Perspectives and experiences of parents of children with juvenile dermatomyositis: a semi-structured interview study.

IF 2.8 3区 医学 Q1 PEDIATRICS
Amy Helen Kelly, Ayano Kelly, Davinder Singh-Grewal, Jeffrey Chaitow, Allison Jaure
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引用次数: 0

Abstract

Background: Juvenile Dermatomyositis (JDM) is a rare, childhood inflammatory disease and its management can be challenging and confronting for both clinicians and caregivers. Little is known about the perspectives of parental caregivers of children with JDM. This study aimed to describe the experiences of parents of children with JDM to inform person-centred care.

Methods: Semi-structured interviews (face-to-face, telephone) were conducted with parents of children with JDM from three centres in Australia. Transcripts were analysed thematically.

Results: Nineteen parents (15 mothers) of 17 children aged 8 to 21 with JDM participated. Six themes were identified. Rapid crescendo of fear and desperation (alarming deterioration, sudden realisation of seriousness, desperate for a diagnosis ), lost and unsupported in the health system (at the mercy of the medical team, frustrated at the lack of services, neglected priorities, protracted and painful search for answers), disrupting family routines (sibling neglect and loss, overloaded with a medicalised schedule, always on standby, burdened by financial strains), grieving what has been lost (missing the sunlight, struggling with the loss of physical function, disrupted schooling, changes in their child from steroid side effects), managing an uncertain future (bound to chronicity, fearing relapse, insecurity with transition to adult care), gaining confidence and motivation (strengthening partnerships with clinicians, growing maturity and independence, gaining hope from shared experiences).

Conclusions: The diagnosis of JDM is often delayed and caregivers of children with JDM report distress, disruption and uncertainty throughout their treatment journey with their child. Addressing these fears and establishing support mechanisms that help parents navigate their way through the medical system and support changing family dynamics are vital to optimise health outcomes for children diagnosed with JDM.

幼年皮肌炎患儿家长的观点和经验:半结构式访谈研究。
背景:青少年皮肌炎(JDM)是一种罕见的儿童炎症性疾病,其管理对临床医生和护理人员来说都是具有挑战性的。关于JDM儿童的父母照顾者的观点知之甚少。本研究旨在描述患有JDM儿童的父母的经验,以告知以人为本的护理。方法:对来自澳大利亚三个中心的JDM儿童的父母进行半结构化访谈(面对面,电话)。转录本按主题进行分析。结果:17例8 ~ 21岁JDM患儿的19位家长(15位母亲)参与调查。确定了六个主题。恐惧和绝望迅速加剧(病情恶化到令人震惊的程度,突然意识到病情的严重性,迫切需要诊断),失去医疗系统的支持和支持(任由医疗团队摆布,对缺乏服务感到沮丧,忽视优先事项,漫长而痛苦地寻找答案),扰乱家庭常规(兄弟姐妹被忽视和失去,医疗安排超负荷,随时待命,承受经济压力),为失去的东西而悲伤(失去阳光、与身体机能丧失作斗争、学业中断、孩子因类固醇副作用而发生变化)、管理不确定的未来(与慢性疾病有关、担心复发、过渡到成人护理的不安全感)、获得信心和动力(加强与临床医生的合作、日益成熟和独立、从分享的经历中获得希望)。结论:JDM的诊断经常被延迟,JDM儿童的照顾者在整个治疗过程中报告了痛苦、干扰和不确定性。消除这些恐惧,建立支持机制,帮助父母在医疗系统中导航,支持不断变化的家庭动态,对于优化诊断为JDM的儿童的健康结果至关重要。
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来源期刊
Pediatric Rheumatology
Pediatric Rheumatology PEDIATRICS-RHEUMATOLOGY
CiteScore
4.10
自引率
8.00%
发文量
95
审稿时长
>12 weeks
期刊介绍: Pediatric Rheumatology is an open access, peer-reviewed, online journal encompassing all aspects of clinical and basic research related to pediatric rheumatology and allied subjects. The journal’s scope of diseases and syndromes include musculoskeletal pain syndromes, rheumatic fever and post-streptococcal syndromes, juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, local and systemic scleroderma, Kawasaki disease, Henoch-Schonlein purpura and other vasculitides, sarcoidosis, inherited musculoskeletal syndromes, autoinflammatory syndromes, and others.
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