Child Care Health and Development最新文献

Background

Wait time at vaccine clinics is a barrier to routine childhood vaccinations in low- and middle-income countries (LMICs). Waiting for a critical mass of clients to accrue before conducting the vaccine health education talk prolongs clinic time.

Methods

We implemented a workflow change, including a looped audiovisual vaccine education talk on a solar-powered television. We compared clients' average clinic time using a before-and-after study, time-motion design, and surveyed providers and clients on their perspectives on the workflow change.

Results

In the post-implementation phase, compared to the pre-implementation phase, the average clinic time for all clients and the subgroup who presented before 9:00 AM was significantly reduced by 13 and 31 min, respectively (p = 0.006 and < 0.000). Providers and clients were positive about the workflow change.

Conclusion

A looped audiovisual vaccine education talk significantly reduces client vaccine clinic wait time and is acceptable to providers. Research on the impact of workflow change with alternate vaccine health talk delivery mode on vaccine uptake and completion is required.

Background

Parents of children with autism often face significant stress, low self-efficacy, and caregiver burden in meeting their children's complex needs. This study evaluated the effectiveness of a parent empowerment program combining parental training and motivational interviewing to support caregivers of children with autism in Türkiye.

Methods

A total of 69 parents (intervention = 34, control = 35) participated in this unblinded, two-group randomized controlled study, which was conducted between September 2020 and May 2022. A parent empowerment program, including four parental training sessions and two motivational interview sessions, was applied to the parents in the intervention group. The Parental Self-Efficacy Scale, Zarit Care Burden Scale, Perceived Stress Scale and Family Empowerment Scale were used to evaluate the effectiveness of the empowerment program. Standard practice was performed for the control group.

Results

Parents in the intervention group showed significantly greater improvements than those in the control group in self-efficacy (t = 5.340, p < 0.001), perceived stress (t = −4.636, p < 0.001) and family empowerment (t = 2.745, p = 0.008). No significant difference was observed between the groups in caregiver burden (p = 0.086).

Conclusion

This study reveals that using a parent empowerment program that includes motivational interviews along with training interventions is effective in empowering parents to manage their children's care, reducing stress, and supporting them to acquire effective parenting skills by increasing self-efficacy. Future research should explore designs that assess the independent and combined effects of motivational interviews and parent training programmes in randomised controlled trials.

The study was registered at ClinicalTrials.gov (https://clinicaltrials.gov/) under the registration number NCT06629974 on October 8, 2024.

Background

Neuroblastoma (NB) is a prevalent malignant tumour affecting children. Due to its insidious onset, malignant nature and poor prognosis, the absence of effective treatments presents a significant challenge, profoundly impacting children and their families. Children embody the core and hope of a family, and when faced with sudden adversity, parents often undergo psychological crises marked by anxiety, depression and severe emotional distress. Fortunately, XXX Hospital serves as a testing ground for novel domestic medications, offering not only therapy but also instilling hope in children with NB and their families. Among these medications, naxitamab (hu3F8) has shown promising efficacy in treating NB. This qualitative study aims to investigate the psychological experiences of caregivers of children with NB undergoing naxitamab treatment at a hospital in China, a specialized institution. Subsequently, tailored psychological support for caregivers will be considered based on the findings.

Method

Employing phenomenological research techniques, we conducted face-to-face semistructured interviews with 14 caregivers of children diagnosed with NB. Colaizzi's seven-step analysis method was employed to analyse the interview data.

Results

The psychological experiences of caregivers of children with NB were categorized into three main themes and 11 subthemes: the pretreatment stage (challenges during diagnosis, shock and collapse upon diagnosis and persistent pursuit of hope); the in-treatment stage (treatment-related worries and fears, significant financial strain, renewed hope and expectations during treatment and reliance on medical staff for trust and hope); and the posttreatment stage (changes in perspectives following treatment, rethinking expectations for children, anticipating the development of novel therapeutic agents and expectations regarding financial support).

Conclusion

Caregivers of children undergoing naxitamab treatment for NB encounter diverse psychological challenges throughout different stages. It is crucial for clinical medical professionals to provide tailored psychological support to both children and their families during various stages of treatment.

Aim

To investigate Conductive Education (CE) interventions in children with cerebral palsy (CP), examining how practice time, assessment methods, and CP characteristics influence treatment outcomes.

Method

A systematic review (PROSPERO-CRD42024578760) searched seven databases using ‘Conductive Education’. Inclusion criteria: interventional studies in young people with CP receiving CE treatment. The PRISMA strategy guided study selection, aided by Rayyan software. Study quality was assessed using ROBINS-I.

Results

Eighteen studies were included. Seven studies showed low risk of bias; considering low and moderate risk studies, 67% demonstrated positive CE effects. Practice duration appeared crucial: Studies reporting positive outcomes averaged 25.2 h/week compared to 17.7 h/week in studies showing no effect. The Gross Motor Function Measure was the most used assessment tool, followed by the Paediatric Evaluation of Disability Inventory. CE showed better outcomes in spastic CP, particularly in cases with diplegic presentation, compared to athetoid or ataxic types.

Interpretation

CE demonstrates promise for improving motor performance in children with CP, particularly with adequate practice time (≈25 h/week). Treatment success appears influenced by CP type and assessment methods. Future research should prioritize standardized protocols and consistent outcome measures to strengthen evidence quality.

Background

Children and young people (CYP) with different long-term physical health conditions report common needs at school, but little is known about the views of their parents. This research sought to provide the parent perspective on what secondary school-aged CYP with medical conditions require at school and the role parents play in negotiating support for their children.

Methods

Parents of CYP aged 11–18 years attending school in the United Kingdom, with one of 10 long-term physical health conditions, took part in interviews about their children's school experiences. To prioritise parent voice, participants completed a preparation activity to encourage them to have more control over the interviews. A needs analysis from the previous INSCHOOL CYP project was used as the basis for a framework analysis of parent interviews and supplemented with an analysis workshop with three parents.

Results

Twenty-seven parents participated from September 2023 to May 2024. Parent views of the needs their CYP have at school corroborated the six needs previously identified by CYP themselves: to safely manage health at school; for a flexible education pathway; to be acknowledged and listened to; to be included in and supported by the school community; to build towards the future; to develop attitudes and approaches to coping in school. In addition, parents reported far more examples of their CYP having significant emotional and mental health needs. Parents played a crucial role in compensating for unmet needs, advocating for CYP, advising schools and championing equality and inclusion. Parents also had their own needs: to feel confident their CYP are safe at school; to be listened to and involved; to have information about rights and responsibilities; and to have mental health and emotional support.

Conclusion

This parent-focused study strengthens an existing needs analysis for CYP, adding to evidence showing significant unmet needs in school. Parents play a crucial role in addressing failures to meet these needs. Navigating the system to secure support can have negative implications for home-school relationships and parent well-being. Requirements for parental agency to ‘battle’ through health and education systems exacerbate health inequalities, as not all parents are able to fulfil this function. Improvements are needed in the support currently offered to CYP with health conditions and their parents.