OBJECTIVE: To explore the experiences of families with a baby with Down syndrome at the time of diagnosis, and their preferences for information and support in the early period after diagnosis. DESIGN, SETTING AND PARTICIPANTS: A qualitative, interview-based study of 18 families living in Victoria with a child with Down syndrome born between 2002 and 2004 who had not been diagnosed with the syndrome before birth. Interviews were transcribed verbatim and interpretive content analysis was undertaken. RESULTS: Parental coping with the unexpected diagnosis of Down syndrome in their infant was influenced by the time interval between birth and disclosure of clinical suspicion of Down syndrome, the level of certainty of the attending physician at the time of disclosure, and the time interval between disclosure of clinical suspicion and confirmation of karyotype. Initial uncertainty and a delay in the diagnosis were detrimental to parental coping, as was premature communication of the news. Perinatal complications increased parental anxiety regarding their child's condition and future. Individual communication style of midwives and physicians was a powerful predictor of parental adaptation. Parental needs for support and information were facilitated through normalising postnatal care, ensuring privacy, and providing early access to peer support and up-to-date written information. Many parents would have appreciated access to a liaison worker. CONCLUSION: The experiences of parents in this study provide practice points for improving postnatal care with minimal changes to formal service systems.
OBJECTIVE: To explore the experiences of families with a baby with Down syndrome at the time of diagnosis, and their preferences for information and support in the early period after diagnosis. DESIGN, SETTING AND PARTICIPANTS: A qualitative, interview-based study of 18 families living in Victoria with a child with Down syndrome born between 2002 and 2004 who had not been diagnosed with the syndrome before birth. Interviews were transcribed verbatim and interpretive content analysis was undertaken. RESULTS: Parental coping with the unexpected diagnosis of Down syndrome in their infant was influenced by the time interval between birth and disclosure of clinical suspicion of Down syndrome, the level of certainty of the attending physician at the time of disclosure, and the time interval between disclosure of clinical suspicion and confirmation of karyotype. Initial uncertainty and a delay in the diagnosis were detrimental to parental coping, as was premature communication of the news. Perinatal complications increased parental anxiety regarding their child's condition and future. Individual communication style of midwives and physicians was a powerful predictor of parental adaptation. Parental needs for support and information were facilitated through normalising postnatal care, ensuring privacy, and providing early access to peer support and up-to-date written information. Many parents would have appreciated access to a liaison worker. CONCLUSION: The experiences of parents in this study provide practice points for improving postnatal care with minimal changes to formal service systems.
Authors: Marcia Van Riper; George J Knafl; Maria do Céu Barbieri-Figueiredo; Maria Caples; Hyunkyung Choi; Gert de Graaf; Elysângela Dittz Duarte; Junko Honda; Elena Marta; Supapak Phetrasuwan; Sara Alfieri; Margareth Angelo; Wannee Deoisres; Louise Fleming; Aline Soares Dos Santos; Maria João Rocha da Silva; Beth Skelton; Shelley van der Veek; Kathleen A Knafl Journal: J Fam Nurs Date: 2020-12-04 Impact factor: 3.818