{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:41:13Z","timestamp":1773052873454,"version":"3.50.1"},"reference-count":56,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Parenting a child with Down syndrome can sometimes present certain difficulties and, thus, spirituality may function as a dimension related to finding meaning in life and as a coping resource. Spirituality is a critical dimension of nursing care, but scarce knowledge is available to specifically inform family nursing practice. The aim of this study was to explore the spiritual aspects of parenting a child with Down syndrome, as a qualitative secondary analysis. This is an observational qualitative study, based on in-depth interviews from 42 participants. Data analysis found seven categories that concern meaning and purpose in life: hope, family strength, spiritual practices, personal beliefs, and love, and trust in healthcare providers. Spirituality is a resource in parents\u2019 lives who are living in this situation. Nurses should consider this dimension in supporting families and in improving management of this life and health condition.<\/jats:p>","DOI":"10.3390\/healthcare10030546","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T22:09:58Z","timestamp":1647468598000},"page":"546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A Qualitative Study of the Spiritual Aspects of Parenting a Child with Down Syndrome"],"prefix":"10.3390","volume":"10","author":[{"given":"Elys\u00e2ngela Dittz","family":"Duarte","sequence":"first","affiliation":[{"name":"Department of Maternal Child and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1756-9186","authenticated-orcid":false,"given":"Patr\u00edcia P.","family":"Braga","sequence":"additional","affiliation":[{"name":"Campus Centro Oeste\u2013Divin\u00f3polis, Federal University of S\u00e3o Jo\u00e3o del Rei, Divin\u00f3polis 35501-296, Brazil"}]},{"given":"B\u00e1rbara R.","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Department of Maternal Child and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1434-8206","authenticated-orcid":false,"given":"Juliana B. da","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Maternal Child and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-2297","authenticated-orcid":false,"given":"S\u00edlvia","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Health, Institute of Health Sciences, Catholic University of Portugal, 1649-023 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1352\/1934-9556-57.6.512","article-title":"Facets of faith: Spirituality, religiosity, and parents of individuals with intellectual disability","volume":"57","author":"Boehm","year":"2019","journal-title":"Intellect. Dev. Disabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1007\/s10943-019-00925-4","article-title":"Spiritual orientation, meaning in life, life satisfaction, and well-being in mothers with disabled children","volume":"58","author":"Yilmaz","year":"2019","journal-title":"J. Relig. Health"},{"key":"ref_3","unstructured":"McSherry, W., and Ross, L.S. (2010). Recognising spiritual needs. Spiritual Assessment in Healthcare Practice, M&K Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/nuf.12128","article-title":"Concept analysis of spirituality: An evolutionary approach","volume":"51","author":"Weathers","year":"2016","journal-title":"Nurs. Forum"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.15649\/cuidarte.v9i1.413","article-title":"Influ\u00eancia da religiosidade\/espiritualidade do profissional de sa\u00fade no cuidado ao paciente cr\u00edtico","volume":"9","author":"Longuiniere","year":"2018","journal-title":"Rev Cuid."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.11606\/issn.2317-0190.v8i3a102355","article-title":"Spirituality based on evidence","volume":"8","author":"Saad","year":"2001","journal-title":"Acta Fisi\u00e1tr."},{"key":"ref_7","first-page":"127","article-title":"Coping with caregiving stress in families of children with congenital heart disease: A qualitative study","volume":"8","author":"Dalir","year":"2020","journal-title":"J. Community Based Nurs. Midwifery"},{"key":"ref_8","first-page":"e51934","article-title":"Understanding spirituality for people with mental disorder: Contributions to nursing care","volume":"37","author":"Salimena","year":"2016","journal-title":"Rev. Ga\u00facha Enferm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1590\/1982-02752017000200008","article-title":"Meanings of spirituality for cancer patients in palliative care","volume":"34","author":"Benites","year":"2017","journal-title":"Estud. Psicol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Martins, H., and Caldeira, S. (2018). Spiritual distress in cancer patients: A synthesis of qualitative studies. Religions, 9.","DOI":"10.3390\/rel9100285"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.pedn.2018.08.003","article-title":"The spirituality of children with chronic conditions: A qualitative meta-synthesis","volume":"43","author":"Bakker","year":"2018","journal-title":"J. Pediatr. Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1177\/1367493517727131","article-title":"Parenting children with down syndrome: Societal influences","volume":"21","author":"Huiracocha","year":"2017","journal-title":"J. Child Health Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1080\/07481187.2019.1648336","article-title":"Understanding the spirituality of parents following stillbirth: A qualitative meta-synthesis","volume":"45","author":"Alvarenga","year":"2021","journal-title":"Death Stud."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1177\/1367493517737183","article-title":"The possibilities and challenges in providing pediatric spiritual care","volume":"21","author":"Alvarenga","year":"2017","journal-title":"J. Child Health Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.pedn.2015.07.008","article-title":"Parent spirituality, grief, and mental health at 1 and 3 months after their infant\u2019s\/child\u2019s death in an intensive care unit","volume":"31","author":"Hawthorne","year":"2016","journal-title":"J. Pediatric Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Romeiro, J., Caldeira, S., Brady, V., Hall, J., and Timmins, F. (2017). The spiritual journey of infertile couples: Discussing the opportunity for spiritual care. Religions, 8.","DOI":"10.3390\/rel8040076"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3917","DOI":"10.1111\/jocn.13813","article-title":"Spiritual aspects of living with infertility: A synthesis of qualitative studies","volume":"26","author":"Romeiro","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"E8","DOI":"10.1097\/01.NCC.0000339260.98818.9c","article-title":"Coping with a child with acute lymphocytic leukemia: The experiences of Chinese fathers in Hong Kong","volume":"32","author":"Wills","year":"2009","journal-title":"Cancer Nurs."},{"key":"ref_19","first-page":"61","article-title":"Thai families\u2019 caring practices for infants with congenital heart disease prior to cardiac surgery","volume":"14","author":"Srichantaranit","year":"2010","journal-title":"Int. J. Nurs. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1590\/S0034-71672009000100015","article-title":"Religion and spirituality: Experience of families of children with chronic renal insufficiency","volume":"62","author":"Paula","year":"2009","journal-title":"Rev. Bras. Enferm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5020\/18061230.2012.s13","article-title":"Pr\u00e1ticas culturais de cuidados entre m\u00e3es de lactentes com infec\u00e7\u00e3o respirat\u00f3ria","volume":"25","author":"Oliveira","year":"2012","journal-title":"Rev. Bras. Promo\u00e7. Sa\u00fade."},{"key":"ref_22","unstructured":"World Health Organization (2021, December 09). Genes and Chromosomal Diseases. Available online: http:\/\/www.who.int\/genomics\/public\/geneticdiseases\/en\/index1.html."},{"key":"ref_23","unstructured":"Minist\u00e9rio da Sa\u00fade (Brasil) (2012). Diretrizes de Aten\u00e7\u00e3o \u00e0 Pessoa Com S\u00edndrome de Down."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3625","DOI":"10.1590\/1413-812320172211.31102016","article-title":"Overload of caregivers of children and adolescents with down syndrome","volume":"22","author":"Barros","year":"2017","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"McCubbin, H.I., Sussman, M.B., and Patterson, J.M. (1983). The family stress process: A double ABCX model of adjustment and adaptation. Advances and Developments in Family Stress Theory and Research, Haworth Press.","DOI":"10.1300\/J002v06n01_02"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"47","DOI":"10.7748\/ns.2017.e10312","article-title":"Assessing the spiritual needs of patients","volume":"31","author":"Timmins","year":"2017","journal-title":"Nurs. Stand."},{"key":"ref_27","unstructured":"North American Nursing Diagnosis Association (2012). NANDA Nursing Diagnoses: Definitions and Classification 2021\u20132023, NANDA. [12th ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e03708","DOI":"10.1590\/s1980-220x2020001803708","article-title":"Problem-solving and coping in family adaptation of children with Down Syndrome","volume":"55","author":"Braga","year":"2021","journal-title":"Rev. Esc. Enferm. USP"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e20190188","DOI":"10.1590\/1980-265x-tce-2019-0188","article-title":"Family appraisal of the down syndrome diagnosis","volume":"29","author":"Schettini","year":"2020","journal-title":"Texto Contexto Enferm."},{"key":"ref_31","unstructured":"Couto, D.L. (2017). A Perspectiva de Cuidadores Prim\u00e1rios Acerca do Diagn\u00f3stico da S\u00edndrome de Down e o Processo de Adapta\u00e7\u00e3o da Fam\u00edlia nos Primeiros Anos de Vida da Crian\u00e7a. [Master\u2019s Thesis, Federal University of Minas Gerais]."},{"key":"ref_32","unstructured":"Maciel, I.V.L. (2017). Adapta\u00e7\u00e3o Familiar ao Cuidado Continuado de Crian\u00e7as com S\u00edndrome de Down. [Master\u2019s Thesis, Federal University of Minas Gerais]."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.pedhc.2017.09.007","article-title":"Qualitative secondary analysis: A case exemplar","volume":"32","author":"Tate","year":"2018","journal-title":"J. Pediatr. Health Care"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Beck, C.T. (2013). Secondary qualitative data analysis. Routledege Internacional Handbook of Qualitative Nursing Research, Routledge.","DOI":"10.4324\/9780203409527"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1177\/0038038518772743","article-title":"Qualitative Secondary Analysis: Building Longitudinal Samples to Understand Men\u2019s Generational Identities in Low Income Contexts","volume":"53","author":"Tarrant","year":"2019","journal-title":"Sociology"},{"key":"ref_36","unstructured":"Danielson, C., Hamel-Bissell, B., and Winstead-Fry, P. (1993). Families coping with illness: The resiliency model of family stress, adjustment, and adaptation. Families, Health and Illness: Perspectives on Coping and Intervention, Mosby."},{"key":"ref_37","unstructured":"Minist\u00e9rio da Sa\u00fade (Brasil) (2013). Resolu\u00e7\u00e3o n\u00b0. 466, de 12 de Dezembro de 2012. Disp\u00f5e Sobre Diretrizes e Normas Regulamentadoras de Pesquisas Envolvendo Seres Humanos."},{"key":"ref_38","unstructured":"Minist\u00e9rio da Sa\u00fade (Brasil) (2016). Resolu\u00e7\u00e3o n\u00b0. 510, de 07 de Abril de 2016. Disp\u00f5e Sobre as Normas Aplic\u00e1veis a Pesquisas em Ci\u00eancias Humanas e Sociais."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2021","journal-title":"Qual. Res. Psychol."},{"key":"ref_40","unstructured":"Guba, E.G., and Lincoln, Y.S. (1981). Effective Evaluation: Improving the Usefulness of Evaluation Results through Responsive and Naturalistic Approaches, Jossey-Bass."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1590\/1982-027520160001000012","article-title":"Indicativos de resili\u00eancia familiar em fam\u00edlias de crian\u00e7as com s\u00edndrome de down","volume":"33","author":"Rooke","year":"2016","journal-title":"Estud. Psicol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1177\/1055665620965407","article-title":"Mothers\u2019 reactions to seeing their children with cleft for the first time: A qualitative study in Ghana","volume":"58","author":"Dapaah","year":"2021","journal-title":"Cleft Palate-Craniofac. J."},{"key":"ref_43","first-page":"113","article-title":"Maternidade como miss\u00e3o! a trajet\u00f3ria militante de uma m\u00e3e de beb\u00ea com microcefalia em PE","volume":"3","author":"Pinheiro","year":"2017","journal-title":"Cad. Gen. Divers."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3745","DOI":"10.36489\/nursing.2020v23i263p3745-3750","article-title":"Viv\u00eancia de m\u00e3es com filhos diagnosticados com s\u00edndrome de down","volume":"23","author":"Benevides","year":"2020","journal-title":"Nursing"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1089\/jpm.2014.9427","article-title":"Improving the spiritual dimension of whole person care: Reaching national and international consensus","volume":"17","author":"Puchalski","year":"2014","journal-title":"J. Palliat. Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Superdock, A.K., Barfield, R.C., Brandon, D.H., and Docherty, S.L. (2018). Exploring the vagueness of religion & spirituality in complex pediatric decision-making: A qualitative study. BMC Palliat Care, 17.","DOI":"10.1186\/s12904-018-0360-y"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e40274","DOI":"10.12957\/reuerj.2019.40274","article-title":"Rede de apoio social da fam\u00edlia para o cuidado da crian\u00e7a com paralisia cerebral","volume":"27","author":"Gomes","year":"2019","journal-title":"Rev. Enferm. UERJ"},{"key":"ref_48","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (2021, December 09). Censo do IBGE do Brasil em 2010, Available online: https:\/\/cidades.ibge.gov.br\/brasil\/pesquisa\/23\/22107."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"40274","DOI":"10.1111\/jocn.15638","article-title":"Hospice palliative care nurses\u2019 perceptions of spiritual care and their spiritual care competence: A mixed-methods study","volume":"30","author":"Kang","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_50","first-page":"358","article-title":"Spiritual support to hospitalized patients: Perceptions of the multiprofessional health team","volume":"20","author":"Silva","year":"2019","journal-title":"Psych. Health Illn."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1590\/1982-02752018000100008","article-title":"Maternal coping of down syndrome: Identifying stressors and coping strategies","volume":"35","author":"Reis","year":"2018","journal-title":"Estud. Psicol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/bld.12231","article-title":"Adaptation and resilience in families of individuals with down syndrome living in Ireland","volume":"46","author":"Caples","year":"2018","journal-title":"Br. J. Learn. Disabil."},{"key":"ref_53","unstructured":"Sabey, A.K. (2016). Love in a Family Context. [Ph.D. Dissertation, Auburn University]."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/ajmg.a.38508","article-title":"Family management of childhood chronic conditions: Does it make a difference if the child has an intellectual disability","volume":"176","author":"Knafl","year":"2018","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s11689-019-9306-9","article-title":"Health comorbidities and cognitive abilities across the lifespan in down syndrome","volume":"12","author":"Startin","year":"2020","journal-title":"J. Neurodev. Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/jmft.12249","article-title":"Hope, coping, and relationship quality in mothers of children with down syndrome","volume":"44","author":"Cless","year":"2018","journal-title":"J. Marital Fam. Ther."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/3\/546\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:37:17Z","timestamp":1760135837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/3\/546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,16]]},"references-count":56,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["healthcare10030546"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10030546","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,16]]}}}