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van Dokkum NH, Bos AF, Kraft KE, Bouma HA, Reijneveld SA, Krabbe PFM, de Kroon MLA. Early stress during NICU stay and parent-reported health-related quality of life after extremely preterm birth: an exploratory study with possible targets for early intervention. Front Pediatr 2024; 12:1381008. [PMID: 38650996 PMCID: PMC11033392 DOI: 10.3389/fped.2024.1381008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction The association between neonatal intensive care unit (NICU) related stress in preterm infants and their health-related quality of life (HRQoL) in the first year following preterm birth remains unexplored. Understanding this association is crucial for enhancing preventive and supportive measures for infants and parents within and beyond the NICU. Methods From a single center observational cohort study, we included infants with gestational ages below 30 weeks and/or birth weights under 1,000 grams. HRQoL was quantified using the Infant Quality of Life Instrument (IQI) at 3-, 6-, 9- and 12-months corrected age, covering seven domains. NICU stress was quantified using the Neonatal Infant Stressor Scale (NISS) for the first week of life. We performed Spearman's correlation analyses to test this association. Results Of the 45 included infants, the IQI was completed for 27 (60%) at 3, 15 (33%) at 6, 14 (31%) at 9 and 15 (33%) at 12 months. The HRQoL sum scores were related to neonatal stress at 9 and 12 months (ρ = 0.643 and 0.591, p = 0.013 and p = 0.019, respectively) but not at 3 and 6 months (ρ = -0.001 and -0.077 respectively, p > 0.05). Higher NICU stress tended to be associated with more respiratory and mood problems throughout the first year. Discussion From a parental perspective on infant HRQoL, extremely preterm infants with higher stress exposure show more problems in the second half-year of life, mainly breathing and possibly mood-related problems. This knowledge may help improve our neonatal care, both during NICU stay and in follow-up clinics, by implementing targeted interventions.
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Affiliation(s)
- Nienke H. van Dokkum
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Arend F. Bos
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Karianne E. Kraft
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Helene A. Bouma
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Paul F. M. Krabbe
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marlou L. A. de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Leuven, Belgium
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Boutillier B, Ethier G, Boucoiran I, Reichherzer M, Luu TM, Morin L, Pearce R, Janvier A. Prenatal Workshops and Support Groups for Prospective Parents Whose Children Will Need Neonatal Care at Birth: A Feasibility and Pilot Study. Children (Basel) 2023; 10:1570. [PMID: 37761531 PMCID: PMC10529479 DOI: 10.3390/children10091570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Introduction: Support groups in neonatal intensive care units (NICUs) are beneficial to parents. The usefulness of prenatal support groups for prospective parents who will have a newborn requiring admission to the NICU has never been investigated. Methods: We assessed the needs of NICU parents regarding topics they would have wished to discuss prenatally and developed the content of a prenatal support workshop. A standardized survey prospectively evaluated the perspectives of pregnant women admitted to a high-risk pregnancy unit who participated in the resulting workshops. Results: During needs assessment, 295 parents invoked themes they would have wished to discuss antenatally: parental guilt, future parental role, normalizing their experience/emotions, coping with many losses, adapting to their new reality, control and trust, information about the NICU, technology around the baby, common neonatal interventions, the NICU clinical team, and the role of parents in the team. These findings were used to develop the workshop, including a moderator checklist and a visual presentation. Practical aspects of the meetings were tested/finalized during a pre-pilot phase. Among 21 pregnant women who answered the survey (average gestational age 29.3 weeks), all agreed that the workshop was useful, that it made them feel less lonely (95%), that exchanges with other women were beneficial (95%) and gave them a certain amount of control over their situation (89%). All answers to open-ended questions were positive. Conclusion: Prenatal educational/support workshops provide a unique and useful means to support future NICU parents. Future investigations will explore whether these prenatal interventions improve clinical outcomes.
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Affiliation(s)
- Béatrice Boutillier
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada; (B.B.); (I.B.); (T.M.L.); (L.M.)
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (G.E.); (M.R.)
- Unité D’éthique Clinique, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
| | - Guillaume Ethier
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (G.E.); (M.R.)
| | - Isabelle Boucoiran
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada; (B.B.); (I.B.); (T.M.L.); (L.M.)
- Division of Maternal-Fetal Medicine, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Department of Obstetrics and Gynecology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Martin Reichherzer
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (G.E.); (M.R.)
| | - Thuy Mai Luu
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada; (B.B.); (I.B.); (T.M.L.); (L.M.)
- Department of Pediatrics, Université de Montréal, Montréal, QC H3T 1C5, Canada
| | - Lucie Morin
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada; (B.B.); (I.B.); (T.M.L.); (L.M.)
- Division of Maternal-Fetal Medicine, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Department of Obstetrics and Gynecology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Rebecca Pearce
- Parent Representative, Collaborates with Canadian Premature Babies Foundation, Etobicoke, ON M8X 1Y3, Canada;
| | - Annie Janvier
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada; (B.B.); (I.B.); (T.M.L.); (L.M.)
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (G.E.); (M.R.)
- Unité D’éthique Clinique, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montréal, QC H3T 1C5, Canada
- Bureau de L’éthique Clinique (BEC), Université de Montréal, Montréal, QC H3C 3J7, Canada
- Unité de Soins Palliatifs, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
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Boutillier B, Embleton ND, Bélanger S, Bigras-Mercier A, Larone Juneau A, Barrington KJ, Janvier A. Butterflies and Ribbons: Supporting Families Experiencing Perinatal Loss in Multiple Gestation. Children (Basel) 2023; 10:1407. [PMID: 37628406 PMCID: PMC10453894 DOI: 10.3390/children10081407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Introduction: In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal. Methods: Two educational programs were evaluated with pre- and post-course surveys, questionnaires administered to participants, and audits. Results: In the online Butterfly project (UK; n = 734 participants), all participants reported that the training exceeded or met their expectations, 97% reported they learned new skills, and 48% had already applied them. Participants expressed gratitude in their open-ended answers: "I feel a lot more confident in supporting parents in this situation". In the Ribbon project (workshop for neonatal clinicians, Quebec; n = 242), 97% were satisfied with the training and reported feeling more comfortable caring for bereaved parents. Knowledge improved pre-post training. Audits revealed that 100% of cases were identified on the incubator and the baby's/babies' admission card, all changed rooms after the death of their co-twin/triplet, and all had the name of their co-twin/triplet on the discharge summary. All clinicians (55) knew what the ribbon symbol meant when asked during surprise audits at the bedside. Conclusion: Different educational strategies to optimize communication with families after the perinatal loss of a co-twin are appreciated and have a positive impact.
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Affiliation(s)
- Béatrice Boutillier
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada
| | | | - Sophie Bélanger
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
| | - Alexie Bigras-Mercier
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
| | - Audrey Larone Juneau
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada
| | - Keith J. Barrington
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada
- Department of Medicine, University of Montreal, Montréal, QC H3T 1J4, Canada
| | - Annie Janvier
- Division of Neonatology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada; (B.B.); (S.B.); (A.B.-M.); (A.L.J.); (K.J.B.)
- CHU Sainte-Justine Research Center, Montréal, QC H3T 1C5, Canada
- Department of Medicine, University of Montreal, Montréal, QC H3T 1J4, Canada
- Unité D’éthique Clinique, Unité de Soins Palliatifs, Bureau du Partenariat Patients—Familles-Soignants, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Clinical Ethics Unit and Palliative Care Unit, Department of Pediatrics and Clinical Ethics, University of Montreal Neonatologist, Sainte-Justine Hospital, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC H3T 1C5, Canada
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Wilaiwongsathien K, Wattanasirichaigoon D, Rattanasiri S, Aonnuam C, Tangshewinsirikul C, Tim-Aroon T. Parental Awareness, Knowledge, and Attitudes Regarding Current and Future Newborn Bloodspot Screening: The First Report from Thailand. Int J Neonatal Screen 2023; 9:ijns9020025. [PMID: 37218890 DOI: 10.3390/ijns9020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
Newborn screening (NBS) is a public health service that is used to screen for treatable conditions in many countries, including Thailand. Several reports have revealed low levels of parental awareness and knowledge about NBS. Because of limited data on parental perspectives toward NBS in Asia and the differences in socio-cultural and economic contexts between Western and Asian countries, we conducted a study to explore parental perspectives on NBS in Thailand. A Thai questionnaire to assess awareness, knowledge, and attitudes regarding NBS was constructed. The final questionnaire was distributed to pregnant women, with or without their spouses, and to parents of children aged up to one year who visited the study sites in 2022. A total of 717 participants were enrolled. Up to 60% of parents were identified as having good awareness, which was significantly associated with gender, age, and occupation. Only 10% of parents were classified as having good knowledge relative to their education level and occupation. Providing appropriate NBS education should be initiated during antenatal care, focusing on both parents. This study noted a positive attitude toward expanded NBS for treatable inborn metabolic diseases, incurable disorders, and adult-onset diseases. However, modernized NBS should be holistically evaluated by multiple stakeholders in each country because of different socio-cultural and economic contexts.
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Affiliation(s)
- Kalyarat Wilaiwongsathien
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Duangrurdee Wattanasirichaigoon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Chanatpon Aonnuam
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Chayada Tangshewinsirikul
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Thipwimol Tim-Aroon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Gapp S, Garbade SF, Feyh P, Brockow I, Nennstiel U, Hoffmann GF, Sommerburg O, Gramer G. German newborn screening for Cystic fibrosis: Parental perspectives and suggestions for improvements. Pediatr Pulmonol 2023; 58:844-852. [PMID: 36444714 DOI: 10.1002/ppul.26263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 11/20/2022] [Accepted: 11/26/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Cystic fibrosis (CF) was added to the German newborn bloodspot screening (NBS) panel in 2016. This study assesses parental perceptions of CF-NBS and confirmatory testing. METHODS Prospective questionnaire-based survey administered to parents of children with positive CF-NBS over 40 months after initiation of CF-NBS in Southwest Germany. Parental perceptions were compared to results from Bavaria and Switzerland. RESULTS Questionnaires with 29 standardized questions were sent to 343 families with children born between October 2016 and January 2020. A total of 178 (51.9%) replied. Although required by law, only a minority were informed about CF-NBS by a physician. The information provided about NBS was sufficient for 78% of parents. Regarding the information about positive CF-NBS, 52.9% were satisfied but the majority expressed negative emotions (89.5%). While most of these were resolved after confirmatory diagnostics, 17% of parents of children with false-positive CF-NBS and 66.7% of children confirmed with CF remained anxious. Waiting time for sweat testing was >3 days in 56.1%, considerably longer than in more centralized screening systems. Parents who waited for a maximum of 3 days were significantly more satisfied. 70.7% of parents were satisfied with the information given during confirmatory diagnostics and 91.4% were satisfied with participating in CF-NBS. CONCLUSIONS CF-NBS stands in high regard with parents. Smooth organization, timely initiation of confirmatory testing, and professional communication are most important to limit parental anxiety. A more centralized system of confirmatory diagnostics appears advantageous in several regards as it reduces time from positive NBS to final diagnosis and increases parental satisfaction.
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Affiliation(s)
- Simon Gapp
- Center for Pediatric and Adolescent Medicine, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Sven F Garbade
- Center for Pediatric and Adolescent Medicine, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Patrik Feyh
- Center for Pediatric and Adolescent Medicine, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Inken Brockow
- Screening Center, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Uta Nennstiel
- Screening Center, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Georg F Hoffmann
- Center for Pediatric and Adolescent Medicine, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Olaf Sommerburg
- Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Center for Pediatric and Adolescent Medicine, Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, University Hospital Heidelberg, Heidelberg, Germany
| | - Gwendolyn Gramer
- Center for Pediatric and Adolescent Medicine, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany.,University Medical Center Hamburg-Eppendorf, University Children's Hospital, Hamburg, Germany
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Thivierge E, Luu TM, Bourque CJ, Barrington KJ, Pearce R, Jaworski M, Janvier A. Pulmonary important outcomes after extremely preterm birth: Parental perspectives. Acta Paediatr 2023; 112:970-976. [PMID: 36815277 DOI: 10.1111/apa.16723] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/20/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023]
Abstract
AIM To describe pulmonary important outcomes (PIO) reported by parents of children born extremely preterm. METHODS Over 1-year, all parents of children aged 18 months-7-years born <29 weeks' GA were asked regarding their perspectives. The proportion of parents who described PIO and the themes they invoked were examined. Results were analysed using mixed methods. RESULTS Among parental responses (n = 285, 98% participation rate), 44% spoke about PIO, invoking 24 themes pertaining to NICU hospitalisation and/or long-term respiratory health. Some themes had an impact primarily on the child (e.g. exercise limitation), while the majority had an impact on the whole family (e.g. hospital readmissions). None mentioned oxygen at 36 weeks nor bronchopulmonary dysplasia (BPD). The proportion of responses invoking PIO were statistically similar between parents of children with and without BPD, born before or after 25 weeks or with birthweight < or ≥750 g. PIO were more likely to be mentioned in males and among those readmitted for respiratory problems. CONCLUSION Parents describe many PIO, most related to the functional impact of lung disease on their child (and family), rather than the diagnosis of BPD itself. Most of these PIO are not primary outcomes in large neonatal trials nor collected in neonatal databases.
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Affiliation(s)
- Emilie Thivierge
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada.,CHU Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada.,CHU Sainte-Justine Research Center, Montréal, Québec, Canada.,Division of general pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada
| | - Claude Julie Bourque
- CHU Sainte-Justine Research Center, Montréal, Québec, Canada.,Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Québec, Canada
| | - Keith J Barrington
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada.,CHU Sainte-Justine Research Center, Montréal, Québec, Canada.,Division of Neonatology, CHU Sainte-Justine, Montréal, Québec, Canada
| | - Rebecca Pearce
- Parent representative; involved in Canadian Premature Babies Foundation, Montréal, Québec, Canada
| | - Magdalena Jaworski
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada.,Division of general pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada.,Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Québec, Canada
| | - Annie Janvier
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada.,CHU Sainte-Justine Research Center, Montréal, Québec, Canada.,Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Québec, Canada.,Division of Neonatology, CHU Sainte-Justine, Montréal, Québec, Canada.,Bureau de l'éthique Clinique, Université de Montréal, Montréal, Québec, Canada.,Unité de soins palliatifs, CHU Sainte-Justine, Montréal, Québec, Canada
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Thivierge E, Luu TM, Bourque CJ, Duquette LA, Pearce R, Jaworski M, Barrington KJ, Synnes A, Janvier A. Guilt and Regret Experienced by Parents of Children Born Extremely Preterm. J Pediatr 2022:S0022-3476(22)01019-8. [PMID: 36463935 DOI: 10.1016/j.jpeds.2022.10.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To explore decisional regret of parents of babies born extremely preterm and analyze neonatal, pediatric, and parental factors associated with regret. STUDY DESIGN Parents of infants born <29 weeks of gestational age, aged between 18 months and 7 years, attending neonatal follow-up were enrolled. Hospital records were reviewed to examine morbidities and conversations with parents about levels of care. Parents were asked the following question: "Knowing what you know now, is there anything you would have done differently?" Mixed methods were used to analyze responses. RESULTS In total, 248 parents (98% participation) answered, and 54% reported they did not have regret. Of those who reported regret (n = 113), 3 themes were most frequently invoked: 35% experienced guilt, thinking they were responsible for the preterm birth; 28% experienced regret about self-care decisions; and 20% regretted decisions related to their parental role, generally wishing they knew sooner how to get involved. None reported regret about life-and-death decisions made at birth or in the neonatal intensive care unit. Impairment at follow-up, gestational age, and decisions about levels/reorientation of care were not associated with regret. More mothers reported feeling guilt about the preterm birth (compared with fathers); parents of children with severe lesions on ultrasonography of the head were less likely to report regret. CONCLUSIONS Approximately one-half of the parents of infants born extremely preterm had regrets regarding their neonatal intensive care unit stay. Causes of regret and guilt should be addressed and minimized.
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Affiliation(s)
- Emilie Thivierge
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada
| | - Claude Julie Bourque
- CHU Sainte-Justine Research Center, Montréal, Canada; Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Canada; Centre d'excellence en éthique clinique, CHU Sainte-Justine, Montréal, Canada
| | | | - Rebecca Pearce
- Canadian Premature Baby Foundation, Montréal, Quebec, Canada
| | - Magdalena Jaworski
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Canada
| | - Keith J Barrington
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada
| | - Anne Synnes
- Department of Pediatrics, BC Women's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annie Janvier
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada; Centre d'excellence en éthique clinique, CHU Sainte-Justine, Montréal, Canada; Bureau de l'éthique Clinique, Université de Montréal, Montréal, Canada; Unité de soins palliatifs, CHU Sainte-Justine, Montréal, Canada.
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Ali S, Kammerer E, Thompson G, Mater A, Rajagopal M, Bone JN, Birnie KA, Oberlander T, Chambers CT, Goldman RD. A multicentre Canadian survey of caregiver perspectives on COVID vaccine-related pain and stress for their family. Br J Pain 2022; 16:490-497. [PMID: 36389007 PMCID: PMC9644106 DOI: 10.1177/20494637221090452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background Caregiver hesitancy for their children to receive the COVID-19 vaccine remains due to concerns regarding safety and efficacy, but also due to fear of vaccine administration-related pain and distress. Study objectives were to determine caregivers' perceptions regarding both their personal and child's COVID-19 vaccine administration-related stress and fear and relate this to their likelihood to allow their child to receive COVID-19 vaccinations. Methods This study was a secondary data analysis of a multicentre, cross-sectional survey of caregivers presenting to four Canadian pediatric emergency departments. Caregivers were surveyed between December 2020 and March 2021 and completed a digital survey on their own smartphones. Results 331 caregivers responded to the survey (mean age 39.9 years [SD 7.71]); 74.2% (245/331) were mothers. Children's mean age was 8.8 years [SD 5.4]; 49.8% (165/331) were female. 64.1% (209/326) of caregivers were willing to vaccinate their child against COVID-19, while 35.9% (117/326) were not. Greater perceived COVID-19 vaccine administration-related pain (0.88 [0.80; 0.95], p = .003) and stress (0.82 [0.76; 0.89], p = <.001) for their child as well as greater perceived personal stress with their own COVID-19 vaccine administration (0.81 [0.75; 0.88], p = <.001) were associated with caregivers being less likely to vaccinate their child. Conclusions During the time period between COVID-19 pandemic waves 2 and 3, and after the vaccine had been federally approved for adults, one-third of Canadian caregivers surveyed reported being unwilling to vaccinate their child against COVID-19 in the future. Managing children's and caregivers' vaccine administration-related fear and stress may improve vaccine uptake for children.
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Affiliation(s)
- Samina Ali
- Departments of Pediatrics and Emergency
Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB,
Canada
- Women and Children’s Health Research
Institute, University of Alberta, Edmonton, AB, Canada
| | - Elise Kammerer
- Department of Pediatrics, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
| | - Graham Thompson
- Departments of Pediatrics and Emergency
Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital, Calgary,
AB, Canada
| | - Ahmed Mater
- Pediatric Emergency Medicine,
University of Saskatchewan, Saskatoon, SK, Canada
- Jim Pattison Children’s Hospital,
Saskatoon, SK, Canada
| | - Manasi Rajagopal
- Department of Pediatrics, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey N Bone
- British Columbia Children’s Hospital
Research Institute, Vancouver, BC, Canada
| | - Kathryn A Birnie
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
- Departments of Anesthesiology,
Perioperative and Pain Medicine, and Community Health Sciences, University of
Calgary, Calgary, AB, Canada
| | - Tim Oberlander
- School of Population and Public
Health, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital, Vancouver,
BC, Canada
| | - Christine T Chambers
- Solutions for Kids in Pain, Halifax,
Halifax, NS, Canada
- Departments of Psychology and
Neuroscience and Pediatrics, Dalhousie University, Halifax, Nova Scotia,
Canada
- Centre for Pediatric Pain Research,
IWK Health Centre, Halifax, NS, Canada
| | - Ran D Goldman
- The Pediatric Research in Emergency
Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of
Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Children’s Hospital Research
Institute, Vancouver, BC, Canada
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9
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Dobosz D, Gierczyk M, Hornby G. Parental perspectives of home-schooling of children with special educational needs and disabilities during the COVID-19 pandemic: a review. J Res Spec Educ Needs 2022; 23:JRS312575. [PMID: 36248611 PMCID: PMC9537896 DOI: 10.1111/1471-3802.12575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The purpose of this paper is to review recent literature on parental perspectives of the impact of the COVID-19 pandemic on the home-schooling of children with special educational needs and disabilities, as well as to consider implications for their education and well-being. Eleven papers were reviewed, published between 2020 and 2021, selected according to a systematic protocol from three widely used online databases. Analysis of the reviewed papers found that transitioning to home-schooling during the pandemic had negative consequences for most of the children, as well as for their parents, though a small but significant number reported positive consequences. Three key areas of concern were identified in the analysis: balancing home-schooling with parent work activities; parent relationships with schools and support services and agencies and home-schooling effects on the well-being and mental health of parents and children.
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Affiliation(s)
| | | | - Garry Hornby
- University of Silesia in Katowice
- University of Plymouth
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10
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Hernandez-Ruiz E, Lehrer G. "Music Therapy Was Never on the Table": Perspectives of Parents of Young Autistic Children. J Music Ther 2022; 59:307-339. [PMID: 35876192 DOI: 10.1093/jmt/thac008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Parent coaching of music interventions is emerging as a viable model for families with young autistic children, yet recruitment difficulties have been apparent in previous studies. Understanding parent perspectives of early intervention services is critical to ensure that interventions are acceptable, feasible, and effective for all family members. In order to understand possible parental resistance to this type of parent education, we explored perspectives regarding music therapy, research, and parent coaching in parents of young autistic children. Fourteen parents attended virtual focus groups to discuss their experiences. We used a descriptive phenomenological approach to uncover the essence of their experience. Our findings indicate that, contrary to our preconceptions, participants did not show negative dispositions towards music therapy, research, or parent coaching. Instead, most participants had very little or no knowledge of music therapy services. They had limited experience with research in general, and only two participants had experienced music therapy directly. Several participants had varying amounts of experience with parent participation or parent coaching outside of music therapy and shared positive experiences with it. Parents seemed willing and eager to learn music strategies to support their children and saw value in the use of music for their child's development. First-contact providers (i.e., early interventionists and diagnosticians) and social media seem influential in parents' decision-making as they navigate early intervention services soon after diagnosis. Music therapy organizations are encouraged to design targeted efforts to make information on music therapy available through these sources.
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11
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Haward MF, Payot A, Feudtner C, Janvier A. Personalized communication with parents of children born at less than 25 weeks: Moving from doctor-driven to parent-personalized discussions. Semin Perinatol 2022; 46:151551. [PMID: 34893335 DOI: 10.1016/j.semperi.2021.151551] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Communication with parents is an essential component of neonatal care. For extremely preterm infants born at less than 25 weeks, this process is complicated by the substantial risk of mortality or major morbidity. For some babies with specific prognostic factors, the majority die. Although many of these deaths occur after admission to the intensive care unit, position statements have focused on communication during the prenatal consultation. This review takes a more comprehensive approach and covers personalized and parent-centered communication in the clinical setting during three distinct yet inter-related phases: the antenatal consultation, the neonatal intensive care hospitalization, and the dying process (when this happens). We advocate that a 'one-size-fits-all' communication model focused on standardizing information does not lead to partnerships. It is possible to standardize personalized approaches that recognize and adapt to parental heterogeneity. This can help clinicians and parents build effective partnerships of trust and affective support to engage in personalized decision-making. These practices begin with self-reflection on the part of the clinician and continue with practical frameworks and stepwise approaches supporting personalization and parent-centered communication.
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12
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McConkie-Rosell A, Schoch K, Sullivan J, Spillmann RC, Cope H, Tan QKG, Palmer CGS, Hooper SR, Shashi V. Clinical application of a scale to assess genomic healthcare empowerment (GEmS): Process and illustrative case examples. J Genet Couns 2022; 31:59-70. [PMID: 34115423 PMCID: PMC8664895 DOI: 10.1002/jgc4.1451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 02/03/2023]
Abstract
The Genome Empowerment Scale (GEmS), developed as a research tool, assesses perspectives of parents of children with undiagnosed disorders about to undergo exome or genome sequencing related to the process of empowerment. We defined genomic healthcare empowerment as follows: perceived ability to understand and seek new information related to the genomic sequencing, manage emotions related to the diagnostic process and outcomes, and utilize genomic sequencing information to the betterment of the individual/child and family. The GEmS consists of four scales, two are primarily emotion-focused (Meaning of a Diagnosis, and Emotional Management of the Process) and two are action-oriented (Seeking Information and Support, and Implications and Planning). The purpose of this research was to provide a strategy for interpreting results from the GEmS and present illustrative cases. These illustrations should serve to facilitate use of the GEmS in the clinical and research arena, particularly with respect to guiding genetic counseling processes for parents of children with undiagnosed conditions.
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Affiliation(s)
- Allyn McConkie-Rosell
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Kelly Schoch
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennifer Sullivan
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Rebecca C. Spillmann
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Heidi Cope
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Queenie K.-G. Tan
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Christina G. S. Palmer
- Department of Psychiatry and Biobehavioral Sciences, Department of Human Genetics, Institute for Society and Genetics, UCLA, Los Angeles, CA, USA
| | | | - Stephen R. Hooper
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Vandana Shashi
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
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13
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Brown KK, Smith J, Bailey TN, Ortiz G, Gu X, Tamplain P. Parent-Reported Motivators and Barriers to Participation in a Community-Based Intervention Designed for Children With Motor Skill Difficulties: A Qualitative Program Evaluation. Adapt Phys Activ Q 2022; 39:109-28. [PMID: 34740990 DOI: 10.1123/apaq.2020-0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Parents play a critical role in their child's participation in community-based intervention programs. Yet, their perspectives remain largely overlooked in the literature. This qualitative program evaluation used social cognitive theory to understand parents' motivators and barriers to participation in a community-based intervention program designed for children with motor skill difficulties. METHOD Parents (n = 15) of children with motor skill difficulties enrolled in a community-based intervention program participated in semistructured interviews. RESULTS Thematic analysis revealed six motivators (child needs, satisfaction, perceived impact, affordability, design, and program culture) and three perceived barriers (parent knowledge, access, and accommodations). DISCUSSION Parents' motivators and barriers reflected a combination of personal and environmental factors consistent with social cognitive theory. This study revealed novel insight into program-related environmental motivators and barriers. Program leaders should consider ongoing evaluation and application of parental perspectives to optimize family participation and retention in community-based interventions.
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14
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Piché‐Renaud P, Thibault L, Essouri S, Chainey A, Thériault C, Bernier G, Gaucher N. Parents' perspectives, information needs and healthcare preferences when consulting for their children with bronchiolitis: A qualitative study. Acta Paediatr 2021; 110:944-951. [PMID: 33006194 DOI: 10.1111/apa.15606] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/23/2020] [Accepted: 09/28/2020] [Indexed: 01/03/2023]
Abstract
AIM Bronchiolitis is the leading cause of hospitalisation in infants, but parental experiences have not been well described. This study explored parents' experiences and asked them how they wanted to receive information. METHODS A qualitative study was conducted in a tertiary paediatric hospital in Québec, Canada. It consisted of semi-structured interviews with 15 parents of 13 children with bronchiolitis. The interview guide was constructed by a multidisciplinary team that included a parent. The interviews, which were transcribed verbatim, were conducted until no new themes emerged. RESULTS We interviewed eight mothers, three fathers and two couples for 22-70 minutes: six were carried out in person during the bronchiolitis episode, and seven were phone interviews after a median interval time of 107 days. Parents were very worried about their child's health and their lack of knowledge about bronchiolitis contributed to their anxiety. They found education resources informative, but expressed a strong need for support and reassurance from healthcare teams. The two groups provided similar feedback, regardless of when they were interviewed or whether their child was admitted. CONCLUSION Although bronchiolitis is common in infancy, parental knowledge was low. Standardised educational tools were useful, but insufficient to meet all their needs.
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Affiliation(s)
| | | | - Sandrine Essouri
- Department of Paediatrics CHU Sainte‐Justine University of Montréal Montréal QC Canada
| | - Annik Chainey
- Parent Partner CHU Sainte‐Justine University of Montréal Montréal QC Canada
| | - Corinne Thériault
- Department of Paediatric Emergency Medicine CHU Sainte‐Justine University of Montréal Montréal QC Canada
| | - Gabrielle Bernier
- Department of Paediatric Emergency Medicine CHU Sainte‐Justine University of Montréal Montréal QC Canada
| | - Nathalie Gaucher
- Department of Paediatric Emergency Medicine CHU Sainte‐Justine University of Montréal Montréal QC Canada
- Clinical Ethics Unit CHU Sainte‐Justine Montréal QC Canada
- CHU Sainte‐Justine Research Center Montréal QC Canada
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15
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Felnhofer A, Bussek T, Goreis A, Kafka JX, König D, Klier C, Zesch H, Kothgassner OD. Mothers' and Fathers' Perspectives on the Causes of Their Child's Disorder. J Pediatr Psychol 2021; 45:803-811. [PMID: 32676645 DOI: 10.1093/jpepsy/jsaa056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Parental beliefs about the cause of their child's illness are thought to affect parents' help-seeking behaviors, treatment decisions, and the child's health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e.g., neurodevelopmental disorders), no study has compared disorders with differing physical versus mental conditions or with mixed comorbidities in children and adolescents or their caregivers. Furthermore, most pediatric research suffers from a lack of data on fathers. OBJECTIVE Hence, the objective of the current study was to test for possible differences in mothers' and fathers' perceptions about the etiology of their child's illness. METHODS Forty-two parent couples (overall N = 84) whose child had been diagnosed either with Attention Deficit Hyperactivity-Disorder (ADHD) or Autism Spectrum Disorder (ASD) (category "neurodevelopmental disorder") or with a primary physical illness and a comorbid mental disorder, e.g. depression (category "psychosomatic disorder") were asked to rate possible causes of their child's illness using a modified version of the revised Illness Perception Questionnaire (IPQ) Cause scale. RESULTS A two-way ANOVA showed that psychosomatic disorders were significantly more strongly attributed to be caused by medical and environmental stressors than neurodevelopmental disorders. A significant parent × illness category interaction revealed that this effect was more pronounced in fathers. CONCLUSIONS By providing first insights into parental beliefs about the etiology of their children's neurodevelopmental versus psychosomatic disorders, this study paves ground for future research and tailored counseling of affected families.
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Affiliation(s)
- Anna Felnhofer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna.,Comprehensive Center for Pediatrics, CCP, Medical University of Vienna
| | - Theresa Bussek
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna
| | - Andreas Goreis
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna.,Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna
| | - Johanna X Kafka
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna.,Comprehensive Center for Pediatrics, CCP, Medical University of Vienna
| | - Dorothea König
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna
| | - Claudia Klier
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna.,Comprehensive Center for Pediatrics, CCP, Medical University of Vienna
| | - Heidi Zesch
- Comprehensive Center for Pediatrics, CCP, Medical University of Vienna.,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna General Hospital
| | - Oswald D Kothgassner
- Comprehensive Center for Pediatrics, CCP, Medical University of Vienna.,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna General Hospital
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16
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Ferreira A, Ferretti E, Curtis K, Joly C, Sivanthan M, Major N, Daboval T. Parents' Views to Strengthen Partnerships in Newborn Intensive Care. Front Pediatr 2021; 9:721835. [PMID: 34646796 PMCID: PMC8504452 DOI: 10.3389/fped.2021.721835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Parental involvement in their newborn's neonatal intensive care reduces stress and helps with the parent-child attachment, transition to home, and future development. However, parents' perspectives are not often sought or considered when adapting family-centered care in neonatal intensive care units (NICUs). Aim: To identify what parents believe helps or hinders their involvement in their newborn's care when admitted to our Level 3B NICU. Methods: Between August and October 2018, nine mothers and one father were interviewed during three 60- to 90-min audiotaped focus groups using a semi-structured interview tool. From the content analysis of the verbatims, three reviewers identified key themes that affected how involved parents could be in their newborn's care. Results: Parents provided examples of factors that facilitated or restricted their involvement. The analysis identified themes: (1) parent-staff interactions, (2) supportive/trustworthy healthcare professionals, (3) consistency in care and caring staff, (4) family, couple, and peer support, (5) newborn status, (6) resources and education for parents, (7) the NICU environment, and (8) academic and research participation. Conclusion: We identified a conceptual framework to allow our NICU team to prioritize working strategies to strengthen parental involvement in newborn care. In addition to implementing ways to involve parents, we need to address parents' satisfaction with their participation. These findings may help other investigators explore parents' expectations toward their NICU experience.
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Affiliation(s)
- Alexie Ferreira
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Emanuela Ferretti
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | - Cynthia Joly
- Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Myuri Sivanthan
- Health Care Systems Division, Health Canada, Ottawa, ON, Canada.,Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Nathalie Major
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Thierry Daboval
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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17
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Viljoen M, Mahdi S, Shelly J, de Vries PJ. Parental perspectives of functioning in their children with autism spectrum disorder: A global scoping review. Autism 2020; 25:176-198. [PMID: 32862674 DOI: 10.1177/1362361320950055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT No paper to date has summarized parents' views on the functional challenges and/or strengths of their children with autism spectrum disorder. In this review we set out to perform a scoping review aiming to (a) find and compare existing research from around the globe on parental perception of functioning and (b) summarize results from these papers using the International Classification of Functioning Disability and Health-Child and Youth version framework. Since we know that the place and circumstances we live in can have a significant influence on our functioning in daily life, we were specifically interested in comparing perceptions from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English studies published between 1990 and June 2016. Papers were summarized and key findings were linked to International Classification of Functioning Disability and Health-Child and Youth categories. Thirty-three studies were identified, of which most were conducted in high-income countries (n = 25/33, 76%) with only six studies in low/middle-income countries (n = 6/33, 18%). Two studies compared views from low/middle-income and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health-Child and Youth framework while functional themes from low-/middle-income countries were mostly focused on environmental factors. It was difficult to directly compare studies from low/middle-income and high-income countries because they investigated and discussed such different parts of functioning. We suggest that future research should use an approach that will allow researchers to directly compare functional categories in order to get a more accurate impression of the impact of context on functioning.
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Affiliation(s)
| | | | - James Shelly
- Eastern Health Child & Youth Mental Health Service, Australia
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18
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Abstract
BACKGROUND Quality of life (QoL) is an important outcome variable while evaluating intervention effectiveness during adolescence. Limited studies have addressed the issues that affect the QoL in adolescents with cerebral palsy. The present study explores the parent-reported QoL in adolescents with cerebral palsy. MATERIALS AND METHODS Using a cross-sectional study design, parental perspectives on QoL were investigated among 35 parents of adolescents with cerebral palsy, aged between 13 and 18 years. Performance on seven domains of QoL across age and gender were explored. RESULTS While the maximum QoL was seen in the domain of social well-being, the least QoL was noted for feelings about functioning. Across age, the early adolescence group (13-15 years) had a poorer quality of life in comparison to the late adolescence group (16-18 years). With respect to the gender, though females had a lower QoL scores, a statistically significant difference was observed only for the domain of general well-being and participation. CONCLUSIONS From a parental perspective, the major issues of concern in adolescents with cerebral palsy were feelings about functioning, general well-being and participation, and access to services. This information will be useful when establishing management options or assessment protocols to improve their overall QoL.
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Affiliation(s)
- Prabhu Prajakta
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sunila John
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajashekhar Bellur
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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19
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Janvier A, Farlow B, Barrington KJ, Bourque CJ, Brazg T, Wilfond B. Building trust and improving communication with parents of children with Trisomy 13 and 18: A mixed-methods study. Palliat Med 2020; 34:262-271. [PMID: 31280664 DOI: 10.1177/0269216319860662] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Trisomy 13 and trisomy 18 are common life-limiting conditions associated with major disabilities. Many parents have described conflictual relationships with clinicians, but positive and adverse experiences of families with healthcare providers have not been well described. AIM (1) To investigate parental experiences with clinicians and (2) to provide practical recommendations and behaviors clinicians could emulate to avoid conflict. DESIGN Participants were asked to describe their best and worse experiences, as well as supportive clinicians they met. The results were analyzed using mixed methods. SETTING/PARTICIPANTS Parents of children with trisomy 13 and 18 who were part of online social support networks. A total of 503 invitations were sent, and 332 parents completed the questionnaire about 272 children. RESULTS The majority of parents (72%) had met a supportive clinician. When describing clinicians who changed their lives, the overarching theme, present in 88% of answers, was trust. Parents trusted clinicians when they felt he or she cared and valued their child, their family, and made them feel like good parents (69%), had appropriate knowledge (66%), and supported them and gave them realistic hope (42%). Many (42%) parents did not want to make-or be part of-life-and-death decisions. Parents gave specific examples of supportive behaviors that can be adopted by clinicians. Parents also described adverse experiences, generally leading to conflicts and lack of trust. CONCLUSION Realistic and compassionate support of parents living with children with trisomy 13 and 18 is possible. Adversarial interactions that lead to distrust and conflicts can be avoided. Many supportive behaviors that inspire trust can be emulated.
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Affiliation(s)
- Annie Janvier
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada.,Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada.,Clinical Ethics Unit and Palliative Care Unit, Sainte-Justine Hospital, Montreal, QC, Canada.,Unité de Recherche en Éthique Clinique et Partenariat Famille, Centre de Recherche, Hôpital Sainte-Justine, Montréal, QC, Canada
| | - Barbara Farlow
- The deVeber Institute for Bioethics and Social Research, North York, ON, Canada.,Patients for Patient Safety Canada, Edmonton, AB, Canada
| | - Keith J Barrington
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada.,Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Claude Julie Bourque
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada.,Unité de Recherche en Éthique Clinique et Partenariat Famille, Centre de Recherche, Hôpital Sainte-Justine, Montréal, QC, Canada
| | - Tracy Brazg
- Ethics Consultation Service, University of Washington Medical Center, Washington, DC, USA
| | - Benjamin Wilfond
- Truman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute and Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
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20
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Tryfon M, Anastasia A, Eleni R. Parental perspectives on inclusive education for children with intellectual disabilities in Greece. Int J Dev Disabil 2019; 67:420-428. [PMID: 34925772 PMCID: PMC8676702 DOI: 10.1080/20473869.2019.1675429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/28/2019] [Accepted: 09/29/2019] [Indexed: 06/14/2023]
Abstract
The current study explores the parental perspectives of children with intellectual disabilities (ID) on the effectiveness of inclusive education in Greek mainstream schools. The participants were 83 parents, whose children had different degrees of ID and all of them were attending mainstream schools at the time of the study. They completed a questionnaire examining their perspectives with regard to (a) the most effective educational placement in mainstream schools (special class, mainstream class or co-teaching), (b) their satisfaction with the inclusive mainstream education, (c) their cooperation with the teachers, (d) the perceived benefits of their children's educational placement and (e) their suggestions regarding the improvement of the inclusive educational model. Results indicated that most parents of children with ID would like their child to attend a mainstream class with a co-teaching arrangement. The perceived benefits are mostly related to the development of their children's social skills. Significant considerations regarding cooperation with the teachers, lack of individualized information and guidance, administrative and organizational issues were expressed.
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Affiliation(s)
- Mavropalias Tryfon
- Faculty of Education, Department of Elementary Education, Florina, Greece
| | | | - Rachanioti Eleni
- Faculty of Education, Department of Early Childhood Education, Florina, Greece
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McConkie-Rosell A, Schoch K, Sullivan J, Cope H, Spillmann R, Palmer CGS, Pena L, Jiang YH, Daniels N, Walley N, Tan KG, Hooper SR, Shashi V. The genome empowerment scale: An assessment of parental empowerment in families with undiagnosed disease. Clin Genet 2019; 96:521-531. [PMID: 31448412 DOI: 10.1111/cge.13635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/12/2019] [Accepted: 07/31/2019] [Indexed: 12/19/2022]
Abstract
While genomic sequencing (ES/GS) has the potential to diagnose children with difficult to diagnose phenotypes, the goal should be not only a diagnosis, but also to empower parents to seek next steps for their children and to emotionally manage the outcome, whether or not a diagnosis is secured. To help achieve this goal, objective measures are needed to assess the process of parental empowerment related to genome sequencing. We present the validity and reliability of the Genome Empowerment Scale (GEmS), developed using a healthcare empowerment theoretical model. To evaluate its psychometric properties, 158 parents of 117 children with an undiagnosed condition undergoing genomic sequencing completed the GEmS, measures for criterion validity and for depression and anxiety. Factor analysis resulted in a four factor solution: (a) meaning of a diagnosis; (b) emotional management of the process; (c) seeking information and support and (d) implications and planning. Reliability and validity analyses show that the GEmS has good psychometric properties. The inter-relationships among the factors revealed a profile that may identify parents at risk for a poorer outcome who may benefit from targeted genetic counseling. The GEmS, an objective measure of parental genomic empowerment, can be utilized for future research and translational applications.
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Affiliation(s)
- Allyn McConkie-Rosell
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Kelly Schoch
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Jennifer Sullivan
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Heidi Cope
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Rebecca Spillmann
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Christina G S Palmer
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, California
| | - Loren Pena
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine
| | - Yong-Hui Jiang
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Nicole Daniels
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Nicole Walley
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
| | - Khoon G Tan
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
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- Undiagnosed Diseases Network, NIH Common Fund, Bethesda, Maryland
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Vandana Shashi
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina
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Giroux CM, Wilson LA, Corkett JK. Parents as partners: investigating the role(s) of mothers in coordinating health and education activities for children with chronic care needs. J Interprof Care 2018; 33:243-251. [PMID: 30303428 DOI: 10.1080/13561820.2018.1531833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Interprofessional collaboration (IPC) between health professionals, and educators is an essential component of academic success and well-being for children who experience chronic illnesses. This study sought to understand parents' roles in and perceptions of IPC between their child's healthcare professionals and educators. We recruited 23 mothers to participate in our study. Data were analyzed using a combination of univariate analyses and content analysis. Overall, parents reported that they could effectively communicate their child's health and educational needs with health and educational professionals, but statistical analysis determined moderately increased challenges presenting information across professions. Most participants (n = 19) indicated that IPC between health and educational professionals could be improved. Effectively engaging parents as partners in IPC can promote more seamless collaboration and communication of a child's needs and offer a greater likelihood of achieving a child's health and educational goals.
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Affiliation(s)
| | - Lindsay A Wilson
- b School of Epidemiology, Public Health, and Preventative Medicine , University of Ottawa , Canada
| | - Julie K Corkett
- c Schulich School of Education , Nipissing University , North Bay , Canada
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Abstract
The 2010 Pediatric Research in Inpatient Settings survey stated that 44% of pediatric hospitals practiced family-centered rounds (FCRs). We aimed to study caregivers' opinions of FCRs and determine if there are demographic associations with these opinions. A cross-sectional survey of caregivers who attended FCRs was conducted at a tertiary-care general pediatrics unit. The survey contained Likert-type scale and qualitative questions. Fisher's exact test was used to test demographic associations. Only English proficient caregivers were included. Almost all (99%) caregivers liked being present during rounds, 19% felt that there were too many people present during rounds and 15% felt that medical jargon was used. Significant demographic associations were found including older caregivers being less comfortable asking questions as well as more neutral responses from African Americans and those with less education. Opportunity exists to customize FCRs and tailor rounding according to demographics, opening the door for future quality improvement projects.
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Affiliation(s)
- Ayesha Ahmed
- 1 Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Dorothy Chu
- 1 Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Susan Wang
- 1 Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
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DeCourcey DD, Silverman M, Oladunjoye A, Balkin EM, Wolfe J. Patterns of Care at the End of Life for Children and Young Adults with Life-Threatening Complex Chronic Conditions. J Pediatr 2018; 193:196-203.e2. [PMID: 29174080 DOI: 10.1016/j.jpeds.2017.09.078] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/14/2017] [Accepted: 09/27/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To characterize patterns of care at the end of life for children and young adults with life-threatening complex chronic conditions (LT-CCCs) and to compare them by LT-CCC type. STUDY DESIGN Cross-sectional survey of bereaved parents (n = 114; response rate of 54%) of children with noncancer, noncardiac LT-CCCs who received care at a quaternary care children's hospital and medical record abstraction. RESULTS The majority of children with LT-CCCs died in the hospital (62.7%) with more than one-half (53.3%) dying in the intensive care unit. Those with static encephalopathy (AOR, 0.19; 95% CI, 0.04-0.98), congenital and chromosomal disorders (AOR, 0.28; 95% CI, 0.09-0.91), and pulmonary disorders (AOR, 0.08; 95% CI, 0.01-0.77) were significantly less likely to die at home compared with those with progressive central nervous system (CNS) disorders. Almost 50% of patients died after withdrawal or withholding of life-sustaining therapies, 17.5% died during active resuscitation, and 36% died while receiving comfort care only. The mode of death varied widely across LT-CCCs, with no patients with pulmonary disorders dying receiving comfort care only compared with 66.7% of those with CNS progressive disorders. A majority of patients had palliative care involvement (79.3%); however, in multivariable analyses, there was distinct variation in receipt of palliative care across LT-CCCs, with patients having CNS static encephalopathy (AOR, 0.07; 95% CI, 0.01-0.68) and pulmonary disorders (AOR, 0.07; 95% CI, 0.01-.09) significantly less likely to have palliative care involvement than those with CNS progressive disorders. CONCLUSIONS Significant differences in patterns of care at the end of life exist depending on LT-CCC type. Attention to these patterns is important to ensure equal access to palliative care and targeted improvements in end-of-life care for these populations.
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Antiel RM, Janvier A, Feudtner C, Blaine K, Fry J, Howell LJ, Houtrow AJ. The experience of parents with children with myelomeningocele who underwent prenatal surgery. J Pediatr Rehabil Med 2018; 11:217-225. [PMID: 30507587 DOI: 10.3233/prm-170483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prenatal surgery for myelomeningocele (MMC) has been demonstrated to have benefits over postnatal surgery. Nevertheless, prenatal surgery requires a significant emotional, physical, and financial commitment from the entire family. METHODS Mixed methods study of parents' perceptions regarding provider communication, treatment choices, and the family impact of having a child with MMC. RESULTS Parents of children with MMC (n= 109) completed questionnaires. Parents were well informed and reported gathering information about prenatal surgery from a wide range of sources. After a fetal diagnosis of MMC, most learned about their options from their obstetrician, although one-third were not told about the option of prenatal surgery. About one-fourth of these parents felt pressure to undergo one particular option. Half of parents said that having a child with MMC has had a positive impact on them and their family, while the other half indicated that having a child with MMC has had both positive and negative impacts. The most commonly noted positive impacts were changes in parental attitudes, as well as having new opportunities and relationships. The most frequently reported negative impacts concerned relational and financial strain. The vast majority of parents indicated that they would still undergo prenatal surgery if they could travel back in time with their present knowledge. CONCLUSIONS A better understanding of the parental experiences and perspectives following prenatal surgery will play an important role in providing overall support for parents and family members.
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Affiliation(s)
- Ryan M Antiel
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Annie Janvier
- Department of Pediatrics and Clinical Ethics, University of Montreal, Neonatology, Clinical Ethics, Palliative Care, Sainte-Justine Hospital, and Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | - Chris Feudtner
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jessica Fry
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, and Division of Neonatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Lori J Howell
- Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amy J Houtrow
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
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