Article Text

Original research
COVID-19 pandemic experiences of parents caring for children with oesophageal atresia/tracheo-oesophageal fistula
  1. Alexandra Stewart1,2,
  2. Christina H Smith2,
  3. Simon Eaton3,
  4. Paolo De Coppi3,4,
  5. Jo Wray5
  1. 1 Department of Speech and Language Therapy, Great Ormond Street Hospital For Children NHS Trust, London, UK
  2. 2 Department of Language and Cognition, University College London, London, UK
  3. 3 Stem Cells and Regenerative Medicine Section, University College London Institute of Child Health, London, UK
  4. 4 Specialist Paediatric and Neonatal Surgery, Great Ormond Street Hospital For Children NHS Trust, London, UK
  5. 5 Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital For Children NHS Trust, London, UK
  1. Correspondence to Ms Alexandra Stewart; alex.stewart{at}gosh.nhs.uk

Abstract

Purpose The COVID-19 pandemic has resulted in a global health crisis of unparalleled magnitude. The direct risk to the health of children is low. However, disease-containment measures have society-wide impacts. This study explored the pandemic experiences of parents of children with oesophageal atresia/tracheo-oesophageal fistula (OA/TOF) in the UK.

Design A phenomenological approach underpinned use of an asynchronous online forum method, in collaboration with a patient support group. Data were evaluated using thematic analysis.

Results The online forum ran between 7 November and 18 December 2020 with 109 participants.

Pandemic experiences were divided into themes relating to healthcare and disease containment. Participants described positive experiences with remote healthcare but identified limitations. Delays and cancellations led to escalation of care to an emergency level, slower developmental progress and feelings of being abandoned by services. Inpatient care was perceived as safe but caring alone was emotionally and practically challenging. Disease containment themes revealed anxiety regarding health risks, ‘collateral’ damage to well-being because of isolation, and an impact on finances and employment. Parents described a transition from worry about direct health risks to concern about the impact of isolation on socialisation and development. A process of risk–benefit analysis led some to transition to a more ‘normal life’, while others continued to isolate. Benefits to their child’s health from isolation were reported.

Conclusions Parents’ experiences of caring for a child with OA/TOF during the pandemic were varied. Rapid adoption of telehealth has demonstrated the enormous potential of remote healthcare delivery but requires refinement to meet the needs of the individual. Future pandemic planning should aim to retain community healthcare services to avoid escalation of care to an emergency, manage chronic and developmental concerns, and support parental well-being. Accurate and consistent disease-specific information is highly valued by parents. Third sector organisations are ideally positioned to support this.

  • COVID-19
  • qualitative research

Data availability statement

No data are available. Although data have been anonymised, we have not made data available to protect the identity of those involved in the research, due to the detail provided by participants.

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Data availability statement

No data are available. Although data have been anonymised, we have not made data available to protect the identity of those involved in the research, due to the detail provided by participants.

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Footnotes

  • Twitter @AlexStewart_SLT

  • Contributors AS, JW and CHS designed the study. AS led the data collection. All authors were involved in data analysis. AS drafted the manuscript. JW, CHS, SE and PDC all revised the work and approved it for submission.

  • Funding AS is currently undertaking a PhD funded by the National Institute for Health Research (NIHR) (award reference: ICA-CDRF-2018–04-ST2-042). This publication indicates independent research funded by the NIHR. Research at Great Ormond Street Hospital for Children NHS Trust is supported by the NIHR GOS/ICH Biomedical Research Centre.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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