The experiences of parents and nurses of hospitalised infants requiring oxygen therapy for severe bronchiolitis

Abstract

Bronchiolitis is a major cause of children's admission to hospital. The study aim was to describe the experiences of parents who had, or nurses who cared for, a child admitted to hospital for severe bronchiolitis requiring oxygen therapy. A descriptive phenomenological approach was used to interview 12 mothers and 12 nurses. The findings were clustered into three domains: fear, parent-child interaction and technical caring. The mothers found the experience to be extremely frightening, based on their fear that their child could die. This was compounded by their lack of knowledge and understanding about what was happening and their inability to fulfil their mothering role. Although nurses recognised that parents were anxious, they did not seem to appreciate fully the depth of fear and emotion that mothers were experiencing and tended to describe procedural aspects of their role. The mothers' relationship with their child was focused upon physical contact and the desire to comfort their child. Their ability to do so was significantly impacted upon by the method of oxygen delivery to their child. For nurses, although they recognised the psychosocial dimension, their emphasis was on health and safety aspects of oxygen therapy, both for the child and themselves.

Perspectives and engagement of caregivers in the care of babies under on Bubble CPAP

“…Emerging caregiver perspectives about bubble CPAP included fear arising from misconceptions about oxygen therapy, the tubes attached to the baby's nose, coffin-shaped baby cots and bubbling sounds made by the device. Our findings on parental fears related to the bubble CPAP machinery (bubbling water and tubes) add to global findings that also concluded that tubes, and coffin shaped beds caused anxiety and discomfort among mothers (Gondwe, Gombachika, & Majamanda, 2017;Cervantes, Feeley, & Lariviere, 2011;Peeler, Fulbrook, & Kildea, 2015).…”

Experiences of caregivers of infants who have been on bubble continuous positive airway pressure at Queen Elizabeth Central Hospital, Malawi: A descriptive qualitative study

“…Oxygen delivery methods create a barrier between a mother and an infant such that mothers are afraid to hold their babies, are unable to see their babies' faces, and skin-to-skin contact is interrupted. 4,5 Physical contact between mother and child is necessary to develop parentinfant bonding, facilitate infant brain development, reduce the level of pain and stress for the child, and reduce depression levels for mothers. 28,29 Furthermore, the caregivers reported that the tubing on bCPAP machines prevented contact between them and their children.…”

“…This was also found in studies done in Canada and Australia, where the equipment necessary for oxygen delivery was a major cause of fear among mothers, as they were worried that their children may be hurt and the sound that the machine produced was terrifying and overwhelming. 4,5 This suggests a need for healthcare providers to explain the treatment plan comprehensively, which may include benefits, risks, functions of the machine, and potential complications, as this will prepare caregivers psychologically and help them adapt better to the situation. This study revealed that caregivers received psychological support from healthcare workers, family members, and friends.…”

“…Studies done in Australia and Canada described different oxygen delivery methods as stressful to caregivers, as they create physical barriers between guardian and child. 4,5 Despite improved child mortality in Malawi, preventable causes of childhood death, such as respiratory failure, remain prevalent. 6 Bubble CPAP was introduced in Malawi to improve the survival of children with respiratory distress.…”

Evidence for the use of high flow nasal cannula therapy for respiratory management in paediatric units

“…They found HFNC allowed them to hold their infant and on occasion breast feed, which allowed the mother a sense of connectedness. This has been explored in detail in the thesis by Peeler,195 however within paediatric literature there are no publications surrounding the patient or parent experience with HFNC use.…”