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养育一名接受肾移植手术的孩子——对日常生活经历的研究。

Parenting a child with a kidney transplant-A study of everyday life experiences.

作者信息

Agerskov Hanne, Thiesson Helle C, Pedersen Birthe D

机构信息

Department of Nephrology, Odense University Hospital, Odense, Denmark.

Department of Clinical Research, Family Focused Health Care Research Center, University of Southern Denmark, Odense, Denmark.

出版信息

J Ren Care. 2023 Jun;49(2):134-143. doi: 10.1111/jorc.12410. Epub 2022 Feb 1.

Abstract

BACKGROUND

Kidney transplantation in children shows excellent long-term outcomes. However, parents feel responsible for ensuring that their child adheres to complex medical interventions. The dual role - as both parent and medical caregiver - gives rise to fatigue, stress, and emotional pain. Parental and family functioning are critically important to a child's disease course, development and well-being.

OBJECTIVE

To explore the experiences and perspectives of mothers and fathers of children with a kidney transplant.

DESIGN

An explorative study using a qualitative method.

PARTICIPANTS

Twelve parents (seven mothers and five fathers) of seven children with a kidney transplant.

APPROACH

A qualitative exploratory study taking a phenomenological-hermeneutic approach.

METHOD

Semi-structured individual interviews were conducted. The data were analysed using Ricoeur's theory of narrative and interpretation on three levels: naïve reading, structural analysis, and critical interpretation and discussion.

FINDINGS

Four themes were generated: Kidney transplantation as a turning point, the importance of a close collaboration with health care professionals, being the child's voice, and managing the dual role as a parent, and medical caregiver in everyday life.

CONCLUSION

Child kidney transplantation led to a transformation in the child, on the physical, mental, and social levels; however, the child was still in need of special attention and support. Problems with the kidney graft functioning resulted in frustration and disappointment in parents. Teamwork between a child's parents became evident, in coping with the dual role as a parent and medical caregiver. Parents aimed to maintain a clear structure related to medication and disease-related treatment. A close and trustful relationship and collaboration with health care professionals were significant and included listening to the voice of the child.

摘要

背景

儿童肾移植显示出优异的长期疗效。然而,父母觉得自己有责任确保孩子坚持复杂的医疗干预措施。父母身兼双重角色——既是家长又是医疗护理者——这会导致疲劳、压力和情感痛苦。父母及家庭功能对孩子的病程、发育和幸福至关重要。

目的

探讨肾移植儿童父母的经历和观点。

设计

采用定性方法的探索性研究。

参与者

7名肾移植儿童的12名父母(7名母亲和5名父亲)。

方法

采用现象学-诠释学方法的定性探索性研究。

方法

进行半结构化的个人访谈。运用利科的叙事与诠释理论,从三个层面分析数据:朴素阅读、结构分析以及批判性诠释与讨论。

结果

产生了四个主题:肾移植作为一个转折点、与医护人员密切合作的重要性、成为孩子的代言人以及在日常生活中兼顾家长和医疗护理者的双重角色。

结论

儿童肾移植在身体、心理和社会层面给孩子带来了转变;然而,孩子仍需要特别关注和支持。肾移植功能出现问题让父母感到沮丧和失望。孩子的父母在应对家长和医疗护理者的双重角色时,团队合作变得明显。父母旨在维持与药物治疗和疾病相关治疗有关的清晰架构。与医护人员建立密切且信任的关系及合作非常重要,其中包括倾听孩子的声音。

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