Impact of COVID-19 on carers of children with tracheostomies

Objectives To explore the impact of the COVID-19 pandemic on the experiences of caregivers of children with tracheostomies. Design Qualitative semistructured interviews. Setting All participants were currently, or had previously cared for, a tracheostomised child who had attended a tertiary care centre in the North of England. Health professionals were purposively sampled to include accounts from a range of professions from primary, community, secondary and tertiary care. Participants Carers of children with tracheostomies (n=34), including health professionals (n=17) and parents (n=17). Interventions Interviews were undertaken between July 2020 and February 2021 by telephone or video link. Main outcome measure Qualitative reflexive thematic analysis with QSR NVivo V.12. Results The pandemic has presented an additional and, for some, substantial challenge when caring for tracheostomised children, but this was not always felt to be the most overriding concern. Interviews demonstrated rapid adaptation, normalisation and varying degrees of stoicism and citizenship around constantly changing pandemic-related requirements, rules and regulations. This paper focuses on four key themes: 'reconceptualising safe care and safe places'; 'disrupted support and isolation'; 'relationships, trust and communication'; and 'coping with uncertainty and shifting boundaries of responsibility'. These are described within the context of the impact on the child, the emotional and physical well-being of carers and the challenges to maintaining the values of family-centred care. Conclusions As we move to the next phase of the pandemic, we need to understand the impact on vulnerable groups so that their needs can be prioritised.