Being 'at-home' on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents' experiences of paediatric OPAT.

OBJECTIVE: To better understand the factors that facilitate and hinder a positive experience of paediatric outpatient parenteral antimicrobial therapy (OPAT). DESIGN: Qualitative study using semistructured interviews. SETTING: A dedicated paediatric consultant-led hospital-based, outreach OPAT service in England. PARTICIPANTS: Participants were primarily parents of children who had received OPAT; one child participated. METHODS: Children and parents of children who received OPAT and who had participated in the survey phase of the larger study were invited to be interviewed. RESULTS: 12 parents (10 mothers and 2 fathers) of 10 children participated; one child (aged 15 years). Data analysis resulted in one meta-theme, 'At-homeness' with OPAT, this reflected the overall sense of home being a place in which the children and their parents could be where they wanted to be. Four key themes were identified that reflect the ways in which parents and children experienced being at-home on OPAT: 'Comfort, security, freedom, and control'; 'Faith, trust and confidence'; 'Explanations and communication' and 'Concerns, restrictions and inconveniences'. CONCLUSIONS: Despite feeling anxious at times, parents reported that they and their children generally had a positive experience of OPAT; being at-home brought many benefits compared with in-patient care. Recommendations arising from the study include a 'whole-system' approach to discharge home that includes support related to return to school/nursery, reduction in disruptions to home-based routines, more clarity on choice and preparation for managing potential anxiety, better consideration of dose timing and enhanced preparation and information.

[Qualitative and collaborative research with cancer patients. Experience narratives of treatments for peritoneal carcinomatosis]. / Une recherche qualitative et collaborative auprès de patients atteints de cancer. Récits d'expérience des traitements de la carcinose péritonéale.

UNLABELLED: This CORCAN study is concerned with the way patients hospitalised for peritoneal carcinosis perceive surgical treatment and hyperthermic intraperitoneal chemotherapy (HIPEC). OBJECTIVES: (1) To identify and analyse, using concepts of social representation and accounts of the illness, characteristics of the way this treatment is experienced; (2) to inform doctors and healthcare workers about patients' representations, with a view to adjusting the treatment, the care and the information given to patients. METHODOLOGY: Fifty-eight directive and nondirective interviews were conducted longitudinally with 21 patients (13 women and 7 men) hospitalised for treatment by cell killing and HIPEC. RESULTS: Five important elements of concern were raised and discussed by the patients at different stages of the disease, then reported and discussed with the doctors and healthcare workers. These were patients' experiences of: the hyperthermic intraperitoneal chemotherapy (HIPEC), randomisation, intensive care, the effects of surgery on the digestive system, reorganising their diet, and returning home.

[Experiences with a completely implantable intravenous system in children]. / Ervaringen met een volledig implanteerbaar intraveneus systeem bij kinderen.

A totally implantable system for venous access has been implanted in 65 children with chronic disease requiring repeated or/and prolonged intravenous therapy. The experiences are described. They indicate that the use of wide catheters (internal diameter greater than or equal to 0.76 mm) and a position of the catheter in the vena cava superior/right atrium rarely give complications, besides a relatively low incidence of sepsis. The children accept the use of the system very well and the easy venous access decreases their emotional stress during a long period of intensive therapy.

Patients' knowledge of their condition and treatment: how it might be improved.

A study was carried out in which patients were asked questions to assess their knowledge of their condition and treatment, the questions relating particularly to care before siting an intravenous infusion and preoperative care. A high proportion of patients knew little about the procedure they were about to undergo. It is recommended that patients should be told more about matters relating to their condition and treatment. Written information could be given to supplement that given verbally by staff. A check list might be drawn up to ensure that patients receive all relevant information.

Some guidelines for uses of hypnotherapy in pediatrics.

Hypnotherapy has many uses in pediatrics, and its value, not only as a adjunct but also as a primary therapy for certain conditions, justifies its inclusion in pediatric training programs. Suggestion and expectation have long been related to therapeutic outcomes in medicine, but not all physicians know how to apply them constructively and systematically in communication with patients. In pediatrics there is a tendency to overlook opportunities in which hypnosis might be the treatment of choice. Because children engage in imagination and fantasy easily without the cognitive inhibitions of adults, they are able to use hypnosis more readily than adults. More research into the imaginative skills of children may facilitate understanding of learning mechanisms and make it possible for professionals to prevent the loss of the natural imaginative capacities in children and, therefore, enhance the ability of mature members of society to use these skills. In addition to reduction of specific symptoms through hypnotherapy, children benefit by the sense of mastery which they acquire, a sense which is surely needed to overcome the feelings of hopelessness, loss of control, and depression induced by many diagnostic and therapeutic procedures in medicine.