Journal of Child Health Care最新文献

The study aimed to evaluate diabetes self-care among diabetic children and adolescents and compare with glycaemic control. Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was distributed to patients aged 10-18 years with types 1 and 2 diabetes mellitus (DM) at paediatric diabetes clinics in Malaysia. Haemoglobin A1c levels were measured after questionnaire completion. A total of 106 patients completed the questionnaire with a mean age of 13.91 (± SD 2.48) years. Mean haemoglobin A1c and SDSCA score were 9.78 (± SD 2.43)% and 19.09 (± SD 5.81), respectively. Type 1 DM patients had significantly higher haemoglobin A1c (10.11 95% CI [9.62, 10.59] vs 8.38 95% CI [7.13, 9.62]). Total score was higher in type 1 DM although not statistically significant (19.32 95% CI [18.21, 20.43] vs 18.08 95% CI [14.28, 21.87]). Blood glucose testing score was significantly higher in type 1 DM (5.24 95% CI [4.82, 5.66] vs 3.50 95% CI [2.23, 4.77]). There was statistically significant negative correlation between score in diet subcategory and haemoglobin A1c. In conclusion, self-care activities among diabetic children and adolescents are still suboptimal. Self-care activities on blood glucose testing are significantly better in type 1 DM. Diet section correlated well with glycaemic control necessitating further research.

This study's primary objective was to establish differences in beliefs about medicines, levels of asthma-related anxiety and diet and exercise behaviours between parents of children with well controlled and poorly controlled asthma. Secondary objectives were to explore how asthma control might shape relationships between parental cognitions and parenting practices concerning paediatric asthma. Parents of children with asthma aged 10-16 years (N = 310) completed standardised questionnaires measuring beliefs about medicines, parental asthma-related anxiety, parenting attitudes towards child activity, parental feeding and asthma control. Parents of children with poorly controlled asthma reported significantly greater asthma medication necessity and concern, asthma-related anxiety, control of child activity, pressure to exercise and unhealthy feeding practices. Moderation analyses indicated that the relationship between parental concern about asthma medicine and parental control of child activity was strongest in children with poorly controlled asthma. Also, the relationship between parental asthma-related anxiety and use of food to regulate child emotion was only significant when asthma was poorly controlled. Parental beliefs about asthma medicines and asthma-related anxiety may indirectly influence asthma outcomes through unhealthy parenting practices around exercise and diet. Eliciting and understanding parents' perceptions of asthma medications and anxiety may facilitate personalised interventions to improve asthma control.

Safety netting (SN) provides specific information to caregivers identifying need to re-consult. SN is often used to bridge diagnostic uncertainty for first-contact healthcare professionals. This systematic narrative review investigated experiences of caregivers' regarding SN information received during acute child health consultations. Searches between April and December 2021 of six bibliographic databases (CINAHL, PsycINFO, BNI, EMCARE, MEDLINE and Web of Science) identified 3258 records. No studies were excluded based on quality and nine papers were included; the Mixed Methods Appraisal Tool was used to critically analyse papers and findings were summarised narratively. Four themes emerged: Importance of receiving Red-Flag-Symptom information, influences of specific mediums for information transfer to caregivers, key principles of SN as desired by caregivers and contextual influences of information transfer to caregivers. Quality of evidence was fair; review findings could provide underpinning principles to enable first-contact clinicians to enhance their person-centred approach to SN practice. There was a paucity of evidence generally, with a relatively small number of studies that captured specific SN activity during consultations. More research is also needed to capture the full-breadth of first-contact clinicians, particularly in non-clinical settings such as the home or school.

We surveyed pediatric primary care clinicians working in Federally Qualified Health Centers about their perceptions of children's social-emotional wellbeing. We identified clinician's current methods for assessing social-emotional wellbeing in practices, perceived implementation barriers to providing behavioral health care, and interest in adopting a validated, low-burden developmentally sensitive parent-report instrument for screening for social-emotional wellbeing in young children. We surveyed 72 PCCs working in FQHCs from 9 US states. Analyses included examining central tendencies, correlations, analysis of variance, and group differences via t-tests. Average PCC perceptions of social-emotional wellbeing importance for overall health were statistically significantly higher than their confidence in providing care for common social-emotional wellbeing concerns (mean difference = 1.31, 95% CI = 1.13-1.49). PCCs expressed low satisfaction with currently available screening measures for identifying concerns in social-emotional wellbeing. Fewer than half of clinicians reported using any standardized parent-reported measure for identifying concerns in social-emotional wellbeing. Assessment methods and decision tools that improve clinician confidence concerning risk indications are needed, particularly at the critical early childhood period. Policymakers and payers ought to facilitate funding mechanisms that support pediatric PCCs in identifying early concerns in social-emotional wellbeing and providing referral guidance to evidence-based interventions to support parents and caregivers.

Children who have been maltreated are at an increased risk of having their pain under-recognized and undertreated by healthcare professionals, and thus, are more susceptible to adverse outcomes associated with undertreated pain. This study's aims were to examine: (1) if healthcare professionals' pediatric pain knowledge is associated with their pain assessment methods, (2) if maltreatment-specific pain knowledge is associated with consideration of child maltreatment when deciding on a pain management strategy, and (3) if pediatric pain knowledge would relate to maltreatment-specific pain knowledge. A sample (N = 108) of healthcare professionals responded to a survey designed to examine their current knowledge and utilization of pediatric pain assessment and management with emphasis on the effects of child maltreatment. Findings revealed healthcare professionals' knowledge of pediatric pain is independent of their pain assessment and management practices. However, general pain knowledge was associated with maltreatment-specific pain knowledge and generally, healthcare professionals were knowledgeable of child maltreatment's impact on pediatric pain. Participants who considered a history of maltreatment were also more likely to employ sensitive questioning strategies when asking children about their pain.

This study aimed to examine how parents develop personal resilience when facing the challenges of caring for a child with tracheostomy. This study employed a longitudinal qualitative design. Unstructured narrative interviews with 12 parents (from nine families) whose child had a new tracheostomy were undertaken at three time points over 12 months. Data were analysed using a socio-narratology method. Findings reveal the journey parents experienced, how their feelings changed and the processes involved in developing resilience over the first 12 months of their child having a tracheostomy. Stories told by parents early in their journey revealed emotional upheaval, negative emotions, stress and shock. Due to medical need, parents had little or no choice for their child to have a tracheostomy. Once their child's life was out of danger, parents started to reframe their experiences and beliefs. Resilience played a major part in how parents perceived and faced their situation, allowing them to deal with what came their way and to move forward with their lives. Different aspects of resilience such as self-awareness, grit, gratitude, internal locus of control and reframing came to the fore at different time points. Parents talked feeling stretched by the challenges they faced and how they reframed their perspectives about their child's tracheostomy. Parents' resilience and reframing is discussed in relation to the ABC-X model. This study identifies a theoretical model that explains this process of change, this results in transferable knowledge, useful for understanding and explaining the experience of other parents and families.

Cystic fibrosis (CF) affects not just patients but also their families, highlighting the need for a comprehensive care approach. This descriptive qualitative study aimed to explore the informational needs of family caregivers of children with CF, focusing on how these needs can be addressed within a Patient and Family-Centered Care (PFCC) framework. The study was conducted at a public hospital in Brazil. Thirteen caregivers were interviewed, and their responses were analyzed using content analysis guided by PFCC principles. Analysis revealed three primary themes: Types of Information for Family Caregivers of Children and Adolescents with CF; sources of Information for Family caregivers of Children and Adolescents with CF; and Beyond Information: the need for emotional support and family-centered care in CF management. Caregivers sought comprehensive information about CF management from healthcare professionals and informal sources like social media. Our findings emphasize the diverse and evolving informational needs of family caregivers. Overall, this study underscores the necessity of incorporating PFCC principles, especially those addressing information sharing, in managing CF, extending beyond medical treatment to include emotional support and active family participation in care and decision-making processes.

Learning to communicate with infants in a neonatal unit setting is challenging. Parents need time and support to feel confident and acquire skills that enable them to care for, be close to, and communicate with their infant. This qualitative, narrative-based study sought to investigate parents' understanding of factors that enhance or prevent the development of early communication and interaction between preterm infants and parents within a neonatal setting. Our study used a narrative interview approach with eight parents of premature infants, to explore the enablers and challenges to communication. Reflexive thematic analysis revealed four main themes: Impact of being in the neonatal unit, different communication strategies, communication barriers and an ongoing need for support at home. Our findings provide parental insight into communication between themselves and their premature infants. Overall, parents spoke highly of communication strategies that they were taught but it was clear they received varying advice and support, in the neonatal unit and post-discharge. There is a need for clear, consistent, and culturally appropriate communication strategies with greater awareness of how to facilitate them. Since failure to enable parent-infant interactions may potentially mean delayed language development, there is an essential need for tailored parent-accessible resources.

Children with chronic illnesses often miss school, leading to negative outcomes like diminished health-related quality of life (HRQoL) and sense of belonging. Telepresence robots are suggested to keep these children connected to peers and education, yet little research has explored their impact. This study assessed effects of a telepresence system on HRQoL and sense of belonging in 29 patients with chronic illnesses aged 6 to 18 years, who were absent from school. Using a one-group pre-posttest design, participants completed questionnaires before and 6 months after receiving the robot. It was expected that HRQoL and sense of belonging would remain stable due to the robot. Wilcoxon tests indicated no decline in HRQoL (Z = -.958, 95% CI [-3.1, 8.3]) or sense of belonging (Z = -1.409, 95% CI [-0.3, 0.8]). Spearman correlations revealed a significant correlation between age and changes in school (rs = 0.621, 95% CI [0.200, 0.848]) and friends' subscales (rs = 0.579, 95% CI [-0.136, 829]), suggesting adolescents benefit particularly from the robot. Consistent with prior research, this study shows no change in psychosocial factors, indicating a stabilizing effect of telepresence robots and contributing to sustainable psychosocial care for pediatric patients.