Skip to main content
Top
Published in: BMC Pediatrics 1/2020

Open Access 01-12-2020 | Care | Research article

Looking into the life of technology-dependent children and their caregivers in Korea: lifting the burden of too many responsibilities

Authors: Yu Hyeon Choi, Min Sun Kim, Cho Hee Kim, In Gyu Song, June Dong Park, Dong In Suh, Hyung-Ik Shin

Published in: BMC Pediatrics | Issue 1/2020

Login to get access

Abstract

Background

The number of technology-dependent children (TDC) is increasing in South Korea, but available healthcare services after their discharge are poor. This study aimed to examine how TDC and caregivers live at home and identify their difficulties and needs regarding home care with few services to support them.

Methods

This cross-sectional study was conducted in a tertiary hospital for children in South Korea. A self-reported questionnaire was completed by primary caregivers of TDC who were younger than 19 years and had been dependent on medical devices for more than 3 months. Technologies included home mechanical ventilation, oxygen supplementation, suction equipment, enteral feeding tube, and home total parenteral nutrition. Patterns of healthcare use and home care of TDC and caregivers’ perception toward child were assessed.

Results

A total of 74 primary caregivers of TDC completed a self-reported questionnaire. About 60% children were aged under 5 years. There were 31.1% children who required both respiratory and nutritional support. On average, caregivers took care of a child for 14.4 (±6.1) hours, slept for 5.6 (±1.6) hours, and spent 2.4 h per day on personal activities. Children used hospital services for 41.3 (±45.6) days in 6 months, and most (78.1%) were transported through private car/ambulance. Participants (75.6%) reported taking more than an hour to get to the hospital. More than 80% of caregivers responded that child care is physically very burdensome. The only statistically significant relationships was between economic status and financial burden (p = 0.026).

Conclusions

Caregivers of TDC reported having significant time pressure regarding childcare-related tasks, insufficient time for personal activities, and inefficient hospital use because of inadequate medical services to support them in South Korea. Thus, it is necessary to support caregivers and develop a home care model based on current medical environment.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SK, Simon TD, et al. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011;127(3):529–38.CrossRef Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SK, Simon TD, et al. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011;127(3):529–38.CrossRef
2.
go back to reference Spratling R. Defining technology dependence in children and adolescents. West J Nurs Res. 2015;37(5):634–51.CrossRef Spratling R. Defining technology dependence in children and adolescents. West J Nurs Res. 2015;37(5):634–51.CrossRef
3.
go back to reference Wang K-WK, Barnard A. Caregivers' experiences at home with a ventilator-dependent child. Qual Health Res. 2008;18(4):501–8.CrossRef Wang K-WK, Barnard A. Caregivers' experiences at home with a ventilator-dependent child. Qual Health Res. 2008;18(4):501–8.CrossRef
4.
go back to reference Pordes E, Gordon J, Sanders LM, Cohen E. Models of care delivery for children with medical complexity. Pediatrics. 2018;141(Suppl 3):S212–s23.CrossRef Pordes E, Gordon J, Sanders LM, Cohen E. Models of care delivery for children with medical complexity. Pediatrics. 2018;141(Suppl 3):S212–s23.CrossRef
5.
go back to reference Park HJ, Moon EK, Yoon JY, Oh CM, Jung KW, Park BK, et al. Incidence and survival of childhood Cancer in Korea. Cancer Res Treat. 2016;48(3):869–82.CrossRef Park HJ, Moon EK, Yoon JY, Oh CM, Jung KW, Park BK, et al. Incidence and survival of childhood Cancer in Korea. Cancer Res Treat. 2016;48(3):869–82.CrossRef
6.
go back to reference Hahn W-H, Chang J-Y, Chang YS, Shim KS, Bae C-W. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA. J Korean Med Sci. 2011;26(4):467–73.CrossRef Hahn W-H, Chang J-Y, Chang YS, Shim KS, Bae C-W. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA. J Korean Med Sci. 2011;26(4):467–73.CrossRef
7.
go back to reference Park M, Jang H, Sol IS, Kim SY, Kim YS, Kim YH, et al. Pediatric home mechanical ventilation in Korea: the present situation and future strategy. J Korean Med Sci. 2019;34(42):e268.CrossRef Park M, Jang H, Sol IS, Kim SY, Kim YS, Kim YH, et al. Pediatric home mechanical ventilation in Korea: the present situation and future strategy. J Korean Med Sci. 2019;34(42):e268.CrossRef
8.
go back to reference Lee JY, Eun SJ, Ock M, Kim HJ, Lee HJ, Son WS, et al. General internists' perspectives regarding primary care and currently related issues in Korea. J Korean Med Sci. 2015;30(5):523–32.CrossRef Lee JY, Eun SJ, Ock M, Kim HJ, Lee HJ, Son WS, et al. General internists' perspectives regarding primary care and currently related issues in Korea. J Korean Med Sci. 2015;30(5):523–32.CrossRef
9.
go back to reference Harrison JK, Chadwick M, Scales M. The relationship between cross-cultural adjustment and the personality variables of self-efficacy and self-monitoring. Int J Intercult Relat. 1996;20(2):167–88.CrossRef Harrison JK, Chadwick M, Scales M. The relationship between cross-cultural adjustment and the personality variables of self-efficacy and self-monitoring. Int J Intercult Relat. 1996;20(2):167–88.CrossRef
10.
go back to reference Kirk S, Glendinning C, Callery P. Parent or nurse? The experience of being the parent of a technology-dependent child. J Adv Nurs. 2005;51:456–64.CrossRef Kirk S, Glendinning C, Callery P. Parent or nurse? The experience of being the parent of a technology-dependent child. J Adv Nurs. 2005;51:456–64.CrossRef
11.
go back to reference McCann D, Bull R, Winzenberg T. The daily patterns of time use for parents of children with complex needs: a systematic review. J Child Health Care. 2012;16(1):26–52.CrossRef McCann D, Bull R, Winzenberg T. The daily patterns of time use for parents of children with complex needs: a systematic review. J Child Health Care. 2012;16(1):26–52.CrossRef
12.
go back to reference Toly VB, Musil CM, Carl JC. Families with children who are technology dependent: normalization and family functioning. West J Nurs Res. 2012;34(1):52–71.CrossRef Toly VB, Musil CM, Carl JC. Families with children who are technology dependent: normalization and family functioning. West J Nurs Res. 2012;34(1):52–71.CrossRef
13.
go back to reference Newacheck PW, Inkelas M, Kim SE. Health services use and health care expenditures for children with disabilities. Pediatrics. 2004;114(1):79–85.CrossRef Newacheck PW, Inkelas M, Kim SE. Health services use and health care expenditures for children with disabilities. Pediatrics. 2004;114(1):79–85.CrossRef
14.
go back to reference Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. Pediatrics. 2012;130(6):e1463–70.CrossRef Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. Pediatrics. 2012;130(6):e1463–70.CrossRef
15.
go back to reference Alfred S, Christina S, Carol C, Mike G. The potential for errors in children with special health care needs. Acad Emerg Med. 2000;7:1330–3.CrossRef Alfred S, Christina S, Carol C, Mike G. The potential for errors in children with special health care needs. Acad Emerg Med. 2000;7:1330–3.CrossRef
16.
go back to reference Caicedo C. Families with special needs children: family health, functioning, and care burden. J Am Psychiatr Nurses Assoc. 2014;20(6):398–407.CrossRef Caicedo C. Families with special needs children: family health, functioning, and care burden. J Am Psychiatr Nurses Assoc. 2014;20(6):398–407.CrossRef
17.
go back to reference Yotani N, Ishiguro A, Sakai H, Ohfuji S, Fukushima W, Hirota Y. Factor-associated caregiver burden in medically complex patients with special health-care needs. Pediatr Int. 2014;56(5):742–7.CrossRef Yotani N, Ishiguro A, Sakai H, Ohfuji S, Fukushima W, Hirota Y. Factor-associated caregiver burden in medically complex patients with special health-care needs. Pediatr Int. 2014;56(5):742–7.CrossRef
18.
go back to reference Elias ER, Murphy NA. Council on children with disabilities. Home care of children and youth with complex health care needs and technology dependencies. Pediatrics. 2012;129(5):996–1005.CrossRef Elias ER, Murphy NA. Council on children with disabilities. Home care of children and youth with complex health care needs and technology dependencies. Pediatrics. 2012;129(5):996–1005.CrossRef
19.
go back to reference Cohen E, Jovcevska V, Kuo DZ, Mahant S. Hospital-based comprehensive care programs for children with special health care needs: a systematic review. Arch Pediatr Adolesc Med. 2011;165(6):554–61.CrossRef Cohen E, Jovcevska V, Kuo DZ, Mahant S. Hospital-based comprehensive care programs for children with special health care needs: a systematic review. Arch Pediatr Adolesc Med. 2011;165(6):554–61.CrossRef
20.
go back to reference D'Aprano A, Gibb S, Riess S, Cooper M, Mountford N, Meehan E. Important components of a programme for children with medical complexity: an Australian perspective. Child Care Health Dev. 2020;46(1):90–103.CrossRef D'Aprano A, Gibb S, Riess S, Cooper M, Mountford N, Meehan E. Important components of a programme for children with medical complexity: an Australian perspective. Child Care Health Dev. 2020;46(1):90–103.CrossRef
21.
go back to reference Kuo DZ, Robbins JM, Lyle RE, Barrett KW, Burns KH, Casey PH. Parent-reported outcomes of comprehensive care for children with medical complexity. Fam Syst Health. 2013;31(2):132–41.CrossRef Kuo DZ, Robbins JM, Lyle RE, Barrett KW, Burns KH, Casey PH. Parent-reported outcomes of comprehensive care for children with medical complexity. Fam Syst Health. 2013;31(2):132–41.CrossRef
Metadata
Title
Looking into the life of technology-dependent children and their caregivers in Korea: lifting the burden of too many responsibilities
Authors
Yu Hyeon Choi
Min Sun Kim
Cho Hee Kim
In Gyu Song
June Dong Park
Dong In Suh
Hyung-Ik Shin
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-020-02388-z

Other articles of this Issue 1/2020

BMC Pediatrics 1/2020 Go to the issue