{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:38:08Z","timestamp":1790962688010,"version":"4.1.0"},"reference-count":47,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,20]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We explored the experiences of treatment strategies for steroid-sensitive nephrotic syndrome (SSNS) and care priorities among children living with the condition and their caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study using semistructured interviews. Data were analysed using reflexive thematic analysis. We coded transcripts in duplicate and developed themes that integrate key concepts across roles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Southern Alberta, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A purposive sample of children aged 8\u201318 years, with SSNS and their caregivers from a paediatric nephrotic syndrome cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      28 individuals (10 children and 18 caregivers) participated in this study. All had experienced a relapse after initial diagnosis and steroid treatment. Participants identified how their experiences with SSNS treatments influenced their willingness to accept further steroids and other second-line agents. Findings are elaborated across the following four themes: (1) reluctant acceptance of steroids (\n                      <jats:italic>steroid aversion<\/jats:italic>\n                      ,\n                      <jats:italic>lack of personalised steroid dosing<\/jats:italic>\n                      ,\n                      <jats:italic>altered self-regulation<\/jats:italic>\n                      and\n                      <jats:italic>acknowledging steroid effectiveness<\/jats:italic>\n                      ); (2) coping with unexpected relapses (\n                      <jats:italic>repeating the cycle<\/jats:italic>\n                      ,\n                      <jats:italic>restricted life participation<\/jats:italic>\n                      and\n                      <jats:italic>tempered optimism<\/jats:italic>\n                      ); (3) uncertainty about second-line therapies (\n                      <jats:italic>striving for stability, cumulative burden of adverse effects<\/jats:italic>\n                      and\n                      <jats:italic>exploring alternatives<\/jats:italic>\n                      ) and (4) directing attention to unmet treatment needs and priorities (\n                      <jats:italic>mechanistic approaches to therapy<\/jats:italic>\n                      ,\n                      <jats:italic>steroid minimisation<\/jats:italic>\n                      ,\n                      <jats:italic>child and family involvement<\/jats:italic>\n                      and\n                      <jats:italic>enhanced social supports<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with SSNS and their caregivers expressed a dislike of steroids and a desire for individualised treatment protocols. Investigation into therapeutic alternatives for SSNS should integrate patients\u2019 preferences, values and care priorities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097602","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T21:30:38Z","timestamp":1751923838000},"page":"e097602","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Patient and caregiver perspectives on treatment strategies and care priorities of childhood steroid-sensitive nephrotic syndrome: a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1663-6863","authenticated-orcid":false,"given":"Augustina","family":"Okpere","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Alberta, 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