游戏式训练对脑瘫儿童家庭环境及疗效的影响

目的探讨游戏式训练对脑瘫儿童家庭环境及疗效的影响。方法将确诊脑瘫患儿89例分为观察组45例和对照组44例,两组患儿均接受医院内正规强化康复,观察组患儿以游戏的方式进行训练。治疗前及治疗6个月后采用家庭环境评定量表（HOME）及贝利婴幼儿发育量表（BSID）进行评定。结果观察组治疗后HOME评分明显高于治疗前及对照组（P<0.01）,两组治疗前后BSID的精神运动发育指数（PDI）均明显改善(P<0.01),治疗后观察组优于对照组（P<0.05）,观察组治疗后BSID的智力发育指数（MDI）明显高于治疗前及对照组（P<0.01）。结论游戏式训练能更好地促进脑瘫儿童家庭环境质量的改善和康复疗效的提高。     

关于游戏在脑瘫儿童康复治疗中应用的调查和思考

脑瘫作为一种儿童时期最常见的神经系统致残性疾患．会给患儿、家庭、社会带来经济和心理的巨大负担。迄今为止，没有证据显示哪些方法可以使脑瘫患儿完全恢复。但是脑瘫并不影响寿命，脑瘫儿童最终会长大成人。因此．如何对脑瘫儿童进行康复，使他们能够在健康快乐中成长，是康复工作者和患儿家长面临的巨大挑战。为了了解脑瘫康复治疗的现状和游戏在治疗中的应用，我们进行了该项调查。     

游戏结合言语训练在脑瘫儿童康复护理中的应用研究

目的:探究游戏结合言语训练在脑瘫儿童康复护理中的应用效果.方法:选择本院于2017年1月至2019年12月收治的80例脑性瘫痪的患儿作为此次研究的对象,对患儿实施游戏结合言语训练康复护理训练,并使用Cesell发育量表对护理前后患儿的语言能力、社会生活能力、运动能力以及智能水平等各项指标进行评分以及调查患儿家属护理满意...     

感觉统合训练治疗脑瘫合并智力低下一例

目的为脑瘫合并智力低下患儿的功能康复训练提供一种可资借鉴的模式。方法 2007年8月20日选择1例3岁的脑瘫合并智力低下患儿,采用以感觉统合训练为主的综合康复方法,包括感觉统合训练、儿童悬吊运动训练、儿童神经发育促进技术和家庭康复训练,治疗3个月。依据Peabody粗大运动发育量表（PDMS-2,GM）进行康复评定。结果 PDMS-2评分各项指标均达到或超过既定康复目标。结论感觉统合训练对脑瘫合并智力低下患儿的功能康复有明显的促进作用,规范、系统的综合康复治疗使脑瘫患儿获得最大限度的功能康复。     

脑瘫患儿家庭康复护理效果评价

目的评价脑瘫患儿家庭康复护理的效果。方法将65例患儿按出院时单、双日随机分为两组,单日出院的33例患儿进行家庭康复护理训练为家庭康复护理组,双日出院的32例患儿仅采用常规出院指导为常规康复护理组。两组均进行常规的院内治疗,采用Gesell发育量表对患儿治疗2个疗程后进行综合疗效评定和Milani的正常儿童发育表中的运动发育指数MQ评分评价肢体运动功能恢复情况。结果家庭康复护理组的总有效率明显高于常规康复护理组,P<0.05。治疗第2疗程后运动发育指数MQ评分家庭康复护理组显著大于常规康复护理组,P<0.01。结论针对性的家庭护理明显改善脑瘫患儿的肢体运动功能,提高其治愈率及有效率,减少患儿的病残率,促进脑瘫患儿的康复。     

目标细化结合游戏对痉挛型脑瘫患儿粗大运动功能的影响

脑性瘫痪是自受孕开始至婴儿期非进行性脑损伤和发育缺陷所导致的综合征,主要表现为运动障碍及姿势异常,是儿童发育过程中最主要的致残性疾病之一,痉挛性脑瘫是其最常见的类型,约占脑瘫患儿的50%—70%,临床以肌张力异常,运动功能障碍等为特点[1—2]。痉挛型小儿脑瘫的康复治疗是一个长期的过程,需要极大的耐心和家属的积极配合,督促、鼓励患儿持之以恒的进行正确足够的训练是影响其康复效果的关键之一[3],目标细化结合游戏可较好地达到上述要求,提高其康复疗效,现报道如下:     

俞募穴针刺对脑瘫患儿运动功能和体格发育的影响*

脑瘫患儿不仅存在运动障碍、姿势异常、智力落后等问题,还普遍存在营养不良[1]、体重低、体质差、免疫低下[2]、易感染等问题,影响及制约脑瘫患儿的康复。笔者所在河南中医学院第一附属医院儿童神经康复病区近1年来在对脑瘫患儿的康复治疗中加用俞募穴针刺法,观察其促进脑瘫患儿运动发育、体格发育、呼吸道及胃肠道感染次数的影响,现报告如下。1资料与方法1.1临床资料按照2006年第九届全国小儿脑瘫康复学术会议修订的     

小儿脑性瘫痪智能评定探讨

220例脑瘫患儿康复治疗前后采用智能评定,发现因后天环境因素、患儿言语障碍或智测方法的局限性等而造成评定中的问题和患儿智能发育中的再障碍。提示儿童康复工作者在评定智能障碍和康复治疗中应充分发挥患儿的智能水平,防止造成患儿第2次心理精神障碍,使脑瘫患儿全面康复达到最佳效果。     

小儿脑性瘫痪的家庭康复指导

目的 指导家长正确掌握脑瘫患儿综合康复中的功能康复训练方法。方法 根据脑瘫儿童的分型及不同的发育年龄阶段、制定详细的日常护理,康复指导计划及功能康复训练方法。从头部、躯干的控制,坐位、站立及行走的控制,双手的直辖市运动;通过家长正确娴熟的手技,帮助脑瘫患儿进行康复训练,抑制异常的姿势反射活动。防止畸形发生,促进正常姿势反射的产生。结果 通过正确的日常护理和功能康复训练使脑瘫患儿获得部分功能康复和日常生活中自理。结论 家长正确有日常护理,功能训练及积极参与,是脑瘫患儿获得良好康复不可缺少的重要组成部分。     

运动障碍儿童Gesell 发育量表评估情况分析

目的了解运动障碍儿童的智力低下发生率和智力结构特点。方法对157 例运动障碍儿童(脑瘫103 例,精神发育迟滞54 例)采用Gesell 发育量表进行评估,发育商<75 为智力低下。结果脑瘫患儿智力低下发生率92.2%,其中痉挛型为91.2%,不随意型、混合型和肌张力低下型均为100%。痉挛型脑瘫患儿大运动发育落后于精神发育迟滞患儿,不随意型脑瘫患儿大运动和精细运动发育均落后于精神发育迟滞患儿。结论运动障碍儿童,特别是不随意型脑瘫患儿的智力评估和康复值得注意。Gesell 发育量表用于运动障碍儿童有其局限性。     

The meaning of hospitalization for the pre-school child: a theoretical model

This study was aimed at comprehending the meaning of being hospitalized for pre-school children. The theoretical references were the Symbolic Interactionism and Vygotsky's theory on the child's symbolic play. The methodological referential was the Theory Based on Data. Eleven children between the ages of 3 and 6 took part in the survey. The strategies for data collection were: participative observation, interviews with the children mediated by the Therapeutic Toy, and interviews with the mothers. The analysis of the data made possible the construction of the technical model Growing up with the mother's protective presence, which puts in evidence the vulnerability, the child's force and the protection given by the mother to face the mystery and the fear of hospitalization.     

Development of a survey to measure parent satisfaction in a pediatric intensive care unit

OBJECTIVE: To use classic survey methodology to develop a specific survey tool that can assess parent satisfaction with medical care in a pediatric intensive care setting. DESIGN: Application of survey design methodology to develop and analyze a parent satisfaction survey. SETTING: A pediatric intensive care unit (PICU) in a large teaching hospital. SUBJECTS: Sixty-six parents of children admitted to a PICU. RESULTS: A four-stage process of item selection, item reduction, pretesting, and test analysis was used to create a 23-item parent satisfaction survey that was statistically analyzed and developed specifically for the PICU setting. The survey tool was developed with the input of parents of children admitted to a PICU, and it was administered to parents in the PICU. The resultant survey was analyzed for validity and reliability. Both test-retest and internal consistency reliability were evaluated. This design yielded a survey with acceptable reliability, as demonstrated by a reliability coefficient of 0.8275. Test-retest reliability also showed good correlation of answers. Validity was partially established by including parents in the identification of survey topics. CONCLUSIONS: Classic survey design methodology was applied to develop a specific satisfaction survey in a pediatric inpatient setting. This stepwise method yielded a parent survey specific to one type of inpatient unit, and the resultant survey tool reliably measured levels of parent satisfaction with medical care in that area. This study demonstrates the feasibility of applying classic survey methodology to develop a statistically analyzed parent satisfaction survey for an inpatient setting.     

Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: a randomized controlled trial study.

PURPOSE: This paper aims to examine the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. DESIGN/METHOD: A randomized controlled trial was employed. Children (7-12 years of age; n = 203) admitted for surgery during a 13-month period were recruited. RESULTS: The results support the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. PRACTICE IMPLICATIONS: The study results promote awareness in nurses and parents that play is a very important part of children's lives, and heighten the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.     

Effects of caregiver-child interactions on play occupations among young children institutionalized in Eastern Europe.

OBJECTIVE: We investigated whether children institutionalized in an orphanage would engage in more developmentally competent play with their caregivers as opposed to playing alone and whether specific qualities of caregiver-child interactions were associated with more developmentally competent play. METHOD: Twenty-six children, ages 10 to 38 months, participated in independent play sessions and in a play session with a caregiver. Interrater reliability for coding play performance was established using the weighted kappa statistic (M = .82). Twelve pediatric experts rated both child and caregiver behaviors for the interactive sessions (mean effective reliability with intraclass correlations = .89). RESULTS: The children demonstrated more developmentally competent play when interacting with a caregiver than when playing alone, t (25) = -1.88, p < .04, one-tailed. The effect size was moderate (d = .53). Longer periods of institutionalization were associated with less improvement in play performance from independent to interactive play sessions (r = -.51, p < .01). Successful engagement for the child was associated with having a caregiver who provided more structure and assistance and who was directive and encouraging (r = .82, .75, .75, and .64, respectively). CONCLUSION: Caregivers facilitated more developmentally competent participation in play with children residing in an orphanage, despite the fact that these interactions occurred in an environment vulnerable to many challenges not typical of an exclusive caregiver-child relationship. Findings are discussed in the context of environmental challenges and occupational therapy practice.     

Population-based survey of childhood disability in eastern Jeddah using the ten questions tool

Purpose: To identify the prevalence of handicapping disabilities among children up to 15 years of age and their epidemiological pattern in the eastern part of Jeddah. Methods: In a population-based cross-sectional household survey in the eastern Jeddah area, Saudi Arabia, a multistage sampling method was applied to screen children in 875 houses using the ten questions survey tool for identification of disabilities. Further information collected for detected disabilities included possible risk factors, cause of the disability as perceived by the family and services previously provided to the child. Results: A total of 137 cases of disability were detected giving a point prevalence rate of 36.7 per 1000 children. Twenty-nine children (21.2%) were discovered for the first time during the survey. The majority of cases were male (57.7%) and the mean age for all cases was 10 years (SD = 5.5) with no case detected under one year of age. Disabled children were in the fourth or fifth birth order among their brothers and sisters and 47 (34%) of them were recorded as a second or third disability in the same family. Number of disabilities in the same child varied widely: 59% of cases had a single disability, 22% had two conditions and 19% had three or more conditions. Speech, motor and mental disabilities ranked top of the disabilities detected by the ten-question tool. The commonest cause of these disabilities as perceived by the family was hereditary diseases followed by childhood illnesses. Significant risk factors associated to these conditions included larger number of children in the family, older age of either parent, histories of handicapping conditions in the original families of either of the parents and presence of handicapping condition in the mothers. Families reported lack of services provided to their disabled children in the community. Conclusions: The survey tool managed to document, successfully, a prevalence rate of childhood disabilities in the community with a general picture of their types and suspected causes which is quite comparable to that found in Saudi Arabia. It also reported a low service delivery for these disabilities and identified some risk factors related to their occurrence. It is recommended to apply this survey method with certain modifications to suit the local culture in Saudi Arabia. Improvement of the services rendered to handicapped children in Jeddah is also recommended.     

Population-based survey of childhood disability in Eastern Jeddah using the ten questions tool

Purpose : To identify the prevalence of handicapping disabilities among children up to 15 years of age and their epidemiological pattern in the eastern part of Jeddah. Methods : In a population-based cross-sectional household survey in the eastern Jeddah area, Saudi Arabia, a multistage sampling method was applied to screen children in 875 houses using the ten questions survey tool for identification of disabilities. Further information collected for detected disabilities included possible risk factors, cause of the disability as perceived by the family and services previously provided to the child. Results : A total of 137 cases of disability were detected giving a point prevalence rate of 36.7 per 1000 children. Twenty-nine children (21.2%) were discovered for the first time during the survey. The majority of cases were male (57.7%) and the mean age for all cases was 10 years (SD = 5.5) with no case detected under one year of age. Disabled children were in the fourth or fifth birth order among their brothers and sisters and 47 (34%) of them were recorded as a second or third disability in the same family. Number of disabilities in the same child varied widely: 59% of cases had a single disability, 22% had two conditions and 19% had three or more conditions. Speech, motor and mental disabilities ranked top of the disabilities detected by the ten-question tool. The commonest cause of these disabilities as perceived by the family was hereditary diseases followed by childhood illnesses. Significant risk factors associated to these conditions included larger number of children in the family, older age of either parent, histories of handicapping conditions in the original families of either of the parents and presence of handicapping condition in the mothers. Families reported lack of services provided to their disabled children in the community. Conclusions : The survey tool managed to document, successfully, a prevalence rate of childhood disabilities in the community with a general picture of their types and suspected causes which is quite comparable to that found in Saudi Arabia. It also reported a low service delivery for these disabilities and identified some risk factors related to their occurrence. It is recommended to apply this survey method with certain modifications to suit the local culture in Saudi Arabia. Improvement of the services rendered to handicapped children in Jeddah is also recommended.     

Play in Mayan children.

OBJECTIVE: The purpose of this study was to describe the characteristics of play activities and playfulness in a group of Mayan children in southern Belize. METHOD: This qualitative study involved participant observation in the daily occupations of 20 children from five Mayan families over a 2-week period. Analysis of the field notes, using open and closed coding, revealed themes specific to customs of child rearing, play activities, and playfulness. FINDINGS: The primacy of adult work is a major cultural principle that influences Mayan children's daily occupations. Parents did not encourage play but permitted play if it did not interfere with work. Children found ways to integrate play activities and playfulness into their daily occupations. CONCLUSION: The statement, "play is a child's major occupation," may not be a universally held belief. Parental values and customs of child rearing should be considered in order to provide culturally sensitive and relevant services.     

Exploring types of play in an adapted robotics program for children with disabilities

Purpose: Play is an important occupation in a child’s development. Children with disabilities often have fewer opportunities to engage in meaningful play than typically developing children. The purpose of this study was to explore the types of play (i.e., solitary, parallel and co-operative) within an adapted robotics program for children with disabilities aged 6–8?years.

Method: This study draws on detailed observations of each of the six robotics workshops and interviews with 53 participants (21 children, 21 parents and 11 programme staff).

Results: Our findings showed that four children engaged in solitary play, where all but one showed signs of moving towards parallel play. Six children demonstrated parallel play during all workshops. The remainder of the children had mixed play types play (solitary, parallel and/or co-operative) throughout the robotics workshops. We observed more parallel and co-operative, and less solitary play as the programme progressed. Ten different children displayed co-operative behaviours throughout the workshops. The interviews highlighted how staff supported children’s engagement in the programme. Meanwhile, parents reported on their child’s development of play skills.

Conclusions: An adapted LEGO^® robotics program has potential to develop the play skills of children with disabilities in moving from solitary towards more parallel and co-operative play.

• Implications for rehabilitation

• Educators and clinicians working with children who have disabilities should consider the potential of LEGO^® robotics programs for developing their play skills.

• Clinicians should consider how the extent of their involvement in prompting and facilitating children's engagement and play within a robotics program may influence their ability to interact with their peers.

• Educators and clinicians should incorporate both structured and unstructured free-play elements within a robotics program to facilitate children's social development.

     

Psychological interventions helping pediatric oncology patients cope with medical procedures: A nurse-centered approach

Purpose of the researchThis study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective.Methods and sampleA web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis.Key resultsPediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%).ConclusionsThis work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions.