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Wu MH, Lee TY, Lin MH. The parental experience of participating in surgical decision-making regarding one's child with a congenital heart disease in Taiwan. J Pediatr Nurs 2023; 68:e103-e108. [PMID: 36437130 DOI: 10.1016/j.pedn.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study explores how parents experienced the surgical decision-making process for their child with a congenital heart disease (CHD). DESIGN AND METHODS Purposive sampling was used in this qualitative descriptive study at a medical center in Northern Taiwan. Twelve parents whose children had cardiac corrective surgery participated in one-to-one in-depth interviews. The interview content subsequently was transcribed verbatim and analyzed by content analysis. RESULTS Five themes, with 2 to 3 subthemes, were identified: 1) accumulating medical knowledge in a short time, 2) trusting the medical teams but parents needing clear communication, 3) feeling pervasive uncertainty, 4) using self-talk to calm down, and 5) looking for positive energy from various sources. CONCLUSIONS For the parents of these children with CHD, participating in surgical decision-making can be a difficult and stressful experience. When explaining the disease and treatment procedures, it is important for medical professionals to make sure of the individual parent's information needs, to use plain language and encourage parents to ask questions. PRACTICE IMPLICATIONS Although the surgery is imperative and inevitable, understanding the parents' worries and providing adequate support can help them reduce feelings of uncertainty during the decision-making and surgical processes.
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Affiliation(s)
- Mei-Hua Wu
- Department of Nursing, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd, Taipei 10002, Taiwan, ROC.
| | - Tzu-Ying Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Rd. Beitou 11219, Taipei, Taiwan, ROC.
| | - Mei-Hsiang Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Rd. Beitou 11219, Taipei, Taiwan, ROC.
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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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Lawrence PR, Spratling R. A Theory for Understanding Parental Workload and Capacity to Care for Children With Medical Complexity. Res Theory Nurs Pract 2022; 36:34-46. [PMID: 35173026 DOI: 10.1891/rtnp-2022-0026] [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: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Children with medical complexity (CMC) experience poor health outcomes despite the high cost of care, and their parents face challenges in providing complex care. Poor health outcomes may be related to an imbalance between parental demands to manage care and their ability to meet the demands needed to provide complex care. However, this phenomenon has not been explored. In addition, much of the existing research focused on CMC lacks an overarching theoretical framework. The purpose of this article is to outline factors that impact families of CMC described in the literature. This article proposes a modified framework using theory derivation, which highlights the concepts of parental workload and capacity and demonstrates how they are related to CMC health. METHODS A revised theoretical framework using theory derivation by Walker and Avant is presented using findings from the CMC literature that most affect the parents of these children. RESULTS Applying content from two existing theories using concepts of relevance results in a framework that provides richer insight into the relationship between parental workload and parental capacity, particularly when parental workload outweighs parental capacity. This framework allows for the examination of how an imbalance between workload and capacity impacts CMC health outcomes. IMPLICATIONS FOR PRACTICE Although further study is needed to test the proposed theory, the framework can be used to examine these relationships with hopes of developing interventions to decrease parental workload and enhance parental ability.
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Affiliation(s)
- Patricia R Lawrence
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, USA
| | - Regena Spratling
- Associate Dean Chief Academic Officer for Nursing, Associate Professor, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, USA
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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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Schulman-Green D, Feder SL, Montano AR, Batten J, Tan H, Hoang K, Grey M. Use of the self- and family management framework and implications for further development. Nurs Outlook 2021; 69:991-1020. [PMID: 34183187 DOI: 10.1016/j.outlook.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF. PURPOSE We reviewed articles citing the SFMF to identify the frequency and nature of use. METHOD We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles. FINDINGS Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework. DISCUSSION The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.
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Affiliation(s)
| | | | | | | | - Hui Tan
- Yale New Haven Health Bridgeport Hospital, Bridgeport, CT
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Knafl KA, Deatrick JA, Gallo AM, Skelton B. Tracing the Use of the Family Management Framework and Measure: A Scoping Review. JOURNAL OF FAMILY NURSING 2021; 27:87-106. [PMID: 33749353 PMCID: PMC8044632 DOI: 10.1177/1074840721994331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article reports the results of a scoping review of research applications of the Family Management Style Framework (FMSF) and the Family Management Measure (FaMM). We identified 32 studies based on the FMSF and 41 studies in which the FaMM was used, 17 of which were based on the FMSF. Both the framework and measure have been used by investigators in multiple countries, with most applications of the FaMM outside the United States. Although the FMSF and FaMM were originally developed for use with families in which there was a child with a chronic physical condition, both have been applied to a broader range of health conditions and to studies focusing on families with an adult member facing a health challenge. Based on our findings, we make recommendations for how researchers can more fully address all aspects of the FMSF.
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Affiliation(s)
| | | | | | - Beth Skelton
- The University of North Carolina at Chapel Hill, USA
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Knight Lozano R, May S, Clarkson C, Sarjeant R. Caregiver experiences of paediatric inpatient cardiac services: A qualitative systematic review. Eur J Cardiovasc Nurs 2020; 20:147-159. [PMID: 33849062 DOI: 10.1177/1474515120951974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/04/2020] [Accepted: 08/02/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Advances in paediatric care have contributed to an increasing survival of children with complex heart disease. Yet, life-saving management demands prolonged inpatient admissions, which contribute to emotional and psychological distress for parents and other caregivers in a role of main custody. AIM The purpose of this study was to identify, appraise and synthesise qualitative studies exploring caregivers' experiences of paediatric inpatient cardiac services, generating an understanding of their needs in hospital and informing priorities for change in healthcare delivery. METHODS Searches were conducted in Medline, Allied and Complimentary Medicine Database, Cumulative Index of Nursing and Allied Health Literature, EMCARE, Scopus, PsychINFO, Proquest, OpenGrey and ETHOs from 2008-2019, reflecting recent advances in cardiac healthcare. Articles were selected using predetermined eligibility criteria dictating qualitative inquiry into caregiver perspectives whilst their child received hospital-based interventions for heart disease. All eligible studies underwent quality appraisal. Framework synthesis was used to analyse and summarise findings. RESULTS Twenty-seven studies involving 689 caregivers from 11 countries were included. Three overarching themes were identified: 'emotional capacity to care', 'practicalities of caring', and 'the bigger picture of caring'. CONCLUSIONS Through analysis and summary of qualitative primary research, this review captures the emotional challenges that caregivers face and practicalities of undertaking a caregiver role, whilst looking after their child with heart disease in hospital. The results widen the context of the caregiver role, encompassing the whole family unit beyond the hospital environment. This review exposes the impact of these challenges on caregiver competence, wellbeing and attachment to their unwell child, informing priorities for development of family-centred paediatric inpatient cardiac services.
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Affiliation(s)
| | - Stephen May
- Faculty of Health and Wellbeing, Sheffield Hallam University, UK
| | - Carl Clarkson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, UK
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Begnini D, Giradon-Perlini NMO, Beuter M, Silva L, Sand ICPVD, Misko MD. Family experience living with advanced neoplasm: a glance at the rural population. Rev Bras Enferm 2020; 73:e20180895. [PMID: 32520097 DOI: 10.1590/0034-7167-2018-0895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/06/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to understand the experience of rural families living with advanced cancer, from Family Management Style Framework's perspective. METHODS a qualitative research conducted in seven cities of the northern of state of Rio Grande do Sul in homes of 11 families (27 people). Data collection took place in 2014, using the genogram and narrative interview. Analysis followed Family Management Style Framework's theoretical model. RESULTS the results were organized into three categories based on conceptual components of the referred model: no more normal life: situation definition; attempt to reconcile care and work: management behavior; imminence of the finitude of life: perception of consequences. FINAL CONSIDERATIONS living in rural context gives families specific ways of dealing with advanced cancer. Understanding the movements undertaken by rural families throughout the experience can guide nursing professionals in planning interventions collaborating with this population's health.
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Affiliation(s)
- Danusa Begnini
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mardrig Beuter
- Universidade Federal de Santa Maria. Santa Maria, Rio Grande do Sul, Brazil
| | - Lucía Silva
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Ergun A, Sisman FN, Erol S, Gur K, Kolac N, Kadioglu H. The Family Management of Childhood Chronic Conditions: Measurement in a Turkish Sample. J Pediatr Nurs 2019; 47:e16-e23. [PMID: 31027867 DOI: 10.1016/j.pedn.2019.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE The principal aim of this study was to adapt the FaMM into the Turkish language and test its validity and reliability. DESIGN AND METHODS Data were collected from a total of 395 parents of children with chronic disease. The FaMM was translated using the translation and back-translation method. The reliability analysis of the FaMM was performed using Cronbach alpha coefficients, item-total correlations and test-retest correlations. Construct validity for the scale was assessed with confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). RESULTS The overall content validity index was 95%, signifying that the FaMM has good content validity. The CFA of the Turkish version of the FaMM did not confirm the original factorial structure. The model of three subscales for the Turkish FaMM was validated using EFA. The values of ≥0.70 for the Cronbach alpha coefficient, >0.25 for the item-total correlations and >0.40 for the test-retest application correlations for 2 weeks were found to be acceptable levels for the instruments and its subscales. CONCLUSIONS The FaMM was found to be valid, reliable and appropriate for Turkish culture and psychometric characteristics were satisfactory. PRACTICE IMPLICATIONS The FaMM can be used in evaluating the management of illness in families with children with chronic disease.
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Affiliation(s)
- Ayse Ergun
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey
| | - Fatma Nevin Sisman
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey.
| | - Saime Erol
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey
| | - Kamer Gur
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey
| | - Nurcan Kolac
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey
| | - Hasibe Kadioglu
- Marmara Unıversity Health Science Faculty, Nursing Department, Basıbuyuk, Maltepe, Istanbul, Turkey
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10
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Adapting the Family Management Styles Framework to Include Children. J Pediatr Nurs 2019; 45:26-36. [PMID: 30597346 DOI: 10.1016/j.pedn.2018.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 11/22/2022]
Abstract
EMPIRICAL STUDY PURPOSE Propose an adapted Family Management Style Framework that includes the perspectives of children with chronic health conditions. DESIGN AND METHODS Building on the current Family Management Style Framework, the authors used recent empirical studies with children to further develop the framework. Definitions of each dimension and component of the framework were reviewed and revised to reflect the perspectives of the child, based on the child data and prior work. RESULTS The Family Management Style Framework was adapted to reflect children's perspectives of themselves and their family. Based upon our understanding of the components of the framework, we expanded the components and revised the definitions of the dimensions to reflect the child perspectives. CONCLUSIONS Incorporating the perspectives of children allows us to consider the transactions that occur during condition management between parents, children and families. Additional research is needed to explore this interaction and the implications it has on the outcomes. PRACTICE IMPLICATIONS Children experience the way their family manages their chronic health condition and incorporate those experiences as part of their developing understanding of themselves and their condition. Practitioners should encourage children to express their understanding of their condition and its management to model and encourage them to dialogue about management with their families.
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Harvey KA, Kovalesky A. Post-Operative Pain and Comfort in Children After Heart Surgery: A Comparison of Nurses and Families Pre-operative Expectations. J Pediatr Nurs 2018; 43:9-15. [PMID: 30473162 DOI: 10.1016/j.pedn.2018.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Parents' and nurses' expectations about pain control and comfort in children after heart surgery were explored to contribute to evidence-based family-centered interventions. DESIGN AND METHODS 20 nurses and 23 parents from a tertiary pediatric center in the Pacific Northwest, were interviewed about their expectations of children's pain control and comfort experience in the hospital after heart surgery. In this descriptive study, data were collected from semi-structured recall interviews and analyzed using content analysis. RESULTS Most parents expected their child be medicated at a level of not feeling any pain. Many expected their child to remain in a heavily sedated state after the surgery. A few parents did not know what to expect. In contrast, nurses expected children to have controlled pain with intermittent discomfort, yet, tolerating recovery activities. CONCLUSIONS Although both parents and nurses expect to partner in the comfort care of the child, there is variation on the expectations around the nurse-parent relationship and the operational definition of pain management and comfort. PRACTICE IMPLICATIONS Awareness of parents' expectations about pediatric post-operative comfort present an opportunity for the development of interventions aimed to enhance alignment of nurse and family strategies for children after heart surgery. Pre-operative preparation for families specific to post-operative recovery and pain management of children hospitalized for heart surgery is needed.
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Affiliation(s)
- Kayla A Harvey
- Mary Bridge Children's Hospital, Pediatric Heart Surgery Program, Tacoma, WA, USA.
| | - Andrea Kovalesky
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, WA, USA.
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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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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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14
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Thakur V, Munk N, Mertens L, Nield LE. Does prenatal diagnosis of hypoplastic left heart syndrome make a difference? - A systematic review. Prenat Diagn 2016; 36:854-63. [DOI: 10.1002/pd.4873] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/27/2016] [Accepted: 07/04/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Varsha Thakur
- Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children; University of Toronto; Toronto Canada
| | - Nadia Munk
- Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children; University of Toronto; Toronto Canada
| | - Luc Mertens
- Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children; University of Toronto; Toronto Canada
| | - Lynne E. Nield
- Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children; University of Toronto; Toronto Canada
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15
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Yang X, Byrne V, Chiu MYL. Caregiving Experience for Children with Intellectual Disabilities among Parents in a Developing Area in China. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:46-57. [PMID: 25753755 DOI: 10.1111/jar.12157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND By utilizing grounded theory methodology, this study attempted to fill a gap whereby little research explored family caregiving perspectives in China where public support is insufficient and familial responsibility is highly valued. METHODS Data were collected through the qualitative methods of interviews and observations among a purposive sample of 15 parents of children with intellectual disabilities in central China. RESULTS The central idea emerging from the data encompassed five broad categories of caregiving experiences: (i) unavoidable caregiving responsibility and (ii) uncertain future as the greatest worries which are the perception towards the recipient; (iii) compromising quality of life and (iv) positive roles of caregiving tasks which focus on the self; and (v) community support which is the perceived support from the external system. CONCLUSION A recursive relationship existed among these categories. Chinese culture and traditional beliefs dominated throughout these issues. The implications and limitations of this study were discussed.
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Affiliation(s)
- Xue Yang
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Victoria Byrne
- Centre for Research in the Social Sciences, University of Huddersfield, Huddersfield, UK
| | - Marcus Y L Chiu
- Department of Social Work, National University of Singapore, Singapore City, Singapore
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16
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Zhang Y, Wei M, Shen N, Zhang Y. Identifying factors related to family management during the coping process of families with childhood chronic conditions: a multi-site study. J Pediatr Nurs 2015; 30:160-73. [PMID: 25450446 DOI: 10.1016/j.pedn.2014.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/30/2014] [Accepted: 10/03/2014] [Indexed: 11/26/2022]
Abstract
This study was designed to determine the key predictors for each aspect of family management of families with children who have chronic conditions in China. The participants included 399 caregivers whose children have chronic illnesses. We used the following instruments: Child Behavior Checklist; Feetham Family Functioning Survey; and Family Management Measures. The final modes of the hierarchical regression explained 29-48% of the variance in aspects of family management. More family support should be provided for those with low family income, children with renal and genetic disorders and rheumatic diseases and those living in rural areas. Child and family functioning affects family management.
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Affiliation(s)
- Ying Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
| | - Min Wei
- Peking Union Medical College Hospital, Pediatric Unit, Beijing, China.
| | - Nanping Shen
- Shanghai Children's Medical Center, Nursing Department, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yaqing Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
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17
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Sullivan-Bolyai S, Bova C, Johnson K, Cullen K, Jaffarian C, Quinn D, Aroke EN, Crawford S, Lee MM, Gupta O. Engaging teens and parents in collaborative practice: perspectives on diabetes self-management. DIABETES EDUCATOR 2014; 40:178-90. [PMID: 24470041 DOI: 10.1177/0145721713520568] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this exploratory focus group study was to describe the perspectives of teens and their parents about self-management knowledge, behaviors (including division of labor associated with T1D management), and resources used to manage T1D. The overall goal is to use this information to develop a teen-family transition clinic. METHODS The self and family management behaviors framework undergirded the separate teen-parent focus groups that were conducted concurrently. Note-based qualitative content analysis was used, resulting in several important messages. RESULTS From the teens' perspective there was variation in interest in learning more about T1D and management. Those teens who had been diagnosed at a very young age reported not knowing anything else but diabetes, while those diagnosed later developmentally embraced the active learning process. Diabetes camp and peer group support were not seen as beneficial. All the teens were interested in "helping others" with diabetes. Parents shared the common struggle with transition of self-management, with variation in parenting styles. A small group of parents reported their "job" as a parent was to make sure their child was self-sufficient in self-management, but felt pressure from the health care providers (HCPs) to physically do the care, defeating the purpose. Parents and teens reported wanting HCPs to be less focused on "numbers" (blood glucose levels) and more on the whole person. Scheduling appointment changes and long waiting times were reported as problematic by all participants. CONCLUSIONS Teen and parent perspectives are critical in designing future well-received adolescent-family transition clinics. Development from the ground up with family recommendations may contribute to high-quality health outcomes.
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Affiliation(s)
| | - Carol Bova
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Kimberly Johnson
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Karen Cullen
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Carol Jaffarian
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Diane Quinn
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Edwin N Aroke
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Sybil Crawford
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Mary M Lee
- University of Massachusetts, Worcester, Massachusetts, USA (Dr Bova, Ms Johnson, Ms Cullen, Ms Jaffarian,
Ms Quinn, Mr Aroke, Dr Crawford, Dr Lee)
| | - Olga Gupta
- University of Texas Southwestern, Dallas, Texas (Dr Gupta)
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18
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Zhang Y, Wei M, Han HR, Zhang Y, Shen N. Testing the Applicability of the Family Management Style Framework to Chinese Families. West J Nurs Res 2013; 35:920-42. [DOI: 10.1177/0193945913482051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Family management is an important concept in caring for chronically ill children. The purpose of this study is to determine the applicability of the Family Management Style Framework for Chinese families with a child who has a chronic condition. The children ranged in age from 6 to 16 years. The structural equation modeling approach was utilized to examine the relationships among the contextual variables, the family management, the child, and the family functioning. A total of 538 caregivers from seven hospitals in China were included in this study. The final model adequately fitted the data. The predictor variables accounted for 23%, 26%, 7.8%, and 12% of the variance in the easy and the challenging parts of family management and the child and family unit, respectively. These findings indicated that the framework is applicable to Chinese families. This result reinforces the importance of interventions designed to enable caregivers to improve family management.
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Affiliation(s)
- Ying Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Min Wei
- Peking Union Medical College Hospital, Beijing, China
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, Baltimore, MD, USA
| | - Yaqing Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Nanping Shen
- Shanghai Children’s Medical Center, Nursing Department, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Al-Farsi YM, Waly MI, Deth RC, Al-Sharbati MM, Al-Shafaee M, Al-Farsi O, Al-Khaduri MM, Gupta I, Ali A, Al-Khalili M, Al-Adawi S, Hodgson NW, Ouhtit A. Low folate and vitamin B12 nourishment is common in Omani children with newly diagnosed autism. Nutrition 2013; 29:537-41. [DOI: 10.1016/j.nut.2012.09.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 09/03/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
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20
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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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21
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Barakat LP. Advancing the family management style framework: incorporating social ecology. JOURNAL OF FAMILY NURSING 2012; 18:5-10. [PMID: 22344716 DOI: 10.1177/1074840711430665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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