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青少年特发性关节炎患儿家长的疾病不确定感

Illness Uncertainty in Parents of Children with Juvenile Idiopathic Arthritis.

作者信息

Pearce Caroline, Newman Stanton, Mulligan Kathleen

机构信息

School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom.

East London NHS Foundation Trust, 9 Alie St, London, E1 8DE, United Kingdom.

出版信息

ACR Open Rheumatol. 2021 Apr;3(4):250-259. doi: 10.1002/acr2.11238. Epub 2021 Mar 12.

Abstract

OBJECTIVE

To gain a better understanding of uncertainty regarding the illness experienced by parents of children with juvenile idiopathic arthritis (JIA).

METHODS

Parents/guardians of a child or young person (aged less than 18 years) diagnosed JIA were recruited in the United Kingdom via the National Rheumatoid Arthritis Society JIA group. Semistructured telephone interviews were conducted with the parents.

RESULTS

Twenty parents took part, including 19 mothers and one father. Their children with JIA were mostly female (n = 15; 75%) with polyarticular arthritis (n = 12; 60%), averaged 8 years of age, and had been diagnosed for a mean of 3.7 (SD 2.3) years. Parents expressed uncertainty in the following five key domains: diagnosis, cause, symptoms, and prognosis; medical management; impact; parenting uncertainty; and awareness of JIA. All participants expressed uncertainty in at least four of the five domains. Although parents' uncertainty in the early stages of the disease related to lack of information and understanding of JIA, much uncertainty could not be resolved by receipt of information. These included concerns about their child's future and a lack of support with managing the emotional aspects of living with JIA.

CONCLUSION

We found that parents' experiences of uncertainty went beyond dealing with the purely medical aspects of JIA. Provision of information about JIA, although essential, is not sufficient to help parents manage the considerable uncertainty they experience about many aspects of their child's JIA. Identifying ways to incorporate support for coping with uncertainty into routine care will be an important way of supporting parents to care for their child with JIA.

摘要

目的

更好地了解青少年特发性关节炎(JIA)患儿父母对其所患疾病的不确定性。

方法

通过英国国家类风湿关节炎协会JIA小组招募了一名被诊断为JIA的儿童或青少年(年龄小于18岁)的父母/监护人。对这些父母进行了半结构化电话访谈。

结果

20名父母参与,其中包括19名母亲和1名父亲。他们患有JIA的孩子大多为女性(n = 15;75%),患多关节型关节炎(n = 12;60%),平均年龄8岁,平均确诊时间为3.7(标准差2.3)年。父母在以下五个关键领域表达了不确定性:诊断、病因、症状和预后;医疗管理;影响;育儿的不确定性;以及对JIA的认识。所有参与者在五个领域中的至少四个领域表达了不确定性。虽然父母在疾病早期的不确定性与对JIA缺乏信息和了解有关,但许多不确定性无法通过获取信息得到解决。这些包括对孩子未来的担忧以及在应对与JIA共同生活的情感方面缺乏支持。

结论

我们发现父母对不确定性的体验超出了应对JIA纯粹医疗方面的范畴。提供有关JIA的信息虽然至关重要,但不足以帮助父母应对他们在孩子JIA的许多方面所经历的相当大的不确定性。确定将应对不确定性的支持纳入常规护理的方法将是支持父母照顾患JIA孩子的重要方式。

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