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先天性心脏病患儿家长手术经历:整体护理模式

The Experiences of Parents of Children Undergoing Surgery for Congenital Heart Defects: A Holistic Model of Care.

作者信息

David Vainberg Leeza, Vardi Amir, Jacoby Rebecca

机构信息

Oncology Center, Assuta Hospital, Tel Aviv, Israel.

Pediatric Cardiac Intensive Care, The Edmond and Lilly Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.

出版信息

Front Psychol. 2019 Nov 27;10:2666. doi: 10.3389/fpsyg.2019.02666. eCollection 2019.

Abstract

The present article is based on a qualitative study focusing on parents of children born with congenital heart defects (CHDs) and hospitalized in the children's intensive care unit post-surgery. Our aim was to explore parents' subjective experiences as primary caregivers. Ten semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis according to the instructions of Smith and Osborn. Our analysis yielded eight categories which were grouped into four themes and two main superordinate themes: (1) dialectical tension between positive and negative experiences; and (2) fluctuations between the inner and the outer world. The two superordinate themes intersect such that parents report positive as well as negative experiences within both their inner and outer worlds. Based on our analysis, we found that the experience of having a child undergo surgery for a CHD can be regarded as a chaotic period characterized by uncertainty, confusion, and helplessness. It is therefore no surprise that many parents display negative psychological outcomes which extend beyond the period of hospitalization and may also affect their future parenting and coping. However, within this chaotic and stressful situation, parents had occasional supportive experiences which decreased their emotional distress and isolation and helped them throughout this difficult period. We thus conclude that the support offered to parents during the hospitalization period should be increased by trying to minimize their negative experiences and strengthen their inner coping abilities. These changes cannot be implemented without also addressing the needs of the medical staff in their role as caregivers. Therefore, we propose a holistic model of care which supports both parents as caregivers of children undergoing surgery for CHD and the medical staff involved in their care.

摘要

本文基于一项定性研究,该研究聚焦于患有先天性心脏病(CHD)且术后在儿童重症监护病房住院的患儿的父母。我们的目的是探索父母作为主要照料者的主观体验。我们进行了10次半结构化访谈,并根据史密斯和奥斯本的指导方针,运用解释现象学分析方法对访谈进行了分析。我们的分析得出了8个类别,这些类别被归纳为4个主题和2个主要的上位主题:(1)积极与消极体验之间的辩证张力;(2)内心世界与外部世界之间的波动。这两个上位主题相互交叉,以至于父母在其内心世界和外部世界中都报告了积极和消极的体验。基于我们的分析,我们发现孩子接受先天性心脏病手术的经历可被视为一个混乱时期,其特征是不确定性、困惑和无助。因此,许多父母表现出负面心理结果也就不足为奇了,这些负面心理结果不仅会持续到住院期之后,还可能影响他们未来的育儿方式和应对能力。然而,在这种混乱和压力巨大的情况下,父母偶尔也会有支持性的经历,这些经历减轻了他们的情绪困扰和孤独感,并在整个困难时期帮助了他们。因此,我们得出结论,应通过尽量减少父母的负面体验并增强他们的内心应对能力,来增加在住院期间为父母提供的支持。如果不满足医护人员作为照料者的需求,这些改变就无法实施。因此,我们提出了一个全面的护理模式,该模式既支持父母作为患有先天性心脏病患儿手术照料者的角色,也支持参与患儿护理的医护人员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91f7/6890854/132b017bd36e/fpsyg-10-02666-g001.jpg

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