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吞咽困难儿童的家长对其多学科团队有何看法?一项定性研究。

What do parents of children with dysphagia think about their MDT? A qualitative study.

作者信息

Cowpe Jebson Emma, Hanson Ben, Smith Christina H

机构信息

Speech and Language Therapy, Royal Free Hospital, London, UK.

Department of Mechanical Engineering, University College London, London, UK.

出版信息

BMJ Open. 2014 Oct 17;4(10):e005934. doi: 10.1136/bmjopen-2014-005934.

Abstract

OBJECTIVES

To seek the experiences and perspectives of parents caring for children with dysphagia, with emphasis on their experiences of working within their child's multidisciplinary team (MDT).

SETTING

This research was completed in community settings, within families' homes across the UK.

PARTICIPANTS

14 families self-selected to participate in the study. Criteria specified that participants must care for a child under the age of 18 and to decrease ambiguity the term 'diagnosis of dysphagia' was defined as the need for modified (thickened) fluids.

EXCLUSION CRITERIA

caring for an adult over the age of 18; diet and fluid modifications for reasons other than dysphagia (eg, for symptomatic treatment of gastro-oesophageal reflux disease. Participants were interviewed within their homes using a semistructured questionnaire and data was analysed using a descriptive phenomenological approach through use of thematic coding and constant comparison. Themes and relationships were inductively generated from the data.

RESULTS

Participants universally expressed a desire to be involved with their child's MDT; this study identified the following facilitators and barriers to collaboration: accessing services, professional knowledge and professional skillset. Participants described three means of responding to these barriers: reacting emotionally, seeking solutions and making decisions.

CONCLUSIONS

This study recorded in-depth reports of participants' experiences of working with healthcare providers. Despite government-driven efforts towards person-centred healthcare and social care, participants shared accounts of times when this has not occurred, describing a negative impact on the well-being and quality of life of their child and family.

摘要

目的

探寻照顾吞咽困难儿童的家长的经历和观点,重点关注他们在孩子的多学科团队(MDT)中工作的经历。

背景

本研究在英国各地家庭的社区环境中完成。

参与者

14个家庭自行选择参与研究。标准规定参与者必须照顾一名18岁以下的儿童,为减少歧义,“吞咽困难诊断”一词被定义为需要食用改良(增稠)液体。

排除标准

照顾18岁以上的成年人;因吞咽困难以外的原因(如用于胃食管反流病的对症治疗)而进行饮食和液体调整。使用半结构化问卷在参与者家中对他们进行访谈,并通过主题编码和持续比较,采用描述性现象学方法对数据进行分析。从数据中归纳出主题和关系。

结果

参与者普遍表示希望参与孩子的多学科团队;本研究确定了以下合作的促进因素和障碍:获得服务、专业知识和专业技能。参与者描述了应对这些障碍的三种方式:情绪化反应、寻求解决方案和做出决策。

结论

本研究记录了参与者与医疗服务提供者合作经历的深入报告。尽管政府推动以患者为中心的医疗和社会护理,但参与者分享了这种情况未发生时的经历,描述了对他们孩子和家庭的幸福及生活质量产生的负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ad/4202020/09cb81807e34/bmjopen2014005934f01.jpg

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