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常见条件下的罕见需求:一项定性研究,旨在探索罕见病儿科患者的护理需求。

Common needs in uncommon conditions: a qualitative study to explore the need for care in pediatric patients with rare diseases.

机构信息

Department of Medical Psychology, Amalia Children's Hospital, Radboud University Medical Center, PO 9101, 6500 HB, Nijmegen, The Netherlands.

Division of Pediatric Urology, Department of Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands.

出版信息

Orphanet J Rare Dis. 2022 Apr 4;17(1):153. doi: 10.1186/s13023-022-02305-w.

Abstract

BACKGROUND

Challenges faced by children diagnosed with a rare disease or complex condition and their family members are often characterized by disease-specific complexities, such as a prolonged diagnostic process, an uncertain prognosis, and the absence of curative treatment. The psychological burden of living with a rare disease or complex condition is often understudied and may present overarching concepts that shape the general experience of having been diagnosed with a rare condition. The present study examines common needs from a comprehensive perspective combining relevant aspects from the rare disease literature in a theoretical perspective from pediatric psychology, such as a family-centred, developmental and interdisciplinary approach. An exploratory study was designed among parents from children with a rare disease or complex condition in an Integrated University Children's Hospital in the Netherlands. Semi-structured interviews were conducted with open-ended questions based around the experience of having a child diagnosed with a rare condition, such as the psychosocial impact on the child and it's development, the impact on the family, and how provided care was experienced.

RESULTS

Twelve interviews were analysed with a thematic content analysis to identify common needs. Eight themes followed from the analysis and uncovered the need for (1) family-focused care, (2) coping with uncertainty, (3) empathic communication, (4) practical support, (5) information, (6) psychological support, (7) interdisciplinary care, and (8) social support.

CONCLUSIONS

The results from our study provide directions for research and health care to support young patients with a rare disease or complex condition and their families. Moreover, our results demonstrated that there are overarching concepts across different rare diseases that may be optimally supported with interdisciplinary care.

摘要

背景

患有罕见病或复杂疾病的儿童及其家庭成员所面临的挑战通常具有疾病特异性的复杂性,例如诊断过程漫长、预后不确定以及缺乏治愈性治疗。患有罕见病或复杂疾病的心理负担往往研究不足,可能存在影响整体诊断经历的重要概念。本研究从综合的角度审视常见需求,将罕见病文献中的相关方面与儿科心理学的理论观点相结合,例如以家庭为中心、发展和跨学科的方法。在荷兰的一所综合大学儿童医院,对患有罕见病或复杂疾病的儿童的父母进行了一项探索性研究。半结构式访谈采用开放式问题,围绕孩子被诊断出患有罕见疾病的经历展开,例如对孩子及其发展的心理社会影响、对家庭的影响以及所提供的护理的体验。

结果

对 12 次访谈进行了主题内容分析,以确定常见需求。分析得出了 8 个主题,揭示了对(1)以家庭为中心的护理、(2)应对不确定性、(3)共情沟通、(4)实际支持、(5)信息、(6)心理支持、(7)跨学科护理和(8)社会支持的需求。

结论

本研究结果为研究和医疗保健提供了方向,以支持患有罕见病或复杂疾病的年轻患者及其家庭。此外,我们的研究结果表明,不同罕见病之间存在着普遍的概念,通过跨学科护理可以最佳地支持这些概念。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9461/8981675/759fee9b90f3/13023_2022_2305_Fig1_HTML.jpg

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