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Healthcare providers' perceptions of infant physical activity and communication 医疗服务提供者对婴儿体育活动和沟通的看法。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-26 DOI: 10.1111/cch.13312
Priyanka Chaudhary, Kailey Snyder, Shari DeVeney, Danae Dinkel

Background

Healthcare providers (HPs) play a critical role in disseminating information about infant health and development. Two key developmental areas for infants are physical activity (PA) and communication. Few studies have examined HPs views of these topics. Thus, HPs may need support to promote these early development outcomes in infants. Thus, the study explored HPs' perceptions of infant PA and communication.

Methods

A total of 13 HPs with a wide variety of backgrounds were recruited. Zoom semi-structured interviews were based on the Health Belief Model. Deductive content analysis was utilized to analyze data.

Results

HPs knew little about PA guidelines. HPs were concerned about an infant's PA because of limited playtime and tummy time. Most HPs advised parents on PA and motor development milestones, with crawling, walking, and tummy time. HPs also wanted to learn about PA measurement tools. PA promotion was hindered by parents' busy schedules, lack of time, and language barriers. Most HPs advised parents on verbal and nonverbal communication. Many HPs were unfamiliar with communication assessment methods and wanted to learn more.

Conclusions

HPs had limited knowledge about PA guidelines and communication measurement tools. Efforts are needed to identify easily accessible ways to educate HPs that could be disseminated to parents.

背景:医疗保健提供者(HPs)在传播有关婴儿健康和发育的信息方面发挥着至关重要的作用。婴儿发育的两个关键领域是身体活动(PA)和沟通。很少有研究调查过医疗服务提供者对这些主题的看法。因此,保健医生可能需要得到支持,以促进婴儿的这些早期发育成果。因此,本研究探讨了助产士对婴儿体能活动和沟通的看法:方法:共招募了 13 名不同背景的助产士。变焦半结构式访谈以健康信念模型为基础。采用演绎式内容分析法对数据进行分析:保健医生对 PA 指南知之甚少。由于婴儿的玩耍时间和吃奶时间有限,保健医生对婴儿的 PA 表示担忧。大多数助产士向父母提供了关于 PA 和运动发育里程碑的建议,包括爬行、走路和吃奶时间。保健医生还希望了解 PA 测量工具。父母工作繁忙、缺乏时间和语言障碍阻碍了儿童自我保护的推广。大多数家政服务人员向家长提供语言和非语言沟通方面的建议。许多保健医生不熟悉沟通评估方法,希望了解更多:家政服务人员对PA指南和沟通测量工具的了解有限。需要努力找出易于使用的方法来教育保健医生,并将其传播给家长。
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引用次数: 0
How best to support parents in the management of standing frame usage in home settings: A mixed methods study 在家庭环境中如何更好地支持家长管理站立架的使用:混合方法研究。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-26 DOI: 10.1111/cch.13310
Laerke Hartvig Krarup, Anders Holsgaard-Larsen, Helle Mätzke Rasmussen, Stine Østergaard Kyed, Charlotte Skau Pawlowski

Background

An improved understanding of the current practice of standing frame use may have implications for supporting parents in managing standing frames. We aimed to investigate how parents of children with cerebral palsy perceive and manage standing frame use in home settings.

Methods

We conducted a mixed methods study with an explanatory sequential design, first collecting and analysing quantitative questionnaire data and then using these results to inform a qualitative follow-up phase to explain them. The questionnaire was answered by 103 parents of children with cerebral palsy across five countries, Denmark, Norway, Great Britain, Canada and the United States, and 12 Danish families participated in the subsequent interviews. A descriptive analysis was conducted using the questionnaire data. The qualitative data were analysed using a directed content analysis, enabling integration of the quantitative and qualitative data.

Results

The quantitative analysis showed that 89% of the parents felt confident with their child's standing frame, and 82% felt they had sufficient knowledge about how their child's standing frame could/should be used. However, the qualitative analysis showed that even when feeling confident, the parents experienced insecurity regarding whether their child was positioned correctly, and being responsible for positioning was challenging.

Conclusion

Our study implies a need for providing educational materials to assist the parents in ensuring optimal positioning of their child in the standing frame to decrease insecurity. Additionally, our study suggests a need to provide more thorough information about the benefits of using a standing frame and ensure alignment of expectations in relation to the child's prognosis of functional independence.

背景:更好地了解目前站立架的使用情况可能会对支持家长管理站立架产生影响。我们旨在调查脑瘫儿童的父母如何看待和管理家庭环境中站立架的使用:我们进行了一项混合方法研究,采用解释性顺序设计,首先收集和分析定量问卷数据,然后利用这些结果为定性后续阶段提供信息,以解释这些结果。丹麦、挪威、英国、加拿大和美国五个国家的 103 名脑瘫儿童家长回答了问卷,12 个丹麦家庭参加了随后的访谈。对问卷数据进行了描述性分析。定性数据采用定向内容分析法进行分析,从而将定量和定性数据结合起来:定量分析显示,89% 的家长对孩子的站立架有信心,82% 的家长认为他们对如何/应该使用孩子的站立架有足够的了解。然而,定性分析显示,即使家长感到有信心,他们也会对自己孩子的站立姿势是否正确感到不安全感,而且负责孩子的站立姿势也具有挑战性:我们的研究表明,有必要提供教育材料,帮助家长确保孩子在站立架上的最佳姿势,以减少不安全感。此外,我们的研究还表明,有必要就使用站立架的益处提供更全面的信息,并确保与儿童功能独立的预后相一致。
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引用次数: 0
Assessing the acceptability of a culturally adapted group-based pediatric intervention, Kokajjiriri, for Marshallese mothers and infants to improve nutrition and prevent childhood obesity 评估马绍尔母婴对基于文化的集体儿科干预措施 Kokajjiriri 的接受程度,以改善营养状况并预防儿童肥胖。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-26 DOI: 10.1111/cch.13311
Britni L. Ayers, Eliza Short, Chloe Cline, Alice S. Ammerman, Sarah K. Council, Philmar Mendoza Kabua

Background

Marshallese Pacific Islanders experience higher rates of obesity than other racial and/or ethnic communities. Despite the obesity rates experienced in this community, there are currently no childhood obesity prevention interventions designed for Marshallese Pacific Islanders in the United States. The purpose of this study is to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity.

Methods

A multi-methods design was used to culturally adapt the Kokajjiriri intervention for Marshallese mothers in Arkansas (n = 17). In phase one, we conducted 24-h dietary recalls with 20 Marshallese mothers to inform the cultural adaptation of the group-based pediatric intervention, and then in phase two, we culturally adapted and piloted three sessions of the intervention to determine the acceptability and feasibility of the intervention.

Results

Participants found the adapted intervention to be acceptable and feasible, found the location to be convenient and found the facilitator to be knowledgeable. Four themes emerged from the qualitative data: (1) Lactation Support; (2) Introducing Healthy Solids; (3) Rice Portion Control; and (4) Finding Resources.

Conclusions

This is the first study to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. The results from this culturally adapted group-based pediatric intervention, Kokajjiriri, will be used to inform future adaptations and implementation of the full intervention for Marshallese women and children.

背景:马绍尔太平洋岛民的肥胖率高于其他种族和/或族裔社区。尽管该社区的肥胖率很高,但目前美国还没有针对马绍尔太平洋岛民设计的儿童肥胖预防干预措施。本研究的目的是评估马绍尔母亲对基于文化的小组儿科干预Kokajjiriri的接受度和可行性,以改善营养状况,减少儿童肥胖:方法:我们采用了多种方法设计,针对阿肯色州的马绍尔母亲(n = 17)对 Kokajjiriri 干预措施进行了文化调整。在第一阶段,我们对 20 位马绍尔母亲进行了 24 小时饮食回顾,为基于小组的儿科干预措施的文化调整提供信息;然后在第二阶段,我们对干预措施进行了文化调整并试行了三节课,以确定干预措施的可接受性和可行性:结果:参与者认为调整后的干预措施可以接受且可行,认为地点方便,并认为主持人知识渊博。定性数据中出现了四个主题:(1)哺乳支持;(2)引入健康固体食物;(3)米饭分量控制;以及(4)寻找资源:这是第一项评估马绍尔母亲对基于文化的集体儿科干预Kokajjiriri的接受度和可行性的研究,旨在改善营养状况和减少儿童肥胖。Kokajjiriri "这一基于文化的小组儿科干预措施的结果将被用于为马绍尔妇女和儿童未来调整和实施完整的干预措施提供信息。
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引用次数: 0
Online occupational therapy group training for mothers of children with feeding problems: A randomized controlled trial 为有喂养问题儿童的母亲提供在线职业治疗小组培训:随机对照试验
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-26 DOI: 10.1111/cch.13315
Rukiye Begum Koca, Gokcen Akyurek

Aim

The aim of this study was to scrutinize how online occupational therapy group training for mothers influenced their attitudes and stress levels relating to feeding their children and the eating behaviours of the children. The secondary purpose of the study is to evaluate the satisfaction of the participants of this program. Twenty-nine mothers of children aged 3–6 years, experiencing feeding issues, were randomly allocated to either an intervention or control group.

Background

Feeding problems including selective eating, loss of appetite, and mealtime behaviour problems are prevalent during childhood. Parents play a fundamental role in acquiring knowledge about feeding. Problems in the feeding process may lead to parental stress, feelings of despair, and incorrect attitudes.

Results

The mothers in the research group participated in the 4-week training. Results indicated positive effects on both maternal attitudes and their children's eating behaviours (p < 0.05). No significant change was found in mothers' state and trait anxiety levels (p > 0.05). Participants were asked to score their satisfaction level with the program between 1 and 10, and the average of the scores was 9.78 ± 0.42.

Conclusion

This study shows that online group education for mothers can support existing treatments and guide clinicians working with children with feeding problems.

目的:本研究的目的是仔细研究为母亲提供的在线职业治疗小组培训如何影响她们在喂养孩子和孩子饮食行为方面的态度和压力水平。研究的第二个目的是评估该计划参与者的满意度。29 位有 3-6 岁喂养问题儿童的母亲被随机分配到干预组或对照组:背景:喂养问题,包括选择性进食、食欲不振和进餐行为问题,在儿童时期十分普遍。家长在掌握喂养知识方面扮演着重要角色。喂养过程中出现的问题可能会导致家长产生压力、绝望感和不正确的态度:研究组的母亲参加了为期 4 周的培训。结果表明,培训对母亲的态度和孩子的饮食行为都产生了积极影响(P 0.05)。参与者被要求在 1 到 10 之间对项目的满意度打分,平均分为 9.78 ± 0.42:这项研究表明,针对母亲的在线小组教育可以支持现有的治疗方法,并为临床医生处理有喂养问题的儿童提供指导。
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引用次数: 0
Enhancing school health programmes post-pandemic: Insights from Taiwan's integrated mental health initiatives 大流行后加强学校保健计划:台湾综合心理健康计划的启示。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-22 DOI: 10.1111/cch.13313
Ya-Yun Tsai, Lien-Chung Wei
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引用次数: 0
Systematic review of educator behaviours associated with physical activity of early years children 对与幼儿体育活动相关的教育者行为进行系统审查
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-19 DOI: 10.1111/cch.13308
Chris Wright, Sarah Kirkhope, E. Jean Buckler

Background

Educators in early years settings influence children's physical activity (PA) levels through their pedagogical choices and behaviours. To date, minimal research has been conducted on the relationship between educator action and children's PA levels. The purpose of this systematic review was to understand which educator behaviours and actions in early years settings have been shown to engage children in PA.

Methods

Five online databases (Academic Search Complete, ERIC, SPORTDiscus, CINAHL Complete and PubMed) were searched for articles that showed an association between educator behaviour and the PA level of children between the ages of zero and eight.

Results

Eleven studies met all inclusion criteria, yet showed great variability in design and data collection methods. The risk of bias was assessed using previously published criteria adapted to this study and inline with the CONSORT statement. A binomial test on the data revealed a statistically significant deviation from chance expectation (p < .001) in relation to educator action influencing child PA. Ten of the studies focussed on educator PA, four studies highlighted the use of prompting and encouragement, three studies analysed broad statements of adult interaction, two studies called for planning activity sessions and discussions and two studies encouraged role modelling. The low number of studies included in the review and the high risk of bias indicates that caution with these results is needed.

Conclusions

While this review highlights the importance of educator PA (and other behaviours that had a positive association) on child PA level, it underscores the need for high-quality research to examine the relationship between educator actions and child PA. (PROSPERO registration: CRD42022338819).

背景 幼儿教育机构的教育者通过其教学选择和行为影响儿童的体育活动(PA)水平。迄今为止,有关教育者的行为与儿童 PA 水平之间关系的研究极少。本系统性综述的目的是了解幼儿教育机构中哪些教育者的行为和行动已被证明能让儿童参与体育锻炼。 方法 在五个在线数据库(Academic Search Complete、ERIC、SPORTDiscus、CINAHL Complete 和 PubMed)中搜索显示教育者行为与 0-8 岁儿童 PA 水平之间存在关联的文章。 结果 有 11 项研究符合所有纳入标准,但在设计和数据收集方法上存在很大差异。根据 CONSORT 声明,我们采用之前发布的标准对偏倚风险进行了评估。对数据进行二项式检验后发现,在教育者的行为影响儿童 PA 方面,与预期结果存在显著的统计学偏差(p < .001)。其中 10 项研究侧重于教育者的 PA,4 项研究强调了提示和鼓励的使用,3 项研究分析了成人互动的广泛陈述,2 项研究呼吁规划活动课程和讨论,2 项研究鼓励榜样示范。由于纳入综述的研究数量较少且存在较高的偏倚风险,因此需要谨慎对待这些结果。 结论 虽然本综述强调了教育者 PA(以及其他具有正相关性的行为)对儿童 PA 水平的重要性,但同时也强调了需要开展高质量的研究,以探讨教育者的行为与儿童 PA 之间的关系。(PROSPERO 注册:CRD42022338819)。
{"title":"Systematic review of educator behaviours associated with physical activity of early years children","authors":"Chris Wright,&nbsp;Sarah Kirkhope,&nbsp;E. Jean Buckler","doi":"10.1111/cch.13308","DOIUrl":"https://doi.org/10.1111/cch.13308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Educators in early years settings influence children's physical activity (PA) levels through their pedagogical choices and behaviours. To date, minimal research has been conducted on the relationship between educator action and children's PA levels. The purpose of this systematic review was to understand which educator behaviours and actions in early years settings have been shown to engage children in PA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five online databases (Academic Search Complete, ERIC, SPORTDiscus, CINAHL Complete and PubMed) were searched for articles that showed an association between educator behaviour and the PA level of children between the ages of zero and eight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven studies met all inclusion criteria, yet showed great variability in design and data collection methods. The risk of bias was assessed using previously published criteria adapted to this study and inline with the CONSORT statement. A binomial test on the data revealed a statistically significant deviation from chance expectation (<i>p</i> &lt; .001) in relation to educator action influencing child PA. Ten of the studies focussed on educator PA, four studies highlighted the use of prompting and encouragement, three studies analysed broad statements of adult interaction, two studies called for planning activity sessions and discussions and two studies encouraged role modelling. The low number of studies included in the review and the high risk of bias indicates that caution with these results is needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While this review highlights the importance of educator PA (and other behaviours that had a positive association) on child PA level, it underscores the need for high-quality research to examine the relationship between educator actions and child PA. (PROSPERO registration: CRD42022338819).</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"50 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.13308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factor structure of FUNDES-Child-SE measuring the participation and independence of children with disabilities 衡量残疾儿童参与和独立性的 FUNDES-Child-SE 的因子结构。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-16 DOI: 10.1111/cch.13306
Jennifer Gothilander, Anna Karin Axelsson, Henrik Danielsson, Lena Almqvist, Anna Ullenhag

Background

FUNDES-Child-SE is a proxy rating questionnaire for measuring participation and independence in children with disabilities in a Swedish context. It includes the components of frequency of attendance, engagement and independence. The original, Taiwanese FUNDES-Child 7.0, has previously been found to have a four-factor structure for frequency of participation and a two-factor structure for independence. The aim of this study was to test the factor structure in FUNDES-Child-SE. The factor structure is an important part of construct validity.

Methods

Caregivers of 163 children with disabilities aged 6–18 years participated in this cross-sectional study. Exploratory factor analysis was used to find the factor structure for Engagement. Confirmatory factor analysis was used to test the factor structure for all three components.

Results

The proposed factor structure for frequency of participation (daily living participation frequency, mobility participation frequency, learning participation frequency and community participation frequency) and independence (daily living independence and social participation independence) fit with data from FUNDES-Child-SE after excluding three to five items and adding two to five covariances of residuals. In the engagement component, two factors, named engagement in informal activities and engagement in formal activities, were found. After excluding one item and adding 10 covariances of residuals, the factor structure had an acceptable fit to data.

Conclusions

Differences in components' factor structure indicate that attendance and engagement are separate aspects of participation. Before using numeric scores from FUNDES-Child-SE in clinical settings, responsiveness and interpretability should be evaluated.

背景:FUNDES-Child-SE是瑞典用于衡量残疾儿童参与度和独立性的代理评级问卷。它包括出席频率、参与度和独立性三个部分。台湾原版的 FUNDES-Child 7.0 曾被发现在参与频率方面具有四因素结构,在独立性方面具有双因素结构。本研究旨在测试 FUNDES-Child-SE 的因子结构。因子结构是建构效度的重要组成部分:163 名 6-18 岁残疾儿童的照顾者参与了这项横断面研究。研究采用探索性因子分析来确定 "参与 "的因子结构。结果:所提出的参与频率的因子结构是正确的:在排除三至五个项目并加入二至五个残差协方差后,所提出的参与频率(日常生活参与频率、行动参与频率、学习参与频率和社区参与频率)和独立性(日常生活独立性和社会参与独立性)因子结构与 FUNDES-Child-SE 的数据相吻合。在 "参与 "部分,发现了两个因子,分别名为 "参与非正式活动 "和 "参与正式活动"。在剔除一个项目并加上 10 个残差协方差后,因子结构与数据的拟合程度可以接受:结论:成分因子结构的差异表明,出席和参与是参与的两个不同方面。在临床环境中使用 FUNDES-Child-SE 的数字分数之前,应对其响应性和可解释性进行评估。
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引用次数: 0
“Still work?” Design and effect of interventions used to modify feeding problems in children with autism: A systematic review of studies employing group designs "仍然有效吗?用于改变自闭症儿童喂养问题的干预措施的设计和效果:对采用小组设计的研究进行系统回顾。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-16 DOI: 10.1111/cch.13307
Louisa Ming Yan Chung, Yuan Fang, Peggy Pui Lai Or, Fenghua Sun, Eric Tsz Chun Poon, Carmen Ka Man Chan

Background

Feeding problems in children with autism jeopardize the well-being of both children with autism and their families. Mixed findings were reported from previous interventions, which were mostly evaluated by single subject research design (SSRD) studies. Moreover, feasibility assessment and social validity measurement were unaddressed by these SSRD studies. To fill this substantial knowledge gap, the present review systematically summarized and evaluated feeding interventions implemented in children with autism, which were assessed by studies employing group designs.

Method

An extensive literature search in eight established online databases was conducted, and a total of 17 eligible studies published in 2009–2021 were included for further analysis. A descriptive account of the features of the investigations is provided, including assessment of study quality.

Results

A total of 449 children with autism and 203 parents/caregivers participated in the included studies. The multiple use of five strategic intervention components were highlighted in this review, including nutrition education/consultations, environmental modifications, sensory exposure, cognitive components, and behaviour interventions. The reviewed interventions showed a preliminarily positive effect for modifying feeding problems in children with autism. Furthermore, the evaluation based on the RE-AIM framework (reach, efficacy, adoption, implementation, and maintenance) demonstrated that an interdisciplinary multi-component intervention strategy may achieve high effectiveness and feasibility in improving feeding problems in a wide range of children with autism.

Conclusions

This review found that interventions achieved and maintained a positive effect on modification of feeding problems in groups of children with autism. Information and gaps identified and summarized in the implementation process may assist both researchers and stakeholders to further support these vulnerable children.

背景:自闭症儿童的喂养问题损害了自闭症儿童及其家庭的福祉。以往的干预措施大多采用单人研究设计(SSRD)进行评估,结果不一。此外,这些单人研究设计研究并未涉及可行性评估和社会有效性测量。为了填补这一巨大的知识空白,本综述系统地总结和评估了针对自闭症儿童实施的喂养干预措施,这些干预措施通过采用小组设计的研究进行评估:方法:在八个已建立的在线数据库中进行了广泛的文献检索,共纳入了 17 项 2009-2021 年间发表的符合条件的研究,并对其进行了进一步分析。结果:共有 449 名患有自闭症的儿童被纳入研究范围:共有 449 名自闭症儿童和 203 名家长/照顾者参与了所纳入的研究。本综述强调了五种策略性干预成分的多重使用,包括营养教育/咨询、环境改造、感官接触、认知成分和行为干预。综述的干预措施初步显示出对自闭症儿童喂养问题的积极改善效果。此外,基于RE-AIM框架(覆盖、疗效、采用、实施和维持)的评估表明,跨学科的多成分干预策略在改善各类自闭症儿童的喂养问题方面具有较高的有效性和可行性:本综述发现,干预措施对改善自闭症儿童群体的喂养问题取得并保持了积极效果。在实施过程中发现和总结的信息和差距可帮助研究人员和利益相关者进一步支持这些弱势儿童。
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引用次数: 0
‘There was nothing, just absolute darkness’: Understanding the needs of those caring for children and young people with complex neurodisability in a diverse UK context: A qualitative exploration in the ENCOMPASS study 什么都没有,只有绝对的黑暗":了解在英国多元化背景下照顾患有复杂神经残疾的儿童和青少年的人的需求:ENCOMPASS 研究中的定性探索。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-11 DOI: 10.1111/cch.13303
Kirsten Prest, Emma Wilson, Io Vassiliadou, Sayeeda Ali, Monica Lakhanpaul, Christopher Morris, Cally Tann, Phillip Harniess, Sasha Lewis-Jackson, Hannah Kuper, Michelle Heys

Background

Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme (‘Ubuntu’) to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data.

Methods

Two rounds of semi-structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open-ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data-driven inductive thematic analysis.

Results

Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate.

Conclusions

The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP.

背景:患有复杂性神经残疾的儿童和青少年(CYP)在身体、沟通、教育和社交方面面临多重挑战,需要复杂的多学科综合护理。所需的整体护理包括为家庭和父母/照顾者提供支持。这项广泛研究的目的是向父母/照顾者和医疗保健专业人员(HCPs)介绍一项新计划("Ubuntu"),以测试其概念和内容的可行性和可接受性,并考虑在英国进行可能的调整。通过数据收集和分析,我们发现了有关护理历程、医疗服务导航和服务差距的丰富数据。本文仅关注这些主题。后续论文将报告可行性和适应性数据:2020 年,我们从英国伦敦纽汉区的社区儿童健康服务机构招募了 12 名患有复杂神经残疾的儿童青少年的照顾者和 6 名来自不同学科的保健人员,对他们进行了两轮半结构化访谈。访谈内容包括开放式问题,以探讨护理历程、健康服务导航经验和感知到的服务差距。访谈记录采用数据驱动归纳式主题分析法进行分析:结果:我们确定了三个主题,这些主题与了解护理者的经历和与当前服务提供相关的未满足需求这一目标相关。这三个主题分别是:(1) 照顾者的心理健康;(2) 信息差距;(3) 全面支持的需求。据报告,精神健康方面存在困难,尤其是在诊断期间。优先需求包括提供有关诊断和所提供服务的明确信息、建立同伴支持网络的机会以及社区服务合作:结论:为患有神经系统残疾的儿童提供医疗服务时,除了满足儿童的临床需求外,还应考虑其家庭的广泛需求。
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引用次数: 0
No one really plans to have multiple sclerosis: Transition readiness and quality of life in paediatric multiple sclerosis 没有人真的打算患多发性硬化症:儿科多发性硬化症患者的过渡准备和生活质量。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-10 DOI: 10.1111/cch.13304
Estherline Thoby, Julissa Veras, Spandana Nallapati, Manuel E. Jimenez, Vikram Bhise

Aim

We sought to explore the experiences and perceptions of the quality of life of adolescents with pediatric-onset multiple sclerosis and assess their readiness for academic, employment and/or health care-related transitions.

Background

Adolescents with pediatric-onset multiple sclerosis face unique challenges in managing a chronic illness while navigating future scholastic, social and occupational goals. We conducted a qualitative study with in-depth, semi-structured interviews from July 2017 to March 2019. Adolescents with pediatric-onset multiple sclerosis were recruited from a pediatric neurology subspeciality practice until reaching data saturation. A total of 17 interviews were completed via telephone with participants ages 15 through 26.

Results

Through content analysis of the interviews, we identified five major themes: (1) receiving a new diagnosis; (2) adapting to life with pediatric-onset multiple sclerosis; (3) evaluating education/career transition preparedness; (4) adjusting within family life and establishing support systems; and (5) assessing current medical services and preparedness for adult medical care.

Conclusions

Autonomy in health care management, adequate control of physical symptoms and sufficient family support impacted perceptions of quality of life. Implementing a dedicated transition visit, including the parent(s) of those with pediatric-onset multiple sclerosis, early in adolescence may provide an avenue for appropriate anticipatory guidance regarding available services, independent medical management and continuity of care.

目的:我们试图探索患有小儿多发性硬化症的青少年对生活质量的体验和看法,并评估他们在学业、就业和/或医疗保健相关过渡方面的准备情况:背景:患有小儿多发性硬化症的青少年在管理慢性疾病的同时,还面临着实现未来学业、社会和职业目标的独特挑战。我们在 2017 年 7 月至 2019 年 3 月期间开展了一项定性研究,进行了深入的半结构式访谈。我们从一家儿科神经病学亚专科诊所招募了患有小儿多发性硬化症的青少年,直到数据达到饱和为止。通过电话共完成了 17 次访谈,参与者的年龄从 15 岁到 26 岁不等:通过对访谈内容的分析,我们确定了五大主题:(1) 接受新的诊断;(2) 适应小儿多发性硬化症患者的生活;(3) 评估教育/职业过渡准备情况;(4) 适应家庭生活并建立支持系统;(5) 评估当前的医疗服务并为成人医疗做好准备:结论:医疗保健管理的自主性、对身体症状的充分控制以及充分的家庭支持影响了对生活质量的看法。在青春期早期实施专门的过渡访视,包括儿科发病型多发性硬化症患者的父母,可以提供一个渠道,就可用服务、独立医疗管理和持续护理提供适当的预期指导。
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Child Care Health and Development
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