Ryerson Espino Susan L, Kelly Erin H, Rivelli Anne, Zebracki Kathy, Vogel Lawrence C
Shriners Hospitals for Children, Chicago, IL, USA.
Marquette University, Milwaukee, WI, USA.
Spinal Cord. 2018 Mar;56(3):284-294. doi: 10.1038/s41393-017-0022-6. Epub 2017 Nov 30.
Focus group study.
Explore unmet needs and support preferences of caregivers of youth with spinal cord injury (SCI).
One pediatric specialty rehabilitation hospital system in the United States.
Four focus groups were conducted with a convenience sample of 26 caregivers who were primarily mothers (96%) and married (65%), and had at least some college education (85%). Children living with SCI were on average 12.8 years old (SD = 3.3, 8-18). The average age of injury was 4.7 years (SD = 4.4, 0-16.2); mean injury duration was 8.2 years (SD = 3.9, 2-16); 77% had paraplegia; and 58% were male. Focus groups were digitally recorded, transcribed verbatim, and coded using thematic analysis and NVivo.
Qualitative data highlighted caregiver perspectives on unmet needs relating to two phases of care: acute and rehabilitation vs. current life with SCI, and two kinds of stressors: those associated with SCI and care vs. those related to other areas of the caregivers' lives, especially their families. Caregivers described stressful interactions with care systems and community services, articulated several concerns regarding well-being of family members, and noted that both they and their children with SCI experienced isolation. Caregivers articulated preferences for additional support from professionals and peers.
Data suggest the need for ongoing caregiver interventions and strengthened family-centered care systems, including professional assistance navigating health systems and peer support. Intervention development would benefit from further qualitative data collection with additional caregivers of youth with SCI, including multiple family members, and families from more diverse care settings.
焦点小组研究。
探讨脊髓损伤(SCI)青少年照料者未满足的需求及支持偏好。
美国一家儿科专科康复医院系统。
对26名照料者进行了4个焦点小组访谈,这些照料者主要是母亲(96%),已婚(65%),至少受过一些大学教育(85%)。患有SCI的儿童平均年龄为12.8岁(标准差=3.3,8 - 18岁)。平均受伤年龄为4.7岁(标准差=4.4,0 - 16.2岁);平均受伤持续时间为8.2年(标准差=3.9,2 - 16年);77%患有截瘫;58%为男性。焦点小组访谈进行了数字录音、逐字转录,并采用主题分析和NVivo进行编码。
定性数据突出了照料者对与两个护理阶段相关的未满足需求的看法:急性和康复阶段与SCI后的当前生活,以及两种压力源:与SCI和护理相关的压力源与照料者生活中其他领域(尤其是家庭)相关的压力源。照料者描述了与护理系统和社区服务的紧张互动,阐述了对家庭成员福祉的若干担忧,并指出他们自己和患有SCI的孩子都感到孤立。照料者明确表示希望得到专业人员和同伴更多的支持。
数据表明需要持续的照料者干预和强化以家庭为中心的护理系统,包括在医疗系统导航方面的专业协助和同伴支持。进一步收集更多患有SCI青少年的照料者(包括多名家庭成员)以及来自更多样化护理环境家庭的定性数据,将有助于干预措施的制定。