Journal of Child Health Care最新文献

Parents and youth across Alberta were engaged to identify specific research questions that are a priority to them. Two lists, containing 27 topics were developed with local parent and youth advisory groups, and sent to participants via online questionnaires. Topics were rated from one (least important) to five (most important) and ranked in order of priority. Initial questionnaires were completed by 263 (46%) parents and 308 (54%) youth. Parents rated five topics (behaviour, learning, and developmental disorders; mental health; food, environment and lifestyle; quality of health care; and vaccines) and youth rated four topics (brain and nerve health; mental health; quality of health care; and vaccines) as a high priority. Research questions stemming from 4 parent (12 [5%]) and 6 youth (21 [7%]) focus group discussions were then ranked in a second questionnaire, completed by 43 (43%) parents and 56 (56%) youth. Parents' highest ranked research question was 'What is the effect of screen time on cognition and neurodevelopment for children and adolescents?', while the highest ranked question from youth was 'What are the early signs of anxiety and depression and when should an individual seek help?'. These topics highlight areas that are important to parents and youth where funding, research, and knowledge mobilization efforts should be directed.

Non-urgent paediatric Emergency Department presentations contribute to overcrowding, poor patient health outcomes, and burden acute healthcare services. A study was conducted to explore motivations and factors that influence decision-making processes of parents who presented their child to ED for non-urgent conditions. An exploratory study using a qualitative descriptive design was undertaken to address research aims. Semi-structured interviews were conducted with a purposive sample of eight parents who presented their child (birth to 14 years of age), to ED for non-urgent conditions. Parental decision-making regarding ED presentations were influenced by a constellation of factors; however, three main themes emerged. These included Parental Anxiety, There is Only One Place, and Mitigating Perceived Delay or Inaccessibility. As such, centred on how parents addressed their anxiety when a child was ill, accessibility and capacity of EDs to provide immediate relief to parents and children, and parents' perception that accessing other healthcare services impacted crucial time for treatment. EDs remain a preferred healthcare service to address non-urgent paediatric needs, despite adequate health literacy among participants. When improving models of care within EDs, non-urgent presentations must be considered, including management of parental anxiety, along with establishing non-urgent care adjacent to or integrated within an ED.

This review aimed to analyze the effects of laughter-inducing therapy on anxiety, pain, and stress in children by synthesizing existing randomized controlled trials (RCTs). Researchers conducted a systematic literature review and meta-analysis, following the Cochrane Collaboration's methodology for systematic literature review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We selected and evaluated 12 studies for quality using the Risk of Bias 2.0 tool. Seven studies were included in the meta-analysis, which showed that clown therapy produced a moderate effect on pain relief and a large effect on anxiety reduction in pediatric patients. In conclusion, this review highlights the potential of laughter-inducing therapies as an effective clinical intervention for reducing anxiety, pain, and stress in pediatric patients. These findings provide evidence supporting the use of laughter-based interventions as alternative or complementary approaches in medical settings. The review also underscores the need for further research across diverse clinical environments to validate the effectiveness of laughter-inducing therapies in broader pediatric populations. Overall, the incorporation of laughter-inducing therapy into clinical practice may play a valuable role in enhancing the overall well-being of pediatric patients.

There is limited literature on nurse leaders' perceptions of organisational policies, guidelines, and practices that enact children and young people's (CYP) involvement in hospitals. Nurse leaders within what were the four District Health Board providers of children's tertiary health services in New Zealand (Auckland, Counties Manukau, Wellington, and Canterbury) were invited to respond to an online survey during November 2022 through to January 2023. The survey was developed by the researchers in accordance with the literature and included 11 open-ended questions. The open-ended questions were analysed iteratively through inductive thematic analysis. Eight out of 24 invited nurse leaders responded to the survey. Thematic analysis of the findings resulted in four key themes that highlighted how nurse leaders perceived their organisations provided a platform for children and young people's involvement in hospital: Policy and Guidelines; Diversity, Equity, and Inclusion; Models of Care; and CYP's Voices. Nurse leaders described various means and methods utilised to enact CYP's participation within paediatric settings in New Zealand. A multi-tiered collaborative approach with government, industry, leaders, healthcare professionals, family and CYP is required to enhance CYP's agency/voice in New Zealand hospitals as in alignment with the United Nation Convention of the Rights of the Child.

Care leavers face adversity and poor psychological outcomes, despite being a significantly under researched population. Childhood maltreatment is associated with attachment insecurity and Early Maladaptive Schemas (EMS); however, there is little research into the relationships between these variables, and none exploring these variables in care leavers. The study aimed to investigate the relationship between childhood maltreatment, attachment, EMS and maladaptive coping in care leavers, hypothesising that higher levels of childhood maltreatment would be associated with increased attachment insecurity, EMS severity and maladaptive coping. Participants were 53 UK-based adults, with experience of living in care during childhood. An opportunity sample and a within-subjects, cross-sectional survey design was used with hierarchical multiple regression. High levels of childhood maltreatment, attachment insecurity (both anxious and avoidant), EMS and maladaptive coping were found within the sample of care leavers. Hierarchical regression indicated that both attachment anxiety and attachment avoidance, and EMS domain 'disconnection and rejection' were significant predictors in the relationship between childhood maltreatment and maladaptive coping. The study adds to the current knowledge about psychological vulnerabilities for care leavers. Results highlight the importance of targeted assessment, formulation and psychological interventions targeting attachment domains and EMS, with particular focus on the disconnection and rejection schema domain for this population.

There is a gap between children's right to report on their own experience of inpatient care, and availability of a validated measure to facilitate consistent reporting by children and young people. This study aimed to understand children and young peoples (aged 12-18 years) preferences for reporting their own experience of inpatient health care, and validate a revised question set. A three-phase study assessed: content analysis of focus group discussions; face and content validity of an adapted question set; construct validity using confirmatory factor analysis. Children and young people chose to adapt a survey titled 'Australian Hospital Patient Experience Question Set'. Suggested changes to wording reflected their experiences of feeling listened to, heard, and safe, in contrast to feeling overlooked or overpowered. Assessment of construct validity demonstrated a sound one-factor model (n = 193, Root Mean Square Error of Approximation 0.033, Comparative Fit Index 0.997, Tucker Lewis Index 0.996, composite reliability 0.951). Children and young people valued participating in survey design. The resulting question set is a reliable and valid tool to measure self-reported experience of care for children and young people aged 12 to 17 years on their own or with their parent.

Approximately 13% of children and adolescents struggle with a mental health disorder. Adolescents must often disclose information about their mental health (MH) distress to their parents to receive social support or professional care, but parents' anticipated responses to these disclosures have also been identified as a barrier to disclosure. This study explored factors that influence parents' negative emotional response to MH disclosure. Parents (N = 322) of adolescents were recruited to take an online survey that explored their depression literacy, stigmatizing beliefs about depression, and perceptions of a positive parent/child relationship. Results suggest that parents' depression literacy is indirectly related to parents' negative emotional response to disclosure through influencing parents' depression stigma, and this indirect relationship was higher among parents who perceived a more warm parent/child relationship. The proposed model shows that parents' depression literacy was first negatively associated with parents' stigmatizing beliefs and that this was indirectly related to parents' negative emotional response to disclosure. Physicians, MH professionals, and parents can use these findings to better understand factors that influence parents' negative responses to MH disclosures.

Mental health (MH) problems in children and young people (CYP) are on the rise, negatively affecting their quality of life. General Practitioners (GPs) are the first port of call for any health-related issue; however, it has not been fully explored what kind of training, tools or management strategies they use for CYP's MH. The study's aim was to explore and report experiences, challenges and strategies that GPs in the UK have to address the MH needs of CYP. Ten semi-structured interviews were conducted with GPs. Qualitative content analysis was used resulting in two themes and five subthemes. Most GPs reported receiving experiential training to address MH issues on CYP and explained some of the most common presentations and whether these are primary or secondary causes for consultation. In the second theme 'Management Approaches', GPs draw on different barriers to communicating with CYP and their families or other relevant parties (school for instance), but they also discuss treatment approaches including pharmaceutical. Participants shared myriad tools, resources and strategies they have used to address CYP's MH. Although GPs provided valuable insights on this topic, the study shows an urgent need for providing systematic training and management strategies to respond to MH problems appropriately.

According to current knowledge, impaired spontaneous movements of infants can be an early indicator of developmental difficulties. This study aimed to evaluate velocity, acceleration, and parameters describing the range, nature, and location of individual limb movements in infants with normal pregnancy and delivery histories on the second or third day of life. General Movement Assessment was used to qualitatively assess spontaneous activity, while computer-aided movement analysis provided a quantitative assessment based on video recordings. Statistical analysis revealed significant differences in limb movement parameters between the left and right sides. Additionally, the results indicated that limb movements in infants with writhing movements were dynamic, exhibiting greater range and a circular shape. In contrast, infants with poor repertoire movements showed less variation in mean velocity, acceleration, and range of motion. These findings confirm the feasibility of using computer-aided video analysis to support early neonatal diagnosis by objectifying movement descriptions through quantitative measures, contributing valuable insights to the current understanding of spontaneous movements in newborns, particularly during the second and third days of life.

One way to prevent or minimize adverse effects from pediatric cancer is to adopt and maintain healthy behaviours. However, there is limited knowledge on how to successfully implement health promotion (HP) interventions in clinical settings. This study aimed to determine the factors affecting the participation in and implementation of an HP program from the perspective of adolescents impacted by cancer, parents of children or adolescents impacted by cancer, and healthcare professionals (HCPs). We conducted semi-structured interviews with adolescents and parents, and focus groups with HCPs. Data were analysed using thematic analysis. A total of five adolescents, nine parents, and eleven HCPs were interviewed. Three major themes were determined: (1) facilitators to participation and implementation, (2) barriers to participation and implementation, and (3) suggestions for improvement. Factors identified as keys to participation include tailoring interventions to families' specific needs and social support. Organizational barriers, health issues, and a lack of interest or need hampered participation in the program. Implementation was positively impacted by the interventions' perceived relevance and negatively by their lack of integration in clinical care. While HP interventions hold promise for improving quality of life, successful implementation requires addressing the multifaceted challenges faced by participants and providers.