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“当你知道自己的孩子无法呼吸时,你还有什么选择?!”:接受气管造口术儿童的父母角色适应

"What choice do you have knowing your child can't breathe?!": Adaptation to Parenthood for Children Who Have Received a Tracheostomy.

作者信息

Ledin Ellinor Rydhamn, Eriksson Andrea, Mattsson Janet

机构信息

Department of Ergonomics - CBH, KTH Royal Institute of Technology, Huddinge, Sweden.

Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden.

出版信息

SAGE Open Nurs. 2024 Apr 9;10:23779608241245502. doi: 10.1177/23779608241245502. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

A growing number of parents are navigating parenthood influenced by medical complexity and technological dependency as the group of children with long-term tracheostomy grows. However, little is known regarding the parental experiences of parenthood for this heterogeneous group of children now surviving through infancy and intensive care.

OBJECTIVE

This study aimed to analyze how parents of children who have received a tracheostomy adapted to parenthood.

METHODS

Interviews were conducted and analyzed following a constructivist grounded theory approach. Ten parents of seven children living with a tracheostomy in Sweden were recruited via the long-term intensive care unit (ICU).

RESULTS

The core variable of parenthood "Stuck in survival" was explained by two categories and six subcategories. The category "Unaddressed previous history" describes the experiences from being in the ICU environment and how the parents are not able, due to insufficient time and resources, to address these stressful experiences. The category "Falling through the cracks of a rigid system" describes how the parents found themselves and their children to be continuously ill-fitted in a medical system impossible to adapt to their needs and situation. Parents placed the starting point of parenthood with the birth of the child, whilst the tracheotomy only constituted a turning point and would lead to the loss of any previously held expectations regarding parenthood.

CONCLUSION

This study identified a previously undescribed period prior to tracheostomy placement, which may have long-lasting effects on these families. The care provided in ICUs following the birth of a child who will require tracheostomy may not be tailored or adapted to accommodate the needs of these families leading to long-lasting effects on parenthood.

摘要

引言

随着长期气管造口术患儿群体的不断壮大,越来越多的父母在医疗复杂性和技术依赖性的影响下经历为人父母的过程。然而,对于这一如今在婴儿期和重症监护下存活下来的异质性儿童群体,其父母为人父母的经历却知之甚少。

目的

本研究旨在分析接受气管造口术患儿的父母是如何适应为人父母的角色的。

方法

采用建构主义扎根理论方法进行访谈和分析。通过长期重症监护病房(ICU)招募了瑞典7名接受气管造口术患儿的10位父母。

结果

为人父母的核心变量“困于生存”由两个类别和六个子类别来解释。“未处理的既往经历”类别描述了在ICU环境中的经历,以及由于时间和资源不足,父母无法处理这些压力经历的情况。“在僵化系统的缝隙中滑落”类别描述了父母如何发现自己和孩子在一个无法适应他们需求和状况的医疗系统中持续格格不入。父母将为人父母的起点定在孩子出生之时,而气管切开术只是一个转折点,并会导致失去任何先前对为人父母的期望。

结论

本研究确定了气管造口术放置前一个此前未被描述的时期,这可能对这些家庭产生长期影响。对于需要气管造口术的患儿出生后在ICU提供的护理可能没有针对性或适应性,无法满足这些家庭的需求,从而对为人父母产生长期影响。

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