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Publication Date

2020

First Advisor

Joanne Corbin

Second Advisor

John Hull

Third Advisor

Maria Torres

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

School for Social Work

Keywords

Telemental health intervention, Ventilator-dependent, Disability, Parents, Quality of life, Chronic illness, Parents of children with disabilities, Emotional functioning

Abstract

In pediatric care settings internationally, it is common to discharge children with extensive medical needs to continue treatment at home. Some of these children are technologydependent, a term used to describe those who require the use of durable medical equipment, including mechanical respiratory support, to carry out vital body functions and to sustain activities of daily living. Accessing these devices also prevents long-term hospitalization as well as further morbidities and mortality (Wagner, Power, & Fox, 1988).

Children who require assistive technology at home face some of the most severe healthrelated conditions of children with physical and developmental disabilities. Young patients receiving continuous mechanical respiration support through mechanical ventilators are a growing population, often requiring multiple hospitalizations over a lifetime. These children and their families present with extensive needs. Although parenting a child is challenging, even under ideal circumstances, the care of a child with complex needs requires greater than normal parenting skills.

Medical social workers find themselves providing comprehensive services to ventilatordependent children and their families, in an effort to minimize avoidable hospitalizations. These social workers must also help both the patient and their caregivers’ transition from hospital 6 settings to their homes. Knowledge of this population’s unique psychosocial needs is crucial. Yet, little research exists on psychosocial interventions for this population.

A randomized controlled trial was used to assess the feasibility and efficacy of a Telepsychotherapy (Tele-P) intervention as a way to promote the emotional functioning (i.e., reduced anxiety, depression, and social isolation) of caregivers and to help increase the quality of life of children who are dependent upon a mechanical ventilator at home (DMVH) in the Critical Care, Anesthesia and Perioperative Extension (CAPE) program at Boston Children's Hospital.

In this study, the reduction was found in caregivers' anxiety, depression, and fatigue after participating in a Tele-P intervention. There was no change in social isolation. Systems theory and object relations theory were used as theoretical frameworks, and implications for social work, research, and policy were addressed.

Rights

©2020 Yudy Muneton-Castano Access limited to the Smith College community and other researchers while on campus. Smith College community members also may access from off-campus using a Smith College log-in. Other off-campus researchers may request a copy through Interlibrary Loan for personal use.

Language

English

Comments

149 pages. Includes bibliographical references (pages 87-96)

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