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Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Ill and substance-abusing parents: how can the general practitioner help their children? A qualitative study

Authors: Frøydis Gullbrå, Tone Smith-Sivertsen, Guri Rortveit, Norman Anderssen, Marit Hafting

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

Severe illness among parents may interfere with their parenting. Children having ill or substance-abusing parents are at risk of own health problems and psychosocial difficulties. The health care system should identify families in need of help and provide the help needed. For ill parents, it can be difficult to seek help and advices for their parenting. The aim of this study was to identify important factors for the general practitioner (GP) to bear in mind during encounters with ill and substance-abusing parents, to enable the GP to provide appropriate support for the children.

Method

A qualitative approach was chosen and the data material was semi-structured individual interviews with 12 parents with mental illness, substance abuse or severe somatic illness. The participants were recruited through GPs in Norway, and the interviews were performed in 2014. We used systematic text condensation for analysis.

Results

It was important for the participants that the GP was oriented about their family and children’s situation. They wanted to be regarded as competent parents in ordinary families; however, they were aware that their illness affected their parenting. They expressed a need for advice about how to inform the children of their illness and talk to them about their challenges, and, if necessary, utilize helpers who could inform the children and talk to them directly. There were often many agencies involved, and it was important that the helpers cooperated and shared information. In addition, the parents were in need of information about support services.

Conclusion

Ill parents in this study conveyed a double message to their helpers. They wanted to be considered as responsible and well-intended parents who wished the best for their children. At the same time they needed support in parenting. The GP should take the time to listen to the parents’ first spontaneous description about an ordinary daily life (while realising that it may not necessarily be an accurate report), then explore their worries and needs of support.
Literature
1.
go back to reference Petfield L, Startup H, Droscher H, Cartwright-Hatton S. Parenting in mothers with borderline personality disorder and impact on child outcomes. Evid Based Ment Health. 2015;18:67–75.CrossRefPubMed Petfield L, Startup H, Droscher H, Cartwright-Hatton S. Parenting in mothers with borderline personality disorder and impact on child outcomes. Evid Based Ment Health. 2015;18:67–75.CrossRefPubMed
2.
go back to reference Evans S, Shipton EA, Keenan T. The relationship between maternal chronic pain and child adjustment: the role of parenting as a mediator. J Pain. 2006;7:236–43.CrossRefPubMed Evans S, Shipton EA, Keenan T. The relationship between maternal chronic pain and child adjustment: the role of parenting as a mediator. J Pain. 2006;7:236–43.CrossRefPubMed
3.
go back to reference Psychogiou L, Parry E. Why do depressed individuals have difficulties in their parenting role? Psychol Med. 2014;44:1345–7.CrossRefPubMed Psychogiou L, Parry E. Why do depressed individuals have difficulties in their parenting role? Psychol Med. 2014;44:1345–7.CrossRefPubMed
5.
go back to reference Velleman R, Templeton L. Understanding and modifying the impact of parents’ substance misuse on children. Adv Psychiatr Treatm. 2007;13:79–89.CrossRef Velleman R, Templeton L. Understanding and modifying the impact of parents’ substance misuse on children. Adv Psychiatr Treatm. 2007;13:79–89.CrossRef
6.
go back to reference White LM, McGrew JH, Salyers MP. Parents served by assertive community treatment: parenting needs, services, and attitudes. Psychiatr Rehabil J. 2013;36:22–7.CrossRefPubMedPubMedCentral White LM, McGrew JH, Salyers MP. Parents served by assertive community treatment: parenting needs, services, and attitudes. Psychiatr Rehabil J. 2013;36:22–7.CrossRefPubMedPubMedCentral
7.
go back to reference Fowler C, Reid S, Minnis J, Day C. Experiences of mothers with substance dependence: Informing the development of parenting support. J Clin Nurs. 2014;23:2835–43.CrossRefPubMed Fowler C, Reid S, Minnis J, Day C. Experiences of mothers with substance dependence: Informing the development of parenting support. J Clin Nurs. 2014;23:2835–43.CrossRefPubMed
8.
go back to reference Rimehaug T, Borstad JM, Helmersberg I, Wold JE. The "invisible" children. Tidsskr Nor Laegeforen. 2006;126:1493–4.PubMed Rimehaug T, Borstad JM, Helmersberg I, Wold JE. The "invisible" children. Tidsskr Nor Laegeforen. 2006;126:1493–4.PubMed
9.
go back to reference Schrank B, Moran K, Borghi C, Priebe S. How to support patients with severe mental illness in their parenting role with children aged over 1 year? A systematic review of interventions. Soc Psychiatry Psychiatr Epidemiol. 2015;50:1765–83. Schrank B, Moran K, Borghi C, Priebe S. How to support patients with severe mental illness in their parenting role with children aged over 1 year? A systematic review of interventions. Soc Psychiatry Psychiatr Epidemiol. 2015;50:1765–83.
10.
go back to reference Rutter M, Quinton D. Parental psychiatric disorder: effects on children. Psychol Med. 1984;14:853–80.CrossRefPubMed Rutter M, Quinton D. Parental psychiatric disorder: effects on children. Psychol Med. 1984;14:853–80.CrossRefPubMed
11.
go back to reference Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–58.CrossRefPubMed Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–58.CrossRefPubMed
12.
go back to reference Kaasboll J, Lydersen S, Indredavik MS. Psychological symptoms in children of parents with chronic pain-the HUNT study. Pain. 2012;153:1054–62.CrossRefPubMed Kaasboll J, Lydersen S, Indredavik MS. Psychological symptoms in children of parents with chronic pain-the HUNT study. Pain. 2012;153:1054–62.CrossRefPubMed
13.
go back to reference Brockington IAN, Chandra P, Dubowitz H, Jones D, Moussa S, Nakku J, et al. WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders. World Psychiatry. 2011;10:93–102.CrossRefPubMedPubMedCentral Brockington IAN, Chandra P, Dubowitz H, Jones D, Moussa S, Nakku J, et al. WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders. World Psychiatry. 2011;10:93–102.CrossRefPubMedPubMedCentral
14.
go back to reference Gullbra F, Smith-Sivertsen T, Rortveit G, Anderssen N, Hafting M. To give the invisible child priority: Children as next of kin in general practice A qualitative study among general practitioners. Scand J Prim Health Care. 2014;32:17–23.CrossRefPubMedPubMedCentral Gullbra F, Smith-Sivertsen T, Rortveit G, Anderssen N, Hafting M. To give the invisible child priority: Children as next of kin in general practice A qualitative study among general practitioners. Scand J Prim Health Care. 2014;32:17–23.CrossRefPubMedPubMedCentral
15.
go back to reference Charles G, Stainton T, Marshall S. Young Carers in Canada: An Invisible Population. Relat Child Youth Care Pract. 2008;21:5–12. Charles G, Stainton T, Marshall S. Young Carers in Canada: An Invisible Population. Relat Child Youth Care Pract. 2008;21:5–12.
16.
go back to reference Moore T, McArthur M, Noble-Carr D. Different but the same? Exploring the experiences of young people caring for a parent with an alcohol or other drug issue. J Youth Stud. 2011;14:161–77.CrossRef Moore T, McArthur M, Noble-Carr D. Different but the same? Exploring the experiences of young people caring for a parent with an alcohol or other drug issue. J Youth Stud. 2011;14:161–77.CrossRef
17.
go back to reference Charles G. Bringing Young Carers Out of the Shadows. Reclaiming Children and Youth. 2011;20:26–30. Charles G. Bringing Young Carers Out of the Shadows. Reclaiming Children and Youth. 2011;20:26–30.
18.
go back to reference Ministry of health and care services. Om lov om endringar i helsepersonelloven m.m. (oppfølging av born som pårørande) (On Amendments to the Health Personnel Act (follow-up of children as next of kin)). Ot.prp. nr 84 (2008-2009). Oslo: Norwegian Government Administration Services; 2009. Ministry of health and care services. Om lov om endringar i helsepersonelloven m.m. (oppfølging av born som pårørande) (On Amendments to the Health Personnel Act (follow-up of children as next of kin)). Ot.prp. nr 84 (2008-2009). Oslo: Norwegian Government Administration Services; 2009.
19.
go back to reference Maynard A, Patterson P, McDonald FEJ, Stevens G. What Is Helpful to Adolescents Who Have a Parent Diagnosed with Cancer? J Psychosoc Oncol. 2013;31:675–97.CrossRefPubMed Maynard A, Patterson P, McDonald FEJ, Stevens G. What Is Helpful to Adolescents Who Have a Parent Diagnosed with Cancer? J Psychosoc Oncol. 2013;31:675–97.CrossRefPubMed
20.
go back to reference Hartley K, Phelan M. The needs of children of depressed mothers in primary care. Fam Pract. 2003;20:390–2.CrossRefPubMed Hartley K, Phelan M. The needs of children of depressed mothers in primary care. Fam Pract. 2003;20:390–2.CrossRefPubMed
21.
go back to reference Hosman C, Van Doesum KT, Van Santvoort F. Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: 1. Scientific basis for a comprehensive approach. Aust e-J Advancement Mental Health. 2009;8:250–63. Hosman C, Van Doesum KT, Van Santvoort F. Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: 1. Scientific basis for a comprehensive approach. Aust e-J Advancement Mental Health. 2009;8:250–63.
22.
go back to reference Calhoun S, Conner E, Miller M, Messina N. Improving the outcomes of children affected by parental substance abuse: a review of randomized controlled trials. Subst Abuse Rehab. 2015;6:15–24. Calhoun S, Conner E, Miller M, Messina N. Improving the outcomes of children affected by parental substance abuse: a review of randomized controlled trials. Subst Abuse Rehab. 2015;6:15–24.
23.
go back to reference Reupert A, Maybery D, Morgan B. The family-focused practice of primary care clinicians: a case of missed opportunities. J Ment Health. 2015;24:357–62. Reupert A, Maybery D, Morgan B. The family-focused practice of primary care clinicians: a case of missed opportunities. J Ment Health. 2015;24:357–62.
24.
go back to reference Lauritzen C, Reedtz C, Van Doesum K, Martinussen M. Factors that may Facilitate or Hinder a Family-Focus in the Treatment of Parents with a Mental Illness. J Child Fam Stud. 2015;24:864–71.CrossRefPubMed Lauritzen C, Reedtz C, Van Doesum K, Martinussen M. Factors that may Facilitate or Hinder a Family-Focus in the Treatment of Parents with a Mental Illness. J Child Fam Stud. 2015;24:864–71.CrossRefPubMed
25.
go back to reference McWhinney IR, Freeman T. Textbook of Family Medicine. 3rd ed. New York: Oxford University Press; 2009. McWhinney IR, Freeman T. Textbook of Family Medicine. 3rd ed. New York: Oxford University Press; 2009.
26.
go back to reference Levenstein JH, McCracken EC, McWhinney IR, Stewart MA, Brown JB. The Patient-Centred Clinical Method. 1. A Model for the Doctor-Patient Interaction in Family Medicine. Fam Pract. 1986;3:24–30.CrossRefPubMed Levenstein JH, McCracken EC, McWhinney IR, Stewart MA, Brown JB. The Patient-Centred Clinical Method. 1. A Model for the Doctor-Patient Interaction in Family Medicine. Fam Pract. 1986;3:24–30.CrossRefPubMed
27.
go back to reference Rao JK, Anderson L, Inui TS, Frankel R. Communication Interventions Make A Difference in Conversations Between Physicians and Patients: A Systematic Review of the Evidence. Med Care. 2007;45:340–9.CrossRefPubMed Rao JK, Anderson L, Inui TS, Frankel R. Communication Interventions Make A Difference in Conversations Between Physicians and Patients: A Systematic Review of the Evidence. Med Care. 2007;45:340–9.CrossRefPubMed
28.
29.
30.
go back to reference Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. 2015;1:1–8. Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. 2015;1:1–8.
31.
go back to reference Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40:795–805.CrossRefPubMed Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40:795–805.CrossRefPubMed
32.
go back to reference Kvale S, Brinkmann S. InterViews: Learning the craft of qualitative research interviewing. 2nd ed. Thousand Oaks: SAGE Publications; 2009. Kvale S, Brinkmann S. InterViews: Learning the craft of qualitative research interviewing. 2nd ed. Thousand Oaks: SAGE Publications; 2009.
33.
go back to reference Stige B, Malterud K, Midtgarden T. Toward an agenda for evaluation of qualitative research. Qual Health Res. 2009;19:1504–16.CrossRefPubMed Stige B, Malterud K, Midtgarden T. Toward an agenda for evaluation of qualitative research. Qual Health Res. 2009;19:1504–16.CrossRefPubMed
34.
go back to reference Kvale S. The Social Construction of Validity. Qual Inquiry. 1995;1:19–40.CrossRef Kvale S. The Social Construction of Validity. Qual Inquiry. 1995;1:19–40.CrossRef
35.
go back to reference Ridd M, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives. Br J Gen Pract. 2009;59:e116–33.CrossRefPubMedPubMedCentral Ridd M, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives. Br J Gen Pract. 2009;59:e116–33.CrossRefPubMedPubMedCentral
36.
go back to reference Merriel SW, Salisbury C, Metcalfe C, Ridd M. Depth of the patient-doctor relationship and content of general practice consultations: cross-sectional study. Br J Gen Pract. 2015;65:e545–51.CrossRefPubMedPubMedCentral Merriel SW, Salisbury C, Metcalfe C, Ridd M. Depth of the patient-doctor relationship and content of general practice consultations: cross-sectional study. Br J Gen Pract. 2015;65:e545–51.CrossRefPubMedPubMedCentral
37.
go back to reference Skirbekk H, Middelthon A-L, Hjortdahl P, Finset A. Mandates of Trust in the Doctor–Patient Relationship. Qual Health Res. 2011;21:1182–90.CrossRefPubMed Skirbekk H, Middelthon A-L, Hjortdahl P, Finset A. Mandates of Trust in the Doctor–Patient Relationship. Qual Health Res. 2011;21:1182–90.CrossRefPubMed
38.
go back to reference Gullbra F, Smith-Sivertsen T, Rortveit G, Graungaard A, Hafting M. How can the general practitioner support adolescent children of ill or substance-abusing parents? A qualitative study among adolescents. Scand J Prim Health Care. (in press). Gullbra F, Smith-Sivertsen T, Rortveit G, Graungaard A, Hafting M. How can the general practitioner support adolescent children of ill or substance-abusing parents? A qualitative study among adolescents. Scand J Prim Health Care. (in press).
39.
go back to reference Semple CJ, McCance T. Parents' experience of cancer who have young children: a literature review. Cancer Nurs. 2010;33:110–8.CrossRefPubMed Semple CJ, McCance T. Parents' experience of cancer who have young children: a literature review. Cancer Nurs. 2010;33:110–8.CrossRefPubMed
40.
go back to reference Agledahl KM, Gulbrandsen P, Førde R, Wifstad Å. Courteous but not curious: how doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. J Med Ethics. 2011;37:650–4.CrossRefPubMedPubMedCentral Agledahl KM, Gulbrandsen P, Førde R, Wifstad Å. Courteous but not curious: how doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. J Med Ethics. 2011;37:650–4.CrossRefPubMedPubMedCentral
41.
go back to reference Schibbye. The role of "recognition" in the resolution of a specific interpersonal dilemma. J Phenomenol Psychol. 1993;24:175–89.CrossRef Schibbye. The role of "recognition" in the resolution of a specific interpersonal dilemma. J Phenomenol Psychol. 1993;24:175–89.CrossRef
42.
go back to reference Tylee A, Haller DM, Graham T, Churchill R, Sanci LA. Adolescent Health 6 - Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet. 2007;369:1565–73.CrossRefPubMed Tylee A, Haller DM, Graham T, Churchill R, Sanci LA. Adolescent Health 6 - Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet. 2007;369:1565–73.CrossRefPubMed
43.
go back to reference Maybery D, Reupert A. Parental mental illness: a review of barriers and issues for working with families and children. J Psychiatr Ment Health Nurs. 2009;16:784–91.CrossRefPubMed Maybery D, Reupert A. Parental mental illness: a review of barriers and issues for working with families and children. J Psychiatr Ment Health Nurs. 2009;16:784–91.CrossRefPubMed
44.
go back to reference Keller G, Gottlieb D. Reducing major depression in children at high risk: opportunities for prevention. Int J Psychiatry Med. 2012;44/3:271–90.CrossRef Keller G, Gottlieb D. Reducing major depression in children at high risk: opportunities for prevention. Int J Psychiatry Med. 2012;44/3:271–90.CrossRef
45.
go back to reference Pedersen PV, Barrow SM, Tanggaard Andersen P, Tjornhoj-Thomsen T. “I Sort of Live for My Kids’ Sake Only”: Characteristics and Meaning of Parent–Child Relations Among Socially Marginalized Parents. J Poverty. 2015;19:197–217. Pedersen PV, Barrow SM, Tanggaard Andersen P, Tjornhoj-Thomsen T. “I Sort of Live for My Kids’ Sake Only”: Characteristics and Meaning of Parent–Child Relations Among Socially Marginalized Parents. J Poverty. 2015;19:197–217.
46.
go back to reference Collishaw S, Hammerton G, Mahedy L, Sellers R, Owen MJ, Craddock N, et al. Mental health resilience in the adolescent offspring of parents with depression: a prospective longitudinal study. Lancet Psychiatry. 2016;3:49–57.CrossRefPubMedPubMedCentral Collishaw S, Hammerton G, Mahedy L, Sellers R, Owen MJ, Craddock N, et al. Mental health resilience in the adolescent offspring of parents with depression: a prospective longitudinal study. Lancet Psychiatry. 2016;3:49–57.CrossRefPubMedPubMedCentral
Metadata
Title
Ill and substance-abusing parents: how can the general practitioner help their children? A qualitative study
Authors
Frøydis Gullbrå
Tone Smith-Sivertsen
Guri Rortveit
Norman Anderssen
Marit Hafting
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0553-5

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