The experience of caregiving for children with rare musculoskeletal conditions: a qualitative study in arthrogryposis multiplex congenita.


Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
14 Jun 2024
Historique:
received: 08 11 2023
accepted: 19 05 2024
medline: 15 6 2024
pubmed: 15 6 2024
entrez: 14 6 2024
Statut: epublish

Résumé

Arthrogryposis multiplex congenita (AMC) is a group of rare musculoskeletal conditions that is associated with complex healthcare needs and long-term follow up. The literature reports significant direct, indirect, and psychosocial costs for caregivers of children with neuromuscular conditions. Due to mobility limitations and frequent hospital visits, caring for a child with AMC is complex. Other challenges experienced by caregivers include financial strain, job changes, changes in interpersonal relationships and abandonment. This study was aimed at exploring the lived experience of caregivers of children with AMC. The present study is part of a larger global mixed methods study. In the initial quantitative aspect of the study, caregivers (n = 158) of children and youths with AMC (aged 0-21 years) responded to a cost of care survey on an electronic platform. Of the 158 participants, 13 caregivers then further consented to participate in the qualitative aspect of the study in which a 60-min semi-structured, individual interview was conducted remotely. Open-ended questions were developed to gain a deeper understanding of the direct and indirect costs of care, their impact on the caregivers' lives and the quality of the care-giving experience. Interviews were transcribed, and a coding scheme was developed drawing from both the existing literature and the content of the interviews. A deductive and inductive thematic analysis was used to analyze the qualitative data using the NVivo® qualitative data analysis software. Five themes describing the experiences of caregivers of children with AMC emerged from the analysis of the qualitative data: 1. Impact of the caregiving experience; 2. Cost of childcare; 3. Support system for care; 4. Managing and navigating care; 5. Supporting the child's growth and development. In addition to the results of the thematic analysis, specific recommendations shared by the caregivers included the need for support groups and provision of support to youths to prepare them for adolescence. These findings will inform resource allocation, policymaking, and support services for children with rare conditions, their caregivers and families.

Sections du résumé

BACKGROUND BACKGROUND
Arthrogryposis multiplex congenita (AMC) is a group of rare musculoskeletal conditions that is associated with complex healthcare needs and long-term follow up. The literature reports significant direct, indirect, and psychosocial costs for caregivers of children with neuromuscular conditions. Due to mobility limitations and frequent hospital visits, caring for a child with AMC is complex. Other challenges experienced by caregivers include financial strain, job changes, changes in interpersonal relationships and abandonment. This study was aimed at exploring the lived experience of caregivers of children with AMC.
METHODS METHODS
The present study is part of a larger global mixed methods study. In the initial quantitative aspect of the study, caregivers (n = 158) of children and youths with AMC (aged 0-21 years) responded to a cost of care survey on an electronic platform. Of the 158 participants, 13 caregivers then further consented to participate in the qualitative aspect of the study in which a 60-min semi-structured, individual interview was conducted remotely. Open-ended questions were developed to gain a deeper understanding of the direct and indirect costs of care, their impact on the caregivers' lives and the quality of the care-giving experience. Interviews were transcribed, and a coding scheme was developed drawing from both the existing literature and the content of the interviews. A deductive and inductive thematic analysis was used to analyze the qualitative data using the NVivo® qualitative data analysis software.
RESULTS AND CONCLUSION CONCLUSIONS
Five themes describing the experiences of caregivers of children with AMC emerged from the analysis of the qualitative data: 1. Impact of the caregiving experience; 2. Cost of childcare; 3. Support system for care; 4. Managing and navigating care; 5. Supporting the child's growth and development. In addition to the results of the thematic analysis, specific recommendations shared by the caregivers included the need for support groups and provision of support to youths to prepare them for adolescence. These findings will inform resource allocation, policymaking, and support services for children with rare conditions, their caregivers and families.

Identifiants

pubmed: 38877508
doi: 10.1186/s13023-024-03224-8
pii: 10.1186/s13023-024-03224-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

235

Subventions

Organisme : Fonds de Recherche du Québec - Santé
ID : Junior 1: 2019-2023
Organisme : Fonds de Recherche du Québec - Santé
ID : #267793; Junior 2: 2023-2027
Organisme : Fonds de Recherche du Québec - Santé
ID : #329833

Informations de copyright

© 2024. The Author(s).

Références

Perrin JM. health services research for children with disabilities. Milbank Q. 2002;80(2):303–24.
doi: 10.1111/1468-0009.t01-1-00005 pubmed: 12101874 pmcid: 2690116
Murphy NA, Christian B, Caplin DA, Young PC. The health of caregivers for children with disabilities: caregiver perspectives. Child Care Health Dev. 2007;33(2):180–7.
doi: 10.1111/j.1365-2214.2006.00644.x pubmed: 17291322
Talley RC, Crews JE. Framing the public health of caregiving. Am J Public Health. 2007;97(2):224–8.
doi: 10.2105/AJPH.2004.059337 pubmed: 17194871 pmcid: 1781412
Hoffman D, Zucker H. A call to preventive action by health care providers and policy makers to support caregivers. Preventing Chronic Disease. 2016;13.
Centers for Disease Control and Prevention (2019, July 30). Caregiving for family and friends – a public health issue. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/caregiving/caregiver-brief.html . accessed 15th of July 2023.
Honea NJ, Brintnall R, Given B, Sherwood P, Colao DB, Somers SC, Northouse LL. Putting Evidence into Practice®: Nursing Assessment and Interventions to Reduce Family Caregiver Strain and Burden. Clin J Oncol Nurs. 2008;12(3):507–16.
doi: 10.1188/08.CJON.507-516 pubmed: 18515250
Brehaut JC, Kohen DE, Garner RE, Miller AR, Lach LM, Klassen AF, Rosenbaum PL. Health among caregivers of children with health problems: findings from a Canadian population-based study. Am J Public Health. 2009;99(7):1254–62.
doi: 10.2105/AJPH.2007.129817 pubmed: 19059861 pmcid: 2696656
Kelly AF, Hewson PH. Factors associated with recurrent hospitalization in chronically ill children and adolescents. J Paediatr Child Health. 2000;36(1):13–8.
doi: 10.1046/j.1440-1754.2000.00435.x pubmed: 10723684
Bromley BE, Blacher J. Parental reasons for out-of-home placement of children with severe handicaps. Ment Retard. 1991;29(5):275.
pubmed: 1836031
Landfeldt E, Lindgren P, Bell CF, Guglieri M, Straub V, Lochmüller H, Bushby K. Quantifying the burden of caregiving in Duchenne muscular dystrophy. J Neurol. 2016;263:906–15.
doi: 10.1007/s00415-016-8080-9 pubmed: 26964543 pmcid: 4859858
Ismail A, Sk Abd Razak R, Suddin LS, Mahmud A, Kamaralzaman S, Yusri G. The economic burden and determinant factors of parents/caregivers of children with cerebral palsy in Malaysia: a mixed methods study. Int J Environ Res Public Health. 2022;19(1):475.
doi: 10.3390/ijerph19010475 pubmed: 35010732 pmcid: 8744799
Wang B, Chen Y, Zhang J, Li J, Guo Y, Hailey D. A preliminary study into the economic burden of cerebral palsy in China. Health Policy. 2008;87(2):223–34.
doi: 10.1016/j.healthpol.2008.01.001 pubmed: 18282633
Hill CL, Baird WO, Walters SJ. Quality of life in children and adolescents with Osteogenesis Imperfecta: a qualitative interview-based study. Health Qual Life Outcomes. 2014;12(1):1–9.
doi: 10.1186/1477-7525-12-54
Manalel JA, Sumrall S, Davidson H, Grewal M, Granovetter MA, Koehly LM. Stress, coping, and positive aspects of caregiving among caregivers of children with rare diseases. Psychology & Health. 2022:1–7.
Pelentsov LJ, Laws TA, Esterman AJ. The supportive care needs of parents caring for a child with a rare disease: a scoping review. Disabil Health J. 2015;8(4):475–91.
doi: 10.1016/j.dhjo.2015.03.009 pubmed: 25959710
Dahan-Oliel N, Cachecho S, Barnes D, et al. International multidisciplinary collaboration toward an annotated definition of arthrogryposis multiplex congenita. Am J Med Genet Part C. 2019;181C:288–99. https://doi.org/10.1002/ajmg.c.31721 .
doi: 10.1002/ajmg.c.31721
Lowry RB, Sibbald B, Bedard T, Hall JG. Prevalence of multiple congenital contractures including arthrogryposis multiplex congenita in Alberta, Canada, and a strategy for classification and coding. Birth Defects Res A. 2010;88(12):1057–61. https://doi.org/10.1002/bdra.20738 .
doi: 10.1002/bdra.20738
Hall JG. Arthrogryposis multiplex congenita: etiology, genetics, classification, diagnostic approach, and general aspects. Journal of Pediatric Orthopedics B. 1997;6(3):159–66.
doi: 10.1097/01202412-199707000-00002
Dai S, Dieterich K, Jaeger M, Wuyam B, Jouk PS, Pérennou D. Disability in adults with arthrogryposis is severe, partly invisible, and varies by genotype. Neurology. 2018;90(18):e1596–604.
doi: 10.1212/WNL.0000000000005418 pubmed: 29626181
Steen U, Wekre LL, Vøllestad NK. Physical functioning and activities of daily living in adults with amyoplasia, the most common form of arthrogryposis. A cross-sectional study Disability and rehabilitation. 2018;40(23):2767–79.
doi: 10.1080/09638288.2017.1357211 pubmed: 28738752
Elfassy C, Darsaklis VB, Snider L, Gagnon C, Hamdy R, Dahan-Oliel N. (2020) Rehabilitation needs of youth with arthrogryposis multiplex congenita: Perspectives from key stakeholders. Disabil Rehabil. 2020;42(16):2318–24.
doi: 10.1080/09638288.2018.1559364 pubmed: 30741031
Mody KS, Henstenburg J, Herman MJ. The Health & Economic Disparities of Congenital Musculoskeletal Disease Worldwide: An Analysis of 25 Years (1992–2017). Global Pediatric Health. 2021;8:2333794X21994998.
Braun V, Clarke V. Thematic analysis. American Psychological Association; 2012.
Locke K, Feldman M, Golden-Biddle K. Coding practices and Iteratively: Beyond templates for analyzing qualitative data. Organ Res Methods. 2022;25(2):262–84.
doi: 10.1177/1094428120948600
Miles MB, Huberman AM. Qualitative data analysis: An expanded sourcebook. sage; 1994 Jan 12.
Lincoln Y, Guba E, Naturalistic inquiry. Beverly Hills: Sage master, peter,. editorial. Engl Specif Purp. 1999;1985(18):102–4.
Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16(1):1609406917733847.
doi: 10.1177/1609406917733847
Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22(2):63–75.
Castro A, Morand M, Rauch F, Tsimicalis A. The Direct and Indirect Financial Costs Sustained by Parents of Children with Osteogenesis Imperfecta: A Brief Report. McGill Journal of Medicine. 2022;20(1).
Almasri NA, An M, Palisano RJ. Parents’ perception of receiving family-centered care for their children with physical disabilities: a meta-analysis. Phys Occup Ther Pediatr. 2018;38(4):427–43.
doi: 10.1080/01942638.2017.1337664 pubmed: 28753054
Isa SN, Ishak I, Ab Rahman A, Saat NZ, Din NC, Lubis SH, Ismail MF. Health and quality of life among the caregivers of children with disabilities: A review of literature. Asian J Psychiatr. 2016;23:71–7.
doi: 10.1016/j.ajp.2016.07.007 pubmed: 27969083
Urizar GG Jr, Ramírez I, Caicedo BI, Mora C. Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia. J Community Psychol. 2022;50(6):2682–702.
doi: 10.1002/jcop.22763 pubmed: 34845739

Auteurs

R U Elekanachi (RU)

School of Physical & Occupational Therapy, McGill University, Montreal, Canada. rose.elekanachi@mail.mcgill.ca.

A Lajoie (A)

School of Physical & Occupational Therapy, McGill University, Montreal, Canada.

S Tavukcu (S)

Shriners Hospitals for Children, Montreal, Canada.

L M Snider (LM)

School of Physical & Occupational Therapy, McGill University, Montreal, Canada.

N Dahan-Oliel (N)

School of Physical & Occupational Therapy, McGill University, Montreal, Canada.
Shriners Hospitals for Children, Montreal, Canada.

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