Emotions and experiences of parents of children with liver transplants: A qualitative study
Öz
Purpose: This study was conducted to determine the feelings and experiences of parents of children who underwent liver transplantation.
Method: The study was carried out between July 2019 and October 2021 at the liver transplant institute of a university in eastern Turkey. The population of the research consisted of the parents of 14 children (N=28) hospitalized in the clinic. Purposive sampling was used as the sampling method and 22 parents were included in the study. The data were collected face to face by the researchers with a survey and a semi-structured form and analyzed using the thematic (descriptive) analysis method.
Results: From parents' experiences; emotions (Sadness, Fear/Anxiety, Helplessness, Regret, Joy/Happiness, Hope/Despair, Guilt, Distress), family relationships (Conflict between family members, Inability to spare time for other children, Role change), social relationships (social isolation) and financial Four main themes were created: challenges. As a result of the study, it was determined that mothers experienced feelings of sadness, disappointment, guilt and helplessness when they first learned about their child's diagnosis, while fathers were very upset. It was determined that when the mothers were told that they needed an organ transplant, they saw this as a ray of hope and salvation from the disease and applied to become donors. It was determined that all fathers quit their jobs due to their children's illness and experienced financial difficulties.
Conclusion: It was determined that parents whose children received liver transplantation mostly felt sad and experienced difficulties. In order for nurses caring for children undergoing liver transplantation to provide holistic and family-centered care, it is important to determine the needs of parents during the transplantation process and implement the necessary nursing interventions.
Referanslar
- Açar, A., Karataş, H. & Özgönül, A. (2021). Quality of life and care burden of parents of transplanted. Journal of General Health Sciences, 3(1), 41-50. https://doi.org/10.51123/jgehes.2021.16
- Agerskov, H., Thiesson, H,, Spechte, K. & Pedersen, B.D. (2019). Parents’ experiences of donation to their child before kidney transplantation: a qualitative study. Journal of Clinical Nursing, 28(9-10), 1482-1490. https://doi.org/10.1111/jocn.14734
- Akbulut, S., Gunes, G., Saritas, H., Aslan, B., Karipkiz, Y., Demyati, K., ... & Yilmaz, S. (2020). Differences in parents of pediatric liver transplantation and chronic liver disease patients. World Journal of Clinical Cases, 8(11), 2162. https://doi.org/10.12998/wjcc.v8.i11.2162
- Altuğ, N., Ecevit, Ç. O., Karakoyun, M., Taşçı, E. K., Bolışık, B. & Aydoğdu, S. (2019). Determination of variables influencing the quality of life in children with liver transplantation. J Pediatr Res, 6, 208-12. https://do./10.4274/jpr.galenos.2018.34654
- Ay Kaatsiz, M. A., & Oz, F. (2020). The effectiveness of psychoeducation given to mothers of children with cancer. J Psychiatric Nurs, 11(2), 129-140.
- Baran, G. (2018). The burden of care and life satisfaction of the Turkish mothers of children with cancer. JCCNC, 4(4), 175-184. https://doi.org/10.32598/jccnc.4.4.175
- Basturk, A., Yılmaz, A., Sayar, E., Dinçhan, A., Aliosmanoğlu, İ., Erbiş, H., ... & Artan, R. (2016). Pediatric liver transplantation: our experiences. The Eurasian Journal of Medicine, 48(3), 209. https://doi.org/10.5152/eurasianjmed.2016.0147
- Butsriphum, N,, Getsuwan, S., Prabpram, W., Chuthapisith, J., Tanpowpong, P., Lertudomphonwanit, C. & Treepongkaruna, S. (2020). Family function in pediatric liver transplant recipients residing in a developing country. Transplantation Proceedings,52 (3), 920-925. https://doi.org/10.1016/j.transproceed.2020.01.035
- Cousino, M. K., Rea, K. E., Schumacher, K. R., Magee, J. C. & Fredericks, E. M. (2017). A systematic review of parent and family functioning in pediatric solid organ transplant populations. Pediatric Transplantation, 21(3), 12900. https://doi.org/10.1111/petr.12900
- Cuenca, A. G., Kim, H. B. & Vakili, K. (2017). Pediatric liver transplantation. In Seminars in Pediatric Surgery, 26(4), 217-223.WB Saunders. https://doi.org/10.1053/j.sempedsurg.2017.07.014
- Denny, B., Beyerle, K., Kienhuis, M., Cora, A., Gavidia‐Payne, S. & Hardikar, W. (2012). New insights into family functioning and quality of life after pediatric livertransplantation. Pediatric Transplantation, 16(7), 711-715. https://doi.org/10.1111/j.1399-3046.2012.01738.x
- Doğan, S., Çelik, E., Öztürk, K. & Aydemir, S.(2020). Psychological resilience of families with children with kidney transplantation. Journal of Nephrology Nursing, 15(3), 240-250. https://doi.org/10.47565/ndthdt.2020.21
- Eaton, C.K., Lee, J.L. & Loiselle, K.A. (2016). Pretransplant patient, parent, and family psychosocial functioning varies by organ type and patient age. Pediatric Transplantation, 20(8), 1137-1147. https://doi.org/10.1111/petr.12826
- Engin E, Çam M.O, Demirkol H. (2021). A Life in Purgatory: Being the mother of a child with a bone marrow transplant. Current Approaches in Psychiatry, 13(2), 282-291. https://doi.org/10.18863/pgy.775939
- Evgin, D., Erdem, E., Bayat, M., Poyrazoğlu, H. M. & Dursun, J. (2013). Experienced difficulties of children undergoing peritoneal dialysis and their mothers: A qualitative study. Journal of Health Sciences, 22(1), 7-17.
- Getsuwan, S., Tanpowpong, P., Lertudomphonwanit, C., Chuthapisith, J., Butsriphum, N., Prabpram, W, ... , Treepongkaruna S. (2020). Health-related quality of life in pediatric liver transplant recipients. In Transplantation Proceedings, 53, 141-147. https://doi.org/10.1016/j.transproceed.2020.02.175
- Ghent, E., Robertson, T., Young, K., DeAngelis, M., Fecteau, A., Grant, D., ... & Anthony, S. J. (2019). The experiences of parents and caregiver (s) whose child received an organ from a living anonymous liver donor. Clinical Transplantation, 33(10), e13667. https://doi.org/10.1111/ctr.13667
- Gökçe, S., Durmaz, O., Aydoğan, A., Celtık, C., Ozden, I. & Sökücü, S. (2011). Assessment of living donors with respect to pre-and posttransplant psychosocial properties and posttransplant family functioning in pediatric liver transplantation. The Turkish Journal of Gastroenterology: The official journal of Turkish Society of Gastroenterology, 22(1), 36-41.
- Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research:Concepts, procedures and measures to achieve trustworthiness. Nurse Educ, 24(2), 105–112. http://dx.doi.org/10.1016/j.nedt.2003.10.001.
- Günay, U. & Özkan, M. (2019). Emotions and coping methods of Turkish parents of children with cancer. Journal of Psychosocial Oncology, 37(3), 398-412. https://doi.org/10.1080/07347332.2018.1555197
- Kaller, T., Petersen, I., Petermann, F., Fischer, L., Grabhorn, E. & Schulz, K. H. (2014). Family strain and its relation to psychosocial dysfunction in children and adolescents after liver transplantation. Pediatric Transplantation,18(8), 851-859. https://doi.org/10.1111/petr.12367
- Karabudak, S.S. & Conk, Z. (2018). Phenomenological determination of the biopsychosocial effects of the dialysis treatment of the child on the parents. Journal of Nursing Science, 1(3),7-20. https://dergipark.org.tr/en/download/article-file/638910
- Karakavak, G. & Çırak, Y.(2006). Emotions of mothers with chronic diseased children. Journal of Istanbul University Education Faculty, 7(12), 95- 112.
- Kikuchi, R. & Kamibeppu, K. (2015). Parents' quality of life and family functioning in pediatric organ transplantation. Journal of Pediatric Nursing, 30, 463–477. https://doi.org/10.1016/j.pedn.2014.12.013
- Killian, M.O. (2017). Psychosocial predictors of medication adherence in pediatric heart and lung organ transplantation. Pediatric Transplantation, 21(4), 12899. https://doi.org/10.1111/petr.12899
- Kwong, A., Kim, W. R., Lake, J. R., Smith, J. M., Schladt, D. P., Skeans, M. A., ... & Kasiske, B. L. (2020). OPTN/SRTR 2018 annual data report: Liver. American Journal of Transplantation, 20, 193-299. https://doi.org/10.1111/ajt.15674
- Lefkowitz, D. S., Fitzgerald, C. J., Zelikovsky, N., Barlow, K. & Wray, J. (2014). Best practices in the pediatric pretransplant psychosocial evaluation. Pediatric Transplantation, 18(4), 327-335. https://doi.org/10.1111/petr.12260
- Lerret, S. M., White‐Traut, R., Medoff‐Cooper, B., Simpson, P., Adib, R., Ahamed, S. I. & Schiffman, R. (2020). Pilot study protocol of a mHealth self‐management intervention for family members of pediatric transplant recipients. Research in Nursing & Health, 43(2), 145-154. https://doi.org/10.1002/nur.22010
- Lerret, S.M., Johnson, N.L. & Haglund, K.A. (2017). Parents’ perspectives on caring for children after solid organ transplant. Journal for Specialists in Pediatric Nursing, 22(3), 12178. https://doi.org/10.1111/jspn.12178
- Li, L., Yang, L., Dong, C., Yan, Q., Huang, W., Liao, T. & Sun, X. (2021). Psychosocial assessment of donors in pediatric living donor liver transplantation: A systematic review. In: Transplantation Proceedings. Elsevier, 53, 3-15. https://doi.org/10.1016/j.transproceed.2020.02.150
- LoBiondo‐Wood, G., Williams, L. & McGhee, C. (2004). Liver transplantation in children: Maternal and family stress, coping, and adaptation. Journal for Specialists in Pediatric Nursing,9(2), 59-66. https://doi.org/10.1111/j.1088-145X.2004.00059.x
- Maxwell J.A. (2012). Qualitative Research Design: An Interactive Approach. New York: Sage Publications, 41.
- McLoughlin, A., Wilson, C. & Swords, L. (2021). Parents’ experiences of their child’s solid-organ transplant: A meta-ethnography of qualitative studies. Journal of Pediatric Psychology, 1–13 doi: 10.1093/jpepsy/jsab108. https://doi.org/10.1093/jpepsy/jsab108
- Mjøen, G., Stavem, K., Westlie, L., Midtvedt, K., Fauchald, P., Norby, G. & Holdaas, H. (2011). Quality of life in kidney donors. American Journal of Transplantation, 11(6), 1315-1319. https://doi.org/10.1111/j.1600-6143.2011.03517.x
- Nikeghbalian, S., Malekhosseini, S. A., Kazemi, K., Arasteh, P., Eghlimi, H., Shamsaeefar, A., ... & Salahi, H. (2021). The largest single center report on pediatric liver transplantation: experiences and lessons learned. Annals of Surgery, 273(2), 70-72. https://doi.org/10.1097/sla.0000000000004047
- Ong, Z. H., Ng, C. H., Tok, P. L., Kiew, M. J. X., Huso, Y., Shorey, S. & Ng, Y. P. M. (2021). Sources of distress experienced by parents of children with chronic kidney disease on Dialysis: A qualitative systematic review. Journal of Pediatric Nursing, 57, 11-17. https://doi.org/10.1016/j.pedn.2020.10.018
- Parmar, A., Vandriel, S. M. & Ng, V. L. (2017). Health‐related quality of life after pediatric liver transplantation: a systematic review. Liver Transplantation, 23(3), 361-374. https://doi.org/10.1002/lt.24696
- Petersen, I., Noelle, J., Buchholz. A., Kroencke, S., Daseking, M. & Grabhorn, E. (2019). Fatigue in pediatric liver transplant recipients and its impact on their quality of life. Pediatric Transplantation, 23(1), 13331. https://doi.org/10.1111/petr.13331
- Sarigol Ordin, Y., Karayurt, Ö., Ünek, T. & Astarcıoğlu, İ. (2017). Pediatric liver transplant patients’ transition to adulthood: Patient and parent experiences. Nursing & Health Sciences, 19(3), 393-399. https://doi.org/10.1111/nhs.12358
- Sheikhalipour, Z., Zamanzadeh, V., Borimnejad, L., Newton, S.E. & Valizadeh, L. (2019). Muslim transplant recipients’ family experiences following organ transplantation. Journal of Research in Nursing, 24(5), 291-302. https://doi.org/10.1177/1744987118813671
- Şahin, Y., Ziyaret, O. & Demir, B. (2016). Depression and anxiety in parents of children who are candidates for liver transplantation. Arquivos de Gastroenterologia, 53(1), 25-30. https://doi.org/10.1590/S0004-28032016000100006
- Thys, K., Schwering, K. L., Siebelink, M., Dobbels, F., Borry, P., Schotsmans, P., ... & Elpat Pediatric Organ Donation and Transplantation Working Group. (2015). Psychosocial impact of pediatric living‐donor kidney and liver transplantation on recipients, donors, and the family: A systematic review. Transplant International, 28(3), 270-280. https://doi.org/10.1111/tri.12481
- Umeshita, K., Inomata, Y., Furukawa, H., Kasahara, M., Kawasaki, S., Kobayashi, E., ... & Japanese Liver Transplantation Society. (2016). Liver transplantation in Japan: Registry by the japanese liver transplantation society. Hepatology Research, 46(12), 1171-1186. https://doi.org/10.1111/hepr.12676
- Walker, R. C., Naicker, D., Kara, T. & Palmer, S. C. (2019). Parents' perspectives and experiences of kidney transplantation in children: A qualitative interview study. Journal of Renal Care, 45(3), 193-200. http://dx.doi.org/10.1111/jorc.12292
- Wirken, L., van Middendorp, H., Hooghof, C. W., Sanders, J. S. F., Dam, R. E., van der Pant, K. A., ... & Evers, A. W. (2019). Psychosocial consequences of living kidney donation: A prospective multicentre study on health-related quality of life, donor–recipient relationships and regret. Nephrology Dialysis Transplantation, 34(6), 1045-1055. https://doi.org/10.1093/ndt/gfy307
- Wright, J., Elwell, L., McDonagh, J.E., Kelly, D.A. & Wray, J. (2017). Parents in transition: Experiences of parents of young people with a liver transplant transferring to adult services. Pediatr Transplant, 21, 12760. https://doi.org/10.1111/petr.12760
- Yadav, P., Nunia, S., Bansal, A., Sureka, S. K., Jena, R., Ansari, M. S. & Srivastava, A. (2017). Multidimensional assessment of quality of life of children and problems of parents in Indian society after pediatric renal transplant: Beyond the conventional thoughts. Pediatric Transplantation, 21(6), e13001. https://doi.org/10.1111/petr.13001
- Yayan, E.H. & Düken, M.E. (2019). A Comparison of caregiving burden and social support levels of parents of children undergoing liver transplant. Journal of Pediatric Nursing, 47, 45-50. https://doi.org/10.1016/j.pedn.2019.04.022
- Yayan, E.H. & Düken, M.E. (2020). Comparison of quality of life and caregiving burden of 2-to 4-year-old children post liver transplant and their parents. Gastroenterology Nursing, 43(4), 310-316. http://dx.doi.org/10.1097/SGA.0000000000000448
- Yuen, W. Y., Tan, A., Karthik, S. V., Quak, S. H., Kow, A. W. C. & Aw, M. M. (2019). Health‐related quality of life, clinical outcomes, and subjective experiences of parent donors of pediatric liver transplant recipients. Pediatric Transplantation, 23(2), e13337. https://doi.org/10.1111/petr.13337
- Zhang, W. X., Wei, H., Shen, Z. Y., Peng, X., Chen, X. G., Li, W., ... & Niu, Y. J. (2014). Concerns of and coping strategies by parents of pediatric liver transplant recipients: a qualitative study from China. International Journal of Clinical and Experimental Medicine, 7(12), 5723. https://pubmed.ncbi.nlm.nih.gov/25664098