title: Treatment of hemophilia: A qualitative study of mothers' perspectives.
abstract: In Norway, boys with hemophilia usually begin treatment after their first bleeding episode. Boys with severe hemophilia usually start prophylactic treatment around 18-24 months. Health professionals administer factor concentrate initially, but when boys are around 4 years old most parents start treating their children at home. There is a lack of research on how parents, and especially how carrier mothers, experience the medical treatment for their sons' hemophilia. Our aim was to investigate how carrier mothers experience this treatment in the hospital setting and at home.
  
  
  
  In this qualitative study, we interviewed 16 mothers of boys or men with hemophilia A or B. Data were collected via semistructured interviews and analyzed using an inductive thematic analytical approach.
  
  
  
  Mothers experienced both practical and emotional challenges in relation to their sons' treatment, and repeated venipuncture was especially difficult emotionally. Parents preferred home treatment to hospital treatment because it was less time-consuming, less disruptive to family life, and provided a greater sense of control. Encountering healthcare professionals who were unfamiliar with hemophilia was a second major stress factor, especially when parents felt that health professionals lacked competence and were unwilling to seek advice.
  
  
  
  While home treatment for hemophilia enables freedom, flexibility, and autonomy for the boys as well as for the family, mothers may experience treatment of hemophilia as a burden. Health professionals should provide tailored practical and emotional support to parents by probing into their experiences with treating their sons' hemophilia.
authors.affiliation: Centre for Rare Disorders, Oslo University Hospital HF, Rikshospitalet, Oslo, Norway.
authors.forename: Charlotte
authors.initials: C
authors.lastname: von der Lippe
authors.affiliation: Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Frich
authors.affiliation: Department of Technology and Society Studies, Maastricht University, Maastricht, The Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Harris
authors.affiliation: Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Kari Nyheim
authors.initials: KN
authors.lastname: Solbraekke
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003376:Counseling; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011379:Prognosis; D036301:Qualitative Research
keywords: experiences; hemophilia A; hemophilia B; mothers; qualitative; treatment