Experiences of medical traumatic stress in parents of children with medical complexity

Cliff or bridge: breaking up with the paediatric healthcare system

Transition from paediatric to adult healthcare is a normal part of the care trajectory, yet the process often leaves much to be desired. In this commentary, I share my family's journey of this care transition, particularly the handover aspect, by providing examples of different ways that relationships were ended by paediatric healthcare professionals. The ending of these relationships often felt like 'breaking up'. I also share an example of a supported handover, which bridged the transition from paediatric to adult care. To improve transitions, we need genuine acknowledgement of the paediatric medical trauma stress (PMTS) experienced by families such as mine following years of interactions in the healthcare system. Along with following transition checklists, patients and families need authentic and meaningful closure to longitudinal relationships and trauma-informed care practices as we move forward into the adult care system.

Mothers' experiences of caring for their children with liver transplantation: From sorrow to new determination

This study aims to understand mothers' dynamic experiences of caring for their children with liver transplant. A descriptive phenomenological qualitative approach was applied to this study. A total of seven mothers participated in this study. Data were collected from April 2020 to June 2020 through face-to-face interviews. Data analysis was performed using Giorgi's phenomenological method. By grouping general meaning units, 8 themes and 19 subthemes were derived. Eight themes are as follows: sorrow and distress of accepting a child's diagnosis; difficulties in deciding to undergo liver transplantation; negative emotions before and after transplant; the support system before and after liver transplantation; achieving a sense of trust toward healthcare providers; new concerns about the child's life after undergoing liver transplantation; appreciation of the experience; and new determination and expectations for future life. This study can contribute to the guideline that describes the role and daily life experiences of caregiving for other parents whose children undergo liver transplantation and nurses who work with impacted families. Healthcare providers can refer to the results to provide liver transplantation childcare and hospital-based support groups for child's family to improve nurses' communication skills.

Designing a Child-, Family-, and Healthcare Provider-Centered Procedure Room in a Tertiary Care Children's Hospital

AIM

The study aim was to co-design new pediatric procedure room prototypes with children, caregivers, and healthcare providers (HCPs).

BACKGROUND

Medical procedures can cause pain and anxiety for children and their families. If spaces are not designed for patients' needs, procedures may take longer, require sedation, and result in an inferior care experience. Involving HCPs in co-designing optimal spaces can result in more efficient and safer environments. co-designing spaces with patients and their families can inform psychologically safer and less traumatic environments.

METHODS

We followed human-centered design methodology. Data were collected via semi-structured interviews, field observations, and two multidisciplinary design workshops with patients, caregivers, and HCPs. Themes from the data were extracted using a content analysis and used to make evidence-informed recommendations for design features.

RESULTS

The study took place from October 2021 to February 2022. Patients, families, and HCPs reported similar needs: (1) control over the environment, including the ability to adjust lighting, temperature, and sound; (2) space that supports patient privacy; (3) the use of evidence-based pain reduction and distraction methods; (4) attention to the sensory environment, including visual (light, color), tactile (textures of furniture and equipment), auditory, and olfactory stimuli; (5) human factors organization of the space and equipment; (6) accessible and equitable spatial design; and (7) the significance of the journey leading up to and after the procedure.

CONCLUSIONS

It is feasible to co-design procedure rooms that support evidence-based psychological, physical, and pharmacological interventions that are known to minimize pain for children.

Respite care: qualitative arts-based findings on the perspectives and experiences of families of children and youth with special healthcare needs residing in Manitoba, Canada

OBJECTIVES

Respite for families of children and youth with special healthcare needs (CYSHCN) is essential for sustaining a family care environment. Lacking is an understanding of families' respite experiences who reside in Canada. We sought to understand experiences of the use of respite services by families with CYSHCN with the aim to help improve respite services. This paper reports on the qualitative arts-based findings.

DESIGN

Qualitative methods including open-ended interviews combined with the arts-based methods of ecomaps and the photovoice process were used. Analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements and extracting themes.SettingManitoba, a western Canadian province.

PARTICIPANTS

Thirty-two families (including 38 parents and 13 siblings) of CYSHCN.

RESULTS

We identified six themes surrounding challenges experienced by families' in their journeys accessing, acquiring and navigating the respite care system, and sustainment of respite care for their families, leading to familial burn-out and breakdown, financial stress, unemployment and unaddressed mental health struggles. Families provided multipronged recommendations to address these challenges.

CONCLUSIONS

Through the lens of Canadian families of children with a range of complex care needs, the qualitative arts-based portion of the study underscores the challenges with accessing, navigating and sustaining respite care, which has implications for CYSHCN, their clinicians and the potential for long-term costs for government and society. This study identifies the state of the current Manitoba respite care system as an issue, presenting actionable recommendations from families that can assist policymakers and clinicians in advocating for and implementing a collaborative, responsive, family-centred system of respite care.