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Bogetz JF, Oslin E, O’Donnell M, Barton KS, Yi-Frazier JP, Watson RS, Rosenberg AR. Meaning-Making Among Parents of Children With Severe Neurologic Impairment in the PICU. Pediatrics 2024; 153:e2023064361. [PMID: 38529567 PMCID: PMC10979294 DOI: 10.1542/peds.2023-064361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Parents and family caregivers of children with severe neurologic impairment (SNI) experience many stressors, especially during their child's critical illness. This study aimed to examine parent experiences around the time of their child's PICU care to explore ways parents make meaning in relation to these stressors. METHODS This qualitative study of data from a single center in the United States followed Consolidated Criteria for Reporting Qualitative Research guidelines. One to one semistructured interviews queried parents' psychosocial well-being around the time of their child's PICU care. Eligible participants had a child with an SNI condition for >3 months admitted to the PICU for >24 hours with an expected length of stay >1 week. RESULTS Data were analyzed by a research team with expertise in palliative care, psychology, critical care, and qualitative methods. Fifteen family caregivers of 15 children participated. Children were a median of 8 years old (interquartile range 4-11.5) and 80% (n = 12) had congenital/genetic conditions. Parent/family caregivers were a median age of 39 years old (interquartile range 36-42.5); 20% (n = 3) self-identified as fathers and 47% (n = 7) as having to a minority racial background. Parents discussed ongoing meaning-making that occurred through domains of comprehension and purpose, and themes of understanding of other people and the world around them. Subthemes focused on appreciation/acceptance, adaptability/accountability, valuing all lives, and learning/teaching about their child. CONCLUSIONS Meaning-making may be an opportunity for support in the PICU among parents/family caregivers of children with SNI.
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Affiliation(s)
- Jori F. Bogetz
- Divisions of Bioethics and Palliative Care
- Treuman Katz Center for Bioethics
| | | | | | - Krysta S. Barton
- Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Seattle Children’s Research Institute; Seattle, Washington
| | | | - R. Scott Watson
- Division of Critical Care, Department of Pediatrics, University of Washington School of Medicine; Seattle, Washington
| | - Abby R. Rosenberg
- Division of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute; Department of Pediatrics, Boston Children’s Hospital; Department of Pediatrics, Harvard Medical School; Boston, Massachusetts
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King-Shaw S, King-Shaw N, Sonsteng-Person M, Mikell Montgomery D, Oduro A. "The Things We Carry": Interventions against the cumulative effects of racism in K-12 education. J Prev Interv Community 2024:1-18. [PMID: 38500394 DOI: 10.1080/10852352.2024.2323885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Anti-Black racism in K-12 education settings has long-term impacts on Black students, including negative academic and mental health outcomes. Limited interventions following experiences of racism shape Black students' expectations of K-12 education, accumulating over time into institutional distrust and these mental health outcomes. As such, it is necessary to understand how Black students experience racism within K-12 settings to better inform interventions that can be implemented at the school level. To that end, this study employed the participatory action research (PAR) method of photovoice to understand the impacts of racism in educational settings among 5 Black women undergraduate students. Results highlight the cumulative effects of racism on identity development and early coping. Implications inform future interventions to address the cumulative effects of anti-Black racism in K-12 education.
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Affiliation(s)
- Sam King-Shaw
- Department of Global Gender Studies, University at Buffalo, SUNY, Buffalo, New York, USA
| | - Natalie King-Shaw
- Harvard Medical School, Division of Medical Sciences Speech and Hearing Bioscience and Technology Program, Harvard University, Boston, MA, USA
| | | | | | - Alexia Oduro
- Social Justice and Human Rights, Arizona State University, Phoenix, Arizona, USA
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Sherman J, Bower KL, Eskandanian K. "100 Things I Wish Someone Would Have Told Me": Everyday Challenges Parents Face While Caring for Their Children With a Tracheostomy. QUALITATIVE HEALTH RESEARCH 2024:10497323231217387. [PMID: 38193439 DOI: 10.1177/10497323231217387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Equitable access to appropriate care, emergency department services, and in-home support aids are needed to minimize the occurrences of adverse events that have a significant impact on families. However, many families of children with medical complexity (CMC) lack consistent care due to issues of health inequity. We conducted 11 qualitative interviews with primary caregivers who were asked about their experiences of providing care to children who have a tracheostomy and are supported by multiple life-saving machines at home. Guided by ecological systems theory, we identified three themes that contextualize the lived experiences of the participants who expressed needs that arose from poor interactions within the mesosystem. Findings convey participant frustrations that result from insufficient support, ineffective training, and inadequate healthcare coverage. Although each theme is organized systematically to emphasize specific concerns within the mesosystem, together these themes emphasize the inextricable relationship between daily needs with systemic barriers to care. We provide a discussion of these needs with a broader context that also impacts the perceived quality of care among families managing the needs of their children who are supported by life-saving technology. By addressing existing challenges and identifying opportunities for improvement within the healthcare system, we seek to contribute to the collective effort of advocating for ethical systemic change on behalf of CMC and their families.
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Affiliation(s)
| | - Kyle L Bower
- Department of Human Development & Family Science, The University of Georgia, Athens, GA, USA
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Bogetz JF, Natarajan N, Hauer J, Ramirez JM. Appreciating the Abilities of Children With Severe Neurologic Impairment. Hosp Pediatr 2023; 13:e392-e394. [PMID: 37946661 PMCID: PMC10656431 DOI: 10.1542/hpeds.2023-007463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Jori F. Bogetz
- Divisions of Bioethics and Palliative Care, Department of Pediatrics
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Center for Clinical and Translational Research
| | - Niranjana Natarajan
- Pediatric Neurology, Department of Neurology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Julie Hauer
- Division of General Pediatrics, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Jan-Marino Ramirez
- Center for Integrative Brain Research, Seattle Children’s Hospital and Research Institute, Seattle, Washington
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Naserrudin NA, Yong PPL, Monroe A, Culleton R, Baumann SE, Sato S, Hod R, Jeffree MS, Ahmed K, Hassan MR. Seeing malaria through the eyes of affected communities: using photovoice to document local knowledge on zoonotic malaria causation and prevention practices among rural communities exposed to Plasmodium knowlesi malaria in Northern Borneo Island. Malar J 2023; 22:166. [PMID: 37237418 DOI: 10.1186/s12936-023-04603-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Many rural communities in Malaysian Borneo and Southeast Asia are at risk of Plasmodium knowlesi malaria. Multiple factors contribute to infection, however, a deep understanding of illness causation and prevention practices among at-risk communities remains limited. This study aims to document local knowledge on malaria causation and preventive practices of rural communities in Sabah, Malaysia, using photovoice-a participatory research method. METHODS From January to June 2022, a photovoice study was conducted with rural communities in Matunggong subdistrict, Malaysia, to explore their experiences with and local knowledge of non-human primate malaria and prevention practices. The study included (1) an introductory phase in which participants were introduced to the photovoice method; (2) a documentation phase in which participants captured and narrated photos from their communities; (3) a discussion phase in which participants discussed photos and relevant topics through a series of three focus group discussions (FGDs) per village; and (4) a dissemination phase where selected photos were shared with key stakeholders through a photo exhibition. A purposively selected sample of 26 participants (adults > 18 years old, male, and female) from four villages participated in all phases of the study. The study activities were conducted in Sabah Malay dialect. Participants and the research team contributed to data review and analyses. RESULTS Rural communities in Sabah, Malaysia possess local knowledge that attributes non-human primate malaria to natural factors related to the presence of mosquitoes that bite humans and which carry "kuman-malaria" or malaria parasite. Participants revealed various preventive practises ranging from traditional practises, including burning dried leaves and using plants that produce foul odours, to non-traditional approaches such as aerosols and mosquito repellents. By engaging with researchers and policymakers, the participants or termed as co-researchers in this study, showcased their ability to learn and appreciate new knowledge and perspectives and valued the opportunity to share their voices with policymakers. The study successfully fostered a balance of power dynamics between the co-researchers, research team members and policymakers. CONCLUSION There were no misconceptions about malaria causation among study participants. The insights from study participants are relevant because of their living experience with the non-human malaria. It is critical to incorporate rural community perspectives in designing locally effective and feasible malaria interventions in rural Sabah, Malaysia. Future research can consider adapting the photovoice methodology for further research with the community toward building locally tailored-malaria strategies.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Pau Lin Yong
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia.
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