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应对压力的经验——对患有复杂疾病儿童的家庭照顾者的质性研究

Experiences in Coping with Stress-A Qualitative Study of Family Caregivers of Children with Medical Complexity.

作者信息

Layshock Mikhaila N, Porter Amy S, Bogetz Jori F, McLachlan Lydia, Weill Sydney, Rosenberg Abby, Winger Joseph G, Houtrow Amy, Noll Robert B, Schenker Yael, Yu Justin A

机构信息

University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15213, USA.

Division of Supportive and Palliative Care, Department of Pediatrics, Mass General for Children, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

出版信息

Children (Basel). 2024 Sep 23;11(9):1151. doi: 10.3390/children11091151.

Abstract

OBJECTIVE

To better understand the strategies family caregivers of children with medical complexity (CMC) utilize to deal with the stress and challenges associated with caregiving.

METHODS

We conducted a cross-sectional qualitative study among family caregivers of CMC receiving medical care at a children's hospital in Western Pennsylvania. Participants completed in-depth, semi-structured interviews focused on how CMC family caregivers approach and manage caregiving-related challenges and stress. Using constant comparative methodology, we inductively analyzed deidentified transcripts for emergent themes.

RESULTS

We interviewed 19 participants (89.4% female) with a mean age of 43 years (range 32-54 years). The mean age of the participants' children was 10.8 years (range 1-20 years). Twelve participants' children identified as white and four identified as Black. Three central themes regarding CMC caregivers' stress-coping strategies emerged: (1) maintaining a positive mindset, (2) developing and relying on interpersonal support networks, and (3) making time for self-preservation. All three themes were universally reported ( = 19/19) by our participants. The most common subthemes for each theme, respectively, focused on staying hopeful and celebrating moments of joy; cultivating supportive relationships with family, friends, and fellow CMC family caregivers; and finding pleasure in "little things" (e.g., everyday activities and hobbies).

CONCLUSION

Family caregivers of CMC utilize a multi-faceted approach to cope with the stress and challenges routinely encountered in caring for CMC. This study's findings could be used to inform future clinical efforts and research directions aiming to improve clinicians' ability to support CMC caregivers' well-being.

摘要

目的

为了更好地理解患有复杂疾病儿童(CMC)的家庭照顾者用来应对与照顾相关的压力和挑战的策略。

方法

我们在宾夕法尼亚西部一家儿童医院接受医疗护理的CMC家庭照顾者中开展了一项横断面定性研究。参与者完成了深入的半结构化访谈,重点是CMC家庭照顾者如何应对和管理与照顾相关的挑战及压力。我们采用持续比较法,对去识别化的访谈记录进行归纳分析以找出新出现的主题。

结果

我们访谈了19名参与者(89.4%为女性),平均年龄43岁(范围32 - 54岁)。参与者孩子的平均年龄为10.8岁(范围1 - 20岁)。12名参与者的孩子为白人,4名参与者的孩子为黑人。出现了关于CMC照顾者压力应对策略的三个核心主题:(1)保持积极心态,(2)建立并依赖人际支持网络,(3)留出时间进行自我保护。我们所有的参与者(n = 19/19)都普遍提到了这三个主题。每个主题最常见的子主题分别聚焦于保持希望和庆祝喜悦时刻;与家人、朋友以及其他CMC家庭照顾者建立支持性的关系;以及从“小事”(如日常活动和爱好)中找到乐趣。

结论

CMC的家庭照顾者采用多方面的方法来应对在照顾CMC过程中经常遇到的压力和挑战。本研究的结果可用于为未来旨在提高临床医生支持CMC照顾者幸福感能力的临床工作和研究方向提供参考。

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