Implementing the 2016 American Academy of Pediatrics Guideline on Brief Resolved Unexplained Events: The Parent's Perspective
| Autor: | Donald A Brand, Elizabeth Cohn, Leonard R. Krilov, Ann Mock |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Parents medicine.medical_specialty MEDLINE Resistance (psychoanalysis) Ambivalence Pediatrics 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans 030212 general & internal medicine Child Research question Apprehension business.industry Infant General Medicine Guideline Emergency department Patient Discharge United States Caregivers Family medicine Pediatrics Perinatology and Child Health Emergency Medicine Female medicine.symptom business Emergency Service Hospital Qualitative research |
| Zdroj: | Pediatric emergency care. 37(5) |
| ISSN: | 1535-1815 |
| Popis: | Objectives A "brief resolved unexplained event" refers to sudden alterations in an infant's breathing, color, tone, or responsiveness that prompt the parent or caregiver to seek emergency medical care. A recently published clinical practice guideline encourages discharging many of these infants home from the emergency department if they have a benign presentation. The goal is to avoid aggressive inpatient investigations of uncertain benefit. The present research explored parents' reactions to the prospect of returning home with their infant following such an event. Methods The study used qualitative research methods to analyze semistructured, audio-recorded interviews of parents who had witnessed a brief resolved unexplained event between 2011 and 2015 and taken their infant to the emergency department of an academic teaching hospital. Results A total of 22 parent interviews were conducted. The infants included 8 boys and 14 girls aged 3.6 ± 3.5 months (mean ± SD). Qualitative analysis of interview transcripts revealed a near-universal apprehension about the child's well-being, ambivalence about the best course of action after the evaluation in the emergency department, and need for reassurance about the unlikelihood of a recurrence. Parents did not, however, answer the main research question with a single voice: attitudes toward the return-home scenario ranged from unthinkable to extreme relief. Two-thirds of parents expressed at least some reservations about the idea of returning home. Conclusions Successful implementation of the 2016 guideline will require close attention to the parent's point of view. Otherwise, parental resistance is likely to compromise clinicians' best efforts. |
| Databáze: | OpenAIRE |
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