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儿童血友病患者父母的负担:社会人口学和儿童医疗状况的影响。

Burden on parents of children with haemophilia: The impact of sociodemographic and child's medical condition.

机构信息

Sahlgrenska University Hospital, Gothenburg, Sweden.

Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

J Clin Nurs. 2019 Nov;28(21-22):4077-4086. doi: 10.1111/jocn.15003. Epub 2019 Sep 3.

Abstract

AIMS AND OBJECTIVES

To describe the perceived burden on parents of children with severe or moderate haemophilia and the impact of sociodemographic aspects and the child's medical condition on this.

BACKGROUND

Parents of children with haemophilia face a multitude of demands. The child needs frequent intravenous injections, hospital visits, extra supervision and care. The child's illness and related management might have psychosocial effects on the parents.

DESIGN

A multicentre, cross-sectional study.

METHODS

Caregiver burden was evaluated in 102 parents of children with haemophilia, using the HEMOCAB questionnaire which consists of 54 items divided into 13 domains which are to be answered on a 5-point Likert scale. To assess the impact of sociodemographic aspects and clinical data on parental burden, linear regression analyses were undertaken. The study followed the STROBE checklist throughout the research process.

RESULTS

Greater burden was seen in parents of children with past or present inhibitors, in parents of younger children, if a family member administered the clotting factor and in parents of children with overweight/obesity. No significant differences in burden were observed for type of haemophilia, if the child had bleeding in the past 12 months, if the child self-infused, had another family member with haemophilia or if the parent had more children.

CONCLUSIONS

Parental perceived burden can be negatively affected by the child's medical condition; our results underline that healthcare professionals need to be aware of increased parental burden if the child is young, has or had inhibitors and has overweight/obesity.

RELEVANCE TO CLINICAL PRACTICE

More psychosocial support from the healthcare professionals needs to be directed towards parents of younger children and particularly the parents of young children with inhibitors, thus decreasing the parental burden. Parental burden may be reduced if healthcare professionals more actively treat overweight and refer children to appropriate specialists.

摘要

目的和目标

描述严重或中度血友病患儿父母的感知负担,以及社会人口统计学方面和儿童医疗状况对这种负担的影响。

背景

血友病患儿的父母面临着许多需求。孩子需要频繁的静脉注射、医院就诊、额外的监督和护理。孩子的疾病和相关管理可能会对父母产生心理社会影响。

设计

一项多中心、横断面研究。

方法

使用 HEMOCAB 问卷评估 102 名血友病患儿父母的照顾者负担,该问卷由 54 个项目组成,分为 13 个领域,每个领域都要在 5 点李克特量表上回答。为了评估社会人口统计学方面和临床数据对父母负担的影响,进行了线性回归分析。研究过程始终遵循 STROBE 清单。

结果

过去或现在有抑制剂的患儿的父母、年幼孩子的父母、如果家庭成员给予凝血因子以及超重/肥胖的患儿的父母,他们的负担更大。在血友病类型、孩子过去 12 个月是否有出血、孩子是否自行输注、是否有另一个血友病家庭成员或父母是否有更多孩子方面,父母的负担没有显著差异。

结论

父母的感知负担可能会因孩子的医疗状况而受到负面影响;我们的研究结果强调,如果孩子年幼、有或曾经有抑制剂且超重/肥胖,医疗保健专业人员需要意识到父母的负担增加。

临床相关性

医疗保健专业人员需要向年幼孩子的父母,特别是有抑制剂的年幼孩子的父母提供更多的心理社会支持,从而减轻父母的负担。如果医疗保健专业人员更积极地治疗超重并将儿童转介给适当的专家,那么父母的负担可能会减轻。

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