Positive and Negative Experiences of Parenting a Pre-school Child with 22q11.2 Deletion Syndrome

Abstract

The presentation of 22q11.2 deletion syndrome (22q11DS) is symptomatically variable, presenting diagnostic challenges for paediatricians and anxious uncertainty in parents. The 'lived' experience of parenting a small child diagnosed with 22q11DS is unknown particularly how parents make sense, both positive and negative, of their role. A phenomenological study sought subjective interpretations from two fathers and four mothers of a young child (8-36 months) diagnosed with 22q11DS. Using interpretative phenomenological analysis, data were collected through semi-structured interviews and thematically analysed. Four themes embodied uncertainty and fear simultaneously experienced by these parents such as anticipatory traumatic distress, systemic stigma, confusion at professional smoke screens and 'not knowing'. This cacophony of distressing emotions plagued their unanswered fear, guilt, loss and grief. In seeking hope, their parenting journey was able to be redefined as one of intrapersonal and interpersonal growth from the adversity of 22q11DS. This study provides a lens into the experiences of parents struggling to make sense of their journey with 22q11DS in the early parenting years. It highlights the complex distress of parenting a small child whose development is fraught with uncertainly and where stigma and suspicion are often experienced when seeking support from social and health systems. However, a metamorphosis of personal strengths also emerged facilitated by hope. Healthcare professionals can best assist through open discussion that acknowledges often limited knowledge, using the guidelines for management of 22q11DS in guiding parents.

The psychosocial impact of 22q11 deletion syndrome on patients and families: A systematic review

“…Thirteen studies revealed negative and positive emotions experienced amongst families, caregivers, and patients (Bales et al, 2010a; Briegel et al, 2008; Chan et al, 2015; Costain et al, 2012; Goodwin, Alam, et al, 2017; Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017; Hercher & Bruenner, 2008; Karas et al, 2014; Klingberg et al, 2010; Okashah et al, 2015; Phillips et al, 2017; Reilly et al, 2015). Three subthemes were identified: emotions experienced by parents and caregivers, emotional experiences faced by siblings, shared emotional experiences.…”

“…Eight studies highlighted emotional conflicts experienced by families and caregivers of individuals with 22q11DS, such as feelings of loss, grief, and guilt (Bales et al, 2010a; Briegel et al, 2008; Goodwin, Alam, et al, 2017; Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017; Hercher & Bruenner, 2008; Klingberg et al, 2010; Okashah et al, 2015). Parents’ reflections on what life could be like without 22q11DS raised feelings of grief, such as their child losing out on the milestones that a “normal” child is expected to have (Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017).…”

“…Six studies were qualitative in nature (Bales et al, 2010a; Goodwin, Alam, et al, 2017; Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017; Klingberg et al, 2010; Phillips et al, 2017), seven used mixed methods (Butcher et al, 2012; Chan et al, 2015; Cohen et al, 2017; Hercher & Bruenner, 2008; Karas et al, 2014; Martin et al, 2012; Okashah et al, 2015), and two exclusively quantitative papers were included (Briegel et al, 2008; Reilly et al, 2015). Qualitative methods used included interviews, surveys, and questionnaires.…”

“…The 14 included studies were conducted between 2008 and 2017 (Bales et al, 2010a; Briegel et al, 2008; Chan et al, 2015; Cohen, McCartney, & Crampin, 2017; Costain, Chow, Ray, & Bassett, 2012; Goodwin, Alam, et al, 2017; Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017; Hercher & Bruenner, 2008; Karas, Costain, Chow, & Bassett, 2014; Klingberg, Hallberg, & Óskarsdóttir, 2010; Martin et al, 2012; Okashah et al, 2015; Phillips, Goodwin, Johnson, & Campbell, 2017; Reilly et al, 2015), with the majority published between 2016 and 2017 ( n  = 5).…”

“…Six studies focused on experiences of parents and/or caregivers ( n  = 5) (Briegel et al, 2008; Goodwin & Mccormack, 2017; Goodwin, McCormack, et al, 2017; Hercher & Bruenner, 2008; Klingberg et al, 2010; Reilly et al, 2015), two studies focused exclusively on patients ( n  = 2) (Chan et al, 2015; Phillips et al, 2017), and one study focused on sibling (Goodwin, Alam, et al, 2017). Sample sizes ranged from 5 to 158; sample size largely dependent on study methodology.…”