Parent-led strategies supporting personal well-being when caring for a child with a life-limiting condition: A scoping review

Pediatric Subspecialist Referrals to Peer Support for Families

BACKGROUND AND OBJECTIVES

Families of children with special health care needs (CSHCN) have reported to benefit from social, emotional, and informational support from other families (peer support) with similarly affected children. Pediatric subspecialists often serve as the primary medical providers for CSHCN, as well as educators for these children's families. The extent to which subspecialists refer families to sources of peer support is unknown.

METHODS

A statewide online survey of California pediatric subspecialists investigated opinions about the potential value and challenges of peer support. Data was obtained on the frequency with which families in their practices were referred to peer support, practice characteristics, and personal demographics. Weighted data, descriptive statistics, and regression models were used to characterize and predict factors affecting referral services.

RESULTS

There were 388 respondents, a response rate of 14.5%. Subspecialists were generally unfamiliar with peer support resources in their communities, but many more knew of peer support programs in their institutions. Most (> 85%) held positive views about peer support, though only 40% of practices often referred families for such support. Individual opinions did not predict practice referral processes for peer support which were more influenced by knowledge of resources, and availability of time, staffing, and institutional peer support resources.

CONCLUSION

Offering referral to peer support services is compatible with pediatric subspecialty care. Educating physicians about available resources, assigning responsibility, providing staff time for referring families, and incorporating parent mentors into subspecialty practices can increase access. Future studies of families' referral experiences are needed.

Health-illness transition processes in children with complex chronic conditions and their parents: a scoping review

BACKGROUND

The prevalence of complex chronic conditions (CCC), which cause serious limitations and require specialized care, is increasing. The diagnosis of a CCC is a health-illness transition for children and their parents, representing a long-term change leading to greater vulnerability. Knowing the characteristics of these transitional processes is important for promoting safe transitions in this population. This scoping review aimed to map the available evidence on health-illness transition processes in children with complex chronic conditions and their parents in the context of healthcare.

METHODS

Six databases were searched for studies focusing on children aged 0-21 years with CCC and their parents experiencing health-illness transition processes, particularly concerning adaptation to illness and continuity of care, in the context of healthcare. Studies within this scope carried out between 2013 and 2023 and written in Portuguese or English were identified. The articles were selected using the PRISMA methodology. The data were extracted to an instrument and then presented with a synthesizing approach supporting the interpretation of the results.

RESULTS

Ninety-eight methodologically broad but predominantly qualitative articles were included in this review. Children with CCC have specific needs associated with complex and dynamic health-illness transitions with a multiple influence in their daily lives. Several facilitating factors (p.e. positive communication and a supportive therapeutic relationship with parents and professionals, as well as involvement in a collaborative approach to care), inhibiting factors (p.e. the complexity of the disease and therapeutic regime, as well as the inefficient organization and coordination of teams) and both positive (p.e. well-being and better quality of life) and negative response patterns (p.e. negative feelings about the chronic illness) were identified. Some interventions to support the transitional process also emerged from the literature. Pediatric palliative care is seen as a good practice and an integrative approach for these children and families.

CONCLUSION

Health professionals play a fundamental role in supporting the transitional process and promoting positive response patterns. More significant investment is needed at the clinical and academic levels regarding production and dissemination of knowledge in this area to ensure the awareness of children with CCC and that their needs are fully enhanced.

REVIEW REGISTRATION

https://doi.org/10.17605/OSF.IO/QRZC8 .

'Managing an unexpected life - a caregiver's career': Parents' experience of caring for their child with a non-malignant life-limiting condition

Parents of children with non-malignant life-limiting conditions frequently accept roles that exceed the conventional activities of parenting in relation to the intensity, complexity and temporal nature of the family caregiver experience. This paper explores the prevalent and all-consuming experiences of parents caring for their children. A qualitative descriptive study design was used. Twenty-three parents (both mothers and fathers) were interviewed. Transcribed interview data were analyzed using thematic analysis. 'Managing an unexpected life' was the central concept when parents recounted ongoing efforts to address the emotional and practical effects of their child's condition on their life and that of their family. Analysis revealed three main distinct but interrelated themes within the concept of 'Managing an unexpected life' helping us enhance our understanding of parents' experiences: 'Striving for normality', 'Becoming the expert' and 'Fighting for your child'. Findings suggest that the central concept of 'Managing an unexpected life' appeared to be in keeping with a caregiver's career. Findings likewise suggest the need for improved and focused support and services to enhance parents' career caregiving.