Feng Jui-Chun, Wu Wei-Wen, Chwo Miao-Ju, Liang Shu-Yuan, Cheng Su-Fen
MSN RN, Care Leader, 16 Ward, Mackay Hospital, Tamsui Branch, Taiwan, ROC.
PhD, RN, Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC.
Hu Li Za Zhi. 2019 Feb;66(1):27-37. doi: 10.6224/JN.201902_66(1).05.
Children suffering from adrenoleukodystrophy (ALD) requires life-long care. Little is known about the care needs of parents of ALD children at different stages of their disease.
The purpose of this study was to understand the long-term care experiences and care needs of parents caring for their ALD children.
A descriptive qualitative study with 7 in-depth interviews was conducted with parents.
The results of these care experiences were distinguished into three phases: "pathogenesis to diagnosis", "rapid deterioration of physiological functions", and "bedridden until the death". The long-term care experiences revealed five themes, including "chaos and helplessness to seek medical attention then being forced to accept", "self-accusation and guilt", "strengthening parents' toughness", "seizing the moment and facing the future", and "accompanying children through life without pain". Within the three phases, the care needs comprised the three themes of "integrating resources and providing immediate care", "obtaining information and support regarding ALD rapidly", and "establishing individualized long-term care".
CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study revealed the long-term care experiences and care needs of the parents of ALD children. Providing individualized care, nursing instruction, and telephone consultation as well as connecting case managers with the hospice-care team will help facilitate and meet the care needs of these parents.
患有肾上腺脑白质营养不良(ALD)的儿童需要终身护理。对于ALD患儿父母在疾病不同阶段的护理需求知之甚少。
本研究的目的是了解照顾ALD患儿的父母的长期护理经历和护理需求。
对父母进行了一项描述性定性研究,进行了7次深入访谈。
这些护理经历的结果分为三个阶段:“发病至诊断”、“生理功能迅速恶化”和“卧床直至死亡”。长期护理经历揭示了五个主题,包括“寻求医疗时的混乱与无助,随后被迫接受”、“自责与内疚”、“增强父母的韧性”、“抓住当下,面对未来”以及“陪伴孩子无痛生活”。在这三个阶段中,护理需求包括“整合资源并提供即时护理”、“迅速获取有关ALD的信息和支持”以及“建立个性化长期护理”这三个主题。
结论/对实践的启示:本研究揭示了ALD患儿父母的长期护理经历和护理需求。提供个性化护理、护理指导和电话咨询,以及将个案管理员与临终关怀团队联系起来,将有助于促进并满足这些父母的护理需求。