title: Family caregiver distress with children having rare genetic disorders: a qualitative study involving Russell-Silver Syndrome in Taiwan.
abstract: OBJECTIVE
  To extend nursing knowledge of distress experienced by family caregivers of children with rare genetic disorders, by exploring the perspectives of caregivers of children with Russell-Silver Syndrome in Taiwan.
  
  
  BACKGROUND
  Caring for a child with a rare genetic disorder often has profound effects on families, especially when diagnosis and treatment is complex or not yet well developed, such as that in Russell-Silver Syndrome (or Silver-Russell syndrome). This disorder causes dwarfism and developmental difficulties, requiring long-term care planning. Previous research has focused mostly on medical care, but little is known about families' perspectives of caring difficulties, the help they need and nursing care required.
  
  
  METHODS
  An exploratory qualitative approach was used to inform this study.
  
  
  METHODS
  Family caregivers, whose children were undergoing medical care in a leading Taiwan medical centre, were invited to participate in face-to-face, in-depth interviews. Data were analysed by content analysis.
  
  
  RESULTS
  Fifteen caregivers including 11 mothers, two fathers and two grandmothers participated. Five major themes and 13 sub-themes of care-giving distress were identified: endless psychological worries; the lengthy process to confirm a medical diagnosis; adjustment efforts in modifying family roles; dilemmas in deciding between Western or Chinese traditional medicine; and negative responses to society's concerns. Their primary sources of support were spouses, parents and health professionals, accordingly.
  
  
  CONCLUSIONS
  Complex physio-psycho-social and decision-making distress in caring for children with a rare genetic disorder were systematically revealed from the perspectives of ethnic-Chinese family caregivers.
  
  
  CONCLUSIONS
  Long-term care plans for children with a rare genetic disorder such as Russell-Silver Syndrome need to focus on positive dynamic family interactions, life-stage development and family caregiver support. Research on care-giving in rare genetic disorders is also warranted across cultures and countries to develop a substantial knowledge basis for nursing practice.
authors.affiliation: Department of Nursing, Tajen University, PingTung County, Taiwan.
authors.forename: Hsin-Ju
authors.initials: HJ
authors.lastname: Weng
authors.forename: Dau-Ming
authors.initials: DM
authors.lastname: Niu
authors.forename: Sue
authors.initials: S
authors.lastname: Turale
authors.forename: Lee-Ing
authors.initials: LI
authors.lastname: Tsao
authors.forename: Fu-Jong
authors.initials: FJ
authors.lastname: Shih
authors.forename: Noriko
authors.initials: N
authors.lastname: Yamamoto-Mitani
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chang
authors.forename: Fu-Jin
authors.initials: FJ
authors.lastname: Shih
mesh_terms: D017028:Caregivers / Q000523:psychology*; D002648:Child; D005190:Family / Q000523:psychology*; D006801:Humans; D056730:Silver-Russell Syndrome / Q000451:nursing*; D013315:Stress, Psychological; D013624:Taiwan