Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Psychiatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Stress Health. 2023 Dec;39(5):989-999. doi: 10.1002/smi.3240. Epub 2023 Feb 25.
The objective of this study was to better understand the stressors in families of children with congenital heart disease (CHD) to assist with formulating targeted stress management plans for such families. A descriptive qualitative study was undertaken at a tertiary referral hospital in China. Following purposeful sampling, interviews were conducted with 21 parents of children with CHD regarding the stressors in their families. Following content analysis, 11 themes were generated from the data and categorised into six main domains: the initial stressor and associated hardships, normative transitions, prior strains, the consequences of family efforts to cope, intrafamily and social ambiguity, and sociocultural values. The 11 themes include confusion regarding the disease, hardships encountered during treatment, the heavy financial burden, the unusual growth track of the child due to the disease, normal events becoming abnormal for the family, impaired family functioning, family vulnerability, family resilience, family boundary ambiguity induced by role alteration, a lack of knowledge about community support and family stigma. Various and complex stressors exist for families of children with CHD. Medical personnel should fully evaluate the stressors and take targeted measures before implementing family stress management practices. It is also necessary to focus on the posttraumatic growth of families of children with CHD and strengthen resilience. Moreover, family boundary ambiguity and a lack of knowledge about community support should not be ignored, and further research is needed to explore these variables. Most importantly, policymakers and healthcare providers should adopt a range of strategies to address the stigma of being in a family of a child with CHD.
本研究旨在深入了解先天性心脏病(CHD)患儿家庭的压力源,以便为这些家庭制定有针对性的压力管理计划。本研究在中国一家三级转诊医院进行了描述性定性研究。通过目的性抽样,对 21 名 CHD 患儿的家长进行了家庭压力源访谈。经过内容分析,从数据中生成了 11 个主题,并分为六个主要领域:初始压力源及相关困难、规范性转变、先前的压力、家庭应对努力的后果、家庭内部和社会的模糊性以及社会文化价值观。这 11 个主题包括对疾病的困惑、治疗过程中遇到的困难、沉重的经济负担、因疾病导致的孩子不寻常的成长轨迹、正常事件对家庭变得异常、家庭功能受损、家庭脆弱性、家庭弹性、角色改变引起的家庭边界模糊、对社区支持和家庭耻辱感的知识匮乏。CHD 患儿家庭存在各种复杂的压力源。医务人员在实施家庭压力管理实践之前,应充分评估压力源并采取针对性措施。还需要关注 CHD 患儿家庭的创伤后成长和增强弹性。此外,不应忽视家庭边界模糊和对社区支持的知识匮乏,需要进一步研究这些变量。最重要的是,政策制定者和医疗保健提供者应采取一系列策略来解决 CHD 患儿家庭的耻辱感问题。