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  • 1. Order onlineBuy this publication >>
    Flankegård, Gunilla
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Childhood functional constipation: Parents' everyday life experiences2022Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Functional constipation is the most common chronic disorder in childhood with a great impact on family life. Treatment focuses on the behavioural nature of the disorder with toilet training and laxatives, with the goal of daily stool passage without difficulties. Management of care is predominantly carried out at home by parents, making them key partners in the paediatric care.

    Aim: The overall aim of this thesis was to explore and understand childhood functional constipation through the experiences of parents.

    Design and method: This thesis comprise two studies based on a phenomenological research method and design with an inductive reflective lifeworld approach using qualitative individual interviews to gather data. A theoretical framework was used in the analysis to further elucidate the findings.

    Findings: Shame was the essential finding, providing the reason parents acted in certain ways and the result of the same actions. Study I showed that everyday life was put on hold due to the time and effort invested in the adaptations demanded by the constipation. This left the parents feeling lonely, guilty, and fighting frustrating battles as they tried to gain control by being always one step ahead. Study II showed that giving constipation treatment resulted in parents questioning their parental identity. Treatment needed to be affirmed, as doubt and second thoughts sometimes made parents give treatment against their own will as well as defying their child’s will, bordering on feelings of being abusive. The findings were interpreted in the light of theories of illness beliefs and good parenting beliefs, suggesting belief systems are the path into the parents’ feelings of shame. Re-evaluating the beliefs might diminish failure to adhere to treatment regimens.

    Conclusions: This project shows that functional constipation is like other childhood chronic illnesses in respect of its importance and impact on everyday family life. Shame is a prominent feature of functional constipation experiences. However, the shame felt might be mitigated by targeting and re-evaluating the belief systems that form the lifeworld of the parents and family.

    List of papers
    1. Everyday life with childhood functional constipation: A qualitative phenomenological study of parents' experiences
    Open this publication in new window or tab >>Everyday life with childhood functional constipation: A qualitative phenomenological study of parents' experiences
    2022 (English)In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 67, p. E165-E171Article in journal (Refereed) Published
    Abstract [en]

    Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life.

    Aim

    To explore parents´ experiences of living with a child with FC and its impact on everyday family life.

    Method

    A qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC.

    Findings

    Shame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame.

    Conclusion

    FC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed.

    Practice implications

    Healthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.

    Place, publisher, year, edition, pages
    Elsevier, 2022
    Keywords
    Functional constipation, Children, Parent experiences, Shame, Qualitative, Reflective lifeworld research
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-188960 (URN)10.1016/j.pedn.2022.07.021 (DOI)000922011600022 ()35931621 (PubMedID)
    Available from: 2022-10-04 Created: 2022-10-04 Last updated: 2023-05-04Bibliographically approved
    2. Experiences of parents who give pharmacological treatment to children with functional constipation at home
    Open this publication in new window or tab >>Experiences of parents who give pharmacological treatment to children with functional constipation at home
    2020 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, no 12, p. 3519-3527Article in journal (Refereed) Published
    Abstract [en]

    Aim

    The aim was to explore the lived experiences of parents who give oral and rectal pharmacological treatment to their children with functional constipation at home.

    Design

    A phenomenological design with a reflective lifeworld research approach that describes phenomena as they are experienced by individuals.

    Methods

    From January–May 2019, 15 interviews were conducted with parents of children with functional constipation with home‐based oral and rectal treatment. Parents were recruited from three different healthcare levels. Open‐ended questions were used starting from the description of a normal day with constipation treatment. Analyses were made with an open and reflective ‘bridling’ attitude.

    Findings

    Constipation treatment causes parents to question their parental identity and what it means to be a good parent. Forced treatment makes them feel abusive and acting against their will as parents. There is a conflict between doubt and second thoughts about the treatment, the urge to treat based on the child's needs and encouragement from healthcare professionals to give treatment.

    Conclusion

    As pharmacological constipation treatment can be experienced as challenging, it is important to help parents make an informed decision about how such treatment should be carried out at home. The findings reveal a medical treatment situation where parents hesitate and children resist, resulting in insecure parents who question their parental identity.

    Impact

    The findings point to the importance of supporting parents in treatment situations. Healthcare providers need to treat children with constipation with greater focus and more prompt management to prevent these families from lingering longer than necessary in the healthcare system.

    Place, publisher, year, edition, pages
    Wiley-Blackwell Publishing Inc., 2020
    Keywords
    children; functional constipation; good-parent beliefs; lived experiences; nursing; parental identity; phenomenology; treatment
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-171030 (URN)10.1111/jan.14539 (DOI)000576689300001 ()33043491 (PubMedID)2-s2.0-85092327678 (Scopus ID)
    Note

    Funding Agencies|Swedish Association of Paediatric Nurses

    Available from: 2020-11-01 Created: 2020-11-01 Last updated: 2022-10-07Bibliographically approved
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  • 2.
    Flankegård, Gunilla
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Mörelius, Evalotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. School of Nursing and Midwifery, Edith Cowan University, Australia.
    Rytterström, Patrik
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health.
    Everyday life with childhood functional constipation: A qualitative phenomenological study of parents' experiences2022In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 67, p. E165-E171Article in journal (Refereed)
    Abstract [en]

    Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life.

    Aim

    To explore parents´ experiences of living with a child with FC and its impact on everyday family life.

    Method

    A qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC.

    Findings

    Shame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame.

    Conclusion

    FC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed.

    Practice implications

    Healthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.

    Download full text (pdf)
    fulltext
  • 3.
    Flankegård, Gunilla
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Mörelius, Evalotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Edith Cowan Univ, Australia.
    Duchén, Karel
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Rytterström, Patrik
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Experiences of parents who give pharmacological treatment to children with functional constipation at home2020In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, no 12, p. 3519-3527Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim was to explore the lived experiences of parents who give oral and rectal pharmacological treatment to their children with functional constipation at home.

    Design

    A phenomenological design with a reflective lifeworld research approach that describes phenomena as they are experienced by individuals.

    Methods

    From January–May 2019, 15 interviews were conducted with parents of children with functional constipation with home‐based oral and rectal treatment. Parents were recruited from three different healthcare levels. Open‐ended questions were used starting from the description of a normal day with constipation treatment. Analyses were made with an open and reflective ‘bridling’ attitude.

    Findings

    Constipation treatment causes parents to question their parental identity and what it means to be a good parent. Forced treatment makes them feel abusive and acting against their will as parents. There is a conflict between doubt and second thoughts about the treatment, the urge to treat based on the child's needs and encouragement from healthcare professionals to give treatment.

    Conclusion

    As pharmacological constipation treatment can be experienced as challenging, it is important to help parents make an informed decision about how such treatment should be carried out at home. The findings reveal a medical treatment situation where parents hesitate and children resist, resulting in insecure parents who question their parental identity.

    Impact

    The findings point to the importance of supporting parents in treatment situations. Healthcare providers need to treat children with constipation with greater focus and more prompt management to prevent these families from lingering longer than necessary in the healthcare system.

    Download full text (pdf)
    fulltext
  • 4.
    Dahlberg, Mari
    et al.
    Skånes universitetssjukhus, Malmö, Sweden.
    Flankegård, Gunilla
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Gylin, Meta
    Sabbatsbergs sjukhus, Stockholm, Sweden.
    Westling, Eva
    Sabbatsbergs sjukhus, Stockholm, Sweden.
    Tarmterapi2019In: Uro-tarmterapi / [ed] Anna-Lena Hellström, Birgitta Lindehall, Lund: Studentlitteratur AB, 2019, p. 93-139Chapter in book (Other academic)
1 - 4 of 4
CiteExportLink to result list
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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf