J, Sosa A, Ambrose MB, Shah K, Sanchez Mejia AA, Pridham KF. An mHealth, patient engagement approach to understand and address parents' mental health and caregiving needs after prenatal diagnosis of critical congenital heart disease. PEC INNOVATION 2023; 3:100213. [PMID: 37771461 PMCID: PMC10523263 DOI: 10.1016/j.pecinn.2023.100213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/10/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023]
Abstract
Objective To provide an overview of the development of the Preparing Heart and Mind™ (PHM™) care program designed for parents with a prenatal diagnosis of critical congenital heart disease (CCHD) and describe issues of parental concern, caregiving competencies, and type and timing of PHM™ topics. Methods Guided participation theory underpinned intervention development and a mixed methods pilot of a novel, nurse-guided mHealth intervention. Parents were enrolled from the third trimester of pregnancy-12 weeks postnatally. Online surveys, session transcripts, and app use were descriptively analyzed. Results The sample included 19 mothers/birthing persons and 15 caregiving partners randomized to the intervention group. In 49 sessions, mental health/wellbeing (94%) and condition-specific information (86%) were top issues. Many caregiving competencies were developed, with mothers/birthing persons often focused on feeding (86%). Regulating emotions and co-parenting consistently needed support. PHM™ topics of preparing for hospitalization (47%) and handling uncertainty (45%) were most discussed. Two cases further characterize findings. Conclusion Nurse-parent collaborative understanding of issues emphasized the need for mental health assessments. Prenatal intervention opportunities were underscored through discussions of caregiving issues and PHM™ topics. Innovation PHM™ represents an innovative approach that holds promise for supporting parents' mental health and caregiving needs outside the healthcare setting.
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Affiliation(s)
| | - Kristin M. Elgersma
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Taylor Iwaszko Wagner
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Anna Trebilcock
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Jenna Damico
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Alejandra Sosa
- School of Nursing, Child and Family Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew B. Ambrose
- Medical School, Pediatrics-Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Kavisha Shah
- Medical School, Pediatrics-Cardiology, University of Minnesota, Minneapolis, MN, USA
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Pridham K, Nemykina Y, Connor A, Melby J, Brown R. Caregiving and Support Issues Identified by Parents of an Infant With Congenital Heart Disease for Interactive Problem-Solving. Res Theory Nurs Pract 2023; 37:RTNP-2022-0062.R1. [PMID: 37130796 PMCID: PMC10620106 DOI: 10.1891/rtnp-2022-0062] [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] [Indexed: 05/04/2023]
Abstract
Background and Purpose: Parents of an infant with complex congenital heart disease report caregiving challenges in the infant's first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving. Methods: The issues 31 parent dyads identified for interactive problem-solving at either or both infants aged 2 and 6 months were typed as caregiving or relational/support. The parent dyad's interactive competencies were assessed from video recording for two types of tasks (i.e., caregiving and the parent dyad's relationship as caregivers). Constructs of Iowa Family Interaction Rating Scales were applied to assess the competencies of mothers, fathers, and the parent dyad for a group that received guided participation (n = 17) and a group that received usual care (n = 8). Results: Pie charts showed feeding, most frequently identified for interactive problem-solving at 2 months, was surpassed at 6 months by growth and development. The time parents spent together was the most mentioned relationship issue at 2 and 6 months. Forest plots showed caregiving issues were associated with at least medium effect sizes for dyadic problem-solving for both parents at 2 and 6 months and for problem-solving for fathers at 2 and 6 months. Relational/support issues were associated with higher hostility and communication hindering than caregiving issues. Implications for Practice: Intervention to aid parents in interactive problem-solving for both caregiving and relationship/support issues merits development and testing.
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Affiliation(s)
- Karen Pridham
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
| | - Yuliya Nemykina
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
| | | | - Janet Melby
- Department of Human Development and Family Studies, Iowa State University, Ames IA, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
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Parents of children with congenital heart defects during the COVID-19 pandemic: An examination of mental health variables, risk factors, and protective factors. Heart Lung 2023; 57:130-139. [PMID: 36194947 PMCID: PMC9515340 DOI: 10.1016/j.hrtlng.2022.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/05/2022] [Accepted: 09/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little is known about the mental health burden or the factors that contribute to mental health variables in parents of children with congenital heart defects (CHD) during the COVID-19 pandemic. OBJECTIVE The purpose of this study was to examine risk and protective factors associated with anxiety symptoms, depression symptoms, and perceived stress in parents of young children with CHD during the COVID-19 pandemic. METHODS A nonexperimental design was used in this study of 127 parents of children aged newborn to five years with CHD during the COVID-19 pandemic. Regression analyses were conducted to examine associations between COVID-19 stressors, CHD care-related factors, parental resilience, external support, and mental health variables. RESULTS Parental resilience, emotional support, and informational support were key protective factors for anxiety, depression, and stress. However, resilience was remarkably low in CHD parents. Increased levels of anxiety symptoms, depression symptoms, and perceived stress were associated with 1) Exposure to a greater number of COVID-19-related stressors, 2) Distress from family visitation restrictions during healthcare encounters, 3) Worry related to the perceived risk of their CHD child's exposure to COVID-19 during healthcare encounters, and 4) Worry about their CHD child's risk of death or serious illness from COVID-19. CONCLUSIONS The additive impact of the COVID-19 pandemic plus CHD care-related worries on this parent population's mental health is significant. Interventions that promote resilience, address the effect of healthcare system changes, and support the needs of parents of young children with CHD during this and future pandemics are needed.
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Earle S, Blackburn M, Chambers L, Downing J, Flemming K, Hale J, Marston HR, O’Dell L, Sinason V, Watts L, Whitney S. 'Whose life are They Going to Save? It's Probably Not Going to be Mine!' Living With a Life-Shortening Condition During the Coronavirus (COVID-19) Pandemic: A Grounded Theory Study of Embodied Precarity. QUALITATIVE HEALTH RESEARCH 2022; 32:2055-2065. [PMID: 36250473 PMCID: PMC9574525 DOI: 10.1177/10497323221131692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This article explores the experiences of young adults with a life-shortening condition in the first wave of the Coronavirus (COVID-19) pandemic in the UK. It presents the findings from an inclusive qualitative research study using constructivist grounded theory which aimed to examine the unintended consequences of pandemic control measures (lockdown and 'shielding') on this population. Purposive and theoretical sampling methods were used to recruit young adults with a life-shortening condition, employing a range of recruitment methods such as social media, advertising in newsletters and snowballing. Twenty-six young adults (aged 22-40 years), with a wide range of life-shortening conditions participated in the study. Seventeen participants were female and nine male. The majority identified as White British/Other and the remainder as Black British (2), Mixed Race (2) or Latin American (1). Data were generated iteratively using in-depth guided interviews and analysed collectively by an inclusive research team using the constant comparative method. The article explores a theory of embodied precariousness of living with a life-shortening condition during the first wave of the Coronavirus pandemic in relation to three categories: the rationing of life-saving treatment, the deterioration of health and retraction of healthcare provision, and the disruption of typical care arrangements. The findings show that the pandemic control measures introduced to keep people safe have intensified the precarity of this group promoting inequalities in healthcare and health outcomes. The article identifies some implications for practice to support the future management of unexpected and unwanted change.
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Affiliation(s)
| | | | | | - Julia Downing
- International Children’s Palliative Care
Network, UK/South Africa
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The Relationship of Family Factors to Psychosocial Outcomes in Children with Hypoplastic Left Heart Syndrome at 6 Years of Age. J Pediatr 2022; 255:50-57.e2. [PMID: 36265572 DOI: 10.1016/j.jpeds.2022.10.016] [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: 05/13/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The objective of this study was to describe the relationships between family factors and outcomes for children with hypoplastic left heart syndrome (HLHS). STUDY DESIGN This cross-sectional study was ancillary to the Pediatric Heart Network Single Ventricle Reconstruction Extension Study to examine family factors including parental mental health, quality of life (QOL), family resources, function and management, and their relationships to child psychosocial outcomes (adaptive behavior, internalizing and externalizing behaviors and health-related quality of life [HRQOL]) at 6 years of age. RESULTS Participants were parents (115 mothers, 71 fathers) of children with HLHS. Parents reported anxiety, QOL and family resources that were worse than the general population; 33% reported family dysfunction. There were no meaningful differences between reports from mothers and fathers. Parental perception of better child health was associated with better family management of the condition (P < .05). Several family management factors explained a moderate amount of variance in adaptive behavior (ΔR2 = 0.08-0.14), adaptive skills (ΔR2 = 0.19-0.21), and HRQOL scores (ΔR2 = 0.04-0.18); little variance was explained in internalizing problems (ΔR2 = 0.02-0.03) (all P < .05) above and beyond demographic and clinical variables. CONCLUSIONS HLHS has a significant impact on both children and families. Relationships between child and family characteristics may impose risk or protection. Improved understanding of these associations should guide counseling and tailored interventions.
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Simeone S, Rea T, Platone N, Guillari A, Lanzuise A, Assanta N, Da Valle P, Baratta S, Pucciarelli G. Quality of Life of Families with Children Presenting Congenital Heart Disease:Longitudinal Study Protocol. Healthcare (Basel) 2022; 10:healthcare10071273. [PMID: 35885800 PMCID: PMC9317531 DOI: 10.3390/healthcare10071273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Advances in medicine have caused a notable increase in the survival rates of children born with congenital heart disease, even in the most complicated cases, almost mitigating the disease’s pathology from lethal to chronic. The quality of life perceived by such children is influenced by the perceptions of their parents. However, the international literature has rarely considered the entire family nucleus. AIMS: This study aims to study the temporal trend of quality of life of families with children with congenital heart disease, particularly with respect to parents following a child’s hospitalization for an invasive procedure. DESIGN: A longitudinal study. METHOD: A sample of families (that is, those including a child with congenital heart disease and their parents) will be enrolled following the patient’s discharge from the hospital and examined every 3 months for 1 year. The study’s adopted hypothesis is that there is an interdependence between the subjects of the study that is capable of influencing individual perceptions of quality of life. RESULTS: This study will attempt to identify variables (and their temporal trend) that can be attributed to the family unit and—together with physical and clinical variables—that may influence the quality of life of children with congenital heart disease. CONCLUSION: Examining family quality of life with the longitudinal method will allow us to identify the predictors and interdependence of this factor with respect to children and their parents. This will help to correct and elaborate upon care guidelines, providing better assistance to patients and their caregivers.
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Affiliation(s)
- Silvio Simeone
- Clinical and Experimental Medicine Department, “Magna Graecia” University, 88100 Catanzaro, Italy;
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy;
| | - Nicol Platone
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Assunta Guillari
- Department of Public Health, University Federico II of Naples, 80145 Napoli, Italy
- Correspondence:
| | | | - Nadia Assanta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Paola Da Valle
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Stefania Baratta
- Gaetano Pasquinucci Heart Hospital, 54100 Massa, Italy; (N.P.); (N.A.); (P.D.V.); (S.B.)
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevenion, University of Rome Tor Vergata, 00133 Rome, Italy;
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Parental post-traumatic stress, overprotective parenting, and emotional and behavioural problems for children with critical congenital heart disease. Cardiol Young 2022; 32:738-745. [PMID: 34365986 PMCID: PMC8825886 DOI: 10.1017/s1047951121002912] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine relationships amongst parental post-traumatic stress symptoms, parental post-traumatic growth, overprotective parenting, and child emotional/behavioural problems in families of children with critical CHD. METHOD Sixty parents (15 fathers) of children aged 1-6 completed online questionnaires assessing parental post-traumatic stress symptoms and post-traumatic growth, overprotective parenting, and child emotional/behavioural problems. Bivariate correlations and mediational analyses were conducted to evaluate overprotective parenting as a mediator of the association between parental post-traumatic stress symptoms and child emotional/behavioural problems. RESULTS Parents reported significant post-traumatic stress symptoms, with over 18% meeting criteria for post-traumatic stress disorder and 70% meeting criteria in one or more clusters. Parental post-traumatic growth was positively correlated with intrusion (r = .32, p = .01) but it was not associated with other post-traumatic stress symptom clusters. Parental post-traumatic stress symptoms were positively associated with overprotective parenting (r = .37, p = .008) and total child emotional/behavioural problems (r = .29, p = .037). Overprotective parenting was positively associated with total child emotional/behavioural problems (r = .45, p = .001) and fully mediated the relationship between parental post-traumatic stress symptoms and child emotional/behavioural problems. CONCLUSION Overprotective parenting mediates the relationship between parental post-traumatic stress symptoms and child emotional and behavioural problems in families of children with CHD. Both parental post-traumatic stress symptoms and overprotective parenting may be modifiable risk factors for poor child outcomes. This study highlights the need for interventions to prevent or reduce parental post-traumatic stress symptoms and to promote effective parenting following a diagnosis of CHD.
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Pridham K, Melby J, Connor A, Brown R, Nemykina Y. Parents' Interactive Problem-Solving Behavior and Emotion Studied With Audio Compared With Video Source. Res Theory Nurs Pract 2022; 36:RTNP-2022-0001. [PMID: 35292561 PMCID: PMC9475443 DOI: 10.1891/rtnp-2022-0001] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Parents' communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observational methods that can be applied in home, clinic and community settings. The Iowa Family Interaction Rating Scales provide comprehensive description of communicative and problem-solving behavior and emotion, but have only been applied to video-recorded interaction. Audio recording, in contrast to video recording, has the advantage of being unobtrusive, readily accessible, and generally acceptable, increasing the opportunity for focused examination and intervention of parents' interaction with each other or with clinicians. Our study objective was to examine the agreement of scores obtained on parents' interactive problem-solving behavior coded with the Iowa Family Interaction Rating Scales using an audio-recorded source for coding compared with coding from a video-recorded source. METHOD In secondary analysis, audio-recordings were derived from video recordings of 15 parent-parent interactions. Audio recordings were created and coded blind of the original video recording and coding. RESULTS Using Gwet's AC1 coefficient, agreement was at least moderate (0.61 - 0.80) for 69.1% of paired codes, signifying reliability of coding from audio recording for most codes. IMPLICATIONS FOR PRACTICE Selected Iowa Family Interaction Rating Scales can be used with acceptable reliability for coding parents' interactive problem-solving behavior from audio source, advancing the study of parent interactive-problem solving behavior and potentially parents' problem solving with clinicians.
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Affiliation(s)
- Karen Pridham
- University of Wisconsin-Madison School of Nursing, Madison, WI
| | | | | | - Roger Brown
- University of Wisconsin-Madison School of Nursing, Madison, WI
| | - Yuliya Nemykina
- University of Wisconsin-Madison School of Nursing, Madison, WI
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Willson LR, Rogers LG, Gingrich N, Shearer K, Hryniuk SS. Meeting the Needs of Parents of Children With Scoliosis: A Qualitative Descriptive Study. Glob Qual Nurs Res 2021; 8:23333936211045058. [PMID: 34796260 PMCID: PMC8593288 DOI: 10.1177/23333936211045058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
Needs of parents with children with scoliosis are complex and depend on their child’s treatments. The purpose of this study was to identify needs of parents with children with scoliosis. This qualitative description involved interviews with parents of children at various stages of treatment. A convenience, then purposeful sample of 16 parents (12 mothers, two fathers, and two stepfathers) was interviewed; interviews were transcribed and analyzed using thematic analysis. Parents’ needs included: Needing reliable medical information; Desiring information on complementary treatments; Wanting help in supporting and advocating for their child; Needing to protect the child and family; and Seeking connection and support. Although many parents’ needs are being met, this study recommends a nursing role aimed at providing parents with reliable medical information, discussing alternative treatments, assisting parents in their role of supporting their child, helping parents in their advocacy efforts, and referring parents to appropriate connections.
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Affiliation(s)
| | | | | | | | - Sarah Southon Hryniuk
- Stollery Children's Hospital, Edmonton, AB, Canada.,University of Alberta, Faculty of Nursing, Faculty of Medicine and Dentistry, 4-141, Edmonton Clinic Health Academy, Edmonton, AB, Canada
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Quality of life of parents with children with congenital abnormalities: a systematic review with meta-analysis of assessment methods and levels of quality of life. Qual Life Res 2021; 31:991-1011. [PMID: 34482484 DOI: 10.1007/s11136-021-02986-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantify and understand how to assess the quality of life and health-related QoL of parents with children with congenital abnormalities. METHODS We conducted a systematic review with meta-analysis. The search was carried out in 5 bibliographic databases and in ClinicalTrials.gov. No restriction on language or date of publication was applied. This was complemented by references of the studies found and studies of evidence synthesis, manual search of abstracts of relevant congresses/scientific meetings and contact with experts. We included primary studies (observational, quasi-experimental and experimental studies) on parents of children with CA reporting the outcome quality of life (primary outcome) of parents, independently of the intervention/exposure studied. RESULTS We included 75 studies (35 observational non-comparatives, 31 observational comparatives, 4 quasi-experimental and 5 experimental studies). We identified 27 different QoL instruments. The two most frequently used individual QoL instruments were WHOQOL-Bref and SF-36. Relatively to family QoL tools identified, we emphasized PedsQL FIM, IOFS and FQOL. Non-syndromic congenital heart defects were the CA most frequently studied. Through the analysis of comparative studies, we verified that parental and familial QoL were impaired in this population. CONCLUSIONS This review highlights the relevance of assessing QoL in parents with children with CA and explores the diverse QoL assessment tools described in the literature. Additionally, results indicate a knowledge gap that can help to draw new paths to future research. It is essential to assess QoL as a routine in healthcare providing and to implement strategies that improve it.
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Mussatto KA, Van Rompay MI, Trachtenberg FL, Pemberton V, Young-Borkowski L, Uzark K, Hollenbeck-Pringle D, Dunbar-Masterson C, Infinger P, Walter P, Sawin K. Family Function, Quality of Life, and Well-Being in Parents of Infants With Hypoplastic Left Heart Syndrome. JOURNAL OF FAMILY NURSING 2021; 27:222-234. [PMID: 33535863 PMCID: PMC8594631 DOI: 10.1177/1074840720987309] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Survival for hypoplastic left heart syndrome (HLHS) has improved dramatically. Little is known about early family function, quality of life (QOL), or well-being/adjustment for parents of infants with HLHS. Parent/family outcomes over time, predictors, and differences in 143 mothers and 72 fathers were examined. Parents reported better family function compared with published norms, but 26% experienced family dysfunction. QOL and well-being were significantly lower than adult norms. QOL scores generally declined over time, whereas self-reported well-being improved. Responses from mothers and fathers showed different trends, with mothers having worse scores on most measures and at most time points. Being a single parent was a risk factor for poorer family function, but not for lower individual QOL or well-being. Family characteristics, stress, and coping skills were predictive of outcomes. Parents' psychosocial responses to the challenges of life with infants with HLHS change over time. Individually tailored psychosocial support is needed.
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Affiliation(s)
| | | | | | | | | | - Karen Uzark
- C.S. Mott Children's Hospital, Ann Arbor, MI, USA
| | | | | | | | | | - Kathleen Sawin
- Milwaukee School of Engineering, WI, USA
- Children's Hospital of Wisconsin, Milwaukee, USA
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McKechnie AC, Erickson K, Ambrose MB, Chen S, Miller SJ, Mathiason MA, Johnson KA, Leuthner SR. Development and testing of a self-report measure of preparing to parent in the context of a fetal anomaly diagnosis. PATIENT EDUCATION AND COUNSELING 2021; 104:666-670. [PMID: 32839046 PMCID: PMC7889754 DOI: 10.1016/j.pec.2020.08.017] [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] [Received: 05/14/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To generate a self-report instrument to capture clinically relevant variations in expectant parents' caregiving development, specified by how they are preparing to parent an infant with a major congenital anomaly. METHODS Recent literature structured domains to guide item generation. Evaluations by experts and expectant parents led to a refined instrument for field testing. Psychometric testing included exploratory factor analysis, internal consistency, and test-retest reliability. RESULTS Samples included expert evaluators (n = 9), and expectant parent evaluators (n = 20) and expectant mother field testers (n = 67) with fetal anomaly diagnoses. Preparing to Parent-Act, Relate, Engage (PreP-ARE) resulted from a three factor solution that explained 71.8 % of the total variance, with global Cronbach's α = 0.72, and sub-scales 0.81, 0.65, 0.72 respectively. Cohen's weighted kappa indicated all items were acceptably reliable, with 14 of 19 items showing moderate (≥ 0.41) or good (≥ 0.61) reliability. Convergent validity was found between the maternal antenatal attachment and Act scales (r = 0.39, p = 0.001). CONCLUSION This empirically-based instrument was demonstrated to be valid and reliable, and has potential for studying this transitional time. PRACTICE IMPLICATIONS PreP-ARE could be used to understand patient responses to the diagnosis, level of engagement, readiness to make decisions, and ability to form collaborative partnerships to manage healthcare.
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Affiliation(s)
| | - Kari Erickson
- School of Nursing, University of Minnesota, Minneapolis, USA
| | | | - Sophie Chen
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Sarah J Miller
- School of Nursing, University of Minnesota, Minneapolis, USA
| | | | - Kathy A Johnson
- College of Nursing, Chamberlain University, Downers Grove, USA
| | - Steven R Leuthner
- Department of Pediatrics and Bioethics, Children's Wisconsin Clinics, Medical College of Wisconsin, Milwaukee, USA
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Sananes R, Goldberg CS, Newburger JW, Hu C, Trachtenberg F, Gaynor JW, Mahle WT, Miller T, Uzark K, Mussatto KA, Pizarro C, Jacobs JP, Cnota J, Atz AM, Lai WW, Burns KM, Milazzo A, Votava-Smith J, Brosig CL. Six-Year Neurodevelopmental Outcomes for Children With Single-Ventricle Physiology. Pediatrics 2021; 147:peds.2020-014589. [PMID: 33441486 PMCID: PMC7849196 DOI: 10.1542/peds.2020-014589] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if neurodevelopmental deficits in children with single-ventricle physiology change with age and early developmental scores predict 6-year outcomes. METHODS In the Single Ventricle Reconstruction Trial, Bayley Scales of Infant Development, Second Edition, were administered at 14 months of age, and parents completed the Behavior Assessment System for Children, Second Edition (BASC-2) annually from the ages of 2 to 6 years. Scores were classified as average, at risk, or impaired. We calculated sensitivities, specificities, and positive and negative predictive values of earlier tests on 6-year outcomes. RESULTS Of 291 eligible participants, 244 (84%) completed the BASC-2 at 6 years; more Single Ventricle Reconstruction participants than expected on the basis of normative data scored at risk or impaired on the BASC-2 Adaptive Skills Index at that evaluation (28.7% vs 15.9%; P < .001). Children with Adaptive Skills Composite scores <2 SD below the mean at the age of 6 were more likely to have had delayed development at 14 months, particularly on the Psychomotor Development Index (sensitivity of 79%). However, the positive predictive value of the 14-month Mental Development Index and Psychomotor Development Index for 6-year BASC-2 Adaptive Scores was low (44% and 36%, respectively). Adaptive Skills Composite score impairments at the age of 6 were poorly predicted by using earlier BASC-2 assessments, with low sensitivities at the ages of 3 (37%), 4 (48%), and 5 years (55%). CONCLUSIONS Many children with hypoplastic left heart syndrome who have low adaptive skills at the age of 6 years will not be identified by screening at earlier ages. With our findings, we highlight the importance of serial evaluations for children with critical congenital heart disease throughout development.
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Affiliation(s)
- Renee Sananes
- Department of Pediatrics and Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada;
| | - Caren S. Goldberg
- Department of Pediatrics, Michigan Medicine, Medical School, University of Michigan, Ann Arbor, Michigan
| | - Jane W. Newburger
- Department of Cardiology, Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Chenwei Hu
- New England Research Institutes, Watertown, Massachusetts
| | | | - J. William Gaynor
- Division of Pediatric Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - William T. Mahle
- Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia
| | - Thomas Miller
- Department of Pediatrics, Primary Children’s Hospital, University of Utah, Salt Lake City, Utah;,Division of Pediatric Cardiology, Maine Medical Center, Portland, Maine
| | - Karen Uzark
- Department of Pediatrics, Michigan Medicine, Medical School, University of Michigan, Ann Arbor, Michigan
| | | | - Christian Pizarro
- Department of Surgery, Nemours Cardiac Center, Alfred I du Pont Hospital for Children, Wilmington, Delaware
| | | | - James Cnota
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Andrew M. Atz
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Wyman W. Lai
- Children’s Heart Institute, Children’s Hospital of Orange County, Orange, California
| | | | - Angelo Milazzo
- Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina;,Department of Pediatrics, East Carolina University, Greenville, North Carolina;,Department of Pediatrics, Wake Forest University, Winston-Salem, North Carolina; and
| | - Jodie Votava-Smith
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Cheryl L. Brosig
- Pediatrics, Herma Heart Institute, Children’s Wisconsin and Medical College of Wisconsin, Milwaukee, Wisconsin
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Lumsden MR, Smith DM, Twigg E, Guerrero R, Wittkowski A. Children with single ventricle congenital heart defects: An interpretative phenomenological analysis of the lived parent experience. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McKechnie AC, Johnson KA, Baker MJ, Docherty SL, Leuthner SR, Thoyre S. Adaptive Leadership in Parents Caring for their Children Born with Life-Threatening Conditions. J Pediatr Nurs 2020; 53:41-51. [PMID: 32438191 PMCID: PMC7362670 DOI: 10.1016/j.pedn.2020.03.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to chronicle the adaptive challenges and adaptive work, including emerging leadership behaviors, recounted over time by the parents of very young children diagnosed before birth with life threatening conditions. DESIGN AND METHODS A descriptive, follow-up study design was used for the current study. Following the original grounded dimensional analysis study completed in 2012, the corpus for this analysis was collected in 2014. In-depth, audio-recorded interviews were conducted with 15 families (8 couples, 7 mothers). The 15 children, born with cardiac, abdominal, and cerebrospinal anomalies, were 14 - 37 months or deceased at follow-up. A directed content analysis of transcribed verbatim interviews was structured by the Adaptive Leadership framework. RESULTS Parents described behaviors that indicated a non-linear development towards adaptive leadership as they accomplished the adaptive work within intra- and interpersonal domains that was necessary to address challenges over time. Not all parents described abilities and/or a willingness to mobilize others to do adaptive work, suggesting that adaptive leadership remained an unrealized potential. CONCLUSIONS Understood as a complex adaptive system, parents of medically at-risk children hold potential for development towards adaptive leadership and collaborative partnership within the family and with healthcare providers. PRACTICE IMPLICATIONS Due to improved survival rates, parents face ongoing challenges related to their children's unpredictable and often chronic health needs. Study findings illustrate parents' adaptive work and leadership behaviors, which can inform nursing assessments, as well as the type and timing for intervention.
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Affiliation(s)
- Anne C McKechnie
- Child and Family Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, MN, United States of America.
| | - Kathy A Johnson
- College of Nursing, Chamberlain University, Downers Grove, IL, United States of America
| | - Maureen J Baker
- MSN Division, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Sharron L Docherty
- School of Nursing, Duke University, Durham, NC, United States of America
| | - Steven R Leuthner
- Division of Neonatology, Department of Pediatrics and Bioethics, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Suzanne Thoyre
- PhD Division, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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19
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Williams TS, McDonald KP, Roberts SD, Chau V, Seed M, Miller SP, Sananes R. From Diagnoses to Ongoing Journey: Parent Experiences Following Congenital Heart Disease Diagnoses. J Pediatr Psychol 2020; 44:924-936. [PMID: 31290975 DOI: 10.1093/jpepsy/jsz055] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Using qualitative and quantitative methods, the current cross-sectional study examined parents' experiences at the time of their child's diagnosis, what they thought helped their child recover, barriers to support, and identified needs for future models of care. METHOD The sample included 26 parents (22 mothers, 3 fathers, and 1 mother/father pair) of children with CHD, ranging in age between 6 months and 4 years with a mean age of 2 years. RESULTS Qualitative results were organized around five themes: (a) They (medical team) saved my child's life, (b) My child is going to be okay, (c) Not out of the woods, (d) Optimizing support for my child and myself, and (e) What still gets in the way. Parents uniformly expressed a need for greater mental health support for their children as well as programs to improve parents' skill and confidence, with no difference between age groups (< 2 years and > 2 years of age). Common barriers to service included distance and time off work. CONCLUSION Parents' experiences informed both acute and long term implications following CHD diagnoses, and highlight current gaps in mental health care. Direction for clinical care and improved intervention opportunities are discussed.
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Affiliation(s)
- Tricia S Williams
- Division of Neurology, Department of Psychology, The Hospital for Sick Children.,Department of Pediatrics, The University of Toronto
| | - Kyla P McDonald
- Division of Neurology, Department of Psychology, The Hospital for Sick Children.,York University
| | - Samantha D Roberts
- Division of Neurology, Department of Psychology, The Hospital for Sick Children.,York University
| | - Vann Chau
- Department of Pediatrics, The University of Toronto.,Division of Neurology, Department of Paediatrics, The Hospital for Sick Children
| | - Mike Seed
- Department of Pediatrics, The University of Toronto.,Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children
| | - Steven P Miller
- Department of Pediatrics, The University of Toronto.,Division of Neurology, Department of Paediatrics, The Hospital for Sick Children
| | - Renee Sananes
- Division of Neurology, Department of Psychology, The Hospital for Sick Children.,Department of Pediatrics, The University of Toronto
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20
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Svensson MK, Wahlberg A, Gislason GH. Chronic Paradoxes: A Systematic Review of Qualitative Family Perspectives on Living With Congenital Heart Defects. QUALITATIVE HEALTH RESEARCH 2020; 30:119-132. [PMID: 31526075 DOI: 10.1177/1049732319869909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There have been substantial advances in the diagnostics and treatment of congenital heart defects (CHDs) in recent decades, and this has improved survival significantly. Consequently, there is a growing interest in how CHDs affect the daily lives of children and youth. We examine life with CHDs as a particular kind of living from the perspectives of both children and youth with CHDs and their families through a systematic review of existing qualitative research. Based on a meta-ethnographic analysis of 20 articles (identified through PubMed, EMBASE, EBSCOhost, PSYCHinfo, Scopus, and Web of Science from January 7 to 12, 2016), we argue that living with CHDs is characterized by chronic paradoxes arising out of the transitions, normalities, and futures that families have to navigate.
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Affiliation(s)
- Marie Kofod Svensson
- The Danish Heart Foundation, Copenhagen, Denmark
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Ayo Wahlberg
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar H Gislason
- The Danish Heart Foundation, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Denmark
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21
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Thomi M, Pfammatter JP, Spichiger E. Parental emotional and hands-on work-Experiences of parents with a newborn undergoing congenital heart surgery: A qualitative study. J SPEC PEDIATR NURS 2019; 24:e12269. [PMID: 31468697 DOI: 10.1111/jspn.12269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 07/28/2019] [Accepted: 08/05/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore both mothers' and fathers' experiences from prenatal or postnatal diagnosis of their newborn's congenital heart disease (CHD) to the first discharge after heart surgery in a Swiss university children's hospital. DESIGN AND METHOD A qualitative research approach, based on a constructivist paradigm, was applied to explore participants' experiences and perceptions. Parents of nine children with moderate to severe CHD participated in semistructured joint couple interviews. Data were analyzed inductively via an iterative process, following the steps of thematic analysis. RESULTS Between the child's CHD diagnosis and hospital discharge after neonatal cardiac surgery, the overarching theme for parents was being confronted with demanding emotional and hands-on work. This parental work included four themes with subthemes: Parents had to tackle a route through an unknown hospital world from receiving the CHD diagnosis and experiencing delivery to attending to their child in the pediatric intensive care unit and during surgery, as well as during the transfer to and the stay on the pediatric cardiac unit. They experienced an at times challenging interplay with health care professionals, performed teamwork as the nuclear family and managed concerned relatives and friends. PRACTICE IMPLICATIONS Health care professionals should establish trustful relationships with parents, while accompanying families continuously, providing consistent, straightforward information, and expressing appreciation for the parents' exceptional emotional and hands-on work. Health care professionals' awareness of parent's experiences is vital to compassionate family-centered care.
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Affiliation(s)
- Mirjam Thomi
- University Children's Hospital, Inselspital, Bern University Hospital, Bern, Switzerland.,Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jean-Pierre Pfammatter
- Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Elisabeth Spichiger
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.,Head Office of Nursing and Allied Health Professionals, Inselspital, Bern University Hospital, Bern, Switzerland
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22
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Abstract
Mothers of children with congenital heart disease (CHD) tend to be concerned about their child's normal life. The majority of these mothers tend to experience negative psychological problems. In this study, the adaptation process of mothers raising a child with complex CHD was investigated based on the sociocultural context of Korea. The data collection was conducted by in-depth interviews and theoretical sampling was performed until the data were saturated. The collected data were analyzed using continuous theoretical comparisons. The results of the present study showed that the core category in the mothers' adaptation process was 'anxiety regarding the future', and the mothers' adaptation process consisted of the impact phase, standing against phase, and accepting phase. In the impact phase, the participants emotionally fluctuated between 'feelings of abandonment' and 'entertaining hope'. In the standing against phase, participants tended to dedicate everything to child-rearing while being affected by 'being encouraged by support' and 'being frustrated by tasks beyond their limits'. In the accepting phase, the subjects attempted to 'accept the child as is', 'resist hard feelings', and 'share hope'. Health-care providers need to develop programs that include information regarding CHD, how to care for a child with CHD, and effective child-rearing behaviors.
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Affiliation(s)
- Jeong-Ah Ahn
- College of Nursing, Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Sunhee Lee
- College of Nursing, The Catholic University of Korea, Seoul, Korea
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Patterns of Transition Experience for Parents Going Home from Hospital with their Infant after First Stage Surgery for Complex Congenital Heart Disease. J Pediatr Nurs 2018; 41:e23-e32. [PMID: 29217153 DOI: 10.1016/j.pedn.2017.11.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/20/2017] [Accepted: 11/25/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study was to explore parents' experiences of one specific timepoint in their infant's journey: the transition from hospital to home, following the first stage of their infant's cardiac surgery for complex congenital heart disease. DESIGN AND METHODS A prospective longitudinal mixed methods study, underpinned with Middle Range Transition Theory (Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000). Face to face and telephone interviews were conducted and self-report forms completed by parents at four-time points: before discharge (T0), 2weeks after discharge (T1), 8weeks after discharge (T2) and after stage two surgery (T3). Interviews were transcribed verbatim before inductive thematic analysis. RESULTS Parents were recruited over a 15-month period from 2013 to 2015. Twelve mothers and 4 fathers took part. The infants had functionally univentricular heart (left n=10, right n=1) and a systemic shunt dependent lesion, tetralogy of Fallot (n=1). Dynamic constructivist and constructionist social processes occurred for all parents, involving physical, physiological, psychological and cognitive elements within four 'patterns of experience', two of which 'safety and security' and 'love and support' are presented in this paper. IMPLICATIONS Parental support is essential; parents need to be engaged in discharge planning process and given the opportunity to express their needs to ensure that discharge care is truly patient and family centered. CONCLUSIONS Transition from hospital to home was complex and multi-faceted, with unanticipated physical and emotional transitions superimposed upon those that were expected.
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Wei H, Wei T, Brown KJ, Buck SH, Mill MR. Parents’ Perceptions of Caring Characteristics of Physicians and Nurses. ACTA ACUST UNITED AC 2018. [DOI: 10.20467/1091-5710.22.1.pg47] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The purpose of this study is to describe parents’ perceptions of the caring characteristics of physicians and nurses who take care of their children with CHD undergoing heart surgery. This is a qualitative descriptive study with interviews guided by Swanson Theory of Caring. According to parents’ descriptions, the top four caring characteristics of physicians and nurses are competence, altruism, responsibility, and empathy. Caring physicians and nurses not only treat patients’ physical illnesses with medical knowledge but also care for their psychological and emotional needs. Physicians’ and nurses’ caring characteristics facilitate the dissemination of professional expertise and make advanced technologies meaningful.
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Wray J, Brown K, Tregay J, Crowe S, Knowles R, Bull K, Gibson F. Parents' Experiences of Caring for Their Child at the Time of Discharge After Cardiac Surgery and During the Postdischarge Period: Qualitative Study Using an Online Forum. J Med Internet Res 2018; 20:e155. [PMID: 29743157 PMCID: PMC5966654 DOI: 10.2196/jmir.9104] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/11/2018] [Accepted: 01/29/2018] [Indexed: 11/21/2022] Open
Abstract
Background Congenital heart disease (CHD) is the most common class of birth defects, which encompasses a broad spectrum of severity ranging from relatively minor to extremely complex. Improvements in surgery and intensive care have resulted in an increasing number of infants with the most complex lesions surviving after surgery until the time of discharge from the hospital, but there remain concerns about out-of-hospital mortality, variability in how services are provided at the time of discharge and beyond, and difficulties experienced by some families in accessing care. Objective As part of a mixed-methods program of research, this study aimed to elicit parental experiences of caring for a child with CHD after hospital discharge following a cardiac surgery and collect information to inform interviews for a subsequent stage of the project. Methods A closed online discussion group was set up via the main Facebook page of the Children’s Heart Federation (CHF), a national charity offering support to children with heart disease and their families. The discussion group was advertised through the charity’s webpage, and interested participants were directed to the charity’s Facebook page from where they could access the closed Facebook group and respond to questions posted. The CHF moderated the forum, and the research team provided questions to be posted on the forum. Responses were collated into a single transcript and subjected to thematic analysis. Results The forum was open for 4 months, and 91 participants (mean age 35 years, range 23-58 years, 89 females, 89 parents, and 2 grandparents) submitted demographic information and were given access to the closed forum group. A common experience of isolation emerged from the data, with descriptions of how that isolation was experienced (physical, social, knowledge) and its psychological impact, together with the factors that made it worse or better. Woven through this theme was the notion that parents developed expertise over time. Conclusions The use of an online forum provided a means for eliciting data from a large number of parents regarding their experiences of caring for their child after hospital discharge following cardiac surgery. Parents engaged with the forum and were able to articulate what went well and what went less well, together with sharing their stories and supporting each other through doing so. Some parents clearly found participating in the forum a positive experience in itself, demonstrating the potential of social media as a mechanism for providing support and reducing isolation. Information gained from the forum was used to shape questions for interviews with parents in a subsequent phase of the study. Furthermore, the themes identified in the online forum have contributed to identifying ways of improving the provision of care and support for parents of high-risk babies following discharge after cardiac surgery.
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Affiliation(s)
- Jo Wray
- Charles West Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Katherine Brown
- Charles West Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Jenifer Tregay
- Charles West Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Sonya Crowe
- Clinical Operational Research Unit, University College London, London, United Kingdom
| | - Rachel Knowles
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom
| | - Kate Bull
- Charles West Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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28
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A Metasynthesis: Uncovering What Is Known About the Experiences of Families With Children Who Have Life-limiting and Life-threatening Illnesses. J Pediatr Nurs 2018; 38:88-98. [PMID: 29357986 DOI: 10.1016/j.pedn.2017.11.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/25/2017] [Accepted: 11/03/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE To conduct a metasynthesis of qualitative research exploring parents' psychosocial experiences during complex and traumatic life transitions related to caring for a child with a life-limiting (LLI) or life-threatening illness (LTI). BACKGROUND Parents' experiences of caring for a child impacted by an LLI or LTI are not clearly understood, and holistic, comprehensive pediatric nursing care for parents who have children with LLI and LTIs continues to be developed as treatment improves and survival is extended. REVIEW METHODS Predetermined inclusion and exclusion criteria were used to review qualitative studies. Those included were appraised, classified, and synthesized using systematic procedures guided by Sandelowski and Barroso (2006). DATA SOURCES A systematic search of qualitative research was conducted by an experienced librarian to identify and retrieve studies from 10 databases. RESULTS Of the 3515 studies screened, 23 were included. A synthesis of the findings demonstrated that parents experience profound and pervasive uncertainty, leading to their own illness experience being described as a dual reality in which fighting for survival and recognizing the threat of their child's death were daily challenges. Three key processes emerged: the devastation of living with uncertainty, the emergence of hope, and moving forward. CONCLUSION The integration of findings adds to the current body of knowledge by highlighting the very complex experiences that parents undergo. These findings can support a more comprehensive pediatric nursing plan of care that accounts for the intricacies of the parental experience and the importance of hope.
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Keim MC, Lehmann V, Shultz EL, Winning AM, Rausch JR, Barrera M, Gilmer MJ, Murphy LK, Vannatta KA, Compas BE, Gerhardt CA. Parent-Child Communication and Adjustment Among Children With Advanced and Non-Advanced Cancer in the First Year Following Diagnosis or Relapse. J Pediatr Psychol 2017; 42:871-881. [PMID: 28369400 DOI: 10.1093/jpepsy/jsx058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/09/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives To examine parent-child communication (i.e., openness, problems) and child adjustment among youth with advanced or non-advanced cancer and comparison children. Methods Families (n = 125) were recruited after a child's diagnosis/relapse and stratified by advanced (n = 55) or non-advanced (n = 70) disease. Comparison children (n = 60) were recruited from local schools. Children (ages 10-17) reported on communication (Parent-Adolescent Communication Scale) with both parents, while mothers reported on child adjustment (Child Behavior Checklist) at enrollment (T1) and one year (T2). Results Openness/problems in communication did not differ across groups at T1, but problems with fathers were higher among children with non-advanced cancer versus comparisons at T2. Openness declined for all fathers, while changes in problems varied by group for both parents. T1 communication predicted later adjustment only for children with advanced cancer. Conclusions Communication plays an important role, particularly for children with advanced cancer. Additional research with families affected by life-limiting conditions is needed.
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Affiliation(s)
- Madelaine C Keim
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Vicky Lehmann
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Emily L Shultz
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Adrien M Winning
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Joseph R Rausch
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Maru Barrera
- Hospital for Sick Children, Child Health Evaluative Sciences
| | - Mary Jo Gilmer
- Vanderbilt University, Department of Psychology and Human Development
| | - Lexa K Murphy
- Vanderbilt University, Department of Psychology and Human Development
| | - Kathryn A Vannatta
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
| | - Bruce E Compas
- Vanderbilt University, Department of Psychology and Human Development
| | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.,The Ohio State University, Department of Pediatrics
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30
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Marokakis S, Kasparian NA, Kennedy SE. Caring for infants with posterior urethral valves: A qualitative study of parents' experiences. J Child Health Care 2017; 21:424-434. [PMID: 29110519 DOI: 10.1177/1367493517725833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to explore the perspectives and experiences of parents caring for an infant with posterior urethral valves (PUVs). Eight parents participated in a semi-structured, individual telephone interview, with qualitative data collected and analysed thematically using NVivo11 software. Two main themes emerged as interconnecting aspects of parents' experiences: (1) trying to face the challenges and (2) learning to cope. Parents felt challenged by the need to attend to their child's medical care, while developing a bond with their baby, trying to maintain positivity for their child's future and managing the impact of the condition on their family. Nevertheless, parents developed strategies to cope with these challenges, such as seeking support, normalizing the experience and focusing on the positives. This preliminary understanding of parents' experiences provides direction for improving care pathways for infants with PUV and their parents as well as guides further research in this previously unexplored area.
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Affiliation(s)
- Sarah Marokakis
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nadine A Kasparian
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.,2 Heart Centre for Children, Sydney Children's Hospitals Network, Westmead and Randwick, Sydney, New South Wales, Australia
| | - Sean E Kennedy
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.,3 Department of Nephrology, Sydney Children's Hospital, Randwick, New South Wales, Australia
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Parenting a child at home with hypoplastic left heart syndrome: experiences of commitment, of stress, and of love. Cardiol Young 2017; 27:1341-1348. [PMID: 28583211 DOI: 10.1017/s1047951117000270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the experiences of parenting a child with hypoplastic left heart syndrome after the child has been discharged home from hospital. DESIGN A study of the parents' experiences using face-to-face interviews and psychometric measures with parents whose child had survived stage surgery. SETTING Parents were interviewed within the home environment or within the hospital if that was their choice. SUBJECTS A total of 29 parents (16 mothers and 13 fathers) of surviving children. Intervention A semi-structured face-to-face interview plus psychometric tests (parent demographics, Maslach Burnout Inventory, Impact on Family Scale, and the Psychological Check List - Civilian). Measurements and main results The parents' experience in supporting a child with hypoplastic left heart syndrome is one of stress, of commitment, and of love. Although parents experienced joy in their child, they were also subjected to anxiety with four parents test positive to post-traumatic stress disorder and hypervigilance while monitoring their child's condition. Parents lived with many difficulties, and demands.
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32
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Pridham K, Harrison TM, McKechnie AC, Brown R. Motivations and Features of Co-Parenting an Infant With Complex Congenital Heart Disease. West J Nurs Res 2017; 40:1110-1130. [PMID: 28597724 DOI: 10.1177/0193945917712693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study described co-parenting motivations and quality of co-parenting features for parents of infants with complex congenital heart disease (CCHD), including differences over time by illness severity. Existing transcripts of parenting experience at infant age 1 and 12 months for 23 parent couples were analyzed using directed content analysis. Data were quantitized for additional description. Six co-parenting motivations and five co-parenting features were identified. Two co-parenting motivations had not been previously described: Developing the Co-Parenting Relationship and Maintaining the Couple Relationship. Variability in quality of co-parenting features was evident. However, the majority of parents showed high ratings. Motivations and quality of co-parenting features changed over time and were related to illness severity. Our findings increase the understanding of what parents are working on as a couple to parent an infant with CCHD and the quality of this co-parenting. Several questions for further study are presented.
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Affiliation(s)
| | | | | | - Roger Brown
- 1 University of Wisconsin-Madison, Madison, WI, USA
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33
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Preschool Neurodevelopmental Outcomes in Children with Congenital Heart Disease. J Pediatr 2017; 183:80-86.e1. [PMID: 28081891 PMCID: PMC5368010 DOI: 10.1016/j.jpeds.2016.12.044] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/01/2016] [Accepted: 12/14/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To describe preschool neurodevelopmental outcomes of children with complex congenital heart disease (CHD), who were evaluated as part of a longitudinal cardiac neurodevelopmental follow-up program, as recommended by the American Heart Association and the American Academy of Pediatrics, and identify predictors of neurodevelopmental outcomes in these children. STUDY DESIGN Children with CHD meeting the American Heart Association/American Academy of Pediatrics high-risk criteria for neurodevelopmental delay were evaluated at 4-5 years of age. Testing included standardized neuropsychological measures. Parents completed measures of child functioning. Scores were compared by group (single ventricle [1V]; 2 ventricles [2V]; CHD plus known genetic condition) to test norms and classified as: normal (within 1 SD of mean); at risk (1-2 SD from mean); and impaired (>2 SD from mean). RESULTS Data on 102 patients were analyzed. Neurodevelopmental scores did not differ based on cardiac anatomy (1V vs 2V); both groups scored lower than norms on fine motor and adaptive behavior skills, but were within 1 SD of norms. Patients with genetic conditions scored significantly worse than 1V and 2V groups and test norms on most measures. CONCLUSIONS Children with CHD and genetic conditions are at greatest neurodevelopmental risk. Deficits in children with CHD without genetic conditions were mild and may not be detected without formal longitudinal testing. Parents and providers need additional education regarding the importance of developmental follow-up for children with CHD.
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34
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Stoffel G, Spirig R, Stiasny B, Bernet V, Dave H, Knirsch W. Psychosocial impact on families with an infant with a hypoplastic left heart syndrome during and after the interstage monitoring period - a prospective mixed-method study. J Clin Nurs 2017; 26:3363-3370. [PMID: 28000391 DOI: 10.1111/jocn.13694] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To investigate parents' experiences, coping ability and quality of life while monitoring their sick child with hypoplastic left heart syndrome at home. BACKGROUND Interstage home monitoring for children with hypoplastic left heart syndrome reduces interstage mortality between Norwood stages I and II. Little is known about the psychosocial impact of interstage home monitoring. DESIGN Prospective mixed-method study. METHODS This study assessed the psychosocial impact on parents during interstage home monitoring. This contains for quantitative assessment the Short Form Health Survey questionnaire and the Impact of Family Scale administered one and five weeks following discharge before and after stage II. For qualitative assessment, semi-structured interviews focussing on the postdischarge coping strategies were conducted twice, five weeks after hospital discharge before and after stage II. RESULTS Ten infants (eight males) with hypoplastic left heart syndrome (n = 7) or other types of univentricular heart malformations (n = 3), and their parents (nine mother/father two-parent households, one single mother) were included. There were no interstage deaths. Mental Health Composite Summary scores were low in both parents (mothers: 40·45 ± 9·07; fathers: 40·58 ± 9·69) and lowest for the item 'vitality' (mothers: 37·0 ± 19·46; fathers: 43·12 ± 25·9) before and after stage II. Impact of Family Scale values showed higher daily and social burdens for mothers. 'Becoming a family' was the most important task as coping strategy to equilibrate the fragile emotional balance. The parents judged interstage home monitoring as a protective intervention. CONCLUSIONS Although psychosocial burden before and after stage II remains high, becoming a family is an essential experience for parents and confirms their parenthood. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals must be aware of parents' needs during this vulnerable interstage period and to provide psychosocial and nursing support.
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Affiliation(s)
- Gaby Stoffel
- Division of Cardiology, Pediatric Heart Center, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Rebecca Spirig
- Nursing and MTTB, University Hospital Zürich and Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Brian Stiasny
- Division of Cardiology, Pediatric Heart Center, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Vera Bernet
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Division of Neonatology and Intensive Care, Pediatric Heart Center, University Children's Hospital, Zurich, Switzerland
| | - Hitendu Dave
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Division of Cardiovascular Surgery, Pediatric Heart Center, University Children's Hospital, Zurich, Switzerland
| | - Walter Knirsch
- Division of Cardiology, Pediatric Heart Center, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
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35
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Gómez-Ramírez O, Gibbon M, Berard R, Jurencak R, Green J, Tucker L, Shiff N, Guzman J. A recurring rollercoaster ride: a qualitative study of the emotional experiences of parents of children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2016; 14:13. [PMID: 26961237 PMCID: PMC4784365 DOI: 10.1186/s12969-016-0073-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/02/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Despite the wealth of clinical research carried out in children with juvenile idiopathic arthritis (JIA), little is known about the emotional experiences of their parents. This article describes the predominant emotional experiences reported by parents of children with JIA in two Canadian cities. METHODS Research participants included 15 experienced parents and 8 novice parents (<6 months since children's JIA diagnosis). Their children were 2 to 16 years old with various JIA categories. A qualitative dataset including audio recordings and verbatim transcripts of three focus groups, and written reports of 59 reciprocal interviews (parents interviewing each other) were examined by a multidisciplinary research team following a four-step qualitative analytical process. RESULTS Parents of children with JIA experienced recurrent mixed negative and positive emotions that varied over time. Between disease onset and diagnosis, mounting anxiety, fear and confusion were the predominant emotions. Shortly after diagnosis there were shock, disbelief, and fear, with a sense of having being blindsided by the disease. At times of disease quiescence there was hope and gratitude, but also fatigue and frustration with ongoing treatment and fear of flares. During periods of increasing or ongoing symptoms there was admiration and sympathy for the courageous way children coped with JIA, as well as sorrow and frustration for ongoing pain and limitations. There were at times, frustration and indignation with peers and teachers unable to understand the child's fluctuations in physical activity and schoolwork. Throughout the disease, parents felt an underlying anxiety and powerlessness. CONCLUSIONS Parents of children with JIA described complex emotional journeys akin to the recurring ups and downs of rollercoaster rides, instead of ordered emotional phases ending in resolution. This has implications for healthcare providers who need to be aware of the complexity of these emotional journeys to support parents more effectively, thereby helping improve patient outcomes.
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Affiliation(s)
- Oralia Gómez-Ramírez
- Department of Anthropology, University of British Columbia, 6303 NW Marine Drive, Vancouver, British Columbia V6T 1Z1 Canada
| | - Michele Gibbon
- Division of Rheumatology, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8 L1 Canada
| | - Roberta Berard
- Department of Pediatrics, Western University and Children’s Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 5 W9 Canada
| | - Roman Jurencak
- Department of Pediatrics, University of Ottawa and Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8 L1 Canada
| | - Jayne Green
- British Columbia Children’s Hospital, Room K4-116, 4480 Oak Street, Vancouver, British Columbia V6H 3V4 Canada
| | - Lori Tucker
- Department of Pediatrics, University of British Columbia and British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, British Columbia V6H 3V4 Canada
| | - Natalie Shiff
- Department of Pediatrics, University of Florida, and Department of Community Health and Epidemiology, University of Saskatchewan, 1600 Archer Road, Gainesville, Florida USA
| | - Jaime Guzman
- Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
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36
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McKechnie AC, Pridham K, Tluczek A. Walking the "Emotional Tightrope" From Pregnancy to Parenthood: Understanding Parental Motivation to Manage Health Care and Distress After a Fetal Diagnosis of Complex Congenital Heart Disease. JOURNAL OF FAMILY NURSING 2016; 22:74-107. [PMID: 26704535 DOI: 10.1177/1074840715616603] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Advances in medical technology account for increasingly more couples receiving fetal diagnoses of complex congenital heart disease. Theory on internal working models of caregiving during parenting transitions informed this prospective, exploratory study. Data included conjoint interviews and measures of anxiety, trauma, and depression collected from six couples after diagnosis and after birth. Severity of illness was described using infant health records. Directed content analysis furthered understanding of the caregiving motivation to manage health care that included three categories of parental efforts: (a) to determine expectations of health care providers, (b) to reconcile illness- and non-illness-related care, and (c) to express agency as a parent. Synthesis of qualitative findings transformed into categorical ratings with parents' levels of distress resulted in two profiles characterizing types of internal working models. Findings extend theory on internal working models of caregiving and offer direction for future research regarding parental management of health care for their chronically ill offspring. Implications for practice with families are offered.
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37
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Woodgate RL, Edwards M, Ripat JD, Borton B, Rempel G. Intense parenting: a qualitative study detailing the experiences of parenting children with complex care needs. BMC Pediatr 2015; 15:197. [PMID: 26611116 PMCID: PMC4660805 DOI: 10.1186/s12887-015-0514-5] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased numbers of children with chronic illnesses and/or disabilities who have complex care needs are living at home. Along with the transfer of care to the home setting, parents assume the primary responsibility of their child's complex care needs. Accordingly, it becomes even more important to understand the evolving roles and challenges faced by parents of children with complex care needs in order to better support them. The aim of this paper is to present research findings that add to our understanding of the roles parents assume in parenting their children with complex care needs. METHODS To arrive at a detailed and accurate understanding of families' perspectives and experiences, the qualitative research design of ethnography was used. In total, 68 parents from 40 families were recruited. Data collection strategies included ethnographic methods of interviewing and photovoice. Several levels of analysis generated a sociocultural theme with subthemes representing how parents experienced raising children with complex care needs within the context of their life situations. RESULTS Intense parenting as the overarching theme refers to the extra efforts parents had to commit to in raising their children with complex care needs. Parenting was described as labour-intensive, requiring a readiness to provide care at any time. This left parents with minimal time for addressing any needs and tasks not associated with caring for their child. The main theme is supported by four sub-themes: 1) the good parent; 2) more than a nurse; 3) there's just not enough; 4) it takes a toll on the health of parents. CONCLUSIONS Overall, parents of children with complex care needs take on more roles as well as work more intensely at these roles than parents of healthy children. This, in turn, has led to the need for additional supports and resources for parents. However, to date, parents of children with complex care needs are still lacking adequate services and supports necessary to help them in their role of intense parenting. The findings sensitize professionals to the issues confronted by parents caring for children with complex care needs. Implications for further research and clinical practice are discussed.
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Affiliation(s)
- Roberta L Woodgate
- College of Nursing, Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.
| | - Marie Edwards
- College of Nursing, Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.
| | - Jacquie D Ripat
- College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, R106 - 771 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada.
| | - Barbara Borton
- Rehabilitation Centre for Children, 633 Wellington Crescent, Winnipeg, MB, R3M 0A8, Canada.
| | - Gina Rempel
- College of Medicine, Faculty of Health Sciences, University of Manitoba, 260 Brodie Centre - 727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada.
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Kosta L, Harms L, Franich-Ray C, Anderson V, Northam E, Cochrane A, Menahem S, Jordan B. Parental experiences of their infant's hospitalization for cardiac surgery. Child Care Health Dev 2015; 41:1057-65. [PMID: 25652039 DOI: 10.1111/cch.12230] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parents are increasingly recognized as important partners in children's health care. Despite their involvement in care, parental experiences of their child's hospitalization have received little research attention. In this study we explored parents' perceptions of what they found difficult, what they would like to be different and what they found to be helpful during their infant's hospitalization and surgery for the treatment of congenital heart disease. METHODS Structured interviews were conducted with 154 parents (91 mothers, 63 fathers) whose infant underwent cardiac surgery (at <3 months of age) 1 month post discharge from hospital. Thematic and frequency analyses were performed. RESULTS Parents reported a range of difficulties from dealing with their baby's unfolding illness, surgery and recovery to the structural and systemic issues associated with the broader context of their experiences. In an effort to be near their baby, parents struggled to obtain the necessities for daily living at the hospital and negotiate transitions between their hospital and home lives throughout the admission. Domains parents identified for change included the availability of facilities and resources and the quantity and quality of information and emotional support. Parents reported relationships with hospital staff as the most common source of support during this challenging time. CONCLUSIONS Opportunities to improve parents' experiences when their infant is in hospital exist at an organizational level as well as at the clinical level. The significance of parents' relationship with hospital staff indicates the potential for each professional to impact on families' experiences on a daily basis. The range of challenges indicates the scope and need for allied health services.
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Affiliation(s)
- L Kosta
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - L Harms
- Department of Social Work, The University of Melbourne, Melbourne, Vic., Australia
| | - C Franich-Ray
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - V Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,School of Behavioural Science, The University of Melbourne, Melbourne, Vic., Australia.,Department of Psychology, The Royal Children's Hospital, Melbourne, Vic., Australia
| | - E Northam
- School of Behavioural Science, The University of Melbourne, Melbourne, Vic., Australia.,Department of Psychology, The Royal Children's Hospital, Melbourne, Vic., Australia.,Cell Biology, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - A Cochrane
- MonashHeart, Monash Medical Centre, Clayton, Vic., Australia
| | - S Menahem
- MonashHeart, Monash Medical Centre, Clayton, Vic., Australia.,School of Psychology and Psychiatry, Monash University, Clayton, Vic., Australia
| | - B Jordan
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia.,Social Work Department, The Royal Children's Hospital, Melbourne, Vic., Australia
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39
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Families of children with congenital heart disease: A literature review. Heart Lung 2015; 44:494-511. [PMID: 26404115 DOI: 10.1016/j.hrtlng.2015.08.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/13/2015] [Accepted: 08/25/2015] [Indexed: 11/21/2022]
Abstract
In 2000 and 2002, the National Heart, Lung, and Blood Institute launched two initiatives to encourage treatment innovations and research on children with heart disease and their families. Since then, no systematic reviews have examined the evidence regarding the impacts of having a child with congenital heart disease (CHD) on families. This review synthesized key findings regarding families of children with CHD, critiqued research methods, described what has been done, and provided recommendations for future inquiry. Databases searched included PubMed, CINAHL, Family & Society Studies Worldwide, Women's Studies International, and PsycINFO. The literature search followed the PRISMA guidelines. As a result, ninety-four articles were reviewed. Four major themes were derived: parents' psychological health, family life, parenting challenges, and family-focused interventions. In conclusion, while they found parents having psychological symptoms, researchers did not explore parents' appraisals of what led to their symptoms. Research is needed to explore parents' experiences and expectations.
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40
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Strickland J, Foley Wells C, Porr C. Safeguarding the Children: The Cancer Journey of Young Mothers. Oncol Nurs Forum 2015; 42:534-41. [DOI: 10.1188/15.onf.534-541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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41
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Abstract
OBJECTIVE We sought to determine the prevalence of attention-deficit/hyperactivity disorder in a population of children who underwent neonatal heart surgery involving repair of the aortic arch for Norwood Stage I, interrupted aortic arch, and combined repair of aortic coarctation with ventricular septal defect. METHODS Children between the ages of 5 and 16 were surveyed using the ADHD-IV and the Child Heath Questionnaire-50. Classification as attention-deficit/hyperactivity disorder was defined for this study as either a parent-reported diagnosis of attention-deficit/hyperactivity disorder or ADHD-IV inattention score of ⩾93 percentile. RESULTS Of the 134 surveys, 57 (43%) were returned completed. A total of 25 (44%) children either had a diagnosis of attention-deficit/hyperactivity disorder and/or ADHD-IV inattention score ⩾93 percentile. Eleven of the 13 (85%) children with interrupted aortic arch, 3 of the 7 (42.9%) children with combined coarctation/ventricular septal defect repair, and 9 of the 33 (27.3%) children with hypoplastic left-heart syndrome were classified as having attention-deficit/hyperactivity disorder. Only 7 of the 25 (28%) children received medical treatment for this condition. Quality of life indicators in the Child Heath Questionnaire-50 Questionnaire were highly correlated with the ADHD-IV scores. CONCLUSION The risks for the development of attention-deficit/hyperactivity disorder are multifactorial but are significantly increased in this post-surgical population. This study revealed a low treatment rate for attention-deficit/hyperactivity disorder, and a significant impact on the quality of life in these children.
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42
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Korhonen ES, Nordman T, Eriksson K. Technology and its ethics in nursing and caring journals: An integrative literature review. Nurs Ethics 2014; 22:561-76. [PMID: 25335921 DOI: 10.1177/0969733014549881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified. AIM To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature. METHOD The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed. RESULTS Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality. CONCLUSION In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology.
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Affiliation(s)
- Eila-Sisko Korhonen
- Åbo Akademi University, Finland; Helsinki Metropolia University of Applied Sciences, Finland
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43
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Moola FJ, Faulkner GEJ, White L, Kirsh JA. The psychological and social impact of camp for children with chronic illnesses: a systematic review update. Child Care Health Dev 2014; 40:615-31. [PMID: 25250399 DOI: 10.1111/cch.12114] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool – the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies – was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short-term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long-term follow-up, and incorporating camp-based messaging into routine hospital care,may enhance the utility of camp as a potential psychosocial intervention in paediatrics.
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Affiliation(s)
- F. J. Moola
- Faculty of Kinesiology and Recreation Management; The University of Manitoba; Winnipeg MB Canada
- The Manitoba Institute for Child Health; Winnipeg MB Canada
| | - G. E. J. Faulkner
- Faculty of Kinesiology and Physical Education; The University of Toronto; Toronto ON Canada
| | - L. White
- Faculty of Kinesiology and Physical Education; The University of Toronto; Toronto ON Canada
| | - J. A. Kirsh
- Department of Paediatrics; Hospital for Sick Children and the Faculty of Medicine, University of Toronto
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44
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Giambra BK, Sabourin T, Broome ME, Buelow J. The theory of shared communication: how parents of technology-dependent children communicate with nurses on the inpatient unit. J Pediatr Nurs 2014; 29:14-22. [PMID: 23583360 DOI: 10.1016/j.pedn.2013.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 11/16/2022]
Abstract
Care may be compromised for hospitalized technology-dependent children if nurses do not communicate with parents to include their knowledge in the child's plan of care. A qualitative study using grounded theory methodology was undertaken to identify parental perceptions and experiences of communication with nurses. The Theory of Shared Communication was the result of this study and includes questioning, listening, explaining, advocating, verifying understanding and negotiating roles to achieve the outcome of mutual understanding of the child's plan of care. Nurses should be aware of parent perceptions about communication when working with families to optimize the care they provide.
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Affiliation(s)
| | | | | | - Janice Buelow
- Indiana University, School of Nursing, Indianapolis, IN
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45
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Harvey KA, Kovalesky A, Woods RK, Loan LA. Experiences of mothers of infants with congenital heart disease before, during, and after complex cardiac surgery. Heart Lung 2013; 42:399-406. [DOI: 10.1016/j.hrtlng.2013.08.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/14/2013] [Accepted: 08/15/2013] [Indexed: 11/30/2022]
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46
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Buus N, Caspersen J, Hansen R, Stenager E, Fleischer E. Experiences of parents whose sons or daughters have (had) attempted suicide. J Adv Nurs 2013; 70:823-32. [DOI: 10.1111/jan.12243] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Niels Buus
- Institute of Public Health; University of Southern Denmark; Odense Denmark
| | - Jimmy Caspersen
- The Mental Health Services in the Region of Southern Denmark; Odense Denmark
| | - Rasmus Hansen
- Network for the Suicide Struck (NEFOS); Odense Denmark
| | - Elsebeth Stenager
- The Mental Health Services in the Region of Southern Denmark; Odense Denmark
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47
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Ravindran V, Rempel GR, Ogilvie L. Embracing survival: A grounded theory study of parenting children who have sustained burns. Burns 2013; 39:589-98. [DOI: 10.1016/j.burns.2012.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/09/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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48
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Nicholl HM, Begley CM. Explicating caregiving by mothers of children with complex needs in ireland: a phenomenological study. J Pediatr Nurs 2012; 27:642-51. [PMID: 23101728 DOI: 10.1016/j.pedn.2011.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 07/05/2011] [Accepted: 07/06/2011] [Indexed: 10/17/2022]
Abstract
This qualitative phenomenological study explored mothers' experiences of caring for a child with complex needs. After ethical approval was obtained, data were collected through 11 diaries and 48 interviews with 17 mothers in Ireland. Caring for a child with complex needs involves the delivery of care in an inside world of the home, the world outside the home, and a "going-between" world. Caregiving, 1 of 8 closely linked dimensions, is presented, including its 4 categories. These are normal mothering, technical caregiving, preemptive caregiving, and individualized caregiving. Professionals require a greater understanding of the experiences of mothers caring for children with complex needs at home.
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Affiliation(s)
- Honor M Nicholl
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
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49
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Rempel GR, Ravindran V, Rogers LG, Magill-Evans J. Parenting under Pressure: a grounded theory of parenting young children with life-threatening congenital heart disease. J Adv Nurs 2012; 69:619-30. [DOI: 10.1111/j.1365-2648.2012.06044.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Facets of parenting a child with hypoplastic left heart syndrome. Nurs Res Pract 2012; 2012:714178. [PMID: 22548161 PMCID: PMC3324165 DOI: 10.1155/2012/714178] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 01/04/2012] [Indexed: 12/28/2022] Open
Abstract
The purpose of the study was to conceptualize the needs of parents of young children with hypoplastic left heart syndrome (HLHS) to provide a theoretical framework to inform the development of future parent interventions. Participants were parents and grandparents (n = 53) of 15 young children who had undergone the Sano surgical approach for HLHS. Analysis of recorded and transcribed single interviews with each participant was done as directed by interpretive description methodology. A model of five facets of parenting was conceptualized. These included survival parenting, “hands-off” parenting, expert parenting, uncertain parenting, and supported parenting. The facets of parenting delineated through this study provide a theoretical framework that can be used to guide the development and evaluation of interventions for parents of children with complex congenital heart disease and potentially other life-threatening conditions. Each facet constitutes a critical component for educational or psychosocial intervention for parents.
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