Objectives: To explore the experience of post-traumatic growth among parents of children with biliary atresia undergoing living-related liver transplantation.Methods: Participants were recruited within 2 weeks of their child's transplant surgery using purposive sampling. Transcripts were analyzed using Colaizzi's descriptive analysis framework, with collaborative analysis conducted using NVivo 12 software and a post-traumatic growth model.Results: Five themes were identified: (a) experiencing a devastating blow, (b) cognitive reconstruction under overwhelming pain, (c) an arduous journey of decision-making, (d) rebirth in adversity and (e) post-traumatic growth. Parents undergo significant post-traumatic responses to their child's diagnosis of biliary atresia and liver transplantation, marking two major traumatic events. During the diagnostic stage, parents experience intense post-traumatic reactions characterized by emotional fluctuations and intrusive thoughts. The early treatment phase represents a crucial time for parents to transition from `denial of reality' to `accepting diseases'. The process of liver transplantation is also a significant traumatic event, accompanied by a final hope. Parents in the stable period after liver transplantation feel fortunate, hopeful and grateful, and their post-traumatic growth manifests gradually.Conclusions: Parents' experience of post-traumatic growth involves dynamic changes. Tailored intervention strategies should be developed for different stages to enhance their post-traumatic growth and psychological well-being. During the early treatment stage, mental health professionals could provide cognitive interventions to encourage parents to express their negative emotions and guide them to develop positive cognition toward traumatic events. The coping strategies and increasing personal growth are also important. In the postoperative stage, mental health professionals need to fully evaluate the coping styles of parents, and encourage them to establish effective internal coping strategies, while classic gratitude interventions could be given during the post-traumatic growth stage. Future research could involve a longitudinal qualitative study to explore parents' post-traumatic growth experiences at different stages of their children's transplantation process.
Objetivos: Explorar la experiencia del crecimiento postraumático en padres de niños con atresia biliar sometidos a trasplante hepático de donante vivo.
Métodos: Se utilizó un muestreo intencional para reclutar participantes dentro de las 2 semanas posteriores a la cirugía de trasplante de sus hijos. Se empleó el marco de análisis descriptivo de Colaizzi para analizar las transcripciones. Se utilizó el software NVivo 12 y un modelo de crecimiento postraumático para el análisis colaborativo.
Resultados: Se identificaron cinco temas: (a) experimentar un golpe devastador, (b) reconstrucción cognitiva bajo un dolor abrumador, (c) un arduo camino de toma de decisiones, (d) renacer en la adversidad y (e) crecimiento postraumático. Para los padres, el diagnóstico de atresia biliar de sus hijos y el tratamiento mediante trasplante hepático, son dos eventos traumáticos significativos que implican una respuesta postraumática considerable. La etapa de diagnóstico es el periodo en el que los padres presentan las reacciones postraumáticas más intensas, con fluctuaciones emocionales extremas y deliberación intrusiva. La etapa inicial del tratamiento es un periodo crítico para que los padres logren una transformación de la “negación de la realidad” a la “aceptación de la enfermedad”. El proceso de trasplante hepático es otro evento traumático significativo para los padres, acompañado de una esperanza final. En el periodo estable después del trasplante, los padres se sienten afortunados, esperanzados y agradecidos, y su crecimiento postraumático se manifiesta gradualmente.
Conclusiones: La experiencia del crecimiento postraumático en los padres presentó cambios dinámicos, mostrando diferentes respuestas en cada etapa. Es fundamental formular estrategias de intervención específicas para cada etapa para mejorar el nivel del crecimiento postraumático y el bienestar psicológico de los padres. Durante la etapa inicial del tratamiento, los profesionales de la salud mental podrían proporcionar intervenciones cognitivas para alentar a los padres a expresar sus emociones negativas y guiarlos a desarrollar una cognición positiva hacia los eventos traumáticos. También es importante fomentar estrategias de afrontamiento y el crecimiento personal. En la etapa postoperatoria, los profesionales de la salud mental deben evaluar plenamente los estilos de afrontamiento de los padres, alentarlos a establecer estrategias internas efectivas de afrontamiento y considerar intervenciones clásicas de gratitud durante la etapa de crecimiento postraumático.
Keywords: Fenomenología descriptiva; Post-traumatic growth; atresia biliar; biliary atresia; crecimiento postraumático; descriptive phenomenology; enfermería de salud mental; experiences; experiencias; living-related liver transplantation; mental health nursing; trasplante hepático de donante vivo.
The experience of post-traumatic growth among parents of paediatric living related liver transplantion presenting dynamic changes, and different responses were displayed in each stage, the child’s diagnosis with biliary atresia and receiving liver transplantation treatment are both two major traumatic events for parents, with significant post-trauma response.A positive reassessment of traumatic event is the key for parents to perform active cognitive reconstruction, achieve a transformation from ‘denial of reality’ to ‘accepting diseases’ and move towards growth, and healthcare providers should guide them to develop positive cognition towards traumatic events.We highlighted the importance of coping strategies and gaining personal growth. Healthcare providers should fully evaluate the coping styles of parents and encourage them to establish effective internal coping strategies, and provide targeted psychological interventions at different stages to improve their post-traumatic growth level and psychological well-being, especially those served as both donors and primary caregivers.