共查询到20条相似文献，搜索用时 15 毫秒
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C. Van Pevenage I. Van Pevenage C. Geuzaine M. Schell I. Lambotte V. Delvenne 《Neuropsychiatrie de l'enfance et de l'adolescence》2013,61(7-8):433-440
Within the context of palliative care, supporting the whole family is crucial both during the child's illness and after its death. This approach requires a consideration by the health care teams of the family needs and, among them, the parental needs.ObjectivesOur purpose is to analyze in qualitative and retrospective terms the way in which the needs of the parents facing the death of their child have been met or not by the health care team (physicians, nursing staff, psychologists). We will try to highlight the factors that would either facilitate or impede the parental adjustment to the death of their child.Study designFour mothers and two fathers of children suffering from metabolic and neurodegenerative diseases, that had been deceased for at least six months but less than two years, were met for a semi-directive interview based on medical needs (care to child), social, relational, psychological, cultural, spiritual or existential needs prior to and following the death of their child. An assessment of depression and anxiety was also performed (HADS, Hospital Anxiety and Depression Scale).ResultsFamilies have highly variable needs that require great flexibility on the part of the health care team. Away from the death of their child (18 months), half of the parents still have high HADS scores, without benefiting of grief counseling which is however much needed.ConclusionAt the end of this study and from clinical material and literature, we carried out a mapping so as to help caregivers in identifying among the parents who are facing the death of their child, any ‘barrier’ factors that may complicate their grief, as well as any ‘resource’ factors they can rely on in terms of following-up their grief. 相似文献
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M. Taveira N. Yousef J. Miatello C. Roy C. Claude B. Boutillier C. Dubois A.-F. Pierre P. Tissières P. Durand 《Archives de pédiatrie》2018,25(2):112-117
Background
Lung ultrasound (LU) is a bedside point-of-care technique in critical care and emergency medicine. LU is quick and non-irradiating, and provides accurate diagnostic information when compared with chest radiographs. Specific LU signs have been described for bronchiolitis. This study aimed to evaluate the correlation between severity of LU-diagnosed lung lesions, using a quantitative LU score, and the length of non-invasive ventilation (LOV) for infants diagnosed with severe viral bronchiolitis.Methods
This was a prospective observational single-center study conducted at a level 3 pediatric intensive care unit. A LU score was calculated for 47 infants under 6 months of age with severe acute viral bronchiolitis during the 2015–2016 epidemic, and the number of intercostal spaces with consolidation or interstitial syndrome was counted for each lung. The LU score is based on the presence of A lines or B-line artifacts and consolidation (0–2 points). The modified Wood score (mWCAS) was used to define clinical severity. Other parameters such as gestational age at birth, age, supplemental oxygen (LOS), and length of stay were recorded. All LU scans were later reviewed by two trained ultrasonographers to assess the score's inter-rater reproducibility.Results
The LU score on admission (3.5 ± 2.6) did not correlate with LOV (69 ± 68.6), mWCAS score (4 ± 1.6), LOS (3 ± 3.4), or length of stay (4 ± 3.4). However, there was a significant correlation between the number of affected intercostal spaces on the right and LOS (Spearman's Rho 0.318; P = 0.037).Conclusion
This is the first study to evaluate the use of LU in infants needing PICU admission for severe acute bronchiolitis. The LU score does not correlate with LOV, mWCAS, LOS, or length of stay, but the number of pathological intercostal spaces on the right side correlates significantly with LOS. Although LU scores have been validated for the newborn and the adult, this has been in the setting of restrictive lung diseases. Bronchiolitis is a predominantly obstructive lung disease and this may explain the lack of performance observed. 相似文献7.
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M.-F. Bacqué L. Sani A. Rauner A. Losson D. Merg P. Guillou 《Neuropsychiatrie de l'enfance et de l'adolescence》2018,66(4):240-247
Aim
Interdisciplinary research of emotional constants and the need for social support in grieving parents throughout the ages.Methods
State of the arts of historical publications from 1970 to 2017 on funeral rites for stillborn and young children.Findings
There is some evidence of parents suffering through funeral rites for children in Prehistory, even for a foetus. Since Antiquity, many monuments, epitaphs and funeral furniture have been found for children. Although this is evidence of an economic and political power of patrician families, it is also evidence of parents’ grief suffering. If many infanticides do not seem to have been followed by guilt or grief, the funeral rites for the natural death of a predental child appear to have been very discreet. Parents were sensitive to the death of their child. This is confirmed for rich families but could not be proven for slaves or even the poor because of a lack of evidence. The Middle Ages in Europe are characterized by the hegemony of the Catholic Church which refused to baptize dead people. Stillborn children represented a problem for families because if they were not baptized by priests or midwives, their soul would stay in Hell for eternity. To reassure parents, the Catholic Church created a space between its two central places in its spiritual geography, Hell and Heaven. The Limbus puerorum was a virtual space for unbaptized children, but this was unsatisfactory for Middle Ages’ parents. With the creation of Purgatory, a place for redemption was possible for sinners but not for unbaptized children. The Catholic Church was literally compelled to accept these opportunities because of complaints from families whose suffering was double: parents had not only lost a child but this child would be doomed for eternity. Stillborn children have not kept out sins despite their short life as edited by Saint Augustin (5th century). The parents felt responsible and guilty for this shameful spiritual status. Redemption of sins could be obtained through “sanctuaires à répit”, special places where a child could have “rebirth” and be baptized until he died once again.Conclusion
Parents’ grief can be proven throughout all historic and even prehistoric times. Despite high child mortality rates, the death of a child was not a reality easily admitted by families. Social funeral rites were followed by parents for their moral support, but Catholic Church hegemony in Europe of the Middles Ages became controversial and especially with the development of Protestantism. Until the Enlightenment, the salvation of the soul of a stillborn child constituted a real stake for families. This situation was well understood by Catholic Church which used it to enlarge the baptized community as well maintain power on mourning families as well as tranquilizing parents who had lost a baptized child. 相似文献9.
N. Catheline Y. Gervais P. Ingrand R. Bouet D. Marcelli 《Neuropsychiatrie de l'enfance et de l'adolescence》2018,66(4):210-218
The organization presented here has existed since January 1991 in the department of Vienne. Its longevity permits us to have a critical opinion on the conditions necessary to install and thereafter to make function this dispositive. The originality of this is the association between two systems: permanence in secondary schools by nurses working in mental health services for the adolescents themselves (PEC) and another system for helping teachers and other members of the school community (EAR). This partner system allowed a better regulation for directing an adolescent with psychic discomfort to psychiatry services which has a real effect on the waiting list in medical and psychological centers. It has also sensitized mental health nurses to the impact of scolarization on presence of mind and allowed them to be conscious of difficulties which teachers have and the constraints of a school's organization. On the other hand, frequent meetings and discussions with mental health nurses and school personnel have resulted in a true formation within the school. We have also analyzed statistics after 11 years of functioning. The results of our study are exactly identical to those of the literature. 相似文献
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《Neuropsychiatrie de l'enfance et de l'adolescence》2022,70(5):256-264
BackgroundAt 12 years old, transgender youth who have engaged in a medical gender affirming intervention are concerned to have information about fertility risk prior to starting a treatment.MethodWe introduce a care organization proposed by our center, based on literature data. In order to illustrate some clinical situations, three case reports are presented.FindingsFertility preservation counseling with young trans people have several aims: to adjust to the capacity of the youth to take into consideration current and future fertility issues; to negotiate the exchanges between parents and the youth; and to reduce the effects of the influence by professionals on the decision.PerspectiveThese factors invite a development of counselling in fertility preservation for transgender minors, as well as for cisgender people. 相似文献
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J. Haesebaert S. Bourdy M. Perceval C. Chabloz R. Nove-Josserand P. Reix C. Llerena N. Wion S. Touzet 《Archives de pédiatrie》2009,16(11):1435-1442
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M. Hauet-Wiedemann A. Wiedemann A. Gatin E. Renaud L. Lapp A. Franchi L. Martrille A. Borsa-Dorion 《Archives de pédiatrie》2018,25(4):247-250
Background
When child sexual abuse (CSA) is suspected, the detection of anogenital anomalies is rare. In France, since 2011, most clinical examinations of children for whom CSA is suspected take place in the forensic medical service (FMS).Objectives
To describe a population of children examined for suspected CSA in the FMS of the Nancy Regional University Hospital Center.Patients and methods
Children under the age of 18 who consulted for suspected CSA in the Nancy FMS between 2011 and 2015 were included. Demographic data as well as data from questioning, the physical examination, any further examination, and the medical conclusions were collected.Results
Three hundred and twenty-five girls and 79 boys were enrolled. The average age at the time the abuse was committed was 118.9 months. Two hundred sixty-nine (66.6%) children alleged fondling and 59 (14.6%) fellatio. Two hundred twelve victims (52.5%) described a penetration, 163 (76.9%) in the vagina and 73 (34.4%) in the anus. Significant bruises were found at the examination of 13 children, accounting for 2.5% of all victims. Thirty-four (11.7%) girls had lesions in the external genitalia and 28 (9.8%) lesions of the virginal membrane. One boy (1.3%) had a nonspecific lesion of the external genitalia. Six (8.2%) children alleging anal penetrations showed injury. The examiner concluded that clinical examinations were compatible with alleged facts for 253 (62.6%) victims. It was impossible to conclude for 116 (28.7%) children.Conclusion
In the case of suspected CSA, the clinical examination is frequently normal. This examination must be performed by physicians trained in child abuse, under appropriate conditions. It is important not to jump to conclusions about the reality of the alleged facts. A multidisciplinary approach, with the cooperation of the medical, social, and forensics sector is necessary. 相似文献16.
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F. Dubos I. Maréchal B. Tilmont C. Courouble F. Leclerc A. Martinot 《Archives de pédiatrie》2009,16(7):984-990
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