Conquering the great divide: Rural mothers of children with chronic health conditions accessing specialist medical care for their children

Bristow, Sally; Power, Tamara; Jackson, Debra; Usher, Kim

doi:10.1016/j.colegn.2019.10.001

Cited by 8 publications

(12 citation statements)

References 41 publications

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“…Surmounting the Terrain : maternal resilience. Each of these four significant themes forms part of a more extensive doctoral study; theme one: Heading to the Big Smoke is published (Bristow et al, 2020) with themes three and four to be submitted for publication. For this article, rural mothers Alone in the Outback (theme 2) reveals narrative descriptions of feelings of isolation provided by the mothers conceptualized as three subthemes: On the fringe ; There is no shelter ; and Choosing their own direction.…”

Section: Resultsmentioning

confidence: 99%

“…This article is the second of four finding articles resulting from a more extensive qualitative doctoral study. Article one focused on accessing healthcare services (Bristow et al, 2020), and future articles will explore local support rural mothers acquire and rural maternal resilience. This article explores rural mothers’ feelings of isolation forming the theme: Alone in the Outback .…”

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confidence: 99%

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“Rural mothers’ feelings of isolation when caring for a child chronic health condition: A phenomenological study”

Bristow

Jackson

Power

et al. 2021

J Child Health Care

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Evidence indicates that people in rural settings may experience difficulties in accessing health services, mainly specialist services. Caring for a child with a chronic health condition in a rural environment can present these mothers’ challenges. This article reports one of four finding themes from a more extensive qualitative study on rural mothers’ experiences of providing care for a child with a chronic health condition. Using hermeneutic phenomenological methods, narrative accounts were collected from 17 rural mothers of children with a chronic health condition in 2018. Analysis revealed that these mothers experienced emotional and physical isolation resulting in an overall theme reported within this article: “ Alone in the Outback” : isolation, capturing rural mother’s feelings of isolation; comprising three subthemes: On the fringe; There is no shelter; and Choosing their own direction . Their experiences of caring highlighted a need for additional local carer support services and resources. Nurses can assist in supporting rural mothers through facilitating local social support networks enabling women to connect with others in similar caregiving situations. This study reports following the consolidated criteria for reporting qualitative research guidelines ( Tong et al., 2007 ).

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

“Rural mothers’ feelings of isolation when caring for a child chronic health condition: A phenomenological study”

Bristow

Jackson

Power

et al. 2021

J Child Health Care

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“…Nurses play an essential role in supporting maternal caregivers in managing care for their child with a CHC (S. Bristow et al, 2020;S. Bristow et al, 2019).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Nurses play an essential role in supporting maternal caregivers in managing care for their child with a CHC (S. Bristow et al, 2020; S. Bristow et al, 2019). They do this by understanding the resources, skills and support maternal caregivers need (Rosa et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Understanding maternal resilience; Lesson learnt from rural mothers caring for a child with a chronic health condition

Bristow

Usher

Power

et al. 2021

Journal of Clinical Nursing

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Aim: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving.Background: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources.Design: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ).Methods: Semi-structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2-18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience.Results: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem-solving skills, enhancing their self-efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. Conclusion:This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC.

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“…Additionally, these children have an increased risk of death, with mortality ranging from 2% to 15% [ 15–18 ]. Studies from Australia, the United Kingdom, and the United States demonstrate that infectious diseases (ID) consultation for S. aureus bacteremia improves management and outcomes; however, children residing in rural areas have limited access to pediatric ID subspecialists [ 4 , 18–21 ]. As the impact of rural residence on pediatric S. aureus bacteremia outcomes is unknown, we investigated the influence of rural residence and socioeconomic deprivation on outcomes in children with S. aureus bacteremia.…”

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confidence: 99%

Staphylococcus aureus Bacteremia in Pediatric Patients: Uncovering a Rural Health Challenge

Whittington

Malone

Hogan

et al. 2023

Open Forum Infectious Diseases

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Background Staphylococcus aureus bacteremia poses significant risk for morbidity and mortality. This may be exacerbated in rural populations facing unique health challenges. Methods To investigate factors influencing S. aureus bacteremia outcomes, we conducted a retrospective cohort study of children admitted to St. Louis Children’s Hospital (SLCH) from 2011-2019. Exposures included rurality (defined by the Rural-Urban Continuum Code), Area Deprivation Index, and outside hospital (OSH) admission prior to SLCH admission. The primary outcome was treatment failure, a composite of 90-day all-cause mortality and hospital readmission. Results Of 251 patients, 69 (27%) were from rural areas; 28 (11%) were initially admitted to an OSH. Treatment failure occurred in 39 (16%) patients. Patients from rural areas were more likely to be infected with methicillin-resistant S. aureus (45%) versus urban children (29%, p = 0.02). Children initially admitted to an OSH, versus those presenting directly to SLCH, were more likely to require intensive care unit-level (ICU) care (57% vs. 29%, p = 0.002), have an endovascular source of infection (32% vs. 12%, p = 0.004), have a longer duration of illness before hospital presentation (4.1 vs. 3.0 days, p = 0.04), and have delayed initiation of targeted antibiotic therapy (3.9 vs. 2.6 days, p = 0.01). Multivariable analysis revealed rural residence (adjusted odds ratio [aOR] 2.3, 95% confidence interval [CI] 1.1-5.0), comorbidities (aOR 2.9, 95%CI 1.3-6.2), and ICU admission (aOR 3.9, 95%CI 1.9-8.3) as predictors of treatment failure. Conclusion Children from rural areas face barriers to specialized healthcare. These challenges may contribute to severe illness and worse outcomes among children with S. aureus bacteremia.

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Conquering the great divide: Rural mothers of children with chronic health conditions accessing specialist medical care for their children

Cited by 8 publications

References 41 publications

“Rural mothers’ feelings of isolation when caring for a child chronic health condition: A phenomenological study”

“Rural mothers’ feelings of isolation when caring for a child chronic health condition: A phenomenological study”

Understanding maternal resilience; Lesson learnt from rural mothers caring for a child with a chronic health condition

Staphylococcus aureus Bacteremia in Pediatric Patients: Uncovering a Rural Health Challenge

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