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探讨儿童保健中父母心理健康问题的障碍和促进因素:养育先天性心脏病儿童的父母的观点。

Barriers and facilitators to discussing parent mental health within child health care: Perspectives of parents raising a child with congenital heart disease.

机构信息

Division of Behavioral Health, Department of Pediatrics, Nemours Children's Health, Wilmington, DE, USA.

Center for Research in Education and Social Policy, Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA.

出版信息

J Child Health Care. 2023 Sep;27(3):360-373. doi: 10.1177/13674935211058010. Epub 2021 Dec 8.

Abstract

This study aimed to identify barriers and facilitators to discussing parent mental health within child health care for parents of children with congenital heart disease (CHD). Seventy-nine parents of young children with CHD who received care across 40 hospitals in the United States responded to questions about barriers and facilitators to discussing their mental health with their child's health care providers. Responses were analyzed using qualitative research methods. Parents described multiple barriers: (1) belief that parent mental health support was outside the care team's scope of practice, (2) perceived expectation to "stay strong," (3) fear of negative judgment or repercussion, (4) individual preferences for communication/support, (5) desire to maintain care resources on their child, (6) perceived need to compartmentalize emotions, and (7) negative reactions to past emotional disclosure. Parents also described several facilitators: (1) confidence in the care team's ability to provide support, (2) intentional efforts by the care team to provide support, (3) naturally extroverted tendencies, and (4) developing personal connections with health care providers. It is important that health care providers normalize the impact of child illness on the family and create an environment in which parents feel comfortable discussing mental health challenges.

摘要

本研究旨在确定在儿童保健中心讨论父母心理健康问题的障碍和促进因素,对象为患有先天性心脏病 (CHD) 的儿童的父母。美国 40 家医院的 79 名幼儿父母对与子女保健提供者讨论其心理健康问题的障碍和促进因素做出了回应。采用定性研究方法对这些回应进行了分析。父母们描述了多种障碍:(1) 认为父母心理健康支持不属于护理团队的实践范围;(2) 感觉需要“保持坚强”;(3) 担心负面评价或后果;(4) 对沟通/支持的个人偏好;(5) 希望将孩子的医疗资源维持在自己手中;(6) 需要将情绪分开处理;(7) 对过去情感披露的负面反应。父母们还描述了几个促进因素:(1) 对护理团队提供支持的能力有信心;(2) 护理团队有意提供支持;(3) 天生外向的倾向;(4) 与医疗保健提供者建立个人联系。医疗保健提供者应使父母认识到儿童疾病对家庭的影响是正常的,并创造一个使父母感到舒适的环境,讨论心理健康挑战。

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