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Gowda NC, Chatterjee R, Balakrishnan A, Lawrence A, Aggarwal A. Caregiver burden in families of children with juvenile idiopathic arthritis in India. Clin Rheumatol 2024; 43:2009-2019. [PMID: 38662098 DOI: 10.1007/s10067-024-06975-8] [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: 02/20/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
Juvenile Idiopathic Arthritis (JIA) causes caregiver burden on families with children affected with it. Our study aimed to explore this multifaceted burden in the Indian context. In this cross-sectional study, we administered the Hindi translated CAREGIVER questionnaire to adult caregivers in the families of JIA patients ≤ 18 years. The responses to the 28 items were used to calculate the burden scores in various dimensions. The relationship of the global burden scores with demographic and socioeconomic factors were analysed. Non parametric tests were used. Two hundred twenty-one caregivers participated with a median age of 39 years (IQR 32-45). This included 116 fathers, 50 mothers, 32 brothers, 18 uncles, three grandfathers, one sister, and one grandmother. The JIA patients had a median age of 15 (12-17) years, and the male-to-female ratio was 3.2:1. Enthesitis-related arthritis was the predominant subtype (72.4%). Most caregivers (70.6%) expressed sadness at diagnosis, and 29.9% continued to express sadness. Nearly two-thirds (65.6%) had to borrow money from others. More than half (59.3%) of the caregivers neglected their health, and 9.0% became sick. Male gender of the child, systemic JIA subtype, low socioeconomic status, high disease activity, extra-articular damage, high parent-reported disease activity and poor quality of life were associated with higher global caregiver burden. JIA has a significant emotional, social, economic, and labour impact on caregivers. Economic and psychosocial support needs to be given to family caregivers caring for children with JIA.
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Affiliation(s)
- Nikhil C Gowda
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Rudrarpan Chatterjee
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Anu Balakrishnan
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Able Lawrence
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014
| | - Amita Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 226014.
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Lupini F, Rubinstein TB, Mackey ER, Sule S. Behavioral health outcomes and social determinants of health in children with diabetes and juvenile arthritis. RESEARCH SQUARE 2023:rs.3.rs-3610878. [PMID: 38076886 PMCID: PMC10705696 DOI: 10.21203/rs.3.rs-3610878/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective Children with chronic illnesses, including arthritis, are at increased risk for adverse psychosocial outcomes influenced by social determinants of health (SDOH). Comparing psychosocial outcomes in families affected by juvenile arthritis compared to other chronic illnesses may help identify areas in need of special attention vs areas that may be addressed through adopting other disease examples' care models. We examined child and parent behavioral health outcomes for families with juvenile arthritis compared to diabetes, accounting for SDOH. Methods Secondary data analysis of the National Survey of Children's Health including 365 children (<18yrs) with arthritis and 571 children with diabetes. Psychosocial outcomes were depression, anxiety, ADHD, physical pain, behavioral problems, and treatment for mental health. School outcomes were school engagement, school absence, involvement in clubs/organization, and involvement in organized activities. Parent outcomes were family resilience, emotional support, coping with daily demands of raising a child, job change due to problems with childcare, and parent mental health. SDOH variables were food insecurity, food/cash assistance, unsafe neighborhood, detracting neighborhood elements, parent education, households earning <100% of the federal poverty line. Logistic regression analyses were utilized to examine variation in child and parent outcomes, variation in SDOH, and the role of SDOH. Results Children with arthritis experienced significantly more physical pain, anxiety, depression, ADHD, and behavior problems compared to children with diabetes. Children with arthritis were more likely to see a mental health professional and get treatment for problems with emotions/behaviors. When considering SDOH, children with arthritis were still more likely to experience adverse psychosocial outcomes but were no longer more likely to get treatment. Children with arthritis had increased likelihood of school absence and were less involved in organized activities than children with diabetes. Parents of children with arthritis had poorer mental health than parents of children with diabetes. SDOH were more prevalent in children with arthritis than children with diabetes. Conclusions Increased risk for adverse psychosocial outcomes in youth with arthritis compared to youth with diabetes indicates a need to mirror endocrinology models of care in rheumatology clinics. The role of SDOH highlights the need for regular SDOH screening in clinic.
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Affiliation(s)
| | | | - Eleanor R Mackey
- Children's National Medical Center: Children's National Hospital
| | - Sangeeta Sule
- Children's National Medical Center: Children's National Hospital
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3
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Brandelli YN, Tutelman PR, Chambers CT, Parker JA, Stinson JN, Huber AM, Stirling Cameron E, Wilson JP. "Every Little Furrow of Her Brow Makes Me Want To Stop": An Interpretative Phenomenologic Analysis of Mothers' Experiences With Juvenile Idiopathic Arthritis Treatments. Arthritis Care Res (Hoboken) 2022; 74:1761-1769. [PMID: 34151534 DOI: 10.1002/acr.24735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/29/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Children with juvenile idiopathic arthritis (JIA) are faced with a complex medical journey requiring consistent adherence to treatments to achieve disease management. Parents are intimately involved in JIA treatments; however, little is known about their experiences in this role. This is relevant as many treatments necessitate procedural pain (e.g., self-injections) or side effects (e.g., nausea), which may impact a parents' ability to follow treatment plans. The objective of this study was to explore the lived experiences of parents who identified challenges with their child's JIA treatments. METHODS Parents of children with JIA who identified challenges with their child's treatments were invited to take part in semistructured interviews. Data were analyzed using interpretative phenomenological analysis. RESULTS Ten mothers of children with JIA (60% female with a mean age of 11.83 years [range 4-16 years]) participated. Four superordinate themes were present in mothers' experiences: 1) treatments altered mothers' roles within the family, increasing their caregiver burden and advocacy; 2) treatments positively and negatively impacted their relationships (e.g., increased support from others, decreased time with others); 3) treatments elicited various emotional responses (e.g., frustration, grief), which affected their well-being; and 4) treatments were at times a source of internal conflict, affecting mothers' actions and adherence. CONCLUSION Mothers' experiences with their child's JIA treatments affects them in various ways that can subsequently impact treatment adherence. Results highlight the value of supporting parents through these complex treatment regimens and incorporating their experiences in treatment decisions to help promote optimal outcomes for children with JIA and their families.
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Affiliation(s)
- Yvonne N Brandelli
- Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Perri R Tutelman
- Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | | | | | - Jennifer N Stinson
- University of Toronto and Hospital for Sick Children, Toronto, Ontario, Canada
| | - Adam M Huber
- Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | | | - Jennifer P Wilson
- Cassie & Friends: A Society for Children With Juvenile Arthritis and Other Rheumatic Diseases, Vancouver, British Columbia, Canada
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4
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Girardet RG, Shellman AB, Llorens A, Nguyen L, Ellsworth M, Rennie K, Ha C. Evaluation of an Intensive Program for Children With Co-occurring Medical and Emotional Disorders. Clin Pediatr (Phila) 2022; 61:605-614. [PMID: 35677990 DOI: 10.1177/00099228221091429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study objective was to assess clinical outcomes and cost avoidance of an intensive day treatment program for children with co-occurring chronic medical disease and emotional problems. Intensive day treatment programs for this population are uncommon, and their effectiveness has not been previously reported. A total of 175 children were enrolled during the 3-year study period. Children had more than 30 medical diagnoses including chronic pain, dysautonomia, neurologic disorders, and diabetes. Complete utilization data were available for 118 patients, and demonstrated decreased hospitalizations and increased behavioral health visits during the 12 months post program compared with 12 months prior. Private insurance and female sex were associated with reduced utilization costs after program participation. Estimated avoided cost for the 118 children was $1 111 485. Patients reported significant improvements in somatic symptoms, sleep problems, inattention, depression, anger, and anxiety. Limited data indicated improvements in school attendance. Additional research addressing other outcomes, such as school-related symptoms, would be helpful.
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Affiliation(s)
- Rebecca G Girardet
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Alison B Shellman
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ashlie Llorens
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Anew Psychological Services, Houston, TX, USA
| | - Linh Nguyen
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Misti Ellsworth
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kimberly Rennie
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,NeuroBehavioral Health, Milwaukee, WI, USA
| | - Carolyn Ha
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Katy Psychological Services, Katy, TX, USA
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5
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Bramanti SM, Manippa V, Babore A, Dilillo A, Marcellino A, Martucci V, Mallardo S, Isoldi S, Bloise S, Sanseviero M, Iorfida D, De Luca E, Trumello C, D’Alleva F, Ventriglia F, Lubrano R, Del Giudice E. Comparing parental distress and children's difficulties between parents of children with rheumatic diseases and parents of healthy children in families facing the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-10. [PMID: 35967493 PMCID: PMC9361970 DOI: 10.1007/s12144-022-03589-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
The COVID-19 pandemic could be a threat for the health status of children with a chronic condition. The present study aimed to explore parents' and children's psychological adjustment during the current pandemic, pursuing a triple objective: to compare the psychological adjustment of parents of children with pediatric rheumatic diseases (PRDs) and parents of healthy children; to analyze children's psychological symptoms (emotional problems and hyperactivity) before and during the COVID-19 pandemic, and with or without a PRDs diagnosis; to explore the associations of children's emotional problems and hyperactivity with parents' psychological adjustment, parent-child interactions and belonging or not to families with PRDs. This cross-sectional study involved 56 parents of children with PRDs and 53 parents of healthy children. Self-report questionnaires about parents' depression, anxiety, parenting stress, and children's emotional symptoms and hyperactivity-inattention were administered. No differences were detected on psychological adjustment between parents of children with PRDs and parents of healthy children. Parents of children with PRDs reported statistically significant higher levels of children's emotional problems and hyperactivity before the pandemic, compared to parents of healthy children; during COVID-19 pandemic, emotional symptoms increased for both groups, while hyperactivity-inattention symptoms increased only in the group of healthy children. Children's emotional difficulties were associated with higher levels of parental anxiety, worse parent-child interaction and having PRDs; children's hyperactivity symptoms were related to parent-child difficult interaction and higher levels of parental depression. Findings suggest the importance to target the children in relation to their parents, when approaching the psychological aspects of PRDs.
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Affiliation(s)
- Sonia M. Bramanti
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Valerio Manippa
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
- Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Alessia Marcellino
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Vanessa Martucci
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Saverio Mallardo
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Sara Isoldi
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Silvia Bloise
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Mariateresa Sanseviero
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Donatella Iorfida
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Enrica De Luca
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Francesca D’Alleva
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
| | - Flavia Ventriglia
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Riccardo Lubrano
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Emanuela Del Giudice
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
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Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Bonsel G, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Armbrust W, van den Berg JM, Marshall DA. Factors associated with care- and health-related quality of life of caregivers of children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:51. [PMID: 35870932 PMCID: PMC9308305 DOI: 10.1186/s12969-022-00713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigates the relationship of child, caregiver, and caring context measurements with the care-related quality of life (CRQoL) and health-related quality of life (HRQoL) of caregivers of children with juvenile idiopathic arthritis (JIA). METHODS We performed a cross-sectional analysis of baseline data on caregivers of children with JIA from Canada and the Netherlands collected for the "Canada-Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases" study from June 2019 to September 2021. We used the CRQoL questionnaire (CarerQoL), adult EQ-5D-5L, and proxy-reported Youth 5-Level version of EuroQoL (EQ-5D-5L-Y) to assess caregiver CRQoL, caregiver HRQoL, and child HRQoL, respectively. We used a multivariate analysis to assess the relationship between both caregiver CRQoL and HRQoL and patient, caregiver, and caring context measurements. RESULTS A total of 250 caregivers were included in this study. Most of the caregivers were from the Netherlands (n = 178, 71%) and 77% were females (n = 193). The mean CarerQoL scores was 82.7 (standard deviation (SD) 11.4) and the mean EQ-5D-5L utility score was 0.87 (SD 0.16). Child HRQoL and employment had a positive relationship with both caregiver CarerQoL and EQ-5D-5L utility scores (p < 0.05), while receiving paid or unpaid help had a negative relationship with both scores (p < 0.05). CONCLUSION Our findings indicated that to understand the impact of JIA on families, we need to consider socio-economic factors, such as employment and support to carry caregiving tasks, in addition to child HRQoL.
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Affiliation(s)
- Luiza R. Grazziotin
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Gillian Currie
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Marinka Twilt
- grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Maarten J. IJzerman
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Michelle M. A. Kip
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Hendrik Koffijberg
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Gouke Bonsel
- grid.478988.20000 0004 5906 3508EuroQol Research Foundation, Rotterdam, the Netherlands
| | - Susanne M. Benseler
- grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada ,grid.413574.00000 0001 0693 8815Alberta Health Services, Calgary, Alberta Canada
| | - Joost F. Swart
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Sebastiaan J. Vastert
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Nico M. Wulffraat
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Rae S. M. Yeung
- grid.17063.330000 0001 2157 2938Departments of Paediatrics, Immunology and Medical Science, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Wineke Armbrust
- grid.4494.d0000 0000 9558 4598Wineke Armbrust University of Groningen, University Medical Center Groningen (UMCG), Beatrix Childrens Hospital, Dept Pediatric Rheumatology-Immunology, Groningen, Netherlands
| | - J. Merlijn van den Berg
- grid.7177.60000000084992262Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, Netherlands
| | - Deborah A. Marshall
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
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Cuesta-Lozano D, Lopez-Alcalde J, Castro Molina FJ, García Sastre M, Maravilla Herrera P, Muriel A, Asenjo-Esteve ÁL, Alvarez-Diaz N, Monge Martín D, Carralero-Montero A. Psychoeducation for the parents of people with severe mental illness. Hippokratia 2022. [DOI: 10.1002/14651858.cd014532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Jesús Lopez-Alcalde
- Faculty of Medicine; Universidad Francisco de Vitoria; Pozuelo de Alarcón Spain
- Clinical Biostatistics Unit; Hospital Universitario Ramón y Cajal (IRYCIS). CIBER Epidemiology and Public Health (CIBERESP); Madrid Spain
- Institute for Complementary and Integrative Medicine; University Hospital Zurich and University of Zurich; Zurich Switzerland
| | | | | | | | - Alfonso Muriel
- Department of Nursing and Physiotherapy; Universidad de Alcalá; Madrid Spain
- Clinical Biostatistics Unit; Hospital Universitario Ramón y Cajal (IRYCIS). CIBER Epidemiology and Public Health (CIBERESP); Madrid Spain
| | | | | | - Diana Monge Martín
- Faculty of Medicine; Universidad Francisco de Vitoria; Pozuelo de Alarcón Spain
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Cejalvo E, Martí-Vilar M, Merino-Soto C, Aguirre-Morales MT. Caregiving Role and Psychosocial and Individual Factors: A Systematic Review. Healthcare (Basel) 2021; 9:1690. [PMID: 34946416 PMCID: PMC8700856 DOI: 10.3390/healthcare9121690] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Taking care of a person with a physical disability can become a challenge for caregivers as they must combine the task of caring with their personal and daily needs. The aim of this study was to assess the impact that taking care of a person who needs support has on caregivers and to analyze certain characteristics they present, such as self-esteem and resilience. To that end, a bibliographic review was carried out from 1985, when the first article of taking care of a person who needs support was published, to 2020 (inclusive), in the databases of Web of Science (WoS), Scopus, Pubmed, Eric, Psycinfo, and Embase. The search yielded a total of (n = 37) articles subject to review, following the guidelines established in the PRISMA declaration. The results show that caregiving was highly overburdening and negatively affected the physical condition and the psychological and mental states of caregivers. In addition, certain psychological characteristics present in caregivers such as having high self-esteem and being resilient were found to act as protective factors against the caregiving burden.
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Affiliation(s)
- Elena Cejalvo
- Department of Basic Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, 46010 Valencia, Spain;
| | - Manuel Martí-Vilar
- Department of Basic Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, 46010 Valencia, Spain;
| | - César Merino-Soto
- Psychology Research Institute, Universidad de San Martín de Porres, Lima 34, Peru
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Min M, Hancock DG, Aromataris E, Crotti T, Boros C. Experiences of living with Juvenile Idiopathic Arthritis: a qualitative systematic review. JBI Evid Synth 2021; 20:60-120. [PMID: 34669687 DOI: 10.11124/jbies-21-00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to investigate the available qualitative evidence to enhance understanding of the experiences of children, young adults, and their carers living with Juvenile Idiopathic Arthritis in any setting. INTRODUCTION Juvenile Idiopathic Arthritis is the most common chronic rheumatic disease in childhood. Despite the availability of effective treatments, persistent pain, growth retardation, physical disability, and psychological problems can occur. This may reduce the quality of life for Juvenile Idiopathic Arthritis patients by negatively affecting their family, educational, and social well-being. Patient-centered management and care for Juvenile Idiopathic Arthritis patients requires increasing attention to their self-reported quality of life and experiences, in addition to clinically measured disease activity. Furthermore, taking care of children with Juvenile Idiopathic Arthritis may have negative impacts on the lives of their carers and families. The experiences of carers have been poorly understood and studied. This review describes experiences and perspectives from patients and carers in order to inform the needs of families throughout their Juvenile Idiopathic Arthritis journey. INCLUSION CRITERIA Studies describing the experiences of patients aged <21 years who have been diagnosed with Juvenile Idiopathic Arthritis according to the International League of Associations for Rheumatology criteria, as well as the experiences of their carers, have been considered. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Google Scholar, as well as relevant conference proceedings of the American College of Rheumatology (ACR; 2018-2019), the European Pediatric Rheumatology Congress (PReS) 2018, the European League Against Rheumatism (EULAR; 2018-2019), and the Asia Pacific League of Associations for Rheumatology (APLAR; 2018-2019), was undertaken in December 2020 to identify pertinent published and unpublished studies. Studies published in English from 2001 to 2020 were included. The JBI approach to study selection, critical appraisal, data extraction, and data synthesis was used. RESULTS Ten studies were included in this review. A total of 61 findings were extracted and aggregated to form 12 categories. From the 12 categories, five synthesized findings were developed: i) Self-management of Juvenile Idiopathic Arthritis requires pain management, medication management, and the acquisition of knowledge and professional support; ii) A promising relationship with health care professionals but unbalanced access to services; iii) Parental financial burden and their adjustment to maintain family happiness; iv) Patients and parents support the web-based approach to communicate and develop self-management skills and acknowledge the importance of clinical trials; v) Desire to live a normal life without prejudice from school, social settings, and the workplace. CONCLUSIONS This review has provided a comprehensive overview of experiences and perceptions of Juvenile Idiopathic Arthritis patients and their parents. It is important to understand what they need to know and understand about the disease. This review also highlights the importance of appropriate web-based programs, career counseling, infrastructures, and school facilities. Findings in this review can guide future policy and practice in order to improve care for families and children with Juvenile Idiopathic Arthritis. Further research is required to develop management strategies for medication intolerance and evaluate the longitudinal benefits of relevant Juvenile Idiopathic Arthritis programs. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019133165).
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Affiliation(s)
- Ming Min
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, SA, Australia Women's and Children's Hospital Department of Rheumatology, Adelaide, SA, Australia JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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10
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Jarana-Díaz T, Romero-Martín M, Ponce-Blandón JA, Jiménez-Picón N. Integrative Review of Related Factors and Defining Characteristics of Lack of Family Integrity. Int J Nurs Knowl 2020; 32:44-52. [PMID: 32539236 DOI: 10.1111/2047-3095.12289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/22/2020] [Accepted: 05/10/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify the related factors that compromise family integrity and the defining characteristics of poor family integrity. METHODS Integrative review in databases: Pubmed, Scopus, Cinahl, PsycInfo, and Web of Science. The inclusion and exclusion criteria led to the selection of 12 articles. FINDINGS Family conflicts, lack of communication, and detachment from family as risk factors that have a negative impact on family integrity. A decrease in the physical and psychological quality of life as defining characteristics of poor family integrity. CONCLUSIONS Lack of family integrity has a significant impact on the physical, mental, and social health of its members. IMPLICATIONS FOR NURSING PRACTICE Findings will allow nurses to implement interventions for the maintenance or improvement of family integrity.
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Affiliation(s)
- Trinidad Jarana-Díaz
- Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Spain
| | | | | | - Nerea Jiménez-Picón
- Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Spain
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11
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Waite-Jones JM, Swallow V, Madill A. From 'neurotic' to 'managing' mother: The 'medical career' experienced by mothers of a child diagnosed with Juvenile Idiopathic Arthritis. Br J Health Psychol 2020; 25:324-338. [PMID: 32150659 DOI: 10.1111/bjhp.12409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/13/2020] [Indexed: 11/27/2022]
Abstract
Objective Despite increased research into how caring for a child diagnosed with juvenile idiopathic arthritis (JIA) affects mothers, more needs to be known about ways in which such experiences transform their lives. Insight into the experiences of such mothers was sought through analysis of interviews with eight mothers and one father caring for a child with JIA. Design The study is situated within a larger project involving families with a child with JIA. A social constructionist approach was adopted and grounded theory including a 'negative case,' guided gathering and analysing data. Individual, semi-structured interviews were conducted based on the research question: 'What is it like to be the mother of a child with juvenile idiopathic arthritis?' Results Findings suggest that mothers find difficulty living up to the 'ideal mother' expected within Western society when forced to provide competing demands of age-related, yet illness-relevant care. The unpredictable nature of JIA means mothers face a lack of understanding from professionals so become hyper-vigilant, 'battling' on behalf of their ill child. A self-perpetuating loop develops if this is misperceived as being overprotective, leaving mothers vulnerable to being judged 'neurotic'. However, with experience, often at an emotional cost, such mothers' confidence in managing the competing demands of caring for their ill child increases such they can navigate a positive journey from 'neurotic' to 'managing' mother. Conclusions Understanding this process could help health care professionals reduce stressful experiences faced by mothers when caring for a chronically ill child. Statement of contribution What is already known on this subject? Mothers of chronically ill children are often diagnosed with anxiety and depression. Such mothers will have taken over managing their child's condition, and this can include negative experiences within the health care system. Qualitative methods enable deeper understanding of the experiences of mothers of chronically ill children. What does the study add? Potentially gendered position of mothers of children with chronic conditions. Taken for granted assumptions implicitly underpin interactions between mothers and some professionals. Greater partnership between mothers and professionals ultimately improves the care of the ill child.
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Affiliation(s)
| | - Veronica Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, UK
| | - Anna Madill
- School of Psychology, University of Leeds, UK
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12
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Torres-Made MD, Peláez-Ballestas I, García-Rodríguez F, Villarreal-Treviño AV, Fortuna-Reyna BDJ, de la O-Cavazos ME, Rubio-Pérez NE. Development and validation of the CAREGIVERS questionnaire: multi-assessing the impact of juvenile idiopathic arthritis on caregivers. Pediatr Rheumatol Online J 2020; 18:3. [PMID: 31937332 PMCID: PMC6961380 DOI: 10.1186/s12969-020-0400-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/06/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The primary caregiver is an important person in the life of patients with JIA. Their reactions depend on social, emotional and economic factors that affect the therapeutic alliance. Some generic instruments have been used to evaluate burden, anxiety, or quality of life of caregivers. This study aims to develop a specific instrument to measure the psychosocial and economic impacts on primary caregivers of patients with JIA. METHODOLOGY This is a mixed methods research, that includes qualitative and quantitative data, and was carried out in two phases. First phase: a pragmatic qualitative study (questionnaire construction) was conducted in two parts, a non-systematic literature review followed by interviews with primary caregivers. Second phase: a cross-sectional study (questionnaire validation) to complete validation and estimate Cronbach's alphas based on tetrachoric correlation coefficients, correlation matrix and Cohen's kappa coefficient test. RESULTS There were 38 articles found related to the experience of caregivers. 15 primary caregivers were interviewed (female 93%, median age 45 years). Thematic analysis identified 9 important topics from the perspective of participants (economic impact, coping, family roles, impact of diagnosis, mental health, couple/mate relationships, impact at work, religion, and knowledge of the disease). These topics were combined to create the interview questionnaire (56 items). Later, it was modified to 62 items that were divided into five dimensions: impact of the disease (psychosocial, economic, family, and relationships), knowledge of the disease, alternative medicine, future, and religion. The interview questionnaire was applied to 32 primary caregivers (female 93%, median age 37 years), results identify depression on 29 (90%), 18 (56%) feel sadness at diagnosis, 20 (63%) mentioned that JIA has influenced in their financial situation, 23 (72%) feel anxiety about the future, and 11 (37%) considered that their family relationships have changed. Statistical analysis identified inconsistencies during convergent and divergent validity of the construct. Consequently, 11 items were eliminated, 3 relocated, 6 modified, and 39 compacted obtaining the "Impact of Pediatric Rheumatic Diseases on Caregivers Multi-assessment Questionnaire" (CAREGIVERS questionnaire). This final version resulted on an eight-dimension (28 items) instrument. CONCLUSIONS The CAREGIVERS questionnaire captures perspectives of both the participants and clinicians. It will be helpful to measure the impact of the disease and thus, to improve the quality of care of children with JIA and their families.
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Affiliation(s)
- Marcia Daniela Torres-Made
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Ingris Peláez-Ballestas
- 0000 0001 2221 3638grid.414716.1Rheumatology Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Fernando García-Rodríguez
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Ana Victoria Villarreal-Treviño
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Brenda de Jesús Fortuna-Reyna
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Manuel Enrique de la O-Cavazos
- 0000 0004 1760 058Xgrid.464574.0Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José E. González”, Monterrey, Mexico
| | - Nadina Eugenia Rubio-Pérez
- Department of Pediatrics, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Monterrey, Mexico.
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Khair K, Klukowska A, Myrin Westesson L, Kavakli K, Escuriola C, Uitslager N, Santoro C, Holland M, von Mackensen S. The burden of bleeds and other clinical determinants on caregivers of children with haemophilia (the BBC Study). Haemophilia 2019; 25:416-423. [PMID: 30925018 DOI: 10.1111/hae.13736] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Treatment burden for the people with haemophilia has been documented, as has the burden of caring for a child with a common chronic disease such as asthma or diabetes. However, there remains a paucity of data about caregiver burden in haemophilia. AIMS The aim of this study was to evaluate the impact of bleeding on caregivers of children with haemophilia. Caregiver burden was stratified by the clinical status of their child. METHODS A multinational, non-interventional study of caregivers of children with severe or moderate haemophilia, using the HEMOCABquestionnaire to evaluate caregiver burden. RESULTS A total of 144 caregivers from seven EU countries participated in the study. Differences in caregiver burden were identified based on the clinical situation of the child. Greater burden was seen in caregivers of children who experienced joint bleeding in the preceding 12 months, or had target joints or reduced range of motion in most domains of the HEMOCAB. Caring for a child with a current inhibitor also caused significantly higher burden for caregivers when compared to caring for a child with tolerized inhibitor or without inhibitor. Caregivers of children with chronic pain reported significantly higher burden in all domains of the HEMOCAB except for "interaction with the father." CONCLUSION Caregiver burden can be affected by the child's haemophilia status, particularly if joint health is impacted (eg bleeds, decreased mobility) or if the child suffers from chronic pain which was moderately correlated with joint bleeds.
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Affiliation(s)
- Kate Khair
- Centre for Outcomes and Experience Research in Childhood Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Trust, London, UK.,Haemophilia Centre, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Anna Klukowska
- Department of Paediatrics, Haematology Oncology, Warsaw Medical University, Warsaw, Poland
| | - Linda Myrin Westesson
- Department of Medicine/Haematology and Coagulation Disorders, Coagulation Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Carmen Escuriola
- Haemophilia Centre Rhein Main (HZRM), Mörfelden-Walldorf, Germany
| | - Nanda Uitslager
- Van Creveldkliniek, Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Sylvia von Mackensen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Edmonds J, Twycross A. Mothers' experiences of managing their child's pain before and during attendance at the emergency department. J Clin Nurs 2018; 27:2003-2013. [PMID: 29493831 DOI: 10.1111/jocn.14322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 01/25/2023]
Abstract
AIMS AND OBJECTIVES To explore mothers' experiences of managing their child's pain before and during attendance at the emergency department. BACKGROUND Pain accounts for 50%-80% of all visits to the emergency department. Historically paediatric pain has been poorly managed in the emergency department and there remains variability in practice. It is mothers who usually bring their child to the emergency department and as such it is important to explore their perspectives of how pain is managed. DESIGN Exploratory qualitative study. METHODOLOGY Semi-structured interviews were carried out with mothers (n = 10) of children who have attended the emergency department in one hospital in the East of England during April 2015. RESULTS Most mothers felt able to assess their child's pain and reported attending the emergency department when their normal pain-relieving strategies failed following an injury. Several mothers sought advice from elsewhere before bringing their child to the emergency department. The advice received was usually to take their child to the emergency department. Mothers welcomed the professional approach to pain management in the emergency department and valued being kept informed about their child's care. Mothers rated the care provided in the emergency department as good or very good. CONCLUSIONS Mothers attended the emergency department when their normal pain-relieving strategies failed. This suggests there is a need to provide additional resources to support parents in this context. Mothers often brought their child to the emergency department rather than their General Practitioner or other primary healthcare providers. The reasons for this need exploring further. RELEVANCE TO CLINICAL PRACTICE The results suggest that mothers need additional resources to enable them to manage their child's pain at home following an injury. The reasons mothers attend the emergency department rather than other healthcare providers need exploring in more depth.
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Affiliation(s)
- Jenny Edmonds
- Children's Emergency Department, Norfolk & Norwich University Hospital, Colney Lane, Norwich, UK
| | - Alison Twycross
- Department of Children's Nursing, London South Bank University, London, UK
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Soares H, Barbieri-Figueiredo M, Pereira S, Silva M, Fuertes M. Parents attending to nurse visits and birth age contribute to infant development: A study about the determinants of infant development. Early Hum Dev 2018; 122:15-21. [PMID: 29803997 DOI: 10.1016/j.earlhumdev.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
Abstract
Life experiences and parenting play an important role in infant development. To prevent developmental risks and support parents in their educational role, it is important to identify the determinants of infant development. In this study, we investigate the association between child, maternal, family and social variables, and infant development, as well as we investigate the determinants of infant development. A sample of 86 healthy infants and their mothers participated in this study. At 11-months, infant development was assessed with Schedule of Growing Skills II (SGSII). To assess mother-infant quality of interaction, the dyads were observed in free play at 12-months using CARE-Index. Maternal sensitivity and infant cooperative behavior were correlated with SGSII global scores and sub-scales. Infant development was associated with maternal years of education, number of siblings, birth weight or risks in pregnancy. Number of nurse visits attended by parents during the infant first year and birth age were determinants of infant development.
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Affiliation(s)
- Hélia Soares
- Unidade de Saúde da Ilha Terceira, Centro de Saúde de Angra do Heroísmo, Portugal.
| | - Maria Barbieri-Figueiredo
- ICBAS, UP, Porto, Portugal; NURSID: CINTESIS, Escola Superior de Enfermagem do Porto, Porto, Portugal.
| | - Sandra Pereira
- Instituto de Bioética, Universidade Católica do Porto, Porto, Portugal
| | - Manuela Silva
- Unidade de Saúde da Ilha Terceira, Centro de Saúde de Angra do Heroísmo, Portugal.
| | - Marina Fuertes
- Instituto Politécnico de Lisboa, Escola Superior de Educação de Lisboa, Lisboa, Portugal; University of Porto, Centro de Psicologia, Porto, Portugal.
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Heath-Watson S, Sule S. Living with Juvenile Idiopathic Arthritis: Parent and Physician Perspectives. Rheumatol Ther 2018; 5:1-4. [PMID: 29480358 DOI: 10.1007/s40744-018-0098-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Indexed: 11/30/2022] Open
Abstract
This article, co-authored by a parent of a child with juvenile idiopathic arthritis (JIA) and his pediatric rheumatologist, discusses the parent's experience of having a child with JIA from diagnosis through living day-to-day with the disease.
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Affiliation(s)
| | - Sangeeta Sule
- Department of Pediatrics, Pediatric Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
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Yuwen W, Lewis FM, Walker AJ, Ward TM. Struggling in the Dark to Help My Child: Parents' Experience in Caring for a Young Child with Juvenile Idiopathic Arthritis. J Pediatr Nurs 2017; 37:e23-e29. [PMID: 28778610 PMCID: PMC5681389 DOI: 10.1016/j.pedn.2017.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/28/2017] [Accepted: 07/18/2017] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of this study is to describe parents' experiences in caring for 2-5-year-old children with juvenile idiopathic arthritis (JIA). DESIGN AND METHODS A qualitative study using single-occasion in-depth interviews was conducted. Nine parents (eight mothers and one father) were interviewed in-person or via telephone. Data were analyzed using inductive content analysis. Methods used to protect the trustworthiness of study results included maintenance of an audit trail, peer debriefing, and member checks. RESULTS The core construct Struggling in the Dark to Help My Child explained parents' experience in six domains: not knowing, trying to reach out in the dark, feeling my child's pain, working out the kinks to stay on top to manage, feeling drained by the whole process, and being hard on the entire household. Parents struggled with the unknown, searched for resources, witnessed their child's suffering without knowing how to help, and tried every possible way to stay on top of the child's illness and treatment, even when they felt drained physically and emotionally. JIA not only consumed their lives, but also affected the entire family, including the siblings and spouse, and the relationships among family members. CONCLUSION AND IMPLICATIONS Findings highlight the day-to-day lived challenges parents face when caring for a young child with JIA. Healthcare providers including nurses need to assess the particular needs of an ill child and parents as well as the impact of the illness on the physical and psychosocial health of the entire family so that proper resources can be provided.
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Affiliation(s)
- Weichao Yuwen
- Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, United States.
| | - Frances M Lewis
- Family and Child Nursing, University of Washington, Seattle, WA, United States
| | - Amy J Walker
- Family and Child Nursing, University of Washington, Seattle, WA, United States
| | - Teresa M Ward
- Family and Child Nursing, University of Washington, Seattle, WA, United States
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