Background: There is a growing body of qualitative studies examining parents’ experiences of caring for a child with a life-limiting condition, coinciding with recent evidence that indicates an increasing incidence of paediatric life-limiting conditions. However, research focusing on fathers’ needs remains sparse and is often diluted among a predominant ‘mother’s voice’, raising questions about whether practices in clinical settings meet fathers’ needs. Aim: To provide an in-depth assembly of the current state of knowledge around fathers’ experiences of caring for their children diagnosed with life-limiting conditions and understand the implications for healthcare services and policies. Design: A meta-ethnography was conducted to synthesise findings from existing qualitative studies exploring fathers’ experiences of caring. Data sources: Four electronic databases (PubMed, PsycINFO, CINAHL and Science Direct) were searched up until April 2020. Qualitative studies exploring fathers’ care experience and published in English language were included. The Critical Appraisal Skills Programme (CASP) checklist was employed for study quality appraisal. No temporal limits were used. Results: Sixty-three studies met the inclusion criteria. Thirty life-limiting conditions were included. Based on responses from 496 fathers, a conceptual model was developed which translates key experiences within the fathers’ caregiving journeys. The overarching concepts identified were: the paradox of support, challenges in the caring process, ‘nobody thinks of men’, impact on family life and the fall of the curtain: an irrevocably altered world. These and associated sub-concepts are discussed, with recommendations for future research and practice provided. Conclusion: The findings indicate the value of a family-oriented approach to develop psychosocial interventions and support channels for fathers, thus empowering them whilst reducing the care-giving burden on the family unit.

Supporting positive childhood eating behaviors is a central and ongoing priority for health care providers, encompassing both health outcomes for typical eaters and best practice in relation to pediatric feeding challenges. Building on existing work, this perspective draws on literature from multiple fields to recommend the use of Self-Determination Theory as a framework for responsive feeding. Additionally, it contributes to the definition and conceptualization of responsive feeding. The 3 basic needs proposed by Self-Determination Theory (autonomy, relatedness and competence) have significant implications for both professional practice and the direction of future research.

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Postavaru, G-I. (2018). A meta-ethnography of parents' experiences of their children's life-limiting conditions. Qualitative Research in Psychology.

Receiving and breaking bad news: a qualitative study of family carers Receiving and breaking bad news: a qualitative study of family carers managing a cancer diagnosis and interactions with healthcare services managing a cancer diagnosis and interactions with healthcare services PLEASE CITE THE PUBLISHED VERSION

The aim of this meta-analysis is to provide new evidence on the effects on maternal health of multiple births due to assisted reproductive technology (ART). A bibliographic search was undertaken using PubMed, PsycINFO, CINAHL and Science Direct. Data extraction was completed using Cochrane Review recommendations, and the review was performed following PRISMA and MOOSE guidelines. Meta-analytic data were analysed using random effects models. Eight papers (2993 mothers) were included. Mothers of ART multiple births were significantly more likely to experience depression (standardized mean difference [SMD] d = 0.198, 95% CI 0.050 - 0.345, z = 2.623, P = 0.009; heterogeneity I(2) = 36.47%), and stress (SMD d = 0.177, 95% CI 0.049 - 0.305, P = 0.007; heterogeneity I(2) = 0.01%) than mothers of ART singletons. No difference in psychosocial distress (combined stress and depression) (SMD d = 0.371, 95% CI -0.153 - 0.895; I(2) = 86.962%, P = 0.001) or depression (d = 0.152, 95% CI -0.179 - 0.483: z = 0.901; I(2) = 36.918%) were found between mothers of ART and naturally conceived multiple births. In conclusion, mothers of ART multiple births were significantly more likely to have depression and stress than mothers of ART singletons, but were no different from mothers of naturally conceived multiples.

CONTEXT: Loss of a child to a life-limiting condition (LLC) is 1 of the most traumatic life events for parents. Research focusing on fathers’ experiences is in its infancy. OBJECTIVES: Using a meta-ethnographic approach, we systematically reviewed the literature around fathers’ predeath and postdeath experiences of loss and grief. DATA SOURCES: We searched Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, and Science Direct, and used the meta-ethnography reporting guidelines; the Preferred Reporting Items for Systematic Reviews and Meta-Analyses; and sampling strategy, type of study, approaches, range of years, limits, inclusion and exclusions, terms used, and electronic sources recommendations. STUDY SELECTION: We used the Guide to Children’s Palliative Care and the directory of LLCs to select qualitative articles published up until the end of March 2023 that described fathers’ predeath and postdeath experiences of loss and grief after their child’s LLC. We excluded studies that failed to differentiate outcomes between mothers and fathers. DATA EXTRACTION: Extracted data included study details, participants’ characteristics, response rate, source of participants, method and time of data collection, children’s characteristics, and quality assessment. First-order and second-order data were also extracted. RESULTS: Forty studies informed a FATHER model of loss and grief. This highlights both similarities (ambivalence, trauma responses, fatigue, anxiety, unresolved grief, guilt) and distinct features defining the predeath and postdeath experiences of loss and grief. LIMITATIONS: There was a bias toward greater mother participation in research. Specific categories of fathers remain underrepresented in palliative care literature. CONCLUSIONS: Many fathers experience disenfranchised grief and deterioration in mental health after a child’s diagnosis and postdeath. Our model opens possibilities for personalized clinical support in the palliative care system for fathers.

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