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探索父母在向其年幼子女披露脑瘫诊断时的经历和需求:范围综述。

Exploring Parents' Experiences and Needs During Disclosure of a Cerebral Palsy Diagnosis of Their Young Child: A Scoping Review.

机构信息

Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

CanChild, Center for Childhood Disability Research, McMaster University, Hamilton, Canada.

出版信息

Child Care Health Dev. 2024 Nov;50(6):e13327. doi: 10.1111/cch.13327.

Abstract

BACKGROUND

Parents often perceive the news that their child has cerebral palsy (CP) as overwhelming and shocking. They are at increased risk of parental stress and mental health problems, which in turn can affect the interaction between the parent and the child. Parental mental health outcomes are known to be affected by the process of disclosure of a diagnosis. In this study, we aimed to synthesize the current knowledge about parents' experiences and needs regarding communication during the disclosure of the diagnosis of their child with (or at risk of) CP.

METHODS

A scoping review following the methodological steps outlined by the Joanna Briggs Institute was performed using PubMed, Embase, CINAHL and PsycINFO. We qualitatively explored parent-reported experiences and needs across included studies, using thematic analysis.

RESULTS

A total of 19 studies were included. Six themes were identified, three in relation to experiences (i.e., preceding experiences and feelings, perceptions of the disclosure and emotional impact) and three in relation to needs (i.e., transparency in information, supportive attitude and having a say). Despite high variability across studies regarding parental needs, most studies reported the need for (i) honest and clear information, (ii) good communication skills amongst professionals and (iii) emotional and practical support after diagnosis.

CONCLUSIONS

Our findings suggest that parents' experiences and needs in the period when their child's diagnosis of (high risk of) CP is communicated are highly variable, due to an interplay of personal and contextual factors. To facilitate good communication during disclosure, it is crucial that health care professionals assess and understand this complex process and consider parents' needs for open communication and autonomy in the process. Therefore, professionals need to attune to parents' needs and their individual preferences regarding conversations about their child with (or at risk of) CP.

摘要

背景

父母通常会觉得孩子患有脑瘫(CP)的消息令人难以承受和震惊。他们面临着更高的父母压力和心理健康问题的风险,这反过来又会影响父母与孩子之间的互动。众所周知,父母的心理健康结果受到诊断披露过程的影响。在这项研究中,我们旨在综合目前关于父母在披露其患有(或有风险患有)CP 的孩子的诊断时的沟通经验和需求的知识。

方法

采用乔安娜·布里格斯研究所(Joanna Briggs Institute)概述的方法学步骤进行了范围综述,使用了 PubMed、Embase、CINAHL 和 PsycINFO。我们使用主题分析对纳入研究中的父母报告的经验和需求进行了定性探索。

结果

共纳入了 19 项研究。确定了六个主题,其中三个与经验有关(即,前期经验和感受、对披露的看法和情绪影响),三个与需求有关(即,信息透明度、支持性态度和发言权)。尽管在父母需求方面,各研究之间存在高度的可变性,但大多数研究报告了需要(i)诚实和明确的信息,(ii)专业人员良好的沟通技巧,以及(iii)诊断后的情感和实际支持。

结论

我们的研究结果表明,由于个人和环境因素的相互作用,在向父母传达其孩子(高风险患有)CP 诊断的时期,父母的经历和需求具有高度的可变性。为了促进披露期间的良好沟通,医疗保健专业人员评估和理解这一复杂过程,并考虑父母对开放沟通和自主权的需求至关重要。因此,专业人员需要关注父母的需求以及他们对与患有(或有风险患有)CP 的孩子进行对话的个人偏好。

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