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从危机到自信和适应:作为 VACTERL 协会患儿(一种复杂的先天性畸形)家长的经历。

From crisis to self-confidence and adaptation; Experiences of being a parent of a child with VACTERL association - A complex congenital malformation.

机构信息

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Department of Pediatric Surgery, University Children's Hospital, Uppsala, Sweden.

出版信息

PLoS One. 2019 Apr 19;14(4):e0215751. doi: 10.1371/journal.pone.0215751. eCollection 2019.

Abstract

AIM

Knowledge is scarce regarding mothers' and fathers' experiences of being a parent of a child with VACTERL association-a complex malformation. The aim of the study was to describe experiences of being a parent of a child with VACTERL association.

METHOD

Semi-structured interviews were performed with ten mothers and nine fathers face-to-face or by telephone and analyzed by using Qualitative content analysis.

RESULTS

The parents described crisis reactions at the discovery of malformations in their child. Involvement in care was reported from the initial hospital admission until actively taking responsibility for treatments at home. Eventually the health condition became an integrated part of everyday life. The parents expressed the importance of meeting other families with a child with VACTERL. Descriptions were given of more or less professionalism with perceived discrepancies of knowledge and experience between the healthcare professionals in the tertiary hospital and those in the local hospital. Difficulties in receiving medical support during the initial period at home were described. Furthermore, emotional support and practical arrangements regarding parental accommodation and transportation varied.

CONCLUSION

Being a parent of a child with VACTERL association involves crisis, mixed emotional reactions and shared responsibility for the child´s treatment and care with the professional care providers. Psychological processing, good medical care and support from experts, and peer support from other parents is essential in the parents' struggle to reach self-confidence and adaptation. A care plan with individualized tailored care for each child including a training and support plan for the parents is warranted. To reduce the described discrepancies in knowledge and experience between the local and tertiary hospital, video sessions with the parents and responsible professionals at the local and tertiary hospital could be an appropriate mode of transferring information at discharge and follow up of the child.

摘要

目的

关于 VACTERL 协会复杂畸形患儿父母的经验,相关知识非常匮乏。本研究旨在描述 VACTERL 协会患儿父母的经历。

方法

采用半结构式访谈的方式,面对面或通过电话对 10 名母亲和 9 名父亲进行访谈,并采用定性内容分析法进行分析。

结果

父母在发现孩子畸形时描述了危机反应。从孩子最初住院开始,父母就参与了护理,直到积极承担在家治疗的责任。最终,孩子的健康状况成为日常生活的一部分。父母表示,与其他 VACTERL 患儿家庭见面非常重要。他们描述了在专业知识和经验方面,三级医院和当地医院的医护人员之间存在或多或少的差异。还描述了在孩子最初在家期间,获得医疗支持方面的困难。此外,父母在获得情感支持和实际的住宿安排以及交通方面存在差异。

结论

作为 VACTERL 协会患儿的父母,会经历危机、复杂的情绪反应,并与专业医护人员共同承担孩子的治疗和护理责任。心理处理、良好的医疗护理和专家支持以及来自其他父母的同伴支持,对于父母在努力获得自信和适应过程中至关重要。需要制定个性化的护理计划,包括为父母提供培训和支持计划。为了减少当地和三级医院之间知识和经验的描述差异,在当地和三级医院为父母和负责的专业人员进行视频会议,可能是在孩子出院和随访时传递信息的一种合适模式。

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