Primary care physicians' experience of caring for children with parents with mental health illness: a qualitative study among French general practitioners and paediatricians

BMC Primary Care

Research

Lucie Rosenthal¹  Cécile Ribette¹  Ludivine Franchitto¹  Alexis Revet²  Jean-Philippe Raynaud² 

[1] Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France;Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France;CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France;

关键词: Parental psychiatric disorders;    Attachment disorder;    Private physicians’ experiences;    Qualitative research;    Interpretative phenomenological analysis;   

DOI  :  10.1186/s12875-023-02145-y

 received in 2022-11-04, accepted in 2023-08-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundParental psychiatric disorders can have a significant impact on child development and the parent-infant bond, with a high risk of attachment disorders. Early identification of difficulties in the parent–child relationship is essential to prevent consequences for the child. Childcare practitioners have a major role to play in this early detection process, through regular mandatory consultations during the first two years of a child's life. Thus, the aim of this study was to collect the experience of private practitioners in their care of children of parents with a mental health illness.MethodThis is a cross-sectional, observational, qualitative study. Data were collected by means of semi-structured interviews with eleven general practitioners and private paediatricians between February and July 2021 in Toulouse and its suburbs. We only included practitioners who had followed children of parents with a mental health illness. The interviews were recorded with the agreement of the participants, before being transcribed anonymously. The data were analysed with NVivo software using interpretative phenomenological analysis.ResultsThree main themes emerged from the results, which were further divided into several sub-themes. Addressing psychiatric disorders presents a risk for the therapeutic relationship. Practitioners express a need to preserve this relationship with the parent in joint care. Care is difficult and is permeated by the parents' emotional issues. Furthermore, practitioners face a conflict between their concerns for the parent–child bond and their desire not to stigmatise these families. They express a feeling of isolation in these follow-ups. This stressful care has a significant emotional impact on the doctors. Access to psychiatric training and multidisciplinary collaboration seem to be essential to improve the follow-up experience for practitioners, as these factors strengthen inter-professional connections.ConclusionPractitioners describe a parent-doctor relationship at risk, which is underpinned by the fear of care placement. This study illustrates the need to strengthen multidisciplinary work by promoting interprofessional exchanges, in order to improve the experience of practitioners in this care process. Addressing practitioners’ fear of discussing parental psychiatric illness is very important, so as not to delay the implementation of preventive actions that are likely to improve the developmental prognosis for children.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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