Australian Catholic University, School of Nursing, Midwifery & Paramedicine, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia; Northwestern Mental Health, Melbourne Health, Grattan Street, Parkville, Victoria, 3050, Australia; Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown NSW 2006, Australia.
Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University NSW 2109, Australia.
Injury. 2019 May;50(5):1082-1088. doi: 10.1016/j.injury.2019.01.004. Epub 2019 Jan 10.
Parents of critically injured children can experience high levels of psychological distress post-injury, however little is known about their experiences and needs following injury. This study aimed to explore parent experiences and psychosocial support needs in the six months following child critical injury.
An interpretive qualitative design was used. Semi-structured interviews were conducted with 30 parents of 23 critically injured children. Interviews explored parent experiences and psychosocial support needs. Qualitative data were managed using NVIVO 10 and analysed thematically.
Four themes were identified: integrating back into home life; adjusting mentally and emotionally to injury; coping with injury as a family; and navigating resources to meet family needs. Parents and families experienced substantial ongoing emotional impacts at 6 months following child injury. Parents were unprepared for the negative changes in their child's psychological wellbeing and behaviour post injury, and parents' mental health was negatively impacted, with mothers more likely to seek emotional support than fathers. Parents reported receiving no psychosocial follow-up from the hospital and limited information about community services and accessing local community resources on returning home.
There is a need to include all family members in discharge planning, and to use a family-centred continuity-of-care approach from the time of child injury through to post-discharge recovery. To strengthen parent and family wellbeing, a biopsychosocial holistic approach is recommended, including cognitive-behavioural and other psychological strategies to help reduce distress for parents and all family members and strengthen their coping capacity. A dedicated family support coordinator role to facilitate care over the child recovery trajectory, and development of accessible online and e-psychosocial support resources for parents and families are recommended.
危重病患儿的父母在受伤后可能会经历高度的心理困扰，但人们对他们受伤后的经历和需求知之甚少。本研究旨在探讨患儿危重症后 6 个月内父母的经历和心理社会支持需求。
采用解释性定性设计。对 23 名危重症儿童的 30 名父母进行了半结构式访谈。访谈探讨了父母的经历和心理社会支持需求。使用 NVIVO 10 管理定性数据，并进行主题分析。
确定了四个主题：重新融入家庭生活；心理和情绪上适应受伤；作为一个家庭应对受伤；以及寻找资源满足家庭需求。患儿受伤后 6 个月，父母和家庭经历了持续的重大情绪影响。父母对受伤后孩子心理福利和行为的负面变化毫无准备，父母的心理健康受到负面影响，母亲比父亲更有可能寻求情感支持。父母报告说，他们没有从医院得到任何心理社会随访，也没有关于社区服务的信息，也没有在回家后获得当地社区资源。
有必要在出院计划中包括所有家庭成员，并在儿童受伤后到出院后恢复期间采用以家庭为中心的连续性护理方法。为了加强父母和家庭的幸福感，建议采用生物心理社会整体方法，包括认知行为和其他心理策略，以帮助减少父母和所有家庭成员的痛苦，增强他们的应对能力。建议设立专门的家庭支持协调员，以促进儿童康复过程中的护理，并为父母和家庭开发易于获取的在线和电子心理社会支持资源。
