Davidson Hannah Rochelle, Gelles Shani, Keller Krystyna R, Zajdel Melissa, Koehly Laura M
Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD, USA.
Qual Health Res. 2024 Jan;34(1-2):126-140. doi: 10.1177/10497323231205419. Epub 2023 Oct 25.
Rare diseases constitute a group of conditions that are individually rare, but in aggregate impact between 3 and 6% of the world population. Many of these conditions present during infancy and involve substantial caregiving responsibilities, often assessed via quantitative measurements. However, few qualitative analyses examine lived experiences of parent-caregivers during the early period of their child's life. The purpose of this study was to examine the meaning that rare disease parent-caregivers apply to the postpartum year using data collected from a semi-structured interview exploring significant experiences over the course of their affected child's life. We utilized an interpretative phenomenological analysis (IPA) approach to analyze 22 interview transcripts from caregivers to children with several inherited metabolic and mitochondrial disorders, as well as an undiagnosed disease. Our analysis yielded three superordinate themes: and . Subordinate themes expanded upon these concepts and included distinctions between the parent and caregiving identity, communal coping and shifting of family dynamics, as well as meaning applied to child milestones, anticipatory grief, and parental perception of a new normal. Exploration of these themes in relation to existing literature, as well as future research directions for qualitative research on rare disease caregivers, is discussed. Overall, this work contributes to a growing body of literature exploring the parental experience of rare disease across several condition contexts.
罕见病是一组个体发病率低但总体影响全球3%至6%人口的疾病。这些疾病许多在婴儿期出现,涉及大量的照料责任,通常通过定量测量进行评估。然而,很少有定性分析考察患病儿童生命早期阶段家长照料者的生活经历。本研究的目的是利用从半结构化访谈收集的数据,探讨罕见病患儿家长照料者在产后一年所赋予的意义,该访谈探讨了他们患病子女一生中的重要经历。我们采用解释现象学分析(IPA)方法,分析了22份来自患有几种遗传性代谢和线粒体疾病以及一种未确诊疾病患儿的照料者的访谈记录。我们的分析产生了三个上位主题:以及。下位主题围绕这些概念展开,包括家长身份与照料者身份的区别、共同应对与家庭动态的变化,以及赋予儿童成长节点、预期性悲伤和家长对新常态认知的意义。本文讨论了这些主题与现有文献的关系,以及罕见病照料者定性研究的未来研究方向。总体而言,这项工作为越来越多探索不同疾病背景下罕见病患儿家长经历的文献做出了贡献。