Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs

Open Access Emerg Med. 2024 Jun 19:16:117-131. doi: 10.2147/OAEM.S450191. eCollection 2024.

Abstract

The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental disability (IDD) in the emergency department (ED). We searched six electronic databases and grey literature to identify primary studies in English published since 2000. We synthesized quantitative and qualitative outcome data simultaneously using a convergent integrated approach and used a Mixed Methods Appraisal Tool (MMAT) to assess methodological quality of the included studies. Nine articles derived from seven studies were included (3 qualitative, 3 quantitative, 1 mixed method). Four main themes related to parents' self-reported experiences were identified: 1) appropriateness of the ED to manage and support their child; 2) acknowledgement/recognition of their child's IDD and incorporation of those considerations into overall care and management; 3) managing and navigating the ED environment; and 4) decision to disclose their child's condition when visiting the ED. Two articles provided data relevant to information needs, highlighting parents' desire to have resources supporting ED orientation and access to services within and outside of the ED setting. From the limited number of studies, it was evident that parents wanted better communication with healthcare providers and a greater understanding by ED staff around physical space settings needed to support their child. Resources supporting ED staff and parents to communicate effectively and work together can ensure that children with IDDs care needs are met. Further research into understanding parents' experiences and information needs related to managing a child with an IDD in the ED is needed to guide the development of effective resources.

Keywords: child; communication; developmental disabilities; emergency service; parents.

Publication types

  • Review

Grants and funding

This review was funded by an Alberta Health Services, Emergency Strategic Clinical Network (ESCN) 2022 Systematic Review Grant. The funder had no role in the development of the protocol, implementation of the review, or interpretation and reporting of results. Dr. Hartling is a Canada Research Chair in Knowledge Synthesis and Translation and a Distinguished Researcher, Stollery Science Lab. Dr. Scott is a Canada Research Chair in Knowledge Translation in Children’s Health and a Distinguished Researcher, Stollery Science Lab. The other authors received no external funding.