The health of children with cerebral palsy and stress in their parents

Title.  The health of children with cerebral palsy and stress in their parents.
Aim.  This paper is a report of a study conducted to describe the health of children with cerebral palsy and investigate predictors of stress in their parents.
Background.  Children with severe cerebral palsy tend to have poorer health than their able-bodied peers, and their parents are more likely to be stressed and have poorer health.
Method.  A cross-sectional survey with home visits using standard questionnaires was administered to parents in 2004–05. A total of 102/199 (51%) children and parents participated. The children were compared with a normative sample.
Results.  Children with cerebral palsy had poorer physical health, and 79% of parents reported that their child had moderate to severe pain. Their poorer health, in comparison with the normal sample and measured by the Child Health Questionnaire, was related to feeding problems and seizures, general health perceptions to intellectual and feeding impairment, and family activities with severe motor, intellectual and feeding impairment. Poorer psychological well-being on the hyperactivity domain of the Strengths & Difficulties Questionnaire was related to feeding difficulties, on the prosocial domain to more severe forms of all child impairments, and on the social impairment scale to intellectual impairment. Children with psychological problems had statistically significantly increased odds (OR = 7·2, 95% CIs 2·6–20·3) of having parents with high stress.
Conclusion.  Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support.     

Sleep Deprivation Is an Additional Stress for Parents Staying in Hospital

PURPOSE.  This study aims to describe the sleep experience of parents staying overnight with their children in hospital.
DESIGN AND METHODS.  Parents ( n  = 102) completed the Verran and Snyder-Halpern Sleep Scale following a night spent with their children in an Australian tertiary pediatric hospital .
RESULTS.  Parents experienced sleep deprivation and poor quality of sleep, reporting a mean sleep period of 4.6 hr ( SD  = 2.1). Having only one child in the room was the only variable that significantly influenced the quality or amount of parental sleep .
PRACTICE IMPLICATIONS.  Parental sleep deprivation needs to be acknowledged and accommodated when nurses and parents negotiate the care of children in hospital .     

A randomized controlled trial of an at-home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery

Objectives  To determine whether the implementation of at-home psychological preparation programme for children and family prior to surgery can reduce anxiety for Japanese preschool children undergoing herniorrhaphy and their caregivers assessed as an appropriate outpatient care.
Methods  Patients were randomly assigned to either of two groups: the usual care group or the at-home preparation group. Both two groups viewed a patient-educational video for herniorrhaphy once as outpatients with other patients prior to hospitalization. The control group later underwent surgery without any further preparation. The experimental group watched the same educational video at home again with an auxiliary booklet prior to hospitalization. Children's anxiety was measured by the Wong–Baker FACES Rating Scale (FACES Rating Scale), while caregivers' anxiety was measured by the Spielberger's State Trait Anxiety Inventory (STAI). Both outcomes were measured repeatedly from pre-intervention to 1 month after surgery.
Results  Of the eligible 161 patients participating, 158 (98.1%) were randomly assigned to the control group ( n  = 81) and the experimental group ( n  = 77), and 144 (89.4%) completed the study. The experimental group gained more information and knowledge about surgery from parents and showed significantly lower scores than the controls for FACES and STAI.
Conclusion  A specially designed at-home preparation programme as an outpatient care is effective to encourage parent–child verbal interaction concerning surgery and reduce both children and caregivers' anxiety associated with surgery.     

Ecological Differences in Weight, Length, and Weight for Length of Mexican American Children in the WIC Program

PURPOSE.  Examine factors common in the environments of children who obtain services from a WIC program to determine if differences in ecological/environmental factors can be found in the children who differ in weight , length , and weight for length.
DESIGN AND METHODS.  Cross-sectional study of 300 children , 100 each who were stunted , normal weight for length , or overweight. Instruments used were NCATS , ARSMA II , 24-hr diet recall , and Baecke Activity Questionnaire.
RESULTS.  Significant differences were present in children's diet , parents' BMI , parents' generation in United States , parents' activity levels , and maternal–child relationship.
PRACTICE IMPLICATIONS.  Encourage parents to adopt family approaches to encourage normal body size in children.     

Psychosocial Experiences of Parents of a Child With Imperforate Anus

PURPOSE.  This study aims to examine the psychosocial experiences of parents of children with imperforate anus (IA) and to describe their potential positive experiences.
DESIGN AND METHODS.  Parents of IA children and a comparison group answered a questionnaire, which was analyzed quantitatively and with manifest content analysis.
RESULTS.  Social relationships and respect for the child's will were more affected among IA mothers. Positive experiences were revealed in relation to the child, the parent, and the family.
PRACTICE IMPLICATIONS.  Support to parents in caring for a child with IA should be individualized and occasionally undertaken through collaboration with experts from child and adolescent psychiatry.     

Nursing Care of Families With Parents Who Are Lesbian, Gay, Bisexual, or Transgender

TOPIC:  Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. The numbers of parents and children in these families appear to be increasing with implications for nurses and other clinicians.
PURPOSE:  This paper reviews the current literature to determine the fundamental issues facing alternate families that include sexual minority parents and their children. It also explores the unique nursing needs of families with gay, lesbian, transgender, or bisexual parents in the field, which are critically examined for direct relevance to psychiatric nursing practice.
SOURCES USED:  Current theoretical and research literature in nursing, child development, family law, and healthcare professional journals.
CONCLUSIONS:  Despite a relative lack of pathology noted in the literature related to families with sexual minority parents, nurses, and other healthcare professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Assessments and interventions that address the unique needs of these families may help parents and children to deal with social stress from being perceived as "different" by other children, or as "problematic and threatening" by other parents.     

Factors Associated With Parental Distress

PROBLEM:  Associations of perceptions of social support, personal control, and child behavioral problems to distress in parents of children with mental health problems were examined.
METHODS:  One hundred and fifty-five parents of children 2–19 years old receiving community mental health services participated.
FINDINGS:  Stepwise regression analysis identified internalizing and externalizing child behaviors, perceived personal control, and tangible social support as independent predictors of parental distress. Independent predictors of objective distress included internalizing child behaviors, perceived personal control, and intangible social support.
CONCLUSIONS:  Internalizing and externalizing child behaviors were significantly associated with parental distress. Perceived personal control moderated the relationship between internalizing child behaviors and parental subjective distress.     

Prevention of further weight gain in overweight school children, a pilot study

Background:  Involving school nurses in weight gain prevention activities in already overweight children may be a means to address childhood obesity prevention.
Objective:  To describe and evaluate a treatment method aimed for implementation in school care centres.
Methods:  Twenty families (20 overweight children aged 7 years) were interviewed at baseline with standardized questionnaires, received simple dietary and lifestyle advice. Weight was measured and advice/support by school nurses was available monthly during the 1-year period. A follow-up was made after 1 year. Changes in wellbeing, life style and body mass index (BMI) z -score were recorded and analysed. Experiences from parents and nurses were also examined.
Results:  A good (91%) or fair (54%) adherence to dietary advice was found in children who decreased or maintained their z -score respectively. Mean BMI z -score reduced [−0.16 (p = 0.03)] during the intervention period. Generally, parents and school nurses were satisfied with the programme, helping them to set limits and be more self-confident in their role as 'health adviser' respectively.
Conclusions:  Overweight progression in younger children is possible to modify by increased awareness of the problem, of their food habits and lifestyle practices. Providing school nurses with the knowledge to address the problem and working in collaboration with dieticians and a healthcare team can be an effective means to prevent further weight gain in overweight school-age children. Possibility of stigmatization was expressed thus efforts will need to be made to carry out such a programme to preserve the children's integrity and run activities in a discrete manner in the school environment.