Meaning-Making Among Parents of Children With Severe Neurologic Impairment in the PICU

Author:

Bogetz Jori F.12,Oslin Ellie1,O’Donnell Maeve3,Barton Krysta S.4,Yi-Frazier Joyce P.3,Watson R. Scott5,Rosenberg Abby R.6

Affiliation:

1. aDivisions of Bioethics and Palliative Care

2. bTreuman Katz Center for Bioethics

3. cCenter for Clinical and Translational Research

4. dBiostatistics Epidemiology and Analytics for Research (BEAR) Core, Seattle Children’s Research Institute; Seattle, Washington

5. eDivision of Critical Care, Department of Pediatrics, University of Washington School of Medicine; Seattle, Washington

6. fDivision of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute; Department of Pediatrics, Boston Children’s Hospital; Department of Pediatrics, Harvard Medical School; Boston, Massachusetts

Abstract

BACKGROUND AND OBJECTIVES Parents and family caregivers of children with severe neurologic impairment (SNI) experience many stressors, especially during their child’s critical illness. This study aimed to examine parent experiences around the time of their child’s PICU care to explore ways parents make meaning in relation to these stressors. METHODS This qualitative study of data from a single center in the United States followed Consolidated Criteria for Reporting Qualitative Research guidelines. One to one semistructured interviews queried parents’ psychosocial well-being around the time of their child’s PICU care. Eligible participants had a child with an SNI condition for >3 months admitted to the PICU for >24 hours with an expected length of stay >1 week. RESULTS Data were analyzed by a research team with expertise in palliative care, psychology, critical care, and qualitative methods. Fifteen family caregivers of 15 children participated. Children were a median of 8 years old (interquartile range 4–11.5) and 80% (n = 12) had congenital/genetic conditions. Parent/family caregivers were a median age of 39 years old (interquartile range 36–42.5); 20% (n = 3) self-identified as fathers and 47% (n = 7) as having to a minority racial background. Parents discussed ongoing meaning-making that occurred through domains of comprehension and purpose, and themes of understanding of other people and the world around them. Subthemes focused on appreciation/acceptance, adaptability/accountability, valuing all lives, and learning/teaching about their child. CONCLUSIONS Meaning-making may be an opportunity for support in the PICU among parents/family caregivers of children with SNI.

Publisher

American Academy of Pediatrics (AAP)

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