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质性研究:探索患有囊性纤维化(CF)的幼儿的父母/照料者对CFTR调节剂疗法引入的看法和认知(REVEAL研究;2至5岁儿童使用Kaftrio的父母观点)

Qualitative study exploring the views and perceptions of parents/carers of young children with CF regarding the introduction of CFTR modulator therapy (The REVEAL study; PaRents pErspectiVEs of KAftrio in chiLdren aged 2-5).

作者信息

Davies Sioned Haf, Wade Faye, Fogg Heather, Walsh Adam, Southern Kevin W

机构信息

University of Liverpool School of Health Sciences, Liverpool, UK

Alder Hey Children's NHS Foundation Trust, Liverpool, UK.

出版信息

BMJ Open Respir Res. 2025 Jan 30;12(1):e002522. doi: 10.1136/bmjresp-2024-002522.

Abstract

BACKGROUND

Cystic fibrosis (CF) is associated with a historically high treatment burden which causes anxiety and exhaustion for parents of children with CF, especially in the early years of a child's life. Recently, a new medication, elexacaftor/tezacaftor/ivacaftor (ETI), has become available to some people with CF, which has had a significant impact on the quality of life of older children and adults. This medication will soon be available for children ages 2-5 in the UK. This study investigated parents' perspectives before their children could start ETI.

METHOD

10 parents of young children with CF participated in semistructured online focus groups. The data were analysed using thematic analysis to identify key themes.

RESULTS

Three reviewers identified four main themes: (1) The 'roller coaster' of parental emotions: Shock, hope, uncertainty and anticipation, (2) The dark side of the unknown, side effects and burden of decision making, (3) The value of simple pleasures in a life with CF; treatment burden, normality, future, family life and (4) Reforming clinical care in the new era of CF care; support, communication and the future.

CONCLUSION

Parents experience a range of emotions from the day of diagnosis. While ETI brings hope and positivity, parents are concerned about the medication's safety. Parents have clear hopes and wishes for their child's future and reflect on the need for clinicians to consider reforming clinical care in the new era of CF for those eligible for new therapies.

摘要

背景

囊性纤维化(CF)历来与较高的治疗负担相关,这给CF患儿的父母带来焦虑和疲惫,尤其是在孩子幼年时期。最近,一种新药,依列卡福/替扎卡福/依伐卡福(ETI),已可供一些CF患者使用,这对大龄儿童和成年人的生活质量产生了重大影响。这种药物很快将在英国可供2至5岁的儿童使用。本研究调查了在孩子开始使用ETI之前父母的看法。

方法

10名CF幼儿的父母参加了半结构化在线焦点小组。使用主题分析对数据进行分析以确定关键主题。

结果

三位评审员确定了四个主要主题:(1)父母情绪的“过山车”:震惊、希望、不确定性和期待,(2)未知的阴暗面、副作用和决策负担,(3)CF生活中简单快乐的价值;治疗负担、正常状态、未来、家庭生活,以及(4)CF护理新时代的临床护理改革;支持、沟通和未来。

结论

从诊断之日起,父母就经历了一系列情绪。虽然ETI带来了希望和积极影响,但父母担心药物的安全性。父母对孩子的未来有着明确的希望和愿望,并反思临床医生在CF新时代为那些有资格接受新疗法的患者改革临床护理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f43/11784110/3e12afb79d3e/bmjresp-12-1-g001.jpg

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