P84 How was it for them? Experiences of parents of children undergoing surgical treatment for empyema thoracis

Abstract

Introduction Opinion is divided regarding the management of empyema thoracis in children. There is wide regional variation in treatment, which is only partially related to variations in the availability of skills and resources. There is currently no published evidence of parent experience of treatment of empyema thoracis in children. Objective To explore the experiences of parents of children who have undergone definitive surgical treatment for empyema thoracis. Methods Qualitative, face-to-face, semi-structured interviews with parents of children who had undergone definitive surgical treatment for empyema thoracis. Methodology: interpretative phenomenological analysis. Participants were recruited from a large UK teaching hospital between December 2012 and March 2013. They were interviewed in hospital just before discharge. Parents of 8 children aged 11 months to 6 years, 8 mothers and 2 fathers (2 sets of both parents). Results The overarching theme revealed in all of the parents' accounts was trust. The parents' perceptions of development or undermining of trust was influenced by several factors. They include: communication and interactions with staff; information provision and methods used to provide explanations including use of visual aids; staff competence demonstrated by knowledge and experience; evidence of team-work and non-verbal actions such as smiling, eye contact and perceived attitude. The establishment of trust also differed through the stages from GP referral, admittance to secondary and tertiary hospitals, peri- and post-operative phases. Additionally the accounts revealed that parents were relieved when surgery was undertaken. Most parents were pragmatic about the scars following surgery, but considered that all of the scars were significant, not just the thoracotomy scar. Conclusions Verbal and non-verbal communication used by staff when talking to families can have a significant impact on the development or undermining of trust. This can affect parental perception of competence and care provided by practitioners.