Green Michael D, Prevost-Reilly Alejandra, Parker Devin M, Carpenter-Song Elizabeth
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.
Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, United States of America.
PLOS Ment Health. 2024;1(7). doi: 10.1371/journal.pmen.0000208. Epub 2024 Dec 20.
Hypoplastic Left Heart Syndrome (HLHS) is a critical congenital heart abnormality that, prior to 1980, offered no treatment options beyond comfort care. Surgical advancements have since transformed the prognosis, yet the lived experience of affected families remains complex and multifaceted. This study aims to elucidate the psychosocial challenges accompanying the biomedical management of HLHS, exploring both family and provider perspectives to identify opportunities for more holistic care. We conducted semi-structured interviews with five families and two healthcare providers involved in HLHS management a New England health system. Interview transcripts were analyzed inductively to identify emergent themes, with a focus on the lived experience of families and the perceived role of providers in influencing this experience. Our study illuminates the extensive psychosocial challenges and emotional distress encountered by families dealing with HLHS, indicating a disparity between the advanced biomedical treatments available and the broader, more integrative care needs of patients. Despite healthcare professionals' technical proficiency, there exists a pivotal need for empathetic engagement and support that encompasses the full scope of the patient and family experience. Our findings advocate for an integrated care model that incorporates George Engel's biopsychosocial aspects of health, aligning with the emotional and psychological needs of families. The study underscores the importance of socially conscious care and suggests that enhancing empathetic communication and support in clinical practice can improve both patient outcomes and family well-being in the context of chronic and complex conditions like HLHS.
左心发育不全综合征(HLHS)是一种严重的先天性心脏畸形,在1980年之前,除了姑息治疗外没有其他治疗选择。自那时以来,手术进展改变了预后,但受影响家庭的生活经历仍然复杂多样。本研究旨在阐明HLHS生物医学管理过程中伴随的社会心理挑战,探讨家庭和医疗服务提供者的观点,以确定提供更全面护理的机会。我们对新英格兰医疗系统中参与HLHS管理的五个家庭和两名医疗服务提供者进行了半结构化访谈。对访谈记录进行归纳分析以确定新出现的主题,重点关注家庭的生活经历以及医疗服务提供者在影响这一经历中所感知到的角色。我们的研究揭示了应对HLHS的家庭所面临的广泛社会心理挑战和情绪困扰,表明现有先进的生物医学治疗与患者更广泛、更综合的护理需求之间存在差距。尽管医疗专业人员技术熟练,但迫切需要包含患者和家庭全部经历的同理心参与和支持。我们的研究结果倡导一种整合护理模式,该模式纳入了乔治·恩格尔提出的健康的生物心理社会层面,以符合家庭的情感和心理需求。该研究强调了具有社会意识的护理的重要性,并表明在临床实践中加强同理心沟通和支持可以改善像HLHS这样的慢性和复杂疾病背景下的患者预后和家庭福祉。