Billaud Feragen Kristin, Myhre Anita, Stock Nicola Marie
1 Centre for Rare Disorders, Oslo University Hospital (Rikshospitalet), Oslo, Norway.
2 Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
Cleft Palate Craniofac J. 2019 Oct;56(9):1230-1238. doi: 10.1177/1055665619851650. Epub 2019 May 29.
Childhood is a period of extensive socioemotional development, which can be impacted by the presence of a congenital craniofacial anomaly (CFA). Complex multidisciplinary treatment and long-term follow-up are normally required, yet understanding of children's treatment experiences is limited. The objective of this study was to investigate children's experiences of multidisciplinary team (MDT) consultations from the perspective of their parents.
Thirty-eight parents of children with a rare CFA were interviewed in person or over the telephone. Interviews were transcribed verbatim, translated into English, and explored using thematic analysis.
Background factors influencing the child's experience of the consultation included age, developmental stage, personality, and prior treatment experiences. Participants tried to prepare their child for meeting the MDT, but did not fully understand what to expect themselves. During consultations, participants were acutely focused on their child's emotional state, making it difficult to balance their desire to protect the child from potentially negative experiences, and the need to engage in a constructive dialogue with health professionals. Participants believed that health professionals' conduct could considerably influence the child's well-being and subsequent treatment decisions. Finally, participants highlighted the need to debrief their child to help them adjust positively.
The ultimate goal of craniofacial care is to help children develop into confident adults who are able to cope with the challenges associated with their condition. Multidisciplinary teams play a vital role in creating a safe and supportive environment in which children feel genuinely informed and involved in key aspects of their care.
儿童期是社会情感广泛发展的时期,先天性颅面畸形(CFA)的存在可能会对其产生影响。通常需要进行复杂的多学科治疗和长期随访,但对儿童治疗经历的了解却很有限。本研究的目的是从家长的角度调查儿童参与多学科团队(MDT)会诊的经历。
对38名患有罕见CFA儿童的家长进行了面对面或电话访谈。访谈内容逐字转录,翻译成英文,并采用主题分析法进行探究。
影响儿童会诊体验的背景因素包括年龄、发育阶段、性格和既往治疗经历。参与者试图让孩子为与MDT会面做好准备,但他们自己也不完全清楚会发生什么。在会诊过程中,参与者高度关注孩子的情绪状态,这使得他们难以平衡保护孩子免受潜在负面经历影响的愿望,以及与医疗专业人员进行建设性对话的需求。参与者认为医疗专业人员的行为会极大地影响孩子的幸福感和后续治疗决策。最后,参与者强调需要与孩子进行情况汇报,以帮助他们积极调整。
颅面护理的最终目标是帮助儿童成长为自信的成年人,能够应对与自身病情相关的挑战。多学科团队在营造一个安全、支持性的环境中起着至关重要的作用,在这个环境中,儿童能真正了解情况并参与到其护理的关键环节中。