Comprehensive child and adolescent nursing最新文献

Physically disabled children and young people (PDC&YP) face many challenges when participating in out-of-school activities. PDC&YP should have the same choices and opportunities as other C&YP: to forge friendships locally and to access out-of-school activities. However, PDC&YP have fewer opportunities than their non-disabled peers due to challenges such as access, support, and suitable provision. This multi-method qualitative study examined the factors affecting participation of PDC&YP in out-of-school activities. The perspectives of PDC&YP and parents were sought using a range of data collection tools. These included interviews, focus groups, and creative focus groups with 13 PDC&YP and 19 parents. Play-based creative focus groups were specifically designed for PDC&YP aged 7 to 17 years. The study demonstrated that PDC&YP enjoy specialist disabled activities to meet others 'like them' but want more local opportunities to do this. Some PDC&YP and parents felt they were not disabled enough for 'disabled' activities but not able enough for mainstream. PDC&YP requiring personal care were a 'hidden' group who are at risk of missing out on experiences that they are entitled to. The study concludes by presenting the need to improve provision through disability awareness training and a co-ordinated partnership approach to be employed by the local authority to raise the profile of disability and 'bridge the gap' between service users and service providers. The social needs of children require the same focus and attention to aid their wellbeing and to enhance out-of-school lives.

Early diagnosis of autism spectrum disorder (ASD) is of paramount importance as it opens the road to early intervention, which is associated with better prognosis. However, early diagnosis is often delayed until preschool or school age. The purpose of the current retrospective study was to explore the age of recognition of first alarming symptoms in boys and girls as well as the age at diagnosis of different subtypes of ASD in a small sample. A total of 128 parents' of children with ASDs were participated in the survey by completing a self-report questionnaire about early signs and symptoms that raised their concern. Parents of children with autism voiced concerns earlier and obtained diagnosis significantly earlier compared to parents of children with Asperger syndrome (p value <0.000). No significant difference (p value<0.05) has been detected between males and females in early manifestation of first signs and symptoms of ASD. The mean age at diagnosis was 3.8 years for autistic disorder, 6.2 years for children with Asperger syndrome and 6.4 years for other, e.g., PDD-NOS. The most commonly reported symptoms were speech and language problems (p value = 0.001) for children who were later diagnosed with autism, while behavior problems (p value = 0.046) as well as difficulties in education at school (p value = 0.013) for children with Asperger syndrome. The gap between early identification and diagnosis pinpoints the urgent need for national systematic early screening, the development of reliable and sensitive diagnostic instruments for infants and toddlers and heightened awareness of early signs of ASD among parents, teachers, and healthcare professionals and providers as well.

This study investigated the cross-generational physical activity of primary school-aged children and parents in Australia. Separate child and parent questionnaires were administered to establish a profile of the phenomenon. Cross-generational physical activity occurred across a wide variety of types of physical activity, including recreation, sport, and exercise. The study provides insight into the complexity of the physical activity partnership by showing that in a substantial proportion of partnerships, children initiate the physical activity. The importance of investigating both populations was shown as both common experiences in cross-generational physical activity, such as bonding and enjoyment were identified in addition to unique aspects. For example, child respondents disliked power, fitness, and skills mismatches whilst parent respondents disliked their children fighting and complaining. 59% of parents ranked holidays as a time they were more likely to engage in cross-generational physical activity. Findings from the surveys suggest that this physical activity partnership involves more than the provision of parental support for physical activity and modeling of a healthy behavior from parent to child.

This study was conducted to understand the reasons parents of children with minor conditions attend the Children's Emergency Department (ED), and their views about onsite pediatric same day care (SDC) service as an alternative treatment center. The study was a cross-sectional survey of parents attending an inner-city, district general hospital children's ED, with children aged under 16 years old who were allocated to low triage categories. A convenience sample of 58 parents of 58 children were recruited. All the 58 responses were analyzed. Incomplete questionnaires were not excluded. 47% of attendances were because of minor injury. Most presentations were within 24 hours of the injury or illness. 72% of parents were employed. 91% were registered with a General Practitioner (GP). 29% contacted a GP before the ED visit. The majority of participants who contacted a GP were referred to the ED; others were advised to wait to see if the child's condition improved and to attend the ED if there were any concerns or the child deteriorated in any way. About 50% of those that did not contact GP said the GP surgery was closed and 8% felt the GP could not help. 90% of parents perceived their child's condition as urgent requiring immediate treatment. About 33% of parents said they would be happy for their children to be treated at an onsite SDC center. The study showed limited access to GP services in the community and dissatisfaction with community services and perceived urgency of treatment prompted parents of children with minor conditions to attend the ED. This could mean significant ED attendance by children with minor conditions. The majority of the parents in the study would welcome an onsite pediatric SDC if appropriate to meet their children's care needs. Establishing an onsite SDC may help relieve the ED pressures to attend to more clinically urgent and emergency cases.

More than two million people have asthma in Saudi Arabia: 13% aged 6-10 years. Asthma is one of the most common childhood illnesses. Little has been explored about children's ability to learn more about their own asthma in Saudi Arabia. The study was designed to assess the impact of a school-based, nurse-delivered asthma health education program on asthmatic children's knowledge and attitude toward asthma, quality of life, anxiety level, and school absenteeism. A quasi-experimental, non-equivalent group, pretest-posttest design was used. The education program was developed from existing evidence. The Pediatric Asthma Quality of Life Questionnaire, Spence Anxiety Tool, Asthma Knowledge Questionnaire, and Asthma Attitude Questionnaire were employed for data collection. Intervention (n = 130) and control (n = 98) groups were drawn from 10 schools in Ha'il region, Saudi Arabia. Descriptive and inferential statistics were used to examine differences within and between groups. Knowledge of asthma increased significantly more in the intervention group than in the control group. Attitude toward asthma was not changed by the intervention. Anxiety scores reverted to pretest level by posttest II. The intervention group had significantly better total quality of life scores than the control group, and school absenteeism reduced significantly after the delivery of the program. It was concluded that the asthma education program impacted positively on students' knowledge, quality of life, and school attendance. However, asthma education did not change attitudes toward the condition, and the impact on anxiety was not persistent. The results emphasize the benefits of the provision of health education directly to children. Asthma education should be integrated into the Saudi national child health program.

There is global acceptance that individuals should be allowed to decide whether or not to take part in research studies, and to do so after being informed about the nature of the research and the risk that might attach to participation. The process of providing detailed information before seeking consent (formalized by signatures) in advance of undertaking research procedures may not be possible in some circumstances, and sometimes an amended approach may be adopted. The use of opt-out consent has been recognized as a valid and ethical means of recruiting participants to studies particularly with large samples and where the risk to participants is small. However, it is sometimes misunderstood and can be a problematic factor in being accepted by research ethics committees and governing authorities. This may be due partly to differing expectations of the amount of information and support offered, together with the nature of the process that is adopted to ensure that a decision has been made rather than consent simply being assumed. In accordance with ongoing discussions with young people, and following consultation with parents, an opt-out consent strategy including varied means of providing information was employed in a large study of 44,501 cases of children attending emergency or urgent care departments. The study was conducted over more than 12 months in dissimilar emergency departments and an urgent care unit, and was designed to support better decision-making in pediatric emergency departments about whether children need to be admitted to hospital or can be discharged home safely. Robust analysis of the factors that exerted the greatest impact on predicting the need to admit or the safety of discharging children led to a revised version of an existing tool. In this article, we review approaches to consent in research, the nature and impact of opt-out consent, the factors that made this an effective strategy for this study, but also more recent concerns which may make opt-out consent no longer acceptable.

Living with Type 1 Diabetes Mellitus (T1D) significantly impacts every part of a person's life as optimal glycemic control requires frequent monitoring of blood glucose and the use of complex dose calculations and insulin delivery systems. The intensity of effective diabetes care is particularly challenging during the period of adolescence as adolescents must navigate diabetes management in conjunction with significant physical, cognitive, and psychosocial growth. The task of balancing the typical changes of adolescents alongside diabetes management can have significant negative impacts on an adolescent's quality of life. Quality of life, or an individual's view of their overall well-being, can be used as a psychological indicator of health adaptation in diabetic youth. The study seeks to examine the link between diabetes self-efficacy and perceived quality of life in adolescents living with T1D. While no statistically significant links were found in the pilot study, it is apparent that adolescents with T1D often feel different than their peers. Opportunities for youth with T1D to engage in camps with other diabetic youth is critical for adolescents in order to promote the development of self-identity and self-efficacy that includes effective diabetes management.

Emeritus Professor Alan Glasper, from the University of Southampton, discusses what can be done to protect certain groups of children with long-term health conditions from catching SARS-Cov-2 disease caused by the novel coronavirus COVID-19. Furthermore, it is now being reported that a number of children appear to be reacting to the new coronavirus by developing a multisystem hyperinflammatory state with similar symptoms to that seen in toxic shock syndrome and which necessitates intensive care (Campbell & Sample, 2020).

Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12-26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people's use of alcohol, is needed.