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儿童期危及生命疾病中的养育方式:一项混合方法研究。

Parenting in Childhood Life-Threatening Illness: A Mixed-Methods Study.

机构信息

1 Department of Family and Community Health, School of Nursing, University of Maryland , Baltimore, Maryland.

2 Department of Family and Community Health, School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania.

出版信息

J Palliat Med. 2018 Feb;21(2):208-215. doi: 10.1089/jpm.2017.0054. Epub 2017 Oct 3.

Abstract

BACKGROUND

Parenting children with life-threatening illness (LTI) and their healthy siblings requires parents to consider their various needs.

OBJECTIVE AND METHODS

We conducted a concurrent, cross-sectional mixed-methods study to describe challenges parents face prioritizing tasks and goals for each child with qualitative data, compare parents' tasks and goals for children with LTI and healthy siblings with quantitative data, and describe parenting in terms of the process of prioritizing tasks and goals for all children in the family.

RESULTS

Participants included 31 parents of children with LTI who have healthy siblings and were admitted to a children's hospital. Qualitative interviews revealed how parents managed children's needs and their perceptions of the toll it takes. Quantitative data revealed that parents prioritized "making sure my child feels loved" highest for ill and healthy children. Other goals for healthy siblings focused on maintaining emotional connection and regularity within the family and for ill children focused on illness management. Mixed-methods analysis revealed that parents engaged in a process decision making and traded-off competing demands by considering needs which ultimately transformed the meaning of parenting.

DISCUSSION

Future research can further examine trade-offs and associated effects, how to support parent problem-solving and decision-making around trade-offs, and how to best offer social services alongside illness-directed care.

摘要

背景

养育患有危及生命疾病(LTI)的孩子及其健康的兄弟姐妹需要父母考虑他们的各种需求。

目的和方法

我们进行了一项同时进行的、横断面的混合方法研究,使用定性数据描述父母在为每个孩子确定任务和目标时面临的挑战,使用定量数据比较父母对患有 LTI 和健康兄弟姐妹的孩子的任务和目标,并根据为家庭中所有孩子确定任务和目标的过程来描述育儿。

结果

参与者包括 31 名患有 LTI 且有健康兄弟姐妹的儿童的父母,他们被收治在一家儿童医院。定性访谈揭示了父母如何管理孩子的需求以及他们对这一需求所带来的影响的看法。定量数据显示,父母将“确保我的孩子感到被爱”作为患病和健康孩子的首要任务。对健康兄弟姐妹的其他目标侧重于维持家庭内的情感联系和规律性,而对患病儿童的目标则侧重于疾病管理。混合方法分析显示,父母通过考虑需求进行决策过程并权衡相互竞争的需求,最终改变了育儿的意义。

讨论

未来的研究可以进一步研究权衡和相关影响,如何支持父母在权衡问题上的解决问题和决策,以及如何在提供疾病导向的护理的同时,最好地提供社会服务。

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