Journal of Pediatric Nursing-Nursing Care of Children & Families最新文献

Objective: Due to their medical vulnerability, youngsters with congenital heart disease (CHD) may experience more overwhelming emotions than healthy peers. This multi-informant-based study aims to examine differences between these youngsters and their peers in psychosocial functioning, attachment and emotion regulation.

Study design: 217 youngsters (8-18 years) with CHD (53.9 % boys, 46.1 % girls) were compared to 232 healthy controls (52.6 % boys, 47.4 % girls) matched for gender, age and education. Participants and parents completed online self-report questionnaires assessing psychosocial functioning (SDQ), attachment (ECR-RC), and maladaptive Emotion Regulation Strategies (ERS; FEEL-KJ).

Results: Based on child's self-reports MANOVA's showed no significant differences between the groups in psychosocial functioning. However, based on parent reports, differences were found between the groups in psychosocial functioning for the total scales and overarching subscales. No differences were found between the groups for insecure attachment to either parent. However, youngsters with CHD and their fathers reported more use of self-devaluation compared to controls (p = .03). Other maladaptive ERS (giving up, withdrawal, rumination, aggressive actions) showed no differences.

Conclusions: Care interventions for children with CHD should address medical, emotional, and social needs, with a focus on multi-informant evaluations to support emotional well-being. Nurses are important partners in detecting psychosocial difficulties and providing family support. Patient- and family-centered care involves patients, parents and caregivers in the care plan, recognizing their key role, especially as youngsters often perceive their psychosocial health differently than their parents. Although differences were noted compared to the control group, the study's cross-sectional design limits conclusions on evolution with time.

Purpose: Rare diseases are individually uncommon yet collectively prevalent. They affect over 300,000 people in Ireland, with 50-70 % impacting children. This study explores the supportive care needs of parents caring for children with rare diseases in Ireland, utilising a validated Parental Needs Scale for Rare Diseases (PNS-RD).

Design and methods: This descriptive quantitative study employed survey techniques to assess parental support needs. An online survey was administered to parents across Ireland from August 2021 to December 2021 using the Qualtrics™ platform.

Results: Out of 107 consented participants, 89 provided data suitable for analysis. Findings revealed significant challenges, with children averaging six hospital visits per year; 77 % of families indicated special education needs, and 42 % required medically complex care. The PNS-RD scale mean was M = 48.62 (95 % CI: 44.5-52.7), comprising four dimensions (each scored out of 25): i) Understanding the disease (M = 9.01, 95 % CI: 7.5-10.5), ii) Working with health professionals (M = 13.68, 95 % CI: 12.0-15.4), iii) Emotional issues (M = 13.22, 95 % CI: 12.0-14.5), and iv) Financial needs (M = 12.94, 95 % CI: 11.2-14.6). Parents demonstrated confidence in managing their child's care but reported considerable emotional strain and financial challenges.

Conclusion: While parents generally felt confident in handling their child's rare disease and were moderately satisfied with the care and support received, the emotional, psychological, and financial toll remained high.

Implications for practice: This study underscores the urgent need for comprehensive support systems to alleviate these burdens, advocating for tailored healthcare and social support interventions to meet the diverse needs of these families.

Purpose: To describe nurses' experiences encountering children with suspected neurodevelopmental disorders in Child Health Services.

Design and methods: This qualitative inductive study was conducted in Sweden. Twenty nurses were interviewed individually on a virtual platform using a semi-structured interview guide with open-ended and explorative questions. Interviews were audio recorded and transcribed verbatim and analyzed using qualitative content analysis.

Results: Nurses expressed responsibility for finding deviations in children but described an equilibrium of giving children time to develop without delaying referrals. Nurses had profound competence and intuition, but subjective intuition of assessment evoked a feeling of uncertainty. Nurses were sensitive and open-minded to different and contradictory parental reactions. Reactions were difficult and frustrating to manage, and communication needed to be versatile and flexible to achieve a partnership. When uncertain in an assessment they obtained complementary additional information from the child's preschool teacher. Nurses had several collaborators inside and outside the Child Health Services team and felt successful when correctly referred but frustrated with extended waiting times and protracted interplay.

Conclusions: The results suggest further education for nurses about neurodevelopmental disorders and communication tools like Motivational Interviewing. Furthermore, screening for assessing neurodevelopmental disorders, guidelines in referral management and a care coordinator for multiple referrals should be implemented.

Practice implications: Improvements in Child Health Services nurses' competence, screening methods and referral management could lead to more efficient care interventions and support that can promote health and well-being in the short and long-term for children and families.

Introduction: Foundations for health are set in the first years of life, however many children in Australia do not attain optimal development due to inequitable access to specialist care through impacting social determinants of health. There is a research gap in evidence for sustaining early years services that address these barriers. This study aimed to understand experiences and priorities of parents/carers and service providers around access to specialist early years health services in low socioeconomic areas of Armadale, Western Australia.

Methods: Thematic analysis was used to interpret meanings across focus group discussion data and find priorities for access to care and service delivery using a multilevel socio-ecologic model. Facilitators and barriers to access were identified related to each theme.

Results: Two major themes were identified. Within theme 'Finding Help', facilitators to access included extended family, community, and childcare. Barriers included social isolation, and overwhelm. In theme 'Structural Factors', facilitators included safe places and practices, political action and universal care. Barriers included social determinants of health, institutional bias, and fiscal policy.

Conclusion/discussion: Findings will inform policy, service delivery, and research priorities toward facilitating timely access to integrated care for vulnerable families with young children. Health equity will focus on co-design to remove structural barriers using a "one-stop-shop" model with soft entry, triage capacity, and a key worker to coordinate care for at risk families. To promote structural equity, a focus on access will include continuing engagement with families, facilitated by relational models of care to scaffold and support families toward autonomy.

Purpose: The study was aimed at determining the effect of exposure to white noise and recorded lullaby during breastfeeding on newborn stress, mother's breastfeeding success, and comfort.

Design and methods: This single-blinded and three-parallel group randomized controlled study consisted of mothers who had given birth and whose newborns were at a hospital in Turkey. Seventy-five participants completed the study. They were assigned to white noise, lullaby, and control groups in equal numbers. Each group included 25 women. The questionnaires included descriptive characteristics of mothers, the LATCH Breastfeeding Assessment Tool, the Newborn Stress Scale, and the Visual Analog Scale. During the breastfeeding process, the newborn and mother listened to white noise and lullaby for approximately 15 min. The newborn stress and mothers' level of comfort were assessed before and after the interventions. The breastfeeding success of the mother assessed with the LATCH was completed within the first 15 min of breastfeeding.

Results: The mean scores obtained from the Newborn Stress Scale by the mothers in the lullaby group and white noise group decreased significantly after the intervention. A significant difference was also observed in the control group. There were also significant differences between the changes in the mothers' comfort level of all groups. There were significant differences between the changes in the LATCH scores of the groups.

Conclusion: Both white noise and recorded lullaby significantly reduced newborn stress, and increased mother's comfort in the early postpartum period.

Practice implications: Music should be used as a nonpharmacological method to improve breastfeeding success in newborns.

Genomics is a lifespan competency that has relevance for pediatric nursing practice. Identifying individuals who could benefit from genomic healthcare can enable timely diagnosis and treatment to improve health and wellbeing outcomes. Nurse practitioners (NPs) must have genomic competency to provide high quality, comprehensive pediatric care and support families through the continuum of care. To date, integrating genomics into nursing curricula has been inconsistent and piecemeal. We describe the structure, process, and initial outcomes of a novel genomic nursing simulation for pediatric NP students that uses Turner syndrome and Fragile X as exemplar cases.

Aim: This study aimed to translate the partner breastfeeding influence scale (PBIS) to the Afaan Oromo language and determine its psychometric properties.

Methods: A cross-sectional study involving 320 fathers of infants under six months old was conducted with a 4-week retest. The scale underwent translation and back-translation before its psychometric evaluation. Its content validity was determined using the Content Validity Index (CVI), while construct validity was assessed through Exploratory Factor Analysis (EFA). The scale's reliability was evaluated using Cronbach's alpha and intraclass correlation coefficient (ICC). Mean differences in father breastfeeding support by sociodemographic factors were analysed using independent t-tests and one-way ANOVA.

Results: The EFA conducted on the scale resulted in a 31-item with a five-component structure, demonstrating excellent reliability. The overall scale showed a Cronbach's alpha of 0.96, while the subscales for breastfeeding savvy, helping, appreciation, breastfeeding presence, and responsiveness recorded Cronbach's alpha values of 0.88, 0.92, 0.89, 0.89, and 0.74, respectively. The scale demonstrated high test-retest reliability (ICC = 0.96) and strong content validity (item-level CVI: 0.86-1.00; scale-level CVI: 0.98). Father's age, number of children, education, employment, and income correlated significantly with their breastfeeding support levels.

Conclusion: The study found that the Afaan Oromo version of the Partner Breastfeeding Influence Scale (PBIS-AO) is a reliable and valid tool for assessing father support for breastfeeding among Afaan Oromo-speaking fathers in Ethiopia.

Implications to practice: The validated tool can enhance evidence-based practice by providing healthcare professionals with reliable instruments to evaluate patient outcomes, interventions, and informed decisions on breastfeeding practices.

Aim: This study aimed to evaluate the knowledge, attitudes, and acceptance of Electronic Health Records (EHRs) among nurses in Egypt.

Methods: A descriptive cross-sectional study was conducted involving 1217 nurses from 33 public and private hospitals. Data were collected using a self-administered online questionnaire, which assessed knowledge, attitudes, and acceptance of EHRs. The data were analyzed using Spearman's rank correlation and binary logistic regression.

Results: Significant positive correlations were identified between nurses' knowledge and attitudes towards EHRs (r = 0.72, p < 0.001), knowledge and acceptance (r = 0.67, p < 0.001), and attitudes and acceptance (r = 0.79, p < 0.001). Key predictors of EHR acceptance included higher education (postgraduate) (p = 0.004), good computer skills (p < 0.001), satisfactory knowledge (p < 0.001), and positive attitudes (p < 0.001).

Conclusion: Nurses' knowledge and attitudes play a crucial role in their acceptance of EHRs. These findings underscore the importance of targeted education and skill development programs to support the effective implementation of EHR systems in Egyptian healthcare settings.

Implications to practice: Healthcare leaders and policymakers must champion the adoption of EHRs by creating policies that support their implementation. Creating a supportive environment that encourages the use of EHRs can significantly enhance their acceptance.

Objectives: To examine the predictors of parent-child bonding and parenting satisfaction using structural equation models at three time points across the perinatal period: (1) during pregnancy at >24 gestational weeks, (2) one month postpartum, and (3) three months postpartum.

Methods: This longitudinal exploratory quantitative study recruited a convenient sample of 118 heterosexual couples (236 participants; 118 mothers and 118 fathers) from maternity clinics of a public tertiary hospital in Singapore. Descriptive statistics were used to summarize the parents' characteristics and study variables. Structural equation modeling was used to test the appropriateness of the hypothesized model on the study variables. Multigroup analyses according to gender were conducted to understand the relationships among parental outcome variables for mothers and fathers separately. Goodness-of-fit statistics were used to determine the adequateness of the hypothesized models.

Results: An adequate fit between the hypothesized model and the study's data was reported for all analyses. Among couples, no variable was identified as a significant predictor for parent-child bonding, while parenting self-efficacy, parent-child bonding, and social support were identified as significant predictors of parenting satisfaction. Fathers with more social support had stronger father-infant bonds. Mothers with poorer psychological well-being had more maternal-child bonding and maternal satisfaction. Different relationships between the parental variables among fathers and mothers were reported at only one month postpartum.

Conclusion: Both parents need to receive perinatal support.

Implications to practice: Fathers could receive more encouragement to be involved in perinatal care and maternal-infant bonding can be promoted during the first month postpartum.

Objective: This review aims to investigate parents' preference for and use of Ibuprofen and Paracetamol in managing and treating children's fevers as well as the factors influencing their decision-making and practices.

Introduction: Parents globally face concern over managing children's fever, seeking relief while ensuring safety, often relying on accessible medications like Paracetamol and Ibuprofen.

Inclusion criteria: The review included quantitative studies involving parents and caregivers managing fever in children aged 0-17 years. Studies published in English or in other languages with an English language version from January 2000 to March 2024 were included, excluding hospital-based or healthcare professional-managed studies.

Methods: Searches were conducted using MEDLINE, PubMed, SCOPUS, and CINAHL databases using specific search strategies. Titles and abstracts were screened online, and full reports were obtained for any publication considered useful for this overview. Methodological quality was assessed independently by two reviewers using the JBI critical appraisal instrument. Data extraction was performed in Excel, and statistical meta-analysis was undertaken using JBI SUMARI software.

Results: Approximately 27.4 % of participants utilized Ibuprofen, while 64.3 % opted for Paracetamol. Subgroup analyses revealed that 29.8 % and 63.2 % administered Ibuprofen and Paracetamol to children under five. Additionally, 20.3 % alternated between these medications. Syrup emerged as the preferred mode of administration, with prominent parental involvement in dosage determination. Factors influencing medication choices included efficacy, safety profile, age, weight, ease of administration, and healthcare provider recommendations.

Conclusion: The prevalence of Ibuprofen and Paracetamol usage for pediatric fever management varies significantly. Parental involvement is prominent, guided by factors like efficacy and healthcare provider recommendations. Understanding these dynamics is crucial for informed decision-making and optimizing pediatric medication practices.

Implications to practice: This review highlights the importance of enhancing parental education on antipyretic use, emphasizing safe dosage practices and clear communication with healthcare providers. Healthcare professionals should address misconceptions and provide tailored guidance, fostering more effective and safer fever management strategies for children.