1
|
Chudleigh J, Holder P. Psychosocial Impact of False-Positive Newborn Screening Results: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:507. [PMID: 38790502 PMCID: PMC11120117 DOI: 10.3390/children11050507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
Psychosocial consequences of false-positive results following newborn bloodspot screening have been identified as a potential risk to this highly successful public health initiative. A scoping review was undertaken in October 2023 underpinned by the Arksey and O'Malley framework. Twenty-four papers were included in the review, many of which focused on cystic fibrosis. The results indicated that impact of false-positive results is variable; some studies suggest false-positive results have the potential to result in negative sequelae including increased stress and changes in parental perceptions of their child, while others suggest these impacts are transient and, in some instances, may even lead to positive outcomes. Further evidence is needed to ensure the representation of other conditions included in newborn bloodspot screening and to support strategies to overcome potential negative sequela.
Collapse
Affiliation(s)
- Jane Chudleigh
- Cicely Saunders Institute, King’s College London, London SE5 9PJ, UK;
| | | |
Collapse
|
2
|
Andrews K, Smith M, Cox NS. The physiotherapy consultation: A qualitative study of the experience of parents of infants with cystic fibrosis in Australia. Physiother Theory Pract 2023; 39:540-546. [PMID: 35042441 DOI: 10.1080/09593985.2021.2023932] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physiotherapy is an essential component in the management of cystic fibrosis (CF). OBJECTIVE To explore how parents of infants with CF experience physiotherapy clinic consultations. METHODS A qualitative study, informed by hermeneutic phenomenology, utilizing in-depth semi-structured interviews and daily diaries was conducted with 13 parents of infants (aged 0-2 yrs.) receiving physiotherapy care for CF in Australia. RESULTS Three themes arose from the text. The first was that parents' physiotherapy clinic experience is influenced by the manner in which health professionals communicate to parents about physiotherapy in CF, as well as their own prior experience and knowledge. Secondly, parents receive conflicting messages from the physiotherapy consultation, but perceive the key message to be to prioritize adherence to physiotherapy. The final theme was that parents' expectations of the physiotherapy interaction were often not met, in particular a lack of practical physiotherapy education and training was reported. CONCLUSION Parents of infants with CF seek an optimistic, practical and hands on approach during physiotherapy consultations. Exploring options for providing physiotherapy input outside of traditional clinic environments may help accommodate individual needs. Investigation into the manner in which physiotherapy education is communicated to parents is warranted in light of the influence on parents' expectations of physiotherapy.
Collapse
Affiliation(s)
- Kristen Andrews
- School of Allied Health, Exercise & Sports Sciences, Charles Sturt University, Albury, NSW, Australia
| | - Megan Smith
- Faculty of Science and Health, Charles Sturt University, Albury, NSW, Australia
| | - Narelle S Cox
- Respiratory Research at Alfred, Department of Immunology and Pathology, Monash University and Institute for Breathing and Sleep, Austin Hospital, Heidelberg, VIC, Australia
| |
Collapse
|
3
|
Myer H, Chupita S, Jnah A. Cystic Fibrosis: Back to the Basics. Neonatal Netw 2023; 42:23-30. [PMID: 36631257 DOI: 10.1891/nn-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 01/13/2023]
Abstract
Cystic fibrosis (CF) is the most common genetic disorder in Caucasian individuals, with an incidence of 1/2,500-3,500 live births. When CF was first described in 1938, most children died in infancy. Currently, the average lifespan is 28-47.7 years. Although new breakthroughs have occurred, CF is still incurable. Both early diagnosis and treatment by multidisciplinary teams are essential to optimize short- and long-term outcomes. It is imperative for neonatal clinicians to keep up to date on the most current research, treatment, and management of CF to provide the best outcomes. This article offers clinicians an updated review of the pathophysiology and clinical manifestations of CF, as well as current evidence-based diagnostics and treatment regimens.
Collapse
|
4
|
Andrews K, Smith M, Cox NS. Physiotherapy: At what cost? Parents experience of performing chest physiotherapy for infants with cystic fibrosis. J Child Health Care 2021; 25:616-627. [PMID: 33249885 DOI: 10.1177/1367493520976481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Physiotherapy is one of the most burdensome aspects of cystic fibrosis (CF) care. Healthcare requirements for older children with CF are reported to impact parental quality of life and physiotherapy adherence. How parents of infants experience performing chest physiotherapy as a part of CF care is unknown. This study aimed to explore the experience of performing chest physiotherapy for parents of infants with CF. In this study, 13 parents of infants (aged 1-2 years) with CF participated in one in-depth semi-structured interview and completed a daily diary for five days. Principles of hermeneutic phenomenology guided interpretation of interview transcripts, diary entries, and field notes. For these parents, being responsible for performing chest physiotherapy was an ever-present experience of pressure, doubt, and guilt. Managing chest physiotherapy resulted in sacrifices that were perceived by parents as an expected and necessary part of meeting the healthcare needs of their child. Despite perceived sacrifices, performing chest physiotherapy was also experienced by parents as an opportunity to positively impact the health of their child. Awareness of parental perceptions and experiences of chest physiotherapy in CF may enhance the personalization of physiotherapy and minimize burden.
Collapse
Affiliation(s)
- Kristen Andrews
- School of Community Health, 1109Charles Sturt University, Albury, NSW, Australia
| | - Megan Smith
- Faculty of Science, 1109Charles Sturt University, Albury, NSW, Australia
| | - Narelle S Cox
- Monash University & Institute for Breathing and Sleep, 2541Monash University, Australia
| |
Collapse
|
5
|
Chudleigh J, Shakespeare L, Holder P, Chinnery H, Hack G, Gill T, Gould R, Southern KW, Olander EK, Morris S, Bonham JR, Simpson A, Moody L. Co-designing improved communication to parents of newborn bloodspot screening results (Preprint). J Particip Med 2021; 14:e33485. [PMID: 35896023 PMCID: PMC9377474 DOI: 10.2196/33485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/23/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Each year in England, almost 10,000 parents are informed of their child’s positive newborn bloodspot screening (NBS) results. This occurs approximately 2 to 8 weeks after birth depending on the condition. Communication of positive NBS results is a subtle and skillful task, demanding thought, preparation, and evidence to minimize potentially harmful negative sequelae. Evidence of variability in the content and the way the result is currently communicated has the potential to lead to increased parental anxiety and distress. Objective This study focused on the development of co-designed interventions to improve the experiences of parents receiving positive NBS results for their children and enhance communication between health care professionals and parents. Methods An experience-based co-design approach was used to explore experiences and co-design solutions with 17 health professionals employed in 3 National Health Service Trusts in England and 21 parents (13/21, 62% mothers and 8/21, 38% fathers) of 14 children recruited from the same 3 National Health Service Trusts. Experiences with existing services were gathered via semistructured interviews with health professionals. Filmed narrative interviews with parents were developed into a composite film. The co-design process identified priorities for improving communication of positive NBS results through separate parent and health professional feedback events followed by joint feedback events. In total, 4 interventions were then co-designed between the participants through a web-based platform. Results Parents and health professionals provided positive feedback regarding the process of gathering experiences and identifying priorities. Themes identified from the parent interviews included impact of initial communication, parental reactions, attending the first clinic appointment, impact of health professionals’ communication strategies and skills, impact of diagnosis on family and friends, improvements to the communication of positive NBS results, and parents’ views on NBS. Themes identified from the health professional interviews included communication between health professionals, process of communicating with the family, parent- and family-centered care, and availability of resources and challenges to effective communication. In response to these themes, 4 interventions were co-designed: changes to the NBS card; standardized laboratory proformas; standardized communication checklists; and an email or letter for providing reliable, up-to-date, condition-specific information for parents following the communication of positive NBS results. Conclusions Parents and health professionals were able to successfully work together to identify priorities and develop co-designed interventions to improve communication of positive NBS results to parents. The resulting co-designed interventions address communication at different stages of the communication pathway to improve the experiences of parents receiving positive NBS results for their children. International Registered Report Identifier (IRRID) RR2-10.1186/s40814-019-0487-5
Collapse
Affiliation(s)
- Jane Chudleigh
- Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Lynette Shakespeare
- Pharmacy, Diagnostics and Genetics, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Pru Holder
- Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Holly Chinnery
- Faculty of Sports, Health and Applied Science, St Mary's University, Twickenham, United Kingdom
| | - Gemma Hack
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Tanya Gill
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Rachel Gould
- Inherited Metabolic Diseases and Newborn Screening, Birmingham Women's and Children's NHS Trust, Birmingham, United Kingdom
| | - Kevin W Southern
- Department of Women's & Children's Health, University of Liverpool, Liverpool, United Kingdom
| | - Ellinor K Olander
- School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Stephen Morris
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - James R Bonham
- Pharmacy, Diagnostics and Genetics, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Alan Simpson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Louise Moody
- Centre for Arts, Memory and Communities, Coventry University, Coventry, United Kingdom
| |
Collapse
|
6
|
Chudleigh J, Holder P, Moody L, Simpson A, Southern K, Morris S, Fusco F, Ulph F, Bryon M, Bonham JR, Olander E. Process evaluation of co-designed interventions to improve communication of positive newborn bloodspot screening results. BMJ Open 2021; 11:e050773. [PMID: 34452966 PMCID: PMC8404436 DOI: 10.1136/bmjopen-2021-050773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To implement and evaluate co-designed interventions to improve communication of positive newborn bloodspot screening results and make recommendations for future research and practice. DESIGN A process evaluation underpinned by Normalisation Process Theory. SETTING Three National Health Service provider organisations in England. PARTICIPANTS Twenty-four healthcare professionals (7 newborn screening laboratory staff and 24 clinicians) and 18 parents were interviewed. INTERVENTIONS Three co-designed interventions were implemented in practice: standardised laboratory proformas, communication checklists and an email/letter template. PRIMARY OUTCOME MEASURES Acceptability and feasibility of the co-designed interventions. RESULTS Auditing the implementation of these interventions revealed between 58%-76% of the items on the laboratory proforma and 43%-80% of items on the communication checklists were completed. Interviews with healthcare professionals who had used the interventions in practice provided positive feedback in relation to the purpose of the interventions and the ease of completion both of which were viewed as enhancing communication of positive newborn bloodspot screening results. Interviews with parents highlighted the perceived benefit of the co-designed interventions in terms of consistency, pacing and tailoring of information as well as providing reliable information to families following communication of the positive newborn bloodspot screening result. The process evaluation illuminated organisational and contextual barriers during implementation of the co-designed interventions in practice. CONCLUSION Variations in communication practices for positive newborn bloodspot screening results continue to exist. The co-designed interventions could help to standardise communication of positive newborn screening results from laboratories to clinicians and from clinicians to parents which in turn could improve parents' experience of receiving a positive newborn bloodspot screening result. Implementation highlighted some organisational and contextual barriers to effective adoption of the co-designed interventions in practice. TRIAL REGISTRATION NUMBER ISRCTN15330120.
Collapse
Affiliation(s)
- Jane Chudleigh
- School of Health Sciences, City University of London, London, UK
| | - Pru Holder
- School of Health Sciences, City University of London, London, UK
| | - Louise Moody
- Centre for Arts, Memory and Communities, Coventry University, Coventry, West Midlands, UK
| | - Alan Simpson
- Health Services and Population Research, King's College London, London, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College, London, UK
| | - Kevin Southern
- Paediatrics, University of Liverpool, Liverpool, Merseyside, UK
| | - Stephen Morris
- Primary Care Unit, University of Cambridge, Cambridge, UK
| | - Francesco Fusco
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Fiona Ulph
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Mandy Bryon
- Paediatric Psychology and Play Services, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - James R Bonham
- Pharmacy, Diagnostics and Genetics, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Ellinor Olander
- School of Health Sciences, City University of London, London, UK
| |
Collapse
|
7
|
Communicating cystic fibrosis newborn screening results to parents. Eur J Pediatr 2021; 180:1313-1316. [PMID: 33067713 PMCID: PMC7567649 DOI: 10.1007/s00431-020-03829-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 11/08/2022]
Abstract
The way results of cystic fibrosis (CF) newborn screening are communicated to parents is critical yet is done differently across the globe. We surveyed parents of 101 children in our tertiary London paediatric centre with a 48% response rate. Parental responses were as follows: 40/42 (95%) said the information could not have been given over the phone and 39/43 (91%) said they wanted both partners present; 27/42 (64%) said it was helpful having the health visitor also present; and 37/40 (92%) felt it was acceptable to wait until the next day for the sweat test. We have reduced the time from first contact to arriving in the home to 2-3 h.Conclusion: We believe that this survey backs up our approach of a home visit by a CF nurse specialist with the family's health visitor to break the news. This is challenging in the current COVID-19 pandemic. What is Known: • Breaking bad news can have a lasting impact on parents when not done the right way. • Giving results of cystic fibrosis (CF) newborn screening is done differently within the UK and around the world. What is New: • Our parental survey revealed that the majority (92%) believed this should be done face to face and not over the telephone. • There was a mixed response to whether the parents should be told the genotype (assuming the CF centre knew), and thus the CF diagnosis before the confirmatory sweat test was carried out.
Collapse
|
8
|
Ligita T, Wicking K, Francis K, Harvey N, Nurjannah I. How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS One 2019; 14:e0212019. [PMID: 30794570 PMCID: PMC6386238 DOI: 10.1371/journal.pone.0212019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 01/25/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Diabetes education has been found to impact positively on self-management by people with diabetes although little is known about the process by which they assimilate information. The aim of this study was to generate a theory explaining the process by which people with diabetes learn about their disease in Indonesia. METHODS This study employed a grounded theory methodology influenced by constructivism and symbolic interactionism. A total of twenty-eight face-to-face or telephone interviews with participants from Indonesia that included people with diabetes, healthcare professionals, health service providers and families of people with diabetes were conducted in both Indonesia and Australia. RESULTS This study discloses a core category of Learning, choosing, and acting: self-management of diabetes in Indonesia as the basic social process of how people learn about their diabetes. The process includes five distinctive major categories. People with diabetes acted after they had received recommendations that they considered to be trustworthy. Factors that influenced their choice of recommendations to adopt are also identified. CONCLUSIONS Awareness of the complexity involved in their decision making will assist healthcare professionals to engage effectively with people living with diabetes.
Collapse
Affiliation(s)
- Titan Ligita
- Nursing, Midwifery and Nutrition, College of Healthcare Sciences, James Cook University, Townsville, Australia
- School of Nursing, Universitas Tanjungpura, Pontianak, Indonesia
| | - Kristin Wicking
- Nursing, Midwifery and Nutrition, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Karen Francis
- Nursing, Midwifery and Nutrition, College of Healthcare Sciences, James Cook University, Townsville, Australia
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Nichole Harvey
- Medicine, College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Intansari Nurjannah
- Nursing, Midwifery and Nutrition, College of Healthcare Sciences, James Cook University, Townsville, Australia
- School of Nursing, Universitas Gadjahmada, Yogyakarta, Indonesia
| |
Collapse
|