Maternal Uncertainty about Infants’ Hospitalization for Acute Childhood Illness: A Qualitative Study

Ueki, Showa; Takao, Kenji; Komai, Kazuyo; Fujiwara, Chieko; Ohashi, Kazutomo

doi:10.4236/ojn.2017.76048

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…Influencing factors identified in our findings include these uncertainties which led either to parents’ repeated help seeking or to delay in seeking help. Previous parental research identified all the forms of uncertainty identified here (34-36). Uncertainty led HPs to provide safety netting advice, originally conceived, as also reported here, as a way to manage the clinical risk associated with uncertainties around the diagnosis or anticipated illness trajectory(37).…”

Section: Discussionmentioning

confidence: 90%

Navigating uncertain illness trajectories for young children with serious infectious illness: a mixed-methods modified grounded theory study

Neill

Bray

Carter

et al. 2021

Preprint

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Infectious illness is the biggest cause of death in children due to a physical illness, particularly in children under five years. If mortality is to be reduced for this group of children, it is important to understand factors affecting their pathways to hospital. The aim of this study was to retrospectively identify organisational and environmental factors, and individual child, family, and professional factors affecting timing of admission to hospital for children under five years of age with a serious infectious illness (SII). Methods An explanatory modified grounded theory mixed methods design was used in collaboration with parents. Two stages of data collection were conducted: Stage 1, interviews with 22 parents whose child had recently been hospitalised with a SII and 14 health professionals (HPs) involved in their pre-admission trajectories; Stage 2, focus groups with 18 parents and 16 HPs with past experience of SII in young children. Constant comparative analysis generated the explanatory theory. Findings The core category was Navigating uncertain illness trajectories for young children with serious infectious illness. Uncertainty was prevalent throughout the parents and HPs stories about their experiences of navigating social rules and overburdened health services for these children. The complexity of and lack of continuity within services, family lives, social expectations and hierarchies provided the context and conditions for childrens, often complex, illness trajectories. Parents reported powerlessness and perceived criticism leading to delayed help-seeking. Importantly, parents and professionals missed symptoms of serious illness. Risk averse services were found to refer more children to emergency departments. Conclusions Parents and professionals have difficulties recognising signs of SII in young children and can feel socially constrained from seeking help. The increased burden on services has made it more difficult for professionals to spot the seriously ill child.

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Section: Discussionmentioning

confidence: 90%

Navigating uncertain illness trajectories for young children with serious infectious illness: a mixed-methods modified grounded theory study

Neill

Bray

Carter

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…The majority of the included articles were reported from North America, 18 from the USA,2 5 8–10 20–32 3 from Canada11 33 34 and 2 from Mexico 35 36. Of the remaining, six studies were reported from Europe,37–42 two from Asia,13 43 one from Australia6 and one from New Zealand 12…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies used empirical research to develop classifications, of which 12 used a qualitative methodology,5 11 25 27 29 30 33 34 37 39 42 43 2 used quantitative methodology10 22 and 1 used a mixed-methods approach 36. From the mixed-method study, only the qualitative component which pertained to classification development was considered.…”

Section: Resultsmentioning

confidence: 99%

Developing an integrated multilevel model of uncertainty in health care: a qualitative systematic review and thematic synthesis

Eachempati

Büchter

et al. 2022

BMJ Glob Health

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IntroductionUncertainty is an inevitable part of healthcare and a source of confusion and challenge to decision-making. Several taxonomies of uncertainty have been developed, but mainly focus on decisions in clinical settings. Our goal was to develop a holistic model of uncertainty that can be applied to both clinical as well as public and global health scenarios.MethodsWe searched Medline, Embase, CINAHL, Scopus and Google scholar in March 2021 for literature reviews, qualitative studies and case studies related to classifications or models of uncertainty in healthcare. Empirical articles were assessed for study limitations using the Critical Appraisal Skills Programme (CASP) checklist. We synthesised the literature using a thematic analysis and developed a dynamic multilevel model of uncertainty. We sought patient input to assess relatability of the model and applied it to two case examples.ResultsWe screened 4125 studies and included 15 empirical studies, 13 literature reviews and 5 case studies. We identified 77 codes and organised these into 26 descriptive and 11 analytical themes of uncertainty. The themes identified are global, public health, healthcare system, clinical, ethical, relational, personal, knowledge exchange, epistemic, aleatoric and parameter uncertainty. The themes were included in a model, which captures the macro, meso and microlevels and the inter-relatedness of uncertainty. We successfully piloted the model on one public health example and an environmental topic. The main limitations are that the research input into our model predominantly came from North America and Europe, and that we have not yet tested the model in a real-life setting.ConclusionWe developed a model that can comprehensively capture uncertainty in public and global health scenarios. It builds on models that focus solely on clinical settings by including social and political contexts and emphasising the dynamic interplay between different areas of uncertainty.

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“…The first author conducted open-ended interviews with fifteen mothers of hospitalized children with ACI individually and clarified their uncertainty [12]. The codes in this interview data were replaced with questions.…”

Section: Phase 1: Interviewsmentioning

confidence: 99%

“…Acute childhood illness, in contrast to chronic illness, shows significant changes in symptoms and recovery is expected. We clarified that parents who have a child with ACI felt uncertainty, which composed different from those with chronically ill children [12].…”

mentioning

confidence: 99%

Development of a Scale to Screen Parents with Uncertainty Regarding Their Child with Acute Illness

Ueki¹,

Komai²,

Ohashi³

2017

OJN

Self Cite

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Parents experience uncertainty when their children become sick. The study aimed to develop a Parents' Uncertainty regarding their Child with Acute Illness Scale (PUCAS) and to clarify differences in PUCAS scores between groups that were divided according to participants' demographic characteristics. PUCAS was developed based on interviews, literature review, and a pilot study. We obtained valid responses from 235 parents with children hospitalized due to an acute childhood illness. Exploratory factor analysis narrowed the number of items to 25, divided into the following 5 subscales: unpredictability of the course of the illness, ambiguity about the severity of the illness, ambiguous appropriateness of management, discrepancy of judgement with health care professionals, and lack of information about the causes of the illness. There was satisfactory construct validity and criterion-related validity. Cronbach's alpha was 0.92 for the overall scale. Participants who used ambulances, those who were not given any reliable diagnosis for their children, and fathers scored significantly higher on the PUCAS. PUCAS has high validity and reliability in measuring uncertainty of parents who have children with acute childhood illness and could be a useful screening tool for parents with high uncertainty in a clinical setting.

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Maternal Uncertainty about Infants’ Hospitalization for Acute Childhood Illness: A Qualitative Study

Cited by 8 publications

References 26 publications

Navigating uncertain illness trajectories for young children with serious infectious illness: a mixed-methods modified grounded theory study

Navigating uncertain illness trajectories for young children with serious infectious illness: a mixed-methods modified grounded theory study

Developing an integrated multilevel model of uncertainty in health care: a qualitative systematic review and thematic synthesis

Development of a Scale to Screen Parents with Uncertainty Regarding Their Child with Acute Illness

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