Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, 547315Children's Hospital of Philadelphia, USA.
Independent Consultant, 6572USA.
J Child Health Care. 2022 Mar;26(1):123-138. doi: 10.1177/13674935211001222. Epub 2021 Mar 31.
Adolescents in the United States are increasingly seeking treatment for mental health crises in emergency departments and general medical hospitals. Medical needs are often addressed quickly, yet youth remain hospitalized because further psychiatric treatment is not immediately available. We sought to better understand the experiences of caregivers whose children are "boarding" in a medical hospital while awaiting inpatient psychiatric treatment. We conducted semi-structured interviews with caregivers who were recruited, enrolled, and interviewed during their child's hospital stay. Interviews were audio-recorded, transcribed verbatim, and thematic analysis was facilitated by NVivo 12. Fourteen caregivers enrolled in the study. Themes that emerged included positive hospital and provider experiences; frustration with the medical and mental health care systems; information needs; fears about inpatient psychiatric units; practical challenges and emotional needs; difficulties with caregiver-child communication; difficulties with clinician-caregiver communication; and need for self-care and support. While many caregivers felt positively about the overall experience at the hospital, they also wished for more information about their child's treatment plan and future, as well as social support, emotional comfort for themselves, and self-care skills and resources. Their experiences illuminate ways in which clinical practice can ameliorate concerns and alleviate stress of caregivers related to their child's mental health crisis.
美国的青少年越来越多地在急诊室和综合医院寻求精神健康危机的治疗。医疗需求通常能迅速得到满足，但由于进一步的精神科治疗无法立即提供，年轻人仍需住院治疗。我们试图更好地了解那些孩子在等待住院精神科治疗时“暂留”在医院的照顾者的经历。我们对在孩子住院期间招募、登记和接受采访的照顾者进行了半结构化访谈。采访内容被录音，逐字转录，并通过 NVivo 12 进行主题分析。共有 14 名照顾者参加了这项研究。出现的主题包括对医院和医务人员的积极体验；对医疗和精神卫生保健系统的不满；对信息的需求；对住院精神科病房的担忧；实际挑战和情感需求；照顾者与孩子之间沟通的困难；临床医生与照顾者之间沟通的困难；以及自我保健和支持的需求。虽然许多照顾者对医院的整体体验感到满意，但他们也希望了解更多关于孩子治疗计划和未来的信息，以及社会支持、自身的情感安慰、自我保健技能和资源。他们的经历阐明了临床实践可以减轻与孩子精神健康危机相关的照顾者的担忧和压力的方式。
