Glasscoe Claire, Smith Jonathan A
University of Liverpool, UK.
Clin Child Psychol Psychiatry. 2011 Apr;16(2):279-98. doi: 10.1177/1359104510383207. Epub 2011 Jan 6.
We conducted a qualitative study with caregivers for a contemporary understanding of the challenge of caring for a child with cystic fibrosis (CF). A single case is presented that details one woman's experience from her unique perspective of both, 'mother to a child with CF' and 'CF healthcare provider' using an interpretative phenomenological analysis. Emergent themes include: 'trying to keep things normal,' which includes different types of normality and routine management of treatment; 'when things become difficult,' which includes dealing with symptoms and battling with CF related decline; and, 'the complexity of decision making.' The discussion section expands on how, for this mother contrasting modes of managing CF (everyday life/full-on alert) co-existed and were further complicated by (i) role discrepancies (mother/nurse), and (ii) a dialectic between affect and reason. The CF parenting challenge increasingly involves responsibility for complex healthcare interventions and this study suggests a need for further enquiry into how caregivers are involved in the treatment plan and decision-making about treatment. Practice implications are proposed.
我们开展了一项定性研究,与照顾者进行交流,以便从当代视角了解照顾患有囊性纤维化(CF)儿童的挑战。本文呈现了一个个案,详细阐述了一位女性从“CF患儿的母亲”和“CF医护人员”这两个独特视角出发的经历,采用了解释现象学分析方法。浮现出的主题包括:“努力维持正常生活”,其中涵盖了不同类型的正常状态以及治疗的常规管理;“当情况变得艰难时”,包括应对症状以及与CF相关的身体机能衰退作斗争;还有“决策的复杂性”。讨论部分进一步阐述了,对于这位母亲而言,CF的不同管理模式(日常生活/高度戒备)是如何并存的,又是如何因以下两点而变得更加复杂:(i)角色差异(母亲/护士),以及(ii)情感与理性之间的辩证关系。CF患儿养育面临的挑战越来越多地涉及到复杂医疗干预的责任问题,本研究表明有必要进一步探究照顾者如何参与治疗计划以及治疗决策。文中还提出了对实践的启示。