The Psychosocial Impact on Families of Paediatric Long-Term Mechanical Circulatory Support Patients During In-Hospital Bridge-to-Transplant: A Qualitative Systematic Review.
This qualitative systematic review synthesized six studies involving 49 pooled participants and identified themes of uncertainty, challenges, resilience, and supportive networks among families of children receiving in-hospital long-term mechanical circulatory support as a bridge to heart transplantation.
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This qualitative systematic review synthesized six studies involving 49 pooled participants and identified themes of uncertainty, challenges, resilience, and supportive networks among families of children receiving in-hospital long-term mechanical circulatory support as a bridge to heart transplantation.
Research significance
The review supports the need for tailored education, early multidisciplinary involvement, technology-assisted communication, and organized support networks; it is reasonable to infer that such interventions might reduce family uncertainty and distress, but the supplied record reports no intervention testing or demonstrated clinical benefit, including for pediatric oncology families.
Source abstract
AIM: This review examines the psychosocial impact on families and their resilience strategies during their children's in-hospital bridge-to-transplant while using Long-Term Mechanical Circulatory Support devices to reduce families' uncertainties. DESIGN: A qualitative systematic review. DATA SOURCES: PubMed, CINAHL, ASSIA, Embase, Scopus, and ProQuest (dissertations and theses). METHODS: The search (concluded on 1st March 2025) identified English-language published and unpublished qualitative studies exploring families' experiences of their children's in-hospital bridge-to-transplant from their perspectives. Studies were critically appraised using the Critical Appraisal Skills Programme qualitative tool. Findings were analysed using Braun and Clarke's reflexive thematic analysis (2022). FINDINGS: Six qualitative studies (49 pooled participants) were included. The review synthesised four themes: (1) Commencing the families' journey with Long-Term Mechanical Circulatory Support. (2) Navigating the Long-Term Mechanical Circulatory Support for paediatric patients' families through bridging. (3) Crossroads of blessings and challenges: Long-Term Mechanical Circulatory Supported children's families await a new heart. (4) The power stations (supportive networks) of Long-Term Mechanical Circulatory Supported children's families. Findings were interpreted through the lens of Mishel's Uncertainty in Illness Theory (1981), yielding significant recommendations; however, the review also highlighted secondary data analysis limitations, notably the incomplete reporting of theoretical constructs. CONCLUSION: This review highlights the profound psychosocial impacts and uncertain families' experiences during their children's bridge-to-transplant journey. Interventions are called to mitigate these uncertainties during this period. IMPACT AND IMPLICATIONS FOR THE PROFESSION: This review identified significant implications, including tailoring clinical education for parents of children with end-stage heart failure (congenital versus acquired), technology utilisation, and better organisation of the supportive networks. Additionally, it emphasised the multidisciplinary teams' early involvement policies. Moreover, future research should broaden perspectives by including non-Western participants, siblings, families of children with cancer-related cardiomyopathies, and grieving families to better capture diverse families' psychological impacts and help alleviate their uncertainties during the waiting journey. REPORTING METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.