Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
BMC Pediatr. 2022 May 12;22(1):270. doi: 10.1186/s12887-022-03340-z.
Childhood fractures can have a significant impact on the daily lives of families affecting children's normal activities and parent's work. Wrist fractures are the most common childhood fracture. The more serious wrist fractures, that can look visibly bent, are often treated with surgery to realign the bones; but this may not be necessary as bent bones straighten in growing children. The children's radius acute fracture fixation trial (CRAFFT) is a multicentre randomised trial of surgery versus a cast without surgery for displaced wrist fractures. Little is known about how families experience these wrist fractures and how they manage treatment uncertainty. This study aimed to understand families' experience of this injury and what it is like to be asked to include their child in a clinical trial.
Nineteen families (13 mothers, 7 fathers, 2 children) from across the UK participated in telephone interviews. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis.
Our findings highlight parents' desire to be a good parent through the overarching theme "protecting my injured child". To protect their child after injury, parents endeavoured to make the right decisions about treatment and provide comfort to their child but they experienced ongoing worry about their child's recovery. Our findings show that parents felt responsible for the decision about their child's treatment and their child's recovery. They also reveal the extent to which parents worried about the look of their child's wrist and their need for reassurance that the wrist was healing.
Our findings show that protecting their child after injury can be challenging for parents who need support to make decisions about treatment and confidently facilitate their child's recovery. They also highlight the importance of providing information about treatments, acknowledging parents' concerns and their desire to do the right thing for their child, reassuring parents that their child's wrist will heal and ensuring parents understand what to expect as their child recovers.
儿童骨折会对家庭日常生活产生重大影响，影响儿童的正常活动和父母的工作。手腕骨折是儿童最常见的骨折。更严重的手腕骨折，即看起来明显弯曲的骨折，通常需要手术来重新排列骨骼；但在成长中的儿童中，弯曲的骨骼会自行变直，因此可能不需要手术。儿童桡骨急性骨折固定试验（CRAFFT）是一项多中心随机试验，比较手术与不手术治疗手腕移位骨折的疗效。对于家庭如何经历这种手腕骨折以及如何应对治疗的不确定性，人们知之甚少。本研究旨在了解家庭对这种伤害的体验，以及被要求让孩子参加临床试验的感受。
来自英国各地的 19 个家庭（13 位母亲、7 位父亲、2 位儿童）参与了电话访谈。访谈内容进行了录音、转录，并使用反思性主题分析进行了分析。
我们的研究结果突出了父母通过“保护受伤的孩子”这一主题来保护孩子的愿望。为了保护受伤后的孩子，父母努力做出正确的治疗决策，并为孩子提供安慰，但他们持续担心孩子的康复。我们的研究结果表明，父母对孩子的治疗和孩子的康复负责。研究结果还表明，父母非常关注孩子手腕的外观以及他们需要得到手腕正在愈合的保证。
我们的研究结果表明，受伤后保护孩子对父母来说可能是一个挑战，他们需要支持来做出治疗决策，并自信地促进孩子的康复。研究结果还突出了提供治疗信息、承认父母的担忧和他们为孩子做正确事情的愿望、向父母保证孩子的手腕会愈合以及确保父母了解孩子康复过程中的期望的重要性。
