Exploring young patients’ perspectives on rehabilitation care: methods and challenges of organizing focus groups for children and adolescents

BACKGROUND

In research on quality of care, the experiences of children and (pre)adolescents are usually assessed by asking their parents. However, these young patients may have preferences of their own, and their experiences do not necessarily concur with those of their parents. Therefore, our research aimed to give young patients an opportunity to speak up for themselves.

METHODS

Focus group meetings and online focus groups were organized for two age groups (8–11 and 12–15 years) of young patients from two Dutch rehabilitation centres, with the use of a tailored interview technique. The feasibility and applicability of both types of focus groups were assessed.

RESULTS

For both types of focus groups, recruitment proved a major problem. The focus group meetings with (pre)adolescents proved both feasible and applicable in obtaining information regarding the preferences and experiences towards rehabilitation care. Regarding children's meetings, there were mixed results. The setting suited most of them, but some were more anxious. In general, online focus groups were less successful than expected for both age groups.

CONCLUSIONS

Possibilities for enhancing the recruitment rate should be considered, as the low participation rates limited generalizability of focus group results. The tailored design proved useful for obtaining relevant input from (pre)adolescents through meetings, but, especially for children, repeated meetings or other locations (e.g. at home) could be considered. This may make participants more at ease. For both age groups, the online focus groups proved far less useful, in terms of participation.

Surfactant treatment in premature infants with Respiratory Distress Syndrome in Curaçao

Surfactant replacement therapy for Respiratory Distress Syndrome (RDS) in premature neonates has been established as an effective treatment, although significant mortality and morbidity remain. In Curaçao, surfactant became available as a therapeutic option in 1994. A retrospective cohort study was performed to describe the results of surfactant treatment in premature newborns with RDS in Curaçao between 1994 and 1998. Of 429 infants admitted to the study hospital in this period, 7.5% (n = 32) developed RDS and were treated with surfactant. Twenty-five per cent (n = 8) of these infants died, most of them in the first year of surfactant treatment. Twenty-eight per cent (n = 9) developed bronchopulmonary dysplasia (BPD), the most frequently observed complication. The highest incidence of BPD (44%) was found in the very low birth weight infants (750-1500 g); all infants with BPD were 27-30 weeks of gestational age. The duration of ventilator dependence was significantly associated with the development of BPD (p < 0.05). No other risk factors for complications during the treatment course could be identified. The mean time between birth and the first surfactant treatment was more than nine hours. In this study, we found low incidence rates of RDS and BPD, and a considerable mortality in surfactant treated newborns. This pilot study shows that surfactant treatment of premature infants is feasible in Curaçao. Earlier administration of surfactant, preferably within 2-3 hours after birth, is expected to lower the risk of death and oxygen dependence.