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Kelly KP, Mooney-Doyle K, Waldron M, Knafl KA. Managing Expectations: Understanding Parents' Perceptions of Their Child's Serious Illness. JOURNAL OF FAMILY NURSING 2025; 31:31-44. [PMID: 39812220 DOI: 10.1177/10748407241290305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2025]
Abstract
Parenting a seriously ill child is complex and emotionally intense. To further develop Hinds and colleagues' Good Parent themes: "Keeping a Positive Outlook" and "Keeping a Realistic Outlook," we reviewed grounded theories published in English language journals from January 2006 to April 2021 identifying 18 studies with relevant results. Parents' efforts to keep a positive outlook included cognitive (e.g., remain hopeful, avoid negative thinking) and behavioral (e.g., monitoring child for signs of improvement, information seeking) actions. To keep a realistic outlook, parents acknowledged the serious nature of the condition, negative treatment effects, and limitations to treating the child normally. Parents holding both positive and realistic outlooks recognized the seriousness of their child's illness and remained hopeful while preparing for their child's death. Our analysis extends the understanding of how parents' expectations regarding the course and outcome of their child's illness shape cognitive and behavioral aspects of their parenting.
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Pridham K, Brown R, Schardt D, Kneeland T, Fedderly R. Coparenting Patterns of Parents of an Infant With Complex Congenital Heart Disease: Qualitative Identification and Network Analysis of Effects of Infant Illness Severity and Guided Participation Intervention. Res Theory Nurs Pract 2024; 39:RTNP-2023-0128.R1. [PMID: 39304307 PMCID: PMC11922788 DOI: 10.1891/rtnp-2023-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
Introduction: The purpose of this secondary analysis, from a pilot randomized controlled trial of guided participation (GP), was to describe patterns of coparenting for mother and father dyads caring for an infant with complex congenital heart disease and to examine the influencing factors at infant age 6 months. Our theoretical framework included GP treatment, severity of neonatal illness (severity), coparenting pattern, and parent attention to infant weight gain (weight gain). Method: From transcribed interviews with 25 parent dyads at infant age 2 and 6 months, data relevant to coparenting were categorized for entry into a matrix table. These categories included family circumstances; infant health status, feeding, and sleeping; and how the parents worked in relation to each other for caregiving, the caregiving issues they were working on, and their caregiving goals. Results: The tabled data showed two coparenting patterns, collaborative and cooperative, with very little change from 2 to 6 months, and 6-month weight gain mention. We used Bayesian sensitivity network analysis to examine, at 6 months, GP effect in contrast to usual care (control group) effect and the effect of higher or lower severity on coparenting pattern and weight gain. The treatment group had greater percentage of collaborative coparenting pattern with higher severity. In contrast, the control group showed the percentage of dyads with a collaborative coparenting pattern was similar for higher and lower severity. Weight gain mention was higher with higher severity. Conclusion: Further coparenting pattern identification and study replication with a larger, diversified sample is planned.
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Affiliation(s)
- Karen Pridham
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
| | - Roger Brown
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
| | - Dana Schardt
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
| | - Tondi Kneeland
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Raymond Fedderly
- Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
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Huang CH, Chou CC, Chung HT, Wang JK, Mu PF, Chen SW, Shu YM, Chen CW. "Warrior who transcends adversity": A qualitative examination of resilience among mothers caring for adolescents with congenital heart disease. J Pediatr Nurs 2024; 78:e417-e423. [PMID: 39122579 DOI: 10.1016/j.pedn.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/02/2024] [Accepted: 08/03/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE Parenting resilience is essential for the well-being and development of children with chronic illnesses. Given the importance of parenting resilience in this context, this study explored the nature of parenting resilience among mothers caring for adolescents with congenital heart disease (CHD). DESIGN AND METHODS We adopted Husserl's phenomenological approach and conducted semistructured in-depth interviews. In addition, we conducted purposive sampling at the pediatric cardiology outpatient departments of 2 medical centers in Taiwan to recruit 11 mothers of adolescents with CHD; all of these adolescents had received open-heart surgery. Furthermore, we analyzed data by using Colaizzi's approach, and we adhered to the COnsolidated criteria for REporting Qualitative research checklist. RESULTS Mothers caring for adolescents with CHD was a dynamic process involving problem solving. The 11 mothers in this study employed resilience to remain strong, provided a sense of normalcy for their children, and approached challenges calmly and bravely. We uncovered three major themes among these mothers: "providing support for the child, "facing challenges with equanimity," and "overcoming adversity through positivity and gratitude." CONCLUSIONS The present results provide a deeper understanding of how mothers caring for adolescents with CHD can cultivate resilience. PRACTICE IMPLICATIONS The study's findings can inform transitional programs for adolescents with CHD and their families, with nursing professionals supporting mothers' resilience.
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Affiliation(s)
- Chin-Hui Huang
- Department of Nursing, Hsinchu Mackay Memorial Hospital, No. 690, Sec. 2, Guangfu Rd., East Dist., Hsinchu City, Hsinchu 300044, Taiwan
| | - Cheng-Chen Chou
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei 112304, Taiwan
| | - Hung-Tao Chung
- Department of Pediatrics, Chang Gung Children's Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333423, Taiwan
| | - Jou-Kou Wang
- Department of Pediatric Cardiology, National Taiwan University Children's Hospital, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100226, Taiwan
| | - Pei-Fan Mu
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei 112304, Taiwan
| | - Shu Wen Chen
- School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Mingde Rd., Beitou Dist., Taipei City 112303, Taiwan
| | - Ying-Mei Shu
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333324, Taiwan
| | - Chi-Wen Chen
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei 112304, Taiwan.
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de Silva GNJ, Gamage GP. Queens of hearts: Exploring the lived experiences of mothers caring for infants with complex congenital heart disease in Sri Lanka. J Health Psychol 2024; 29:1266-1280. [PMID: 38384242 PMCID: PMC11378444 DOI: 10.1177/13591053241233382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
This qualitative study explored the lived experiences of eight Sri Lankan mothers of infants with complex congenital heart disease (CCHD) using semi-structured interviews. Four themes were generated as: illness perception, communication with medical staff, challenges faced, and coping mechanisms. These provided insight into the multi-faceted nature of mothers' experiences, importance of medical-caregiver communications and their need for psychosocial services. The findings enhance the limited knowledge of South-Asian primary CCHD caregiver experiences and will help in improving psychosocial support services in Sri Lanka.
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Archer-Kuhn B, Lind C, Beltrano N, Garrisen L, Hettler J, Reilly S. Realizing an Evidence-Based Framework for the Management and Delivery of Family Support Services. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:455-473. [PMID: 38288721 DOI: 10.1080/26408066.2024.2310599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
PURPOSE This paper reports on how service providers and academic researchers partnered to support the journey of a primary prevention organization in western Canada as they reviewed their programming against an evidence-based practice (EBP) framework. The process allows the organization to increase their EBP culture by encouraging staff understanding and uptake of their nine family support programs. It also informs service users and other stakeholders of the evidentiary status of different kinds of support services. In this way, the families become more informed and engaged partners who might easily evaluate the respective risks and benefits of the various applications. METHOD As part of the process, an evidence-based framework used a common language to assess the efficacy of the respective nine programs. RESULTS All nine programs are now mapped into the EBP framework. CONCLUSIONS This review allows staff to become more intentional and informed about the EBPs they employ to support vulnerable families and to use this knowledge to better inform the families with whom they work. This paper and the process the agency followed can be a model for other organizations who serve families experiencing short-term housing crisis, provide infant nursery care, and other support services for families with young children.
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Affiliation(s)
- Beth Archer-Kuhn
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Natalie Beltrano
- School of Social Work, University of Windsor, Windsor, ON, Canada
| | - Lisa Garrisen
- of Programs, Children's Cottage Society, Calgary, AB, Canada
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Pridham K, Nemykina Y, Connor A, Melby J, Brown R. Caregiving and Support Issues Identified by Parents of an Infant With Congenital Heart Disease for Interactive Problem-Solving. Res Theory Nurs Pract 2023; 37:RTNP-2022-0062.R1. [PMID: 37130796 PMCID: PMC10620106 DOI: 10.1891/rtnp-2022-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background and Purpose: Parents of an infant with complex congenital heart disease report caregiving challenges in the infant's first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving. Methods: The issues 31 parent dyads identified for interactive problem-solving at either or both infants aged 2 and 6 months were typed as caregiving or relational/support. The parent dyad's interactive competencies were assessed from video recording for two types of tasks (i.e., caregiving and the parent dyad's relationship as caregivers). Constructs of Iowa Family Interaction Rating Scales were applied to assess the competencies of mothers, fathers, and the parent dyad for a group that received guided participation (n = 17) and a group that received usual care (n = 8). Results: Pie charts showed feeding, most frequently identified for interactive problem-solving at 2 months, was surpassed at 6 months by growth and development. The time parents spent together was the most mentioned relationship issue at 2 and 6 months. Forest plots showed caregiving issues were associated with at least medium effect sizes for dyadic problem-solving for both parents at 2 and 6 months and for problem-solving for fathers at 2 and 6 months. Relational/support issues were associated with higher hostility and communication hindering than caregiving issues. Implications for Practice: Intervention to aid parents in interactive problem-solving for both caregiving and relationship/support issues merits development and testing.
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Affiliation(s)
- Karen Pridham
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
| | - Yuliya Nemykina
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
| | | | - Janet Melby
- Department of Human Development and Family Studies, Iowa State University, Ames IA, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, Madison WI, USA
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Imperial-Perez F, Pike NA, Doering LV, Eastwood JA, Heilemann MV. Caregiving for Interstage Infants: A Continuous Process of Compromise During the Pandemic. World J Pediatr Congenit Heart Surg 2022; 13:443-450. [PMID: 35585726 PMCID: PMC9121143 DOI: 10.1177/21501351221099945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Infants born with single ventricle heart disease require
in-home medicalized care during the interstage period (time between the first
and second staged heart surgery). These caregivers rely on extended family,
friends, and hired caretakers to provide respite time. However, the coronavirus
pandemic removed these families’ options due to stay-at-home and social
distancing directives. We explored the caregivers’ experiences during the
interstage period, including impacts on their lifestyle, as they managed their
infants’ critical needs during the coronavirus disease 2019 pandemic.
Method: In-person or telephonic interviews of 14 caregivers
interviewed once or twice were conducted between November 2019 and July 2020.
Constructivist Grounded Theory methodology guided both data collection and
analysis for the inductive and abductive exploration of caregivers’ experiences.
Results: Data analysis led to the development of 2 concepts:
Accepting and adapting to a restrictive home environment
and Reconciling what is and what is yet to come. Refinement of
the relationship between the 2 concepts led to the development of a theory
grounded in the words and experiences of the participants called: A
Continuous Process of Compromise. Conclusions: Our
findings increase understanding of caregivers’ experiences related to
psychosocial and lifestyle impacts and the need for additional support during
the interstage period.
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Affiliation(s)
- Flerida Imperial-Perez
- 5150Children's Hospital Los Angeles, Heart Institute, Section of Cardiothoracic ICU, Los Angeles, CA, USA.,8783University of California Los Angeles School of Nursing, Los Angeles, CA, USA
| | - Nancy A Pike
- 5150Children's Hospital Los Angeles, Heart Institute, Section of Cardiothoracic ICU, Los Angeles, CA, USA.,8783University of California Los Angeles School of Nursing, Los Angeles, CA, USA
| | - Lynn V Doering
- 8783University of California Los Angeles School of Nursing, Los Angeles, CA, USA
| | - Jo-Ann Eastwood
- 8783University of California Los Angeles School of Nursing, Los Angeles, CA, USA
| | - MarySue V Heilemann
- 8783University of California Los Angeles School of Nursing, Los Angeles, CA, USA
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Winger A, Kvarme LG, Løyland B, Kristiansen C, Helseth S, Ravn IH. Family experiences with palliative care for children at home: a systematic literature review. BMC Palliat Care 2020; 19:165. [PMID: 33099303 PMCID: PMC7585197 DOI: 10.1186/s12904-020-00672-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/15/2020] [Indexed: 01/29/2023] Open
Abstract
Background The main goal of pediatric palliative care (PPC) is to improve or maintain the best possible quality of life (QoL) for the child and their family. PPC can be provided in community health centres, within the specialist health care service and/or in the child’s home. Home is often the preferred place for families, and recommendations state that, whenever possible, the family home should be the centre of care for the child. The aim of this study is to systematically review the experiences and needs of families with children receiving palliative care at home. Methods We conducted a systematic review and searched the peer-reviewed databases CINAHL, Embase, PsycInfo and MEDLINE for articles published between January 2000 and October 2019. We included 23 studies emphasising the experience of family members when their child (0–18 years) received palliative care at home. We used a thematic analysis to identify relevant themes in the literature, and synthesised the findings from the different studies. Results The review represents the experiences of the families of almost 300 children with life-limiting (LL) and life-threatening (LT) conditions receiving palliative care at home. In general, the children’s mothers are interviewed, and seldom the sick children themselves or their siblings. Most families preferred staying at home since it made it easier to maintain a normal family life, was less stressful for the sick child, and meant that siblings could still attend school and be with friends. Families experienced a range of challenges due to the coordination of care, including a lack of support and adequately skilled staff with appropriate experience. Respite care was needed in order to cope with everyday life. Some studies were not specific concerning the place of care, and some relevant papers may have been omitted. Conclusions Families receiving PPC need organised, individualised support from a skilled PPC team. Respite care is necessary in order to manage a demanding home-care situation and parents need support for siblings. Privacy to be a family is a need, and many families need financial support. Future studies should focus on PPC at home in the perspectives of sick children and their siblings.
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Affiliation(s)
- Anette Winger
- Oslo Metropolitan University (OsloMet), P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway.
| | - Lisbeth Gravdal Kvarme
- Oslo Metropolitan University (OsloMet), P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway
| | - Borghild Løyland
- Oslo Metropolitan University (OsloMet), P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway
| | | | - Sølvi Helseth
- Oslo Metropolitan University (OsloMet), P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway
| | - Ingrid H Ravn
- Oslo Metropolitan University (OsloMet), P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway
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