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What can make things better for parents when babies need abdominal surgery in their first year of life? A qualitative interview study in the UK

Abstract:
Objectives To understand the experiences of parents of infants who required surgery early in life. To identify messages and training needs for the extended clinical teams caring for these families—including paediatric surgeons, neonatologists, nurses, obstetricians, midwives and sonographers. Setting UK-wide interview study, including England, Wales and Scotland. Participants In-depth interviews were conducted with 44 parents who had a baby who underwent early abdominal surgery. Conditions included those diagnosed antenatally (eg, exomphalos, gastroschisis, congenital diaphragmatic hernia) or those which were detected postnatally (eg, Hirschsprung’s disease, necrotising enterocolitis). Interviews were video and audio recorded and analysed using a modified grounded-theory approach. Results While some parents reported experiencing excellent communication and felt they were listened to and involved by the care team, this was not always the case. Dealing with large, complex medical and surgical teams could result in conflicting messages, uncertainty and distress. Parents wanted information but also described being overwhelmed and wanting to distance themselves to maintain hope. Information and support from other parents in hospital and online groups were highly valued. Of particular concern was support when going home and caring for their baby after discharge; an open access policy for readmission offered a helpful safety net. Conclusions Listening to the experience of parents provides rich data to enhance clinical understandings on how to improve information and communication with parents, and ameliorate the deep and lasting distress and anxiety that some parents feel when their infants face early surgery. We suggest that the writings of Bourdieu could have resonance in interpreting the experiences of parents as they enter the world of highly technical neonatal medicine and surgery and the knowledge of the professionals who work in these environments.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjopen-2017-020921

Authors


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Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Primary Care Health Sciences; PHC-Herg
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0002-1984-4575


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
8
Issue:
6
Article number:
e020921
Publication date:
2018-06-30
Acceptance date:
2018-05-24
DOI:
ISSN:
2044-6055


Pubs id:
pubs:853725
UUID:
uuid:5d820386-22b9-42ae-96bb-0e25f1323cf3
Local pid:
pubs:853725
Source identifiers:
853725
Deposit date:
2018-05-24

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