Health practitioners’ emotional reactions to caring for hospitalized children in Lomé, Togo: a qualitative study

Abstract Background Health practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in high-income countries. In this study, we explored emotional distress and associated coping strategies among health practitioners working in a pediatric oncology department in a large teaching hospital in Lomé, Togo. Methods We undertook a cross-sectional qualitative research involving in-depth interviews with 21 health practitioners (doctors, nurses, and nursing assistants) as well as facility-based observations Interview data were collected using a semi-structured discussion guide. All interviews were audio-recorded while observational notes were hand-written and ultimately typed. All data were transcribed, coded and analyzed thematically. Results We found that practitioners experienced significant emotional distress. Their emotional distress was compounded by the seriousness of the illnesses they treated, the lack of appropriate medical equipment, and treatment failures that caused their patients to suffer. The health practitioners’ narratives suggested that a key reason for their emotional distress was a mismatch between their professional training and the realities of providing care in a resource-constrained setting. They also reported not receiving any training on how to cope with the emotional stresses associated with care and preventable patient deaths. Conclusion Caring for patients is a source of significant emotional distress. The emotional stress experienced by health practitioners is compounded in resource-limited settings where weak health systems undermine practitioners’ ability to provide quality care. Results underscore the need to train health professionals to positively cope with the emotional stresses associated with patient care and for health systems improvements to ensure quality care

The socio-demographic risk factors for parental burnout in Togo

This study aimed to assess the level of parental burnout in Togo and to examine his association with other socio-demographic variables. It is an investigation that took place alongside the International Investigation of Parental Burnout (IIPB). Using the Parental Burnout Assessment, 103 parents in Lomé and Tsévié were asked to respond on paper or online questionnaires. The results highlighted the low rate of parental burnout among participants and significant associations between parental burnout and the socio-demographic variables. This study suggests that having a high level of education, being male and having very young children are the protective factors against parental burnout. However, few indications were found to establish a relationship between parental burnout and variables like age, ethnic origin, number of children, number of men and women living at home, neighbourhood, or having a paid professional activity. Far from being revealing, this study earns to be investigated deeply in much more robust other studies to identify the protective and risk factors for Togolese parents. In any case, burnout prevention programs in countries (especially in the West) with the highest prevalence of parental burnout should learn from the parenting practices of countries with low levels of parental burnout like in Togo. What is already known about this topic:(1) Parenting is a universal activity that can be stressful for many parents.(2) As child rearing is a collective and social activity, it is the responsibility not only of the family, but also of members of the same neighbourhood, village or ethnic group.(3) The reconfiguration of the family structure (nuclearization) underway in West Africa and Togo limits the role of grandparents, aunts and uncles and cousins in parenting, leaving biological parents alone to deal with the emotional and material needs of children. (1) Parenting is a universal activity that can be stressful for many parents. (2) As child rearing is a collective and social activity, it is the responsibility not only of the family, but also of members of the same neighbourhood, village or ethnic group. (3) The reconfiguration of the family structure (nuclearization) underway in West Africa and Togo limits the role of grandparents, aunts and uncles and cousins in parenting, leaving biological parents alone to deal with the emotional and material needs of children. What this topic adds:(1) This study presents the local situation regarding parental burnout in Togo as part of studies initiated by the International Investigation of Parental Burnout (IIPB).(2) The results of this study highlight the low rate of parental burnout in Togo.(3) They also suggest that in Togo, having a high level of education, being male and having very young children are protective factors against parental burnout.(4) This study suggests that burnout prevention programs in Western (individualistic) countries where the prevalence of parental burnout is highest should be inspired by parenting practices in (collectivistic) countries where the level of parental burnout is low. (1) This study presents the local situation regarding parental burnout in Togo as part of studies initiated by the International Investigation of Parental Burnout (IIPB). (2) The results of this study highlight the low rate of parental burnout in Togo. (3) They also suggest that in Togo, having a high level of education, being male and having very young children are protective factors against parental burnout. (4) This study suggests that burnout prevention programs in Western (individualistic) countries where the prevalence of parental burnout is highest should be inspired by parenting practices in (collectivistic) countries where the level of parental burnout is low.</p

COMMENT DES ADOLESCENTS QUI CONSOMMENT DES SUBSTANCES PSYCHOACTIVES PENSENT INFLUENCER LEURS PARENTS ? HOW DO TEENAGERS WHO USE PSYCHOACTIVE SUBSTANCES THINK THEY CAN INFLUENCE THEIR PARENTS?

Cette étude examine l’influence des adolescents sur leurs parents, dans les contextes socioculturels d’Afrique Subsaharienne (Togo) et d’Europe Occidentale (Belgique). À travers une démarche qualitative inductive, les données d’entretiens semi-directifs avec des adolescents qui consomment des substances psychoactives ont fait l’objet d’une analyse phénoménologique interprétative. Les résultats montrent une bidirectionnalité de cette influence et les thèmes qui émergent renvoient à la préoccupation sur les résultats scolaires, sur la consommation de substances, et sur les besoins matériels et affectifs des adolescents. L’étude a montré que les significations culturelles associées à la relation parent-adolescent et à la consommation de substances impriment l'agentivité de l’adolescent. Elle a permis de mieux comprendre l’adolescent comme un partenaire actif du processus de construction de son identité, au même titre que les parents, et permet de modifier bien d’idées reçues à propos des adolescents qui consomment des substances psychoactives.This study examines the influence of teenagers on their parents in the socio-cultural contexts of sub-Saharan Africa (Togo) and Western Europe (Belgium). Through an inductive qualitative approach, the data of semi-directive interviews with teenagers who use psychoactive substances were analyzed using the Interpretive Phenomenological Analysis method. The results show a bidirectionality of this influence and the themes that emerged refer to the school performance, the substances use and the material and emotional needs of youths. The study showed that the cultural meanings associated with parent-adolescent relationships and substances use influence the teenager’s agency. It has led to a better understanding of the teenager as an active partner in the process of the building of his own identity in the same way as parents and help to change many preconceived ideas about teenagers who use psychoactive substances

Parenting culture(s): Ideal-parent beliefs across 37 countries

What is it to be “an ideal parent”? Does the answer differ across countries and social classes? To answer these questions in a way that minimizes bias and ethnocentrism, we used open-ended questions to explore ideal-parent beliefs among 8,357 mothers and 3,517 fathers from 37 countries. Leximancer Semantic Network Analysis was utilized to first determine parenting culture zones (i.e., countries with shared ideal-parent beliefs) and then extract the predominant themes and concepts in each culture zone. The results yielded specific types of ideal-parent beliefs in five parenting culture zones: being “responsible and children/family-focused” for Asian parents, being “responsible and proper demeanor-focused” for African parents, and being “loving and responsible” for Hispanic-Italian parents. Although the most important themes and concepts were the same in the final two zones—being “loving and patient,” there were subtle differences: English-speaking, European Union, and Russian parents emphasized “being caring,” while French-speaking parents valued “listening” or being “present.” Ideal-parent beliefs also differed by education levels within culture zones, but no general pattern was discerned across culture zones. These findings suggest that the country in which parents were born cannot fully explain their differences in ideal-parent beliefs and that differences arising from social class or education level cannot be dismissed. Future research should consider how these differences affect the validity of the measurements in question and how they can be incorporated into parenting intervention research within and across cultures

Parenting Culture(s): Ideal-Parent Beliefs Across 37 Countries

What is it to be “an ideal parent”? Does the answer differ across countries and social classes? To answer these questions in a way that minimizes bias and ethnocentrism, we used open-ended questions to explore ideal-parent beliefs among 8,357 mothers and 3,517 fathers from 37 countries. Leximancer Semantic Network Analysis was utilized to first determine parenting culture zones (i.e., countries with shared ideal-parent beliefs) and then extract the predominant themes and concepts in each culture zone. The results yielded specific types of ideal-parent beliefs in five parenting culture zones: being “responsible and children/family-focused” for Asian parents, being “responsible and proper demeanor-focused” for African parents, and being “loving and responsible” for Hispanic-Italian parents. Although the most important themes and concepts were the same in the final two zones—being “loving and patient,” there were subtle differences: English-speaking, European Union, and Russian parents emphasized “being caring,” while French-speaking parents valued “listening” or being “present.” Ideal-parent beliefs also differed by education levels within culture zones, but no general pattern was discerned across culture zones. These findings suggest that the country in which parents were born cannot fully explain their differences in ideal-parent beliefs and that differences arising from social class or education level cannot be dismissed. Future research should consider how these differences affect the validity of the measurements in question and how they can be incorporated into parenting intervention research within and across cultures. </jats:p

Parenting Culture(s) : Ideal-Parent Beliefs Across 37 Countries

What is it to be “an ideal parent”? Does the answer differ across countries and social classes? To answer these questions in a way that minimizes bias and ethnocentrism, we used open-ended questions to explore ideal-parent beliefs among 8,357 mothers and 3,517 fathers from 37 countries. Leximancer Semantic Network Analysis was utilized to first determine parenting culture zones (i.e., countries with shared ideal-parent beliefs) and then extract the predominant themes and concepts in each culture zone. The results yielded specific types of ideal-parent beliefs in five parenting culture zones: being “responsible and children/family-focused” for Asian parents, being “responsible and proper demeanor-focused” for African parents, and being “loving and responsible” for Hispanic-Italian parents. Although the most important themes and concepts were the same in the final two zones—being “loving and patient,” there were subtle differences: English-speaking, European Union, and Russian parents emphasized “being caring,” while French-speaking parents valued “listening” or being “present.” Ideal-parent beliefs also differed by education levels within culture zones, but no general pattern was discerned across culture zones. These findings suggest that the country in which parents were born cannot fully explain their differences in ideal-parent beliefs and that differences arising from social class or education level cannot be dismissed. Future research should consider how these differences affect the validity of the measurements in question and how they can be incorporated into parenting intervention research within and across cultures.peerReviewe

Parental burnout around the globe: A 42-country study

High levels of stress in the parenting domain can lead to parental burnout, a condition that has severe consequences for both parents and children. It is not yet clear, however, whether parental burnout varies by culture, and if so, why it might do so. In this study, we examined the prevalence of parental burnout in 42 countries (17,409 parents; 71% mothers; Mage = 39.20) and showed that the prevalence of parental burnout varies dramatically across countries. Analyses of cultural values revealed that individualistic cultures, in particular, displayed a noticeably higher prevalence and mean level of parental burnout. Indeed, individualism plays a larger role in parental burnout than either economic inequalities across countries, or any other individual and family characteristic examined so far, including the number and age of children and the number of hours spent with them. These results suggest that cultural values in Western countries may put parents under heightened levels of stress

Parental Burnout Around the Globe : a 42-Country Study.

High levels of stress in the parenting domain can lead to parental burnout, a condition that has severe consequences for both parents and children. It is not yet clear, however, whether parental burnout varies by culture, and if so, why it might do so. In this study, we examined the prevalence of parental burnout in 42 countries (17,409 parents; 71% mothers; Mage = 39.20) and showed that the prevalence of parental burnout varies dramatically across countries. Analyses of cultural values revealed that individualistic cultures, in particular, displayed a noticeably higher prevalence and mean level of parental burnout. Indeed, individualism plays a larger role in parental burnout than either economic inequalities across countries, or any other individual and family characteristic examined so far, including the number and age of children and the number of hours spent with them. These results suggest that cultural values in Western countries may put parents under heightened levels of stress. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-020-00028-4