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Revisiting medical neglect concerns in children with life-threatening complex chronic conditions
Child Abuse & Neglect ( IF 4.863 ) Pub Date : 2023-05-17 , DOI: 10.1016/j.chiabu.2023.106220
Ross W Cleveland 1 , Rachel S Deming 1 , Gabrielle Helton 1 , Celeste R Wilson 2 , Christina K Ullrich 3
Affiliation  

Background/objectives

Life-Threatening Complex Chronic Conditions (LT-CCCs) increase the complexity of medical neglect concerns. Clinicians' perspectives are central in concerns for medical neglect, yet little is currently known regarding clinicians' understanding of and approach to these situations. We explored how clinicians who care for children with LT-CCCs understand medical neglect.

Methods

We conducted a semi-structured qualitative interview study with 20 clinicians of varying disciplines from critical, palliative, and complex care services about medical neglect in children with LT-CCCs. We used inductive thematic analysis to generate themes.

Results

Three primary themes emerged: Relationship between family and medical community, family overwhelmed with medical demands, and insufficient support. Taken together these themes suggest that concerns for medical neglect are directly related to clinician perception of family inability to meet medical needs.

Conclusion

Clinicians report that concerns for medical neglect in children with LT-CCCs often arise from a mismatch of medical expectations and the perception of familial ability to provide said medical care. Given the complex and delicate medical and psychosocial environments of care for children with LT-CCCs, these medical neglect concerns are more accurately described as Medical Insufficiency, a new term. By reframing this entity, we can reframe the dialogue surrounding this issue, and reconsider approaches to studying, preventing, and resolving it.



中文翻译:

重新审视患有危及生命的复杂慢性病儿童的医疗忽视问题

背景/目标

威胁生命的复杂慢性疾病 (LT-CCC) 增加了医疗忽视问题的复杂性。临床医生的观点是关注医疗忽视的核心,但目前对临床医生对这些情况的理解和处理方式知之甚少。我们探讨了照顾患有 LT-CCC 儿童的临床医生如何理解医疗忽视。

方法

我们对 20 名不同学科的临床医生进行了一项半结构化定性访谈研究,这些临床医生来自重症、姑息性和复杂护理服务领域,涉及 LT-CCC 儿童的医疗忽视。我们使用归纳主题分析来生成主题。

结果

出现了三个主要主题:家庭与医疗社区之间的关系、家庭因医疗需求不堪重负以及支持不足。综合这些主题表明,对医疗忽视的担忧与临床医生认为家庭无法满足医疗需求直接相关。

结论

临床医生报告说,对患有 LT-CCC 的儿童的医疗忽视的担忧通常是由于医疗期望不匹配以及对家庭提供所述医疗服务能力的看法不匹配。鉴于 LT-CCC 患儿的医疗和社会心理环境复杂而微妙,这些医疗忽视问题更准确地描述为医疗不全,一个新术语。通过重构这个实体,我们可以重构围绕这个问题的对话,并重新考虑研究、预防和解决它的方法。

更新日期:2023-05-17
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