Home About us Contact
|
Home About us Contact | ||
|
|
||
Child's Diagnosis (child + diagnosis)
Selected AbstractsThe relationship between healthcare professionals and the parents of chronically ill children: negotiating the boundaries between dependence and expertiseINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2007Alda Hummelinck senior clinical pharmacist Objective Mutual respect and understanding between parents and healthcare professionals are fundamental to the realisation of a partnership in the provision of care to chronically ill children. The aim of this study was an exploration of parents' perspectives on their relationship with healthcare professionals and their involvement in decisions about their child's care. Setting The paediatric department of a district general hospital in the West Midlands, England. Method Qualitative methodology using semi-structured interviews with 27 parents from 20 families with a chronically ill child. Key findings In the time following the child's diagnosis, parents' attitudes towards healthcare professionals often moved from reliance and trust to scepticism and suspicion. This change in attitude derived from their experience of inadequate communication and perception of professionals' failure to understand the reality of the intense and relentless demands and challenges that confront families providing care for a chronically ill child. Parents tended to be initially accepting and deferential to professional expertise. Over time, however, as their experience and confidence increased, they often desired a greater involvement in decisions about treatment and care. This transition, between initial, or episodic, dependency and active partnership, was often not recognised or accommodated by professionals. It was difficult for both parties to negotiate the transition from parents' dependency on health professionals to becoming more independent managers of care. Conclusions Professionals should be aware of parents' preferred and changing level of involvement in care and decision making, and endeavour to accommodate these throughout the process of providing care for chronically ill children. [source] Chronic sorrow in parents of children with type 1 diabetesJOURNAL OF ADVANCED NURSING, Issue 5 2009Susan Bowes Abstract Title.,Chronic sorrow in parents of children with type 1 diabetes. Aim., This paper reports on a study exploring parents' longer-term experiences of having a child with type 1 diabetes. Background., Parents of children with type 1 diabetes may experience a grief reaction at diagnosis similar to that normally associated with bereavement, but little is known about their long-term emotional adaptation. Chronic sorrow, a sustained but intermittent grief reaction, is identified in adults with diabetes but has not previously been explored in relation to parents. Methodology., In-depth interviews were conducted in 2007 with a convenience sample of 17 parents of children with type 1 diabetes 7,10 years after diagnosis. Data were explored within a theoretical framework of grief, loss, adaptation, and change. Findings., Parents had adapted to the needs of diabetes management but most had not ,come to terms' with the diagnosis. They experienced a resurgence of grief at critical times during their child's development and some, particularly mothers, became upset during their interviews, even though these took place 7,10 years after their child's diagnosis. Mothers elaborated more on their emotions than fathers, but continuing feelings associated with grief, such as anger and guilt, were expressed by both fathers and mothers. Conclusion., Greater understanding of parents' long-term emotional responses and recognition that grief may never resolve in these parents may enable healthcare professionals to provide appropriate and timely support at critical times. [source] Posttraumatic stress disorder among parents of children on cancer treatment: a longitudinal studyPSYCHO-ONCOLOGY, Issue 5 2008Ulrika Pöder Abstract The main aim of this study was to investigate the occurrence of cancer-related posttraumatic stress disorder (PTSD) among parents of children on cancer treatment. A longitudinal design with assessments at one week (T1), two (T2), and four (T3) months after the child's diagnosis was used. Two hundred and fourteen parents (107 mothers, 107 fathers) participated at T1,T3. The PTSD Checklist Civilian (PCL-C), a self-report screening instrument for PTSD, was answered by parents over the telephone. According to the PCL-C symptom criteria method 33%, more mothers than fathers, score as potential cases of acute stress disorder (ASD) at T1, whereas 28% as potential cases of PTSD at T2 and 22% at T3. The levels of acute- and posttraumatic stress symptoms show a linear, descending pattern, and mothers report higher levels than fathers. Half of the parents who score as potential cases of ASD a week after the child's diagnosis score as potential cases of PTSD four months later. The findings illustrate that a group of parents of children with cancer experience serious psychological distress related to their child's disease. A traumatic stress perspective on childhood cancer should be applied to paediatric oncology care and appropriate psychosocial interventions should be offered to parents when needed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Short-term changes in parents' resolution regarding their young child's diagnosis of cerebral palsyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2010I. C. M. Rentinck Abstract Objective This study aimed to describe changes in parents' resolution regarding their young child's diagnosis of cerebral palsy over a period of 1 year, and to describe the changes in strategies of resolution. Methods In this longitudinal study, 38 parents of children with cerebral palsy (mean age 18.4 months, SD = 1.1 at baseline) were followed with the Reaction to Diagnosis Interview, assessing their personal reactions to their child's diagnosis (i.e. resolution status). Changes at main and subclassification level of the Reaction to Diagnosis Interview were investigated using a binominal test. Results Twenty-nine parents (76%) were found to be stable with respect to their main resolution status (i.e. ,resolved' or ,unresolved'), while 24% of the parents either had changed from ,unresolved' to ,resolved' or in the opposite way. Furthermore, of the 28 parents who were classified as ,resolved' at both times, 15 (54%) had changed at subclassification level with respect to the specific strategies used. Conclusion Resolution at a main level of parental reactions to their child's diagnosis was predominantly stable. Most parents were classified as ,resolved' at both baseline and follow-up assessment. However, more detailed analyses at subclassification level showed that most parents with a ,resolved' main status showed changing patterns of resolution strategies to their child's diagnosis, suggesting that resolution is an ongoing process. [source] Discussing withdrawing and withholding of life-sustaining medical treatment in a tertiary paediatric hospital: A survey of clinician attitudes and practicesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2008Tom Forbes Aim: To better understand current attitudes and practices relating to discussions concerning the withholding and withdrawing of life-sustaining medical treatment (WWLSMT) among medical staff in the paediatric setting. Methods: An anonymous online survey of paediatricians (senior medical staff , SMS) and paediatric trainees (junior medical staff , JMS) likely to be involved in the care of children with life limiting illness. Results: A total of 162 responses were obtained (response rate 42%). SMS indicated feeling more comfortable with their abilities to discuss WWLSMT than JMS. Barriers to discussing WWLSMT were numerous and included clinician concerns about family readiness for the discussion, prognostic uncertainty, family disagreement with the treating team regarding the child's prognosis/diagnosis and concerns about how to manage family requests for treatments that are not perceived to be in the child's best interests. Fifty-eight per cent of JMS and 35.8% of SMS reported receiving no specific communication training regarding WWLSMT. Most learned through experience and by observing more senior colleagues. There was a high level of support for additional training in this area and for the provision of resources such as discussion guidelines and a structured form for documenting the outcomes WWLSMT discussions. Conclusion: The majority of JMS feel less comfortable with their abilities to facilitate these discussions than their senior colleagues. The results of this study suggest that although confidence correlates with experience, junior and senior clinicians are eager to improve their skills through ongoing professional development and the provision of resources. The education needs of JMS and SMS appear to be different. [source] | ||||||||||