The experiences of parents and nurses of hospitalised infants requiring oxygen therapy for severe bronchiolitis: A phenomenological study

Objectives: Annually, bronchiolitis is a major cause of children's hospital admissions. Children suffering from respiratory distress are provided supplemental oxygen therapy via a headbox. Whilst effective in treating the child physically, the headbox can be very restrictive and limits parental access to their child. This form of oxygen therapy can have a detrimental effect on parental bonding, their relationship with their child, and the parents' ability to fulfil their parenting role. The aim of this study was to investigate the lived experiences of parents and nurses who have had or cared for a child admitted to hospital for severe bronchiolitis and received two types of oxygen therapy; headbox oxygen and high flow nasal prong oxygen therapy. This phenomenon has not been investigated previously. Methods: A descriptive phenomenological design was used to interview a purposive sample of 12 parents and 12 nurses. Results: Several themes emerged from data analysis: 1. It was horrific. We didn't know if she would live or die; 2. I didn't know what was happening; 3. I think some parents do get quite upset; 4. All that I wanted to do was hold her and keep her with me; 5. I felt inadequate, more than useless; 6. I needed her to feel my heart beat; 7. Look but don't touch; 8. I stayed with her day and night and; 9. Babies are hard work in the head box because you can't pick them up. These themes were then divided into three domains; Fear, Parent child interaction, and Technical caring. Conclusions: The mothers found the situation of having a child in a headbox frightening, stating that lack of knowledge and understanding, fear of their child dying, isolation from their child, unfamiliar environments, and the inability to attend to their child's day-to-day care were all contributing factors.;Some of these fears were present when their child received high flow nasal prong oxygen therapy but the increased interaction with their baby allowed the mothers to feel more useful and less frightened. The nurses in the study recognised to a degree these themes surrounding the parent child relationship yet were more concerned about clinical issues involved with caring for a child in a headbox such as safety and ergonomic restrictions. The nurses all stated how the high flow nasal prong oxygen system also improved safety and clinical outcomes.