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An Interpretative Phenomenological Analysis of the Subjective Experience of Children With Cancer in Hospital-at-Home
Voskan Kirakosyan1,2, Caroline Miler3, Adeline Mallard3
1Department of Psychology, CLIPSYD - A2P, Paris Nanterre University, Nanterre, France.
Insights
Hospital-at-Home (HaH) care offers children with cancer a sense of normality and security. However, it can also heighten family emotional dynamics and lead to children taking on parental roles.
Area of Science:
- Pediatric Oncology
- Child Psychology
- Healthcare Delivery Models
Background:
- Pediatric cancer significantly impacts children's lives and well-being.
- Hospital-at-Home (HaH) offers an alternative to inpatient care.
- The subjective experiences of children in HaH settings are not well understood.
Purpose of the Study:
- To explore and understand the lived experiences of children receiving HaH care.
- To gain insight into children's subjective trajectories during HaH treatment.
- To identify the child's perspective on the HaH care model.
Main Methods:
- Qualitative research design.
- Interpretative phenomenological analysis (IPA) methodology.
- In-depth interviews with seven children aged 7-12 undergoing HaH treatment.
Main Results:
- Children perceived HaH as a structured, reassuring environment promoting normality and identity continuity.
- Children recognized their parents' heightened attention and emotional burden.
- Children discovered a sense of agency through their physical vulnerability.
- Some children exhibited parentification, concealing their distress to protect parents.
Conclusions:
- Hospital-at-Home care involves complex emotional and relational dynamics for pediatric cancer patients.
- While HaH can enhance security, it may intensify family emotional processes.
- Psychological support is crucial to ensure children remain children, not just patients, during HaH treatment.
Abstract:
BackgroundPaediatric cancer profoundly disrupts children's lives, with wide-ranging consequences. Hospital-at-Home (HaH) has been developed as an alternative to traditional hospitalisation, yet the subjective experiences of the children remain largely unknown. The aim of this study is to understand these experiences as they are perceived and described by the children themselves and to provide more meaningful insight into their subjective trajectories.MethodA qualitative study based on interpretative phenomenological analysis (IPA) was conducted with seven children aged 7 to 12 receiving HaH.ResultsFour main themes emerged. (1) Homecare - a structured and reassuring routine: the children describe a reassuring environment that fosters continuity of identity and a sense of normality; (2) Perception of parenting - "I became their concern": the children acutely perceive their parents' increased attention, hypervigilance and emotional burden; (3) Discovery of an unprecedented power: physical vulnerability becomes a subtle lever of agency and negotiation in the care relationship; and (4) Parentification of children with cancer: some children protect their parents by concealing their pain or concerns.ConclusionHaH involves complex emotional and relational processes. While reinforcing the child's security and continuity, HaH may also intensify emotional dynamics within the family. These results highlight the need for appropriate psychological support to ensure that the child remains, above all, a child despite their illness.
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