Rent Sharla, Poon Kwai Tei Candy Chan, Sooy-Mossey Meredith, Weeks Mary Frances, Roberts James C, Douglas Dakota, Ellestad Sarah, Lemmon Monica E, Hill Kevin, Windom McAllister
Department of Pediatrics, Duke University School of Medicine, Duke Global Health Institute, Durham, North Carolina.
Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
AJP Rep. 2025 Jan 7;15(1):e6-e17. doi: 10.1055/a-2504-1813. eCollection 2025 Jan.
Congenital heart disease (CHD) is an important contributor to pediatric morbidity and mortality. Unfortunately, disparities in the diagnosis and treatment of CHD exist across racial and ethnic groups. The objective of this study was to share the experiences of Hispanic and Black families with CHD to better understand their needs. This was a descriptive qualitative study involving two 2-part focus groups, one conducted in English and one in Spanish, consisting of parents of infants with CHD. Focus groups were audio recorded, transcribed, and analyzed via a conventional content analysis approach. Six family members participated, representing a range of cardiac diagnoses. Two participants cited their identity as non-Hispanic Black and four as Hispanic. Three organizing themes emerged related to (1) communication, (2) psychosocial needs and processing, and (3) practical challenges associated with having a child with CHD. Together, these organizing themes supported a singular global theme: structural and socioemotional gaps in care exist for families of infants with CHD that need to be met in order to optimize care for patients and families. Societal and systems-level factors, including structural inequities, contribute to the care gaps experienced by racial and ethnic minority families of children with CHD. Poor communication around CHD diagnosis impairs provider-patient trust.Language barriers hinder accurate communication about CHD diagnosis and treatment.Parents of children with CHD have unmet mental health needs.Perinatal providers should champion health equity for CHD patients and their families.
先天性心脏病(CHD)是导致儿童发病和死亡的一个重要因素。不幸的是,不同种族和族裔群体在CHD的诊断和治疗方面存在差异。本研究的目的是分享西班牙裔和黑人家庭患CHD的经历,以便更好地了解他们的需求。
这是一项描述性定性研究,涉及两个由两部分组成的焦点小组,一个用英语进行,一个用西班牙语进行,参与者为患有CHD的婴儿的父母。焦点小组进行了录音、转录,并通过传统的内容分析方法进行分析。
六名家庭成员参与其中,代表了一系列心脏诊断情况。两名参与者称自己为非西班牙裔黑人,四名参与者为西班牙裔。出现了三个组织主题,分别与(1)沟通、(2)心理社会需求及处理过程,以及(3)养育患有CHD的孩子所带来的实际挑战有关。这些组织主题共同支持了一个单一整体主题:患有CHD的婴儿家庭在护理方面存在结构和社会情感差距,为了优化对患者及其家庭的护理,这些差距需要得到弥补。
社会和系统层面的因素,包括结构性不平等,导致了患有CHD的儿童的种族和族裔少数家庭所经历的护理差距。关于CHD诊断的沟通不畅损害了医患信任。语言障碍阻碍了关于CHD诊断和治疗的准确沟通。患有CHD的儿童的父母有未得到满足的心理健康需求。围产期医疗服务提供者应为CHD患者及其家庭倡导健康公平。