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Bereaved Parents More Satisfied With the Care Given to Their Child With Severe Spinal Muscular Atrophy Than Nonbereaved
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.ORCID iD: 0000-0001-9798-0276
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.ORCID iD: 0000-0002-8185-781X
Karolinska institutet.
National Rehabilitation Center for Neuromuscular Diseases (RCFM), Aarhus, Denmark.
Show others and affiliations
2019 (English)In: Journal of Child Neurology, ISSN 0883-0738, E-ISSN 1708-8283, Vol. 34, no 2, p. 104-112Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS:: Children with severe spinal muscular atrophy have complex care needs due to progressive muscle weakness, eventually leading to respiratory failure. To design a care system adapted to families' needs, more knowledge about parents' experience of care and its coordination between settings is required. This study explores (1) whether parents felt that health professionals took every opportunity to help the child feel as good as possible, (2) parents' satisfaction with various care settings, and (3) parents' satisfaction with coordination between settings.

METHODS:: Data derive from nationwide Swedish and Danish surveys of bereaved and nonbereaved parents of children with severe spinal muscular atrophy born between 2000 and 2010 in Sweden and 2003 and 2013 in Denmark (N = 95, response rate = 84%). Descriptive statistics and content analysis were used.

RESULTS:: Although most of the parents reported that care professionals had taken every opportunity to help the child feel as good as possible, one-third reported the opposite. Bereaved parents were significantly more satisfied with care than nonbereaved (81% vs 29%). The children received care at many different locations, for all of which parents rated high satisfaction. However, some were dissatisfied with care coordination, describing lack of knowledge and communication among staff, and how they as parents had to take the initiative in care management.

CONCLUSIONS:: This study highlights the importance of improving disease-specific competence, communication and knowledge exchange among staff. For optimal care for these children and families, parents should be included in dialogues on care and staff should be more proactive and take care management initiatives.

Place, publisher, year, edition, pages
2019. Vol. 34, no 2, p. 104-112
Keywords [en]
Care coordination, Health care professional, Neuromuscular disease, Parental perception, Pediatric palliative care, Spinal muscular atrophy
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-7299DOI: 10.1177/0883073818811544ISI: 000454940800008PubMedID: 30518279OAI: oai:DiVA.org:esh-7299DiVA, id: diva2:1288017
Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2023-08-24Bibliographically approved
In thesis
1. Experiences of care and everyday life in a time of change for families in which a child has spinal muscular atrophy
Open this publication in new window or tab >>Experiences of care and everyday life in a time of change for families in which a child has spinal muscular atrophy
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on children with severe spinal muscular atrophy (SMA) and their families. Although the disease is severe, and the families are faced with challenges in everyday life related to the progressive muscle weakness that SMA causes, knowledge of their experiences of the situation is limited. The overall purpose of this thesis was therefore to explore how families, with a child who has SMA, experience the care received and their everyday life.The thesis encompasses two projects: a two-nationwide survey with 95 bereaved and non-bereaved parents (response rate of 84%) and an ethnographical study with two families (17 interviews and participant observations at six occasions).The findings showed that parents were generally pleased with the care their children received. However, there were some shortcomings, especially that staff lacked knowledge about the diagnosis, leading the parents to feel that they themselves had to take initiatives for measurements and treatments (Paper II).Further, the parents reported deficiencies in coordination between care providers (Papers I–II). The parents emphasised the importance of having a good relationship with staff (Paper II), to find ways to cope with everyday life and get practical support in everyday activities, as well as social support in dealing with disease and grief (Paper III). With the new medicine for SMA, the families’narratives were rewritten, and the families were facing slow improvements; small events that made a big difference. Hope was negotiated and struggled with indifferent ways by different family members, but contributed to how they dealt with the disease and the outlook on the future (Paper IV).Many of the experiences described by the families can be useful for professionals in modifying their work to support these families in accordance with their needs.

Place, publisher, year, edition, pages
Stockholm: Ersta Sköndal Bräcke University College, 2020. p. 117
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 7
Keywords
Spinal muscular atrophy, family, advice, paediatric palliative care, health care professional, parental perception, hope, resilience
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
urn:nbn:se:esh:diva-8293 (URN)978-91-985808-5-3 (ISBN)
Public defence
2020-09-25, Aulan, Campus Ersta,, 09:30
Opponent
Supervisors
Available from: 2020-08-31 Created: 2020-08-17 Last updated: 2023-09-22

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Hjorth, ElinKreicbergs, UlrikaLövgren, Malin

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