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母亲们在多学科儿科喂养项目中对孩子从管饲断奶过程的经历和看法。

Mothers' experiences and perceptions of their child's weaning process from tube feeding within a multidisciplinary Paediatric Feeding Program.

作者信息

Cipolla Josie, Reeves-Latour Jonathan, Ramsay Maria, Li Patricia

机构信息

Department of Pediatrics, Faculty of Medicine, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.

Centre for Outcomes Research and Evaluation, the Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.

出版信息

Paediatr Child Health. 2022 Jul 9;27(6):353-358. doi: 10.1093/pch/pxac055. eCollection 2022 Oct.

Abstract

OBJECTIVES

Previous studies have described the negative impact that tube feeding of children with complex chronic diseases has on the caregivers' emotions, relationships and daily life. It is unclear whether these negative experiences persist or change during and after the weaning process. We sought to explore mothers' experiences and perceptions of their child being weaned off tube feeding within a Paediatric Feeding Program (PFP).

METHODS

We conducted a qualitative study using semi-structured interviews with mothers whose children <4 years old had experienced feeding tube weaning within an outpatient, family-centred, telemedicine-supported PFP. The transcripts were analyzed using thematic analysis.

RESULTS

We conducted 9 interviews with mothers of children ( = 10) in the PFP at which point data saturation was achieved. Three main themes emerged: a) the initial emotional toll on mothers stemming from fear of perceived adverse consequences of decreasing tube feeds and uncertainty surrounding efficacy of weaning; b) achievement of weaning via a family-centered approach through gaining trust, close contact, and collaboration with the team; and c) attainment of mothers' expectations of family life through transformed relationships and social activities. A positive evolution of emotions was observed, attributable to the support of the PFP.

CONCLUSIONS

These experiences suggest that our outpatient weaning program had a positive impact on the stress, fear, and relational challenges that mothers reported before and during initial tube weaning. These findings highlight potential areas of discussion with families at multiple stages of the child's tube feeding experience, to help normalize emotions for families and support coping strategies.

摘要

目的

以往研究描述了对患有复杂慢性病儿童进行管饲喂养对照顾者的情绪、人际关系和日常生活产生的负面影响。目前尚不清楚这些负面经历在断奶过程中及断奶后是否持续存在或发生变化。我们试图探讨母亲们在儿科喂养项目(PFP)中让孩子断奶的经历和看法。

方法

我们进行了一项定性研究,对孩子年龄小于4岁且在门诊、以家庭为中心、远程医疗支持的PFP中经历过喂养管断奶的母亲进行半结构化访谈。使用主题分析法对访谈记录进行分析。

结果

我们对PFP中孩子的母亲进行了9次访谈(n = 10),此时达到了数据饱和。出现了三个主要主题:a)母亲最初的情绪负担源于对减少管饲喂养的不良后果的恐惧以及断奶效果的不确定性;b)通过与团队建立信任、密切联系和合作,以家庭为中心的方法实现断奶;c)通过转变关系和社交活动实现母亲对家庭生活的期望。观察到情绪有积极的演变,这归因于PFP的支持。

结论

这些经历表明,我们的门诊断奶项目对母亲在最初管饲断奶前和断奶期间报告的压力、恐惧和关系挑战产生了积极影响。这些发现突出了在孩子管饲喂养经历的多个阶段与家庭进行讨论的潜在领域,以帮助家庭情绪正常化并支持应对策略。

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