Be my guest! Challenges and practical solutions of undertaking interviews with children in the home setting

‘ZOOMing’ in on Consulting with Children and Parents Remotely to Co-Create Health Information Resources

The COVID-19 pandemic altered the way many people worked. Remote and creative ways were favoured and utilised for consultation activities. In this paper, we draw attention to how we have used creative methods over the teleconferencing platform ‘ZOOM’ to consult with children and their parents when we were unable to consult with them face-to-face. We document a clear timeline of how we have worked together to co-create an animation and information sheet about receiving outpatient parenteral antimicrobial therapy (OPAT). We identify the opportunities and challenges we faced.

The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents: a qualitative study

BACKGROUND

When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs).

METHODS

Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method.

RESULTS

Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: 'Normalising'; 'Maintaining hope and a sense of the future'; 'Dealing with an uncertain future'; and 'Seeking Support'.

CONCLUSIONS

Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or 'better' place than they have been previously.

Communication styles between family carers and children with leukaemia in occupied Palestinian territory

This study explores the experience of communication regarding the care of children with cancer, from the perspective of family carers, children and health professionals in occupied Palestinian territory. This study employed an ethnographic collective qualitative case study approach, which was applied in one oncology unit in a Palestinian hospital. Participant observation and semi-structured interviews were used. This study only reports the findings of the interviews with the participating family carers. Fifteen interviews were conducted with family carers (n = 14 children), namely mothers (n = 7), grandmothers (n = 7) and a father (n = 1). The findings reveal that styles of information were given to children by their family carers: minimal/practical information, gradual information, false information, reassuring information and several sources of information. The term cancer was avoided in the discussion of the disease to ameliorate the negative effect of this term, which is considered taboo in the studied culture. Despite the recent trend emphasising the importance of parents communicating openly with their children with cancer, the findings of this study suggest that such open communication is not accepted by all parents. Hence, a case-by-case strategy could be adopted to treat each child in a way that is individual to that child and their culture.

Challenges Faced by Mothers Caring for Children with Leukaemia During COVID-19 Pandemic: A Qualitative Study

PURPOSE

This study aimed to investigate the experiences of parents who care for children diagnosed with leukaemia. This paper is focused solely on reporting the interview findings from participating mothers regarding the challenges of caring for children with leukaemia in the context of the COVID-19.

DESIGN AND METHODS

The study took place in a Jordanian hospital where a descriptive qualitative design approach was applied on one oncology floor and an oncology clinic. Semi-structured interviews were conducted with mothers of children aged 1-12 with acute lymphoblastic leukaemia (ALL). Inductive thematic analysis approach was undertaken. Written consent was obtained from all participants.

RESULTS

Fifteen interviews were conducted with fifteen mothers. Four major themes reflect the different challenges parents and children face during the COVID-19 pandemic: children refusing to wear masks, social isolation, family relationship and financial concerns.

CONCLUSIONS

The findings of the current study present important data for health care professionals to help them understand the challenges faced by parents and children with leukaemia, especially during the COVID-19 pandemic.

PRACTICAL IMPLICATIONS

This study suggests activating emotional support teams in hospitals. These teams can actively help mothers express their concerns and worries which might otherwise foster self-blame, guilt and isolation.

Psychosocial resources contributing to resilience in Austrian young carers-A study using photo novella

Caring for their chronically ill or disabled family members is a responsibility that may be assumed by children and adolescents (“young carers”) and may affect young carers’ lives in many ways. Some young carers may experience long‐term adverse health effects related to their early caring responsibilities and others may demonstrate healthy adaptation. Little research applying nonretrospective designs, however, has been done from the perspective of young carers regarding the psychosocial resources that enable them to handle the responsibility of caring for chronically ill or disabled family members. The aim of the present study, therefore, was to identify psychosocial resources used by young carers in Austria. Ten children and adolescents (aged 9–17) took photographs to illustrate their everyday lives. The photographs were then used to guide subsequent interviews. Data were analyzed following the principles of directed qualitative content analysis and using the theoretical lens of resilience. We identified two sets of psychosocial resources: (1) Personal resources comprising (a) being able to spend leisure time and (b) finding distraction from sorrows and problems. (2) Interpersonal resources comprising (a) fostering meaningful friendships, (b) receiving support from the family, and (c) bonding with the ill or disabled family member. Young carers largely have the same repertoire of resources as other children and can use them specifically to respond to the care burden. Interventions to support young carers must focus on promoting peer contact and cohesion within the nuclear family as well as bonding with the ill or disabled relative.

'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation

Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.

The journey through care: study protocol for a longitudinal qualitative interview study to investigate the healthcare experiences and preferences of children and young people with life-limiting and life-threatening conditions and their families in the West Midlands, UK

INTRODUCTION

The number of children and young people living with life-limiting and life-threatening conditions is rising. Providing high-quality, responsive healthcare for them and for their families presents a significant challenge. Their conditions are often complex and highly unpredictable. Palliative care is advocated for people with life-limiting and life-threatening conditions, but these services for children are highly variable in terms of availability and scope. Little is known about the lived experiences and preferences of children and their families in terms of the palliative care that they do, or do not, receive. This study aims to produce an in-depth insight into the experiences and preferences of such children and families in order to develop recommendations for the future provision of services. The study will be carried out in the West Midlands, UK.

METHODS AND ANALYSIS

A qualitative study comprising longitudinal interviews over a 12-month period with children (aged 5-18 years) living with life-limiting or life-threatening conditions and their family members. Data analysis will start with thematic analysis, followed by narrative and cross-case analysis to examine changing experiences and preferences over time, at the family level and within the wider healthcare system. Patient and public involvement (PPI) has informed the design and conduct of the study. Findings will be used to develop recommendations for an integrated model of palliative care for children in partnership with the patient and public involvement (PPI) group.

ETHICS AND DISSEMINATION

Ethical approval was granted in September 2016 by the National Health Service Health Research Authority (IRAS ID: 196816, REC reference: 16/WM/0272). Findings will be of immediate relevance to healthcare providers, policy-makers, commissioners and voluntary sector organisations in the UK and internationally. Reports will be prepared for these audiences, as well as for children and their families, alongside academic outputs.

In their own words: the value of qualitative research to improve the care of children with chronic kidney disease

Patient- and family-centered care is hailed as a hallmark of high-quality pediatric care. This partnership between patients, families and their healthcare providers is central to caring for children with chronic kidney disease (CKD), given the long-term and profound impact of the disease and its treatment on the development and quality of life of these children. This paradigm hinges on a comprehensive and detailed understanding of the needs, beliefs and values of children with CKD and their families. However, their perspectives may remain undisclosed during time-limited clinical consultations and because of beliefs that if they did disclose their concerns, their care would be jeopardized. Qualitative research provides an avenue for children and families to articulate their perspectives and experiences and thereby to generate relevant, in-depth and often compelling insights to inform care. Yet, qualitative studies remain sparse in biomedical journals. Increasing both our awareness of the role of qualitative research in improving care and outcomes for children and adolescents with CKD and our understanding of the conduct and rigor of qualitative studies is required. This article will outline how qualitative research can generate relevant evidence to inform practice and policy in children with CKD, provide an overview of qualitative methods and introduce a framework to appraise qualitative research. More evidence derived from qualitative research is needed to inform shared decision-making and the development of interventions and policies that address the preferences and priorities of children with CKD and their families. Ultimately, this strategy may help to improve the outcomes that they regard as critical to their care.