Factors Involved in Decision-Making Dilemmas Faced by Parents of Children with Severe Asthma in PICU During the Development of Discharge Care Plans: A Phenomenological Study

IF 3.7 3区医学 Q2 ALLERGY

Journal of Asthma and Allergy Pub Date : 2023-12-27 DOI:10.2147/jaa.s438318

Guimei Fan, Mo Yi, Xiangmin Qiu, Jinfang Zhao

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Abstract

Purpose: This study aims to explore the complicated decision-making dilemma and challenges confronted by parents of children suffering from severe asthma within the Pediatric Intensive Care Unit (PICU) when participating in the development of their children’s discharge care plans.
Patients and Methods: Employing a phenomenological methodology, a purposive sampling was performed to engage with 17 parents who participated in in-depth and semi-structured interviews between October 2022 and February 2023. The transcripts of these interviews were transcribed into textual data, which was then subjected to Colaizzi’s seven-step analysis for meticulous coding and comprehensive thematic elucidation.
Results: The comprehensive analysis of the factors involved in the intricate decision-making dilemmas faced by parents of children with severe asthma during the process of crafting discharge care plans in the PICU revealed five themes and eight sub-themes: 1) Complexity of asthma-related information; 2) Insufficient provision of comprehensive decision-making support; 3) Encountering negative emotions and wavering confidence; 4) Navigating realistic constraints impacting both parents and HCPs; 5) Balancing the advantages and disadvantages of various plans.
Conclusion: Parents of children with severe asthma in the PICU encounter intricate and multifaceted decision-making dilemmas while engaging in the formulation of discharge care plans. These complexities significantly dampen their decision-making enthusiasm and introduce potential risks to the children’s prognosis and recovery. In the future, it is imperative to leverage the guidance provided by healthcare professionals (HCPs) in the decision-making process, develop tailored decision support tools specifically designed for the formulation of discharge care plans for children with severe asthma in the PICU.

Keywords: severe asthma, parents, discharge care plan, decision-making dilemma, phenomenological study

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PICU 重症哮喘患儿家长在制定出院护理计划过程中面临的决策困境所涉及的因素：现象学研究

研究目的：本研究旨在探讨儿科重症监护室（PICU）中严重哮喘患儿的家长在参与制定患儿出院护理计划时所面临的复杂决策困境和挑战：采用现象学方法，有目的的抽样调查了17位家长，他们在2022年10月至2023年2月期间参加了深入的半结构化访谈。访谈记录被转录为文本数据，然后经过科莱兹的七步分析法进行细致编码和全面的主题阐释：对重症哮喘患儿家长在 PICU 制定出院护理计划过程中面临的错综复杂的决策困境所涉及的因素进行的综合分析揭示了五个主题和八个次主题：1）哮喘相关信息的复杂性；2）提供的综合决策支持不足；3）遭遇负面情绪和信心动摇；4）应对影响家长和 HCP 的现实限制；5）平衡各种计划的利弊：结论：PICU 重症哮喘患儿的家长在参与制定出院护理计划时会遇到错综复杂、多方面的决策困境。这些复杂性极大地挫伤了他们的决策热情，并为患儿的预后和康复带来了潜在风险。未来，必须充分利用医护人员（HCPs）在决策过程中提供的指导，开发量身定制的决策支持工具，专门用于制定PICU重症哮喘患儿的出院护理计划。关键词：重症哮喘；家长；出院护理计划；决策困境；现象学研究

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Asthma and Allergy Medicine-Immunology and Allergy

CiteScore

5.30

自引率

6.20%

发文量

185

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.