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Patient-Centered Outcomes in Bronchiolitis
Jennifer E Lane1, Byron A Foster1,2
1Division of Pediatric Hospital Medicine, Oregon Health and Science University.
Insights
Hospitalization for bronchiolitis significantly impacts caregiver bonding, holding, and breastfeeding, with effects worsening with increased patient support levels. This highlights the need for tailored care strategies.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Patient-Centered Care
Background:
- Bronchiolitis is a common respiratory infection in infants.
- Hospitalization for bronchiolitis can affect patient and caregiver well-being.
- The impact of varying support levels during hospitalization is not well understood.
Purpose of the Study:
- To examine the impact of bronchiolitis hospitalization on patient-centered outcomes.
- To assess how different levels of patient support influence these outcomes.
Main Methods:
- 92 caregivers of infants hospitalized for bronchiolitis completed a validated questionnaire.
- Patients were categorized by support level: no support, low, moderate, high, and positive pressure support.
- Descriptive statistics analyzed the impact scores across support groups.
Main Results:
- Increased support levels correlated with higher scores for difficulty holding the infant (P = .003).
- Higher support levels also showed increased difficulty in bonding (P = .04) and breastfeeding disruption (P < .001).
Conclusions:
- Bronchiolitis hospitalization negatively impacts caregiver bonding, infant holding, and breastfeeding.
- The severity of these impacts is associated with the level of respiratory support required by the infant.
Objectives:
We examined the impact of hospitalization for bronchiolitis on patient-centered outcomes across patients with varying levels of support.
Methods:
The participants included primary caregivers of children aged 0 to 24 months hospitalized for bronchiolitis at an 150-bed tertiary care children's hospital. Data were collected using a 30-item questionnaire examining quality of life impact, adapted from the previously validated survey, the Impact of Bronchiolitis Hospitalization Questionnaire.1 The survey contained questions asking to what extent the hospitalization interfered with different aspects of care. After all surveys were collected, the patients were split into groups categorized by level of support and defined as no support, low support (low-flow nasal cannula only or nasogastric [NG] only), moderate support (high-flow nasal cannula without NG), high support (high-flow nasal cannula with NG support), and positive pressure (with or without NG support). Descriptive statistics were used to examine the distribution of mean impact scores across these groups.
Results:
A total of 92 caregivers and their children were included. The mean impact score for variables of difficult to hold, difficult to bond, and breastfeeding disruption increased with greater levels of support with P values of P = .003, P = .04, and P < .001, respectively.
Conclusions:
We found that the impact on patient-reported outcomes varied by level of support, as defined here, among children hospitalized with bronchiolitis, with significant impacts being in areas of caregiver bonding, caregiver holding, and breastfeeding.
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