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新生儿先天性巨细胞病毒感染诊断后家长对医疗服务提供者沟通的看法:一项定性研究的二次分析

Parental Perspectives on Communication from Health Care Providers following a Newborn Diagnosis of Congenital Cytomegalovirus Infection: A Secondary Analysis of a Qualitative Study.

作者信息

Lanzieri Tatiana M, Hall Mary Ann K, Rau Ashrita, McBride Holly, Watson Danie, Rheaume Carol, Demmler-Harrison Gail

机构信息

Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop A-34, Atlanta, GA 30333, USA.

Division of Hospital Medicine, Emory University School of Medicine, 101 Woodruff Cir, Atlanta, GA 30322, USA.

出版信息

Int J Neonatal Screen. 2023 Aug 27;9(3):49. doi: 10.3390/ijns9030049.

Abstract

The study objective was to identify communication messages that parents of children diagnosed with congenital cytomegalovirus (cCMV) infection reported as essential and helpful. We performed a secondary analysis of focus groups and interviews conducted with 41 parents of children with cCMV who had enrolled in a long-term follow-up cCMV study at an academic medical center. Three groups of parents who had children with cCMV participated in the study: parents with children symptomatic at birth, parents with children asymptomatic at birth who later developed sensorineural hearing loss, and parents with children asymptomatic at birth who remained asymptomatic into adulthood. Using a health marketing approach, we identified six general themes from the focus group sessions: initial diagnosis, likely health outcome(s), comfort and coping, symptom watch, resources, and prevention. Receiving the initial diagnosis was shocking for many parents, and they wanted to know how their child would or could be affected. They valued access to the information, follow-up visits for early detection of hearing loss and other developmental delays, and support from other parents. Parents wished to obtain this information from their pediatrician but felt that experts offered more up-to-date knowledge about prognosis, monitoring, and treatment. With more U.S. states implementing cCMV screening strategies which would lead to more infant diagnoses, it will be necessary for providers to meet parents' expectations and communication needs.

摘要

该研究的目的是确定被诊断为先天性巨细胞病毒(cCMV)感染的儿童的家长报告为至关重要且有帮助的沟通信息。我们对在一家学术医疗中心参加cCMV长期随访研究的41名cCMV患儿的家长进行的焦点小组讨论和访谈进行了二次分析。三组有cCMV患儿的家长参与了该研究:孩子出生时出现症状的家长、孩子出生时无症状但后来出现感音神经性听力损失的家长,以及孩子出生时无症状且成年后仍无症状的家长。采用健康营销方法,我们从焦点小组讨论中确定了六个一般主题:初始诊断、可能的健康结果、安慰与应对、症状观察、资源和预防。对许多家长来说,收到初始诊断令人震惊,他们想知道自己的孩子将会或可能受到怎样的影响。他们重视获取信息、进行后续随访以早期发现听力损失和其他发育迟缓,以及得到其他家长的支持。家长希望从儿科医生那里获得这些信息,但觉得专家能提供更多关于预后、监测和治疗的最新知识。随着美国更多州实施cCMV筛查策略,这将导致更多婴儿被诊断出感染,医疗服务提供者有必要满足家长的期望和沟通需求。

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