Parents' Experiences of Their Child's Solid-Organ Transplant: A Meta-Ethnography of Qualitative Studies

An Unheard Voice: The Perspectives of Siblings of Solid Organ Transplant Recipients

BACKGROUND

Solid organ transplantation requires complex and ongoing medical management that impacts the family system. However, the experiences of siblings of transplant recipients are not well described. Therefore, the purpose of this study was to elucidate the perspectives of siblings of pediatric kidney and liver transplant recipients.

METHODS

Siblings (ages 12-17 years) of kidney and liver transplant recipients completed a semi-structured interview (Via Zoom) and demographic information. The interview data were analyzed using inductive content analysis.

RESULTS

Twelve adolescents (9 males, 2 females, 1 non-binary; M = 15.25 Years, SD = 2.13) completed a virtual interview. Four major themes emerged describing the transplant experience: (1) Transplant changes the family system: Impact on family relationships, dynamics, and cohesiveness, (2) Transplant affects social-emotional development and adjustment, (3) new meaning assigned to family and increased commitment to the health of sibling, and (4) growth from the transplant experience as a way to help others.

CONCLUSIONS

These findings affirm that the transplant event is distressing and impacts the sibling, their relationships, and family functioning in the moment and for years afterward. Opportunities exist to raise healthcare providers' awareness of providing care through a family lens, which can positively impact the patient and the family. These findings are an initial step toward developing interventions that incorporate siblings of transplant recipients in healthcare interactions and create a more family-inclusive model of care in the transplant setting.

Multidisciplinary approach to optimizing long-term outcomes in pediatric kidney transplant recipients: multifaceted needs, risk assessment strategies, and potential interventions

The post-transplant course of pediatric kidney transplant recipients is marked by a myriad of challenges, encompassing medical complications, recurrent hospitalizations, physical and dietary restrictions, and mental health concerns such as depression, anxiety, and post-traumatic stress disorder. Moreover, pediatric recipients are at risk of neurodevelopmental impairment, which may result in neurocognitive deficits and pose significant psychosocial obstacles. Addressing these multifaceted demands necessitates a multidisciplinary approach to pediatric kidney transplant care. However, the existing literature on the effective implementation of such a model remains scarce. This review examines the psychosocial and neurodevelopmental challenges faced by pediatric kidney transplant recipients and their families, discussing their impact on long-term transplant outcomes. Furthermore, it provides insights into risk assessment strategies and potential interventions within a multidisciplinary framework, aiming to enhance patient care and optimize post-transplant outcomes.

Parents' experience of children's transitions from intensive care unit after liver transplantation: A qualitative study

OBJECTIVE

The aim of this study was to understand parents' perspectives on caring for children who underwent liver transplantation in the intensive care unit transition period and to provide a reference for the development of targeted intervention strategies.

METHODS

Thirteen parents of children who underwent liver transplantation at a tertiary hospital in Hangzhou, Zhejiang Province were chosen for in-depth semi-structured interviews via purposive sampling. The interview data were analyzed and summarized via content analysis.

FINDINGS

Three themes were extracted, including a period of separation and suffering (being apart from child is tough, chilling atmosphere, and limited family access); being an overwhelming caregiver (hope coupled with worry, conflict of roles, and existential care dilemmas); and facing a new normal: searching for information and support (information on medical conditions, post-discharge care assistance, educational support, and peer support).

CONCLUSION

For parents whose child underwent liver transplantation, the transition period from the intensive care unit to the general ward is challenging. Parents are burdened with several caregiving responsibilities and require a variety of information and support. It is advised that nurses should offer sufficient information and suitable educational approaches to enhance these parents' capacity to care for their children and assist children and their parents in making a smooth transition.

IMPLICATIONS FOR CLINICAL PRACTICE

This study highlights parents' perspectives on caring for children with liver transplants transferred from the intensive care unit to a general ward. Transitional care is strenuous, evoking different feelings before and after transfer. The health care professionals should focus on the needs and challenges faced by parents who are caring for children with liver transplants during the intensive care unit transition period. To achieve this, it is critical to establish a supportive environment and provide suitable information and education for parents to enhance their caregiving abilities.