Abstract

AimKnowledge is scarce regarding mothers’ and fathers’ experiences of being a parent of a child with VACTERL association—a complex malformation. The aim of the study was to describe experiences of being a parent of a child with VACTERL association.MethodSemi-structured interviews were performed with ten mothers and nine fathers face-to-face or by telephone and analyzed by using Qualitative content analysis.ResultsThe parents described crisis reactions at the discovery of malformations in their child. Involvement in care was reported from the initial hospital admission until actively taking responsibility for treatments at home. Eventually the health condition became an integrated part of everyday life. The parents expressed the importance of meeting other families with a child with VACTERL. Descriptions were given of more or less professionalism with perceived discrepancies of knowledge and experience between the healthcare professionals in the tertiary hospital and those in the local hospital. Difficulties in receiving medical support during the initial period at home were described. Furthermore, emotional support and practical arrangements regarding parental accommodation and transportation varied.ConclusionBeing a parent of a child with VACTERL association involves crisis, mixed emotional reactions and shared responsibility for the child´s treatment and care with the professional care providers. Psychological processing, good medical care and support from experts, and peer support from other parents is essential in the parents’ struggle to reach self-confidence and adaptation. A care plan with individualized tailored care for each child including a training and support plan for the parents is warranted. To reduce the described discrepancies in knowledge and experience between the local and tertiary hospital, video sessions with the parents and responsible professionals at the local and tertiary hospital could be an appropriate mode of transferring information at discharge and follow up of the child.

Highlights

  • Involvement in care was reported from the initial hospital admission until actively taking responsibility for treatments at home

  • The health condition became an integrated part of everyday life

  • VACTERL association is a complex condition of congenital malformations that coexist in a single patient and the acronym stands for vertebral defects (V), anorectal malformations (A), cardiac defects (C), tracheo-esophageal fistula (TE), renal anomalies (R) and limb abnormalities (L)

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Summary

Introduction

VACTERL association is a complex condition of congenital malformations that coexist in a single patient and the acronym stands for vertebral defects (V), anorectal malformations (A), cardiac defects (C), tracheo-esophageal fistula (TE), renal anomalies (R) and limb abnormalities (L). Most children require surgery during the first days of life and often repeatedly during childhood [1]. Bowel dysfunction is common in children with anorectal malformations (ARM) often requiring daily treatment with enemas. Cardiac defects may result in impaired physical capacity and children with esophageal atresia (EA) often suffer from dysphagia, gastroesophageal reflux and respiratory symptoms [1,2,3,4]. Children with VACTERL association may need extra support and adjustments in school due to physical dysfunction and attention difficulties [4]

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