Journal of Child Health Care最新文献

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.

This descriptive cross-sectional study investigated the demographic profile of surveyed Australian neonatal nurses, explored their self-reported professional quality of life status, and appraised the strength and direction of relationships between these variables. Australian College of Neonatal Nurses (ACNN) general members (N = 950) were invited to participate. An online Qualtrics^TM survey was distributed via email. Compassion satisfaction (CS) and fatigue (CF) scores were measured using the Modified Professional Quality of Life Scale (ProQOL-21]). Spearman's correlation calculated the strength and direction of relationships between variables. Fifty-three neonatal nurses responded to the survey (N = 950, response rate = 5.58%). Respondents reported moderate to high-level compassion satisfaction and high-level compassion fatigue. Nurses in clinical roles revealed higher compassion fatigue scores than those in non-clinical roles. A statistically significant positive correlation was detected between years of experience in neonatal care and compassion satisfaction (r = 0.277, 95% CI [0.002, 0.513]). These findings question the belief that education and experience safeguard against work-related stress and emphasise that strategies to offset the fatigue reported by this female-dominated workforce are needed.

Sickle Cell Disease (SCD) is associated with neurocognitive impairment, and routine cognitive and academic screening is recommended. Traditional reports following testing are often not health literate, limiting the usefulness of evaluations. This study investigated whether a small "passport" summarizing results and recommendations would be helpful in increasing understanding of results and follow-through on recommendations. Participants (N = 46) were randomized to two groups. Following evaluations, the control group received a report in the mail while the experimental group received the report with a printed "passport." Seven to fourteen weeks after receiving results, a follow-up phone call was conducted to assess recall. Results did not support the effectiveness of a neurocognitive passport for improving understanding or recall of neurocognitive testing results, nor did this approach demonstrate improvement in follow-through on recommendations. However, results did suggest variability in caregiver understanding and recall, suggesting that ongoing efforts to improve outcomes in these domains is important. Follow-up studies should look at other novel methods to achieve this goal.

Fear of progression (FoP) is a prevalent psychological strain for cancer patients associated with poor quality of life and psychological morbidity. However, little evidence exists on FoP in children with cancer. Our study aimed to determine prevalence and correlates of FoP of cancer in children. From December 2018 to March 2019, cancer patients from Children's Hospital in Chongqing, Southwest China, were recruited. A Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) was adopted to assess children' FoP. Descriptive statistics (percentages, median, and interquartile range), non-parametric tests, and multiple regression analyses were performed on these data. Prevalence of high-level FoP was 43.75% among these 102 children. Multiple regression analysis showed that reproductive system tumors (beta = 0.315, t = 3.235 95% CI [3.171, 13.334]), and level of psychological care needs (beta = -0.370, t = -3.793 95% CI [-5.396, -1.680]) were independent predictors of FoP. Regression model explained 27.10% of all included variables (adjusted R square = 27.10%). As with adults with cancer, children with cancer also have FoP. More attention should be paid to FoP in children with reproductive tumors and in children who need psychological support. More access to psychological support should be offered to reduce FoP and to improve their quality of life.

To determine the effectiveness and safety of prophylactic phototherapy compared with conventional phototherapy for the prevention of neonatal jaundice. We included clinical trials comparing prophylactic phototherapy to conventional phototherapy to prevent jaundice in premature newborns. We searched Embase, MEDLINE, LILACS, Central, and others. The statistical analysis was performed in RevMan (Review Manager 5.3). Outcomes were analyzed according to the type of variable: risk difference (RD) and mean difference (MD). A random effects model was used due to heterogeneity. We reported results in forest plots. Risk of bias was evaluated, and a sensitivity analysis was made. 1127 articles were found, and six studies (2332 patients) were included in the meta-analysis. Five studies evaluated the need for exchange transfusion as the primary outcome RD -0.01, 95% CI [-0.05 to 0.03]. One study evaluated bilirubin encephalopathy RD -0.04, 95% CI [-0.09 to 0.00]. Five studies evaluated the duration of phototherapy, MD 38.47, 95% CI [1.28 to 55.67]. Four studies evaluated levels of bilirubin (MD -1.23, 95% CI [-2.25 to -0.21]. Two studies evaluated mortality, RD 0.01, 95% CI [-0.03 to 0.04]. As a conclusion, compared to conventional phototherapy, prophylactic phototherapy decreases the last measured level of bilirubin, as well as the probability of neurodevelopmental disturbances. However, it increases phototherapy duration.

Exercise interventions are identified as effective treatments for children not meeting developmental milestones. This systematic review synthesizes research regarding exercise interventions that involved social participatory elements, for children with complex developmental needs. Academic Search Complete, CINAHL, Emcare, Proquest Theses and Dissertations, MEDLINE, and Google Scholar were searched systematically for relevant studies. Peer-reviewed studies meeting the review aim and published between 2000 and 2021 in English, were included. Methodological quality of 49 eligible studies (47 controlled trials, two mixed methods, total of 2355 participants) was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis identified two groups of studies: Group 1 incorporated intentional social participatory elements; Group 2 likely involved incidental social participation. Most studies were of moderate to low methodological quality. Few measured impacts of interventions upon total physical activity levels. Short-term improvements in physical outcomes - particularly motor skills - were most frequently reported and were the main benefit of social exercise interventions for children with complex developmental needs, for which evidence exists. Further rigorous, longitudinal research is needed to assess social, psychological, and executive function outcomes of social exercise interventions in this population. Such interventions should incorporate booster sessions to provide children with greater opportunity to meet developmental milestones.