“我们像一个器官一样运作”:在农村地区有一个患有1型糖尿病的孩子的父母经历。

Laura Foran Lewis, Paige MacDonald Brower, Sarah Narkewicz
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摘要

目的:探讨农村地区1型糖尿病(T1DM)患儿家长的护理经验。生活在农村地区的个人在获得医疗保健方面面临障碍,导致严重的健康差距,发病率和死亡率增加。有必要了解生活在农村社区的人的独特经历,以支持他们的保健需求。方法:在本定性研究中,通过与当地卫生专业人员和家庭支持网络的联系,招募了11名居住在佛蒙特州的儿童在过去10年内被诊断为T1DM的父母,并对他们的经历进行了访谈。访谈被逐字记录下来,并使用Braun和Clarke的反身性主题分析六步法进行分析。结果:确定了五个主题来捕捉在农村社区养育T1DM儿童的经历,包括忍受情感创伤,随叫随到,适应日常挑战,缺乏支持的安全网,以及找到节奏。结论:尽管研究结果与之前关于T1DM儿童父母经历的研究中发现的许多主题相呼应,但参与者也发现了独特的障碍,如与正式和非正式支持系统的物理距离,技术资源的不可靠和/或不足,以及社区(包括儿童保育和学校)对T1DM缺乏了解。与生活在农村地区的家庭一起工作的糖尿病护理和教育专家必须探索如何教育这些家庭的关键支持,以尽量减少父母之间的孤立、耻辱和倦怠。
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"We Operate as an Organ": Parent Experiences of Having a Child With Type 1 Diabetes in a Rural Area.

Purpose: The purpose of this study is to explore the experiences of parents of children with type 1 diabetes mellitus (T1DM) who are living in rural areas. Individuals living in rural areas face barriers to accessing health care that lead to significant health disparities with increased morbidity and mortality. There is a need to understand the unique experiences of those living in rural communities to support their health needs.

Methods: In this qualitative study, a convenience sample of 11 parents of children who were diagnosed with T1DM in the last 10 years living in Vermont were recruited through connections with local health professionals and family support networks and interviewed about their experiences. Interviews were transcribed verbatim and analyzed using Braun and Clarke's 6-step approach to reflexive thematic analysis.

Results: Five themes were identified to capture the experience of parenting a child with T1DM in a rural community, including enduring emotional traumas, living life on call, adapting to everyday challenges, lacking a safety net for support, and finding a rhythm.

Conclusions: Although findings echo many themes found in previous studies on experiences of parents of children with T1DM, participants also identified unique barriers such as physical distance from formal and informal support systems, unreliable and/or insufficient technological resources, and lack of understanding of T1DM by their communities, including among child care and schools. Diabetes care and education specialists working with families living in rural areas must explore ways to educate key supports to these families to minimize isolation, stigma, and burnout among parents.

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