Pelentsov Lemuel J, Fielder Andrea L, Laws Thomas A, Esterman Adrian J
School of Nursing & Midwifery, Division of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia.
Sansom Institute for Health Research and School of Nursing and Midwifery, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia.
BMC Fam Pract. 2016 Jul 21;17:88. doi: 10.1186/s12875-016-0488-x.
Parents caring for a child affected by a rare disease have unmet needs, the origins of which are complex and varied. Our aim was to determine the supportive care needs of parents caring for a child with a rare disease.
An online survey was developed consisting of 45 questions (108 items) and separated into six domains. The survey included questions about perceived level of satisfaction with receiving care, experiences and needs of providing daily care, the impacts of disease on relationships, the emotional and psychological burdens of disease, and parents overall satisfaction with the support received.
Three-hundred and one parents from Australia and New Zealand completed the survey; 91 % (n = 275/301) were mothers, with 132 distinct rare diseases being reported. Fifty-four percent (n = 140/259) of parents were dissatisfied with health professionals' level of knowledge and awareness of disease; 71 % (n = 130/183) of parents felt they received less support compared to other parents. Information regarding present (60 %, n = 146/240) and future services (72 %, n = 174/240) available for their child were considered important. Almost half of parents (45 %, n = 106/236) struggled financially, 38 % (n = 99/236) reduced their working hours and 34 % (n = 79/236) ceased paid employment. Forty-two percent (n = 99/223) of parents had no access to a disease specific support group, and 58 % (n = 134/230) stated that their number of friends had reduced since the birth of their child; 75 % (n = 173/230) had no contact with other parents with a child with a similar disease, and 46 % (n = 106/230) reported feeling socially isolated and desperately lonely. Most frequent emotions expressed by parents in the week prior to completing the survey were anxiety and fear (53 %, n = 119/223), anger and frustration (46 %, n = 103/223) and uncertainty (39 %, n = 88/223).
This study is the first to develop an online survey specifically for use with parents to investigate their supportive care needs across a large and diverse group of rare diseases. The findings highlight that parents with a child with a rare disease have common unmet needs regardless of what disease their child has. Such information may allow health providers to improve child outcomes through improving parental supportive care.
照顾患有罕见病孩子的父母有着未被满足的需求,其根源复杂多样。我们的目的是确定照顾患有罕见病孩子的父母的支持性护理需求。
开展了一项在线调查,包含45个问题(108项),分为六个领域。该调查包括关于对接受护理的满意度、提供日常护理的经历和需求、疾病对人际关系的影响、疾病带来的情感和心理负担,以及父母对所获支持的总体满意度等问题。
来自澳大利亚和新西兰的301位父母完成了调查;91%(n = 275/301)是母亲,报告了132种不同的罕见病。54%(n = 140/259)的父母对医护人员对疾病的了解程度和认知不满意;71%(n = 130/183)的父母觉得与其他父母相比,他们得到的支持更少。关于孩子当前(60%,n = 146/240)和未来可获得的服务的信息被认为很重要。近一半的父母(45%,n = 106/236)在经济上有困难,38%(n = 99/236)减少了工作时间,34%(n = 79/236)停止了带薪工作。42%(n = 99/223)的父母无法加入特定疾病的支持小组,58%(n = 134/230)表示自孩子出生以来朋友数量减少;75%(n = 173/230)与其他患有类似疾病孩子的父母没有联系,46%(n = 106/230)报告感到社交孤立和极度孤独。在完成调查前一周,父母表达的最常见情绪是焦虑和恐惧(53%,n = 119/223)、愤怒和沮丧(46%,n = 103/223)以及不确定(39%,n = 88/223)。
本研究首次专门为父母开发了一项在线调查,以调查他们在一大群多样的罕见病中的支持性护理需求。研究结果突出表明,无论孩子患何种疾病,患有罕见病孩子的父母都有共同的未被满足的需求。此类信息可能使医疗服务提供者通过改善对父母的支持性护理来改善孩子的状况。