[Parental Burden, Need for Support and Resources After Almost Two Years of COVID-19-Pandemic: Results of a Representative Study in Germany]

Studies assessing the burden of families in the second year of the COVID-19-pandemic and the need for support are scarce. Burden, negative and positive changes, resources, and the need for support during the COVID-19-pandemic of a representative sample of 1,087 parents (52,0 % female; mean age 40,4) of minors in Germany were assessed in December 2021. We used a mixed-method approach.More than 50 % percent of parents were burdened about the development of the pandemic (58,5 %), restrictions in activities outside (54,8 %), the mental health of others (54,0 %), and social distance (53,7 %). Parents reported negative changes in partnership (esp. increase in conflicts and crises; 29,4 %), school development (esp. deterioration of school performance; 25,7 %), and mental health of children (38,1 %). In retrospect, over one-third of the parents saw a need for better political communication (36,0 %) and financial support (34,1 %) during the pandemic. In December, 23,8 % of parents still reported the need for support: financial (51,3 %), social (26,6 %), and psychotherapy for themselves (25,8 %). However, parents reported positive changes, especially within the family, feelings of gratitude and new attitudes. Social interaction and positive activities were identified as resources. In the second year of the pandemic, parents experienced much burden and needed support. Interventions and policies should be more targeted and needs-oriented.

Skin toxicities and unmet supportive care needs of patients with cancer undergoing EGFR-inhibitor therapy

Background: Targeted therapies, such as the EGFR (epidermal growth factor receptor) inhibitor therapy, are being used to treat patients with various solid and metastatic tumours. Skin toxicities are a common side effect of this therapy. Aim: The aim of this study was to assess the effects of skin toxicities on quality of life of patients with cancer undergoing EGFR inhibitor therapy, as well as their unmet supportive care needs. Method: Embedded design. A standardised quantitative survey was administered and analysed. In addition, memos and audiotaped material of insightful conversations with the patients after survey administration were included in the analyses. Results: Among the three domains of the effects of skin toxicities on quality of life, physical symptoms (e. g. itching skin, rash) were most frequently reported to impair quality of life, while associated emotional and functional impairments were less frequently reported. Patients don’t consider the management of skin toxicities to be a priority during their treatment, skin toxicities are rather perceived in context of the total symptom burden. Yet, we observed significant correlations between the assessed quality of life and unmet supportive care need domains, especially concerning physical and psychological needs. Conclusions: Although no clinically significant impairment of quality of life of patients undergoing EGFR inhibitor therapy was found, skin changes should be addressed in supportive interventions embedded in routine symptom management.

[Needs of parents in bereavement care after perinatal loss of their preterm infant in the NICU]

BACKGROUND

In Germany, 9% of babies are born preterm, 32 % of them die. A neonatal death is a challenge for both parents and neonatal health care professionals alike. In 1994 the Department of pediatric nursing of the Klinik für Neonatologie/Charité launched an initiative to offer bereavement care for parents who have experienced a perinatal death.

AIM

The aim of this study was to determine the needs of parents after the perinatal loss of their child from the perspective of health care professionals (HCP).

METHOD

Six interviews were conducted with the HCP in Neonatology, Charité – University of Medicine in Berlin and analyzed using qualitative content analysis according to Mayring.

RESULTS

The results show the differing needs of the parents and are focused on five main points: “Avoid and protection of overtaxing”, “express emotions”, “safety and family support”, “bonding with the child” and “give understanding and meaning”.

CONCLUSIONS

The parents needs connected with the Caring Theory of Swanson show that they mostly correspond with the dimension of “Being with”. It underlines the importance of the emotional and educational support of parents in bereavement care during the perimortal period. A major requirement here is to “get to know” the parents and their needs and to accompany them individually. Offering compassionate care and interaction between nurses and bereaved parents complys with the “doing for” and “enabling” from Swanson's model.

[Experiences and support needs of parents of hospitalized children with multiple disabilities: a qualitative study]

BACKGROUND

The hospitalisation of a multiple disabled child is stressful for parents because they continue to carry out demanding care procedures in hospital. Yet, systematic knowledge of the parental experience and of their support needs is missing.

QUESTION

How do parents experience the hospitalisation, and which support needs do they identify for this period? Methods: Twenty-six parents (24 mothers, 2 fathers) of 24 children with multiple disabilities have participated in this qualitative study. Between 1 January 2011 and 1 September 2013, semi-structured interviews were conducted in a children's university hospital. A qualitative content analysis formed the basis for the analysis.

RESULTS

“Concerns for the child's well-being” was central for the parents and focussed on the areas of “Pain”, “Complications” and “Development”. Perception of the child's well-being governs the extent of the “Parents' Work” and defines the parental “Support needs” to “Receive information and training”, “Be known and experience continuity”, “Be taken seriously and experience communion”, “Be accompanied by experienced nurses”, and “Be relieved and get organisational support”.

CONCLUSION

Parents work hard to safeguard the well-being of their hospitalised child with multiple handicaps. Care professionals can ease the parents' burden by promoting parental confidence in their child's welfare in hospital. This will be successful if continuity of care and competence are ensured, for instance if it is provided by nurses with Advanced Practice background.