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“我需要每个人明白,他是一个完整的孩子”:一项探索照顾患有复杂疾病儿童的照顾者经历的混合方法研究。

"I need everybody to understand that he's a whole child": A mixed-methods study exploring caregivers' experiences with their children with medical complexities.

作者信息

Jensen Emily J, Douglas Sarah N, Khan Sarah, Bullock Katharine

机构信息

Human Development and Family Studies, Michigan State University, 552 W. Circle Dr., East Lansing, MI 48824, USA.

College of Osteopathic Medicine, Michigan State University, 965 Wilson Rd., East Lansing, MI 48824, USA.

出版信息

J Pediatr Nurs. 2025 May-Jun;82:1-10. doi: 10.1016/j.pedn.2025.01.025. Epub 2025 Feb 6.

Abstract

PURPOSE

Children with medical complexities (CMC) access medical care at high rates and rely heavily on caregivers for daily care. Little research has explored the medical care experiences of caregivers of CMC to understand the holistic impact on the caregiver and their children. The goal of this study was to understand the experiences and challenges faced by CMC and their caregivers, explore the impact of COVID-19 on this population, and highlight the suggestions caregivers have to improve medical care for their children.

DESIGN AND METHODS

We conducted an explanatory sequential mixed method study utilizing surveys (n = 149) and in-depth interviews (n = 26) with a subset of survey participants. Descriptive and inferential quantitative analysis strategies as well as qualitative thematic and content analysis techniques were used to analyze the survey and interview data.

RESULTS

Our findings included insights such as the frequent need to access medical care/specialists, the demand and emotional process of caring for CMC, the risk of pediatric medical trauma and stress, the unique impact of COVID-19 on this population, challenges navigating medical insurance, and the impact of the medical provider and system qualities on overall experiences. We also had findings related to the personal challenges associated with caregiving for CMC, caregiver coping and advocacy, and suggestions for improving care for CMC.

CONCLUSIONS

These findings suggest a need for improved practices and policies to support CMC and their families.

PRACTICE IMPLICATIONS

This study identifies opportunities for healthcare professionals to learn from the experiences of caregivers of CMC.

摘要

目的

患有复杂疾病的儿童(CMC)频繁接受医疗护理,且在日常生活中严重依赖照料者。很少有研究探讨CMC照料者的医疗护理经历,以了解其对照料者及其子女的整体影响。本研究的目的是了解CMC及其照料者所面临的经历和挑战,探讨新冠疫情对这一群体的影响,并突出照料者对改善其子女医疗护理的建议。

设计与方法

我们开展了一项解释性序列混合方法研究,对一部分调查参与者进行了调查(n = 149)和深入访谈(n = 26)。运用描述性和推断性定量分析策略以及定性主题和内容分析技术来分析调查和访谈数据。

结果

我们的研究结果包括以下见解,如频繁需要就医/看专科医生、照料CMC的需求和情感过程、儿科医疗创伤和压力的风险、新冠疫情对这一群体的独特影响、医保报销方面的挑战,以及医疗服务提供者和系统质量对整体体验的影响。我们还得出了与照料CMC相关的个人挑战、照料者的应对和维权,以及改善CMC护理的建议等方面的研究结果。

结论

这些研究结果表明需要改进做法和政策,以支持CMC及其家庭。

实践意义

本研究确定了医疗保健专业人员向CMC照料者的经验学习的机会。

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