Journal of Child Health Care最新文献

Previous studies have demonstrated that Buzzy® is effective for pain reduction during vaccination. This study aimed to determine if Buzzy® would have an effect on either duration of vaccine administration and/or patient satisfaction. Pediatric patients aged birth to 18 years old receiving a vaccination were randomized to either a control group receiving no intervention, or the experimental group, utilizing Buzzy®. Time of administration was measured by the number of seconds required by nursing to administer vaccines. Patient satisfaction was measured with a survey given to guardians. Time required was reduced by almost 2 min when utilizing Buzzy®, with median time dropping to 190, 95% CI [26.99, 415.92] seconds from 333, 95% CI [51.35, 627.21] seconds. Patient satisfaction surveys showed positive impacts of using the device, with 100% that used the device reporting that it "made a difference in the pain level experienced," but did not demonstrate statistical significance. This study shows that use of Buzzy® increases efficiency of appointments with possible positive effect on patient satisfaction.

Adolescents with inflammatory bowel disease (IBD) are at an increased risk of anxiety and depression compared to peers, but availability of mental health services in IBD clinics does not meet patients' needs, and use of primary care services for mental health screening and care is low. This study provides qualitative data regarding adolescent and caregiver perspectives on addressing mental health in IBD. Interviews were conducted with adolescents with IBD and caregivers of adolescents with IBD. Interview transcripts were coded and analyzed for prominent themes. Thirteen adolescents and fourteen caregivers were interviewed. Three primary themes emerged: mental health stigma makes discussing it more difficult, physician-adolescent trust makes conversations about mental health easier, and asking about mental health directly can help adolescents feel comfortable. Adolescents and caregivers highlighted the importance of considering each patient and their family individually when choosing how to discuss mental health. Fostering trust with adolescents with IBD is vital to addressing mental health. While encouraging standardized screening is important, the most patient-centered approach to mental health involves considering families individually to identify and address mental health challenges. Given the increased risk of anxiety and depression in pediatric patients with IBD, all providers encountering these patients should be equipped to discuss mental health non-judgmentally.

We aimed to systematically categorize evidence on the types of early visual stimulation applied to preterm infants (PTIs) admitted to neonatal intensive care units (NICUs), aiming to improve visual function parameters. This study was conducted according to PRISMA and registered in PROSPERO with CRD42022333753. Last search was conducted on March 15, 2023, in four different databases. Articles written in English, Portuguese, Spanish, or Italian, and available in full text were included. Two independent authors performed study selection, data extraction, and bias risk assessment. If there was any disagreement, a third author was contacted. A total of eight studies were included. From these, 62.5% presented a low risk of bias. 100% used a multisensory intervention, which included visual stimulation. In 50%, visual intervention consisted of black and white stimulation cards placed inside the incubator for three minutes. The outcomes showed positive benefits in visual function parameters and other reported clinical benefits in breastfeeding and neuromuscular development. This review demonstrated there is still scarce literature on the effects of early visual stimulation on purely visual functional outcomes, although the existing findings are promising. Parental involvement has been generating unquestionable benefits for the binomial mother-infant and gaining greater acceptance by health professionals.

Parents of a child with a chronic illness can experience greater distress than the average population, yet little is understood about differences between illness groups. This cross-sectional survey study aimed to compare parents' psychological distress and perceived wellbeing across five chronic illnesses. Parents from one Australian pediatric hospital completed the Kessler Psychological Distress Scale and seven purpose-designed items about their wellbeing. Data from 106 parents (cancer = 48, cystic fibrosis [CF] = 27, kidney disease = 12, gastrointestinal condition/disorder = 9, developmental and epileptic encephalopathy [DEE] = 10) was analysed using bivariate Pearson's Correlation and linear mixed-effects models. Parents' distress scores differed between groups (F(4,80) = 2.50, p = .049), with the DEE group reporting higher distress than the CF group (mean difference = 6.76, 95% CI [0.11, 13.42]). Distress scores were moderately correlated to parents' perceptions of their child's health and their own wellbeing. Parents' self-reported coping with their child's condition/treatments differed (F(4,81) = 3.24, p = .016), with the DEE group rating their coping as poorer than the CF group (mean difference = -25.32, 95% CI [-46.52, 4.11]). Across all groups, parents reported unmet needs, particularly for psychosocial support and practical/financial assistance. Support interventions may be most effective if tailored to the child's illness, with greater support potentially needed for parents who have a child with DEE and/or severe comorbidities.

Parents encounter challenges when their child with congenital heart disease is transferred from pediatric to adult care. Until recently these parents' experiences and expectations of their child's transfer have received less attention. This systematic review aims to identify and synthesize qualitative evidence on parental experiences and expectations about their child's transfer from pediatric to adult care using a meta-aggregation approach. Six studies were included with 39 findings being aggregated into seven categories. Three syntheses were formed: Information is a prerequisite for supporting young people's transfer. The transition process should be well-prepared, individualized, and based on young people's maturity. Changing parental roles causes ambivalent feelings requiring support in the transfer process. Parents regard transfer from pediatric to adult care as a natural developmental step. However, some parents are anxious and worried while others found the transfer as feasible as other transitions in their child's life. Involving parents in the transition process enables them to facilitate their child's transfer. Parents worry their child is too young to take responsibility for their health. Parental roles from being a full caregiver to becoming a supportive person cause ambivalent feelings. These findings align with research on parents' experiences of young people with long-term conditions.

Effects of the Coronavirus disease 2019 (COVID-19) pandemic on children stem beyond immediate infectious and post-infectious risks. Our aim was to conduct a scoping review and produce an online Interactive Evidence Map (IEM) highlighting available literature around unintended effects of the pandemic on children's and adolescents' mental, psychosocial, and physical health. A search was run monthly in MEDLINE, PsycINFO, CENTRAL, and Cochrane COVID-19 Study Register from May 1^st 2021 through April 30^th 2022. All articles involving children and adolescents under 18 years of age relating to any unintended mental, psychosocial, and physical health consequences of the pandemic and resultant restrictions were included. Data were extracted and topics categorized, with corresponding data uploaded into EPPI-Reviewer and transferred to EPPI-Mapper for visualization. A total of 14,555 citations were screened and 826 (6%) articles included. Most articles reported on mental health outcomes, particularly anxiety (n = 309, 37%) and depression (n = 294, 36%). Psychosocial outcomes related to lockdowns such as loneliness (n = 120, 15%) and impact on adolescent relationships with others (n = 149, 18%) were also reported. Fewer articles examined physical consequences, but those that did mostly focused on child abuse (n = 73, 9%). Overall, currently mapped literature focuses on consequences related to mental health outcomes such as anxiety and depression.

Globally, the number of Children and Young People (CYP) that experience mental health crisis and access paediatric acute hospital settings continues to increase. Many of these CYP present with thoughts and behaviours of self-harm and/or suicide and often experience severe and fluctuating emotional states. It is therefore important that the risk of self-harm/suicide is assessed during an inpatient admission and strategies implemented to mitigate risk. This study aimed to identify self-harm and suicidality risk management pathways that have been developed and evaluated for use with CYP admitted to acute hospital settings with mental health crisis. A systematic review was conducted. Eight online academic database were searched up to February 2022. The critical appraisal skills programme tool was used to assess the methodological rigour of included studies. Online searches identified 120 potential studies. Five studies met the predefined inclusion criteria. Six risk mitigation strategies were identified; safety huddles, urgent full mental psychiatric review within 2-h of assessment, feedback on screening responses, motivational and barrier-reducing intervention, 1:1 constant observations and environmental safety. All included strategies targeted environmental, family, and individual CYP involving modifications to equipment, surveillance, and communication to enhance safety.

In Occupied Palestinian territory (OPT), which is in a complex political situation and has limited access to resources, there is a critical need to deepen the understanding of how children with life-limiting and life-threatening illnesses are cared for. This study explores the experiences of parents caring for more than one child with a chronic or serious illness. A qualitative descriptive method was adopted, with data collected from several paediatric units in two OPT cities, Tulkarm and Ramallah. Semi-structured, face-to-face interviews were conducted with 16 parents (each interview was of an individual parent). Data were analysed using thematic analysis, and the analysis unearthed seven major themes that reflected the parents' experiences. These were as follows: Significant life changes with the first child's illness; the second experience; becoming stronger; support systems; economic difficulties; social stigma; and social isolation. Data analyses suggest that there is a significant need for emotional and physical support to be provided to parents, and culturally salient social service provisions should be implemented to alleviate the burden placed on these parents.

This study aimed to describe parents' experiences of children with temporary feeding tubes by surveying parents whose children required tubes. This survey included three sections including; (A) Depression Anxiety Stress Scale (DASS-21); (B) Paediatric Assessment Scale for Severe Feeding Problems (PASSFP); and (C) open-ended questions on satisfaction and experiences. Data were analysed using descriptive statistics and inductive content analysis. A total of 44 parent participants completed the survey. Most participants reported satisfaction with their child's care, although for most, tube removal occurred after ≤5 days (n = 25, 57%). Children who were discharged home with a temporary feeding tube (n = 7, 16%) had more feeding difficulties. Two themes were identified: 1) navigating tube feeding and 2) health service experiences. Although parents were generally positive about their child's care, some described ongoing medical and psychosocial impacts. Many parents desired more involvement in decision-making and tube feeding care. Parents described varied experiences regarding temporary tube feeding both in hospital and after discharge home. Further studies are needed across all spectrums of temporary tube feeding care, especially those discharged home. These findings underscore a need for enhanced support and education for parents, which could improve outcomes for children with temporary feeding tubes.

Whether spoken language influences experiences of trans and non-binary youth (TNBY) with healthcare systems is unknown. We analyzed Quebec data from the Canadian Trans and Non-Binary Youth Health Survey to illustrate healthcare experiences of predominantly French-speaking TNBY aged 14-25 and influence of gender identity and language on those experiences. We included 220 participants of whom 71% identified as French-speaking. Up to 78% reported a mental health problem and 51% reported foregoing mental health care in the last year. Only 26% of non-binary versus 57% of trans youth were comfortable discussing healthcare needs with providers (OR 0.26; 95% CI [0.13-0.54]). English youth were less likely than French youth to be comfortable discussing healthcare needs (aOR 0.33, 95% CI [0.13-0.83]. They were also more likely to forgo care because of negative experiences (aOR 2.21, 95% CI [1.00, 4.87]) and out of fear (aOR 2.38, 96% CI [1.08, 5.28]). Our study found that TNBY had a high prevalence of foregone health care despite a great need. In Quebec, a predominantly French-speaking area within Canada, language-minority English TNBY were less comfortable than French TNBY discussing healthcare needs and accessing needed resources. Limited availability of language-specific resources may be an additional barrier to healthcare access for TNBY.