Parental hopes for therapy outcomes: children with sensory modulation disorders.

OBJECTIVE: Understanding parents' hopes for therapy outcomes is essential to family-centered care. This qualitative study explored parents' points of view regarding their hopes for the outcomes of occupational therapy using a sensory integration treatment approach. METHOD: Data were collected as part of a larger research project on the effectiveness of rehabilitating children who have sensory modulation disorders. Five interviews were randomly selected from 17 parent interviews conducted in the larger study. Data were analyzed using grounded theory methods. FINDINGS: Three themes pertinent to the occupations of children and two themes related to the occupations of parenting and sustaining family life emerged. Child-focused outcomes include social participation, self-regulation, and perceived competence. Parent-focused outcomes include learning strategies to support children and obtaining personal validation. DISCUSSION: Interventions are proposed that relate to children's participation in contexts in which they live, learn, and play, as well as the support of parents in the occupations of parenting.     

家长营养知识和文化程度对儿童营养状况的影响

目的探讨家长营养知识、文化程度与儿童营养状况之间的关系,促进小儿健康成长。方法对213例0～6岁儿童行体格检查,了解其营养状况;采用自行设计的问卷调查家长文化程度和营养知识掌握情况。对家长的文化程度、营养知识掌握情况与子女的营养状况进行stearman相关分析,了解其相关性。结果儿童的营养状况与父母文化程度无明显关系,父母营养知识与子女营养状况有明显相关性(P<0.01)。结论儿童的营养状况主要与家长对营养知识掌握的程度密切相关,应采用各种健康教育措施提高家长营养知识,尤其不能忽略文化程度高的家长。     

Comparisons of parent cardiovascular knowledge, attitudes, and behaviors based on screening and perceived child risks

Questionnaire reports and universal screening procedures from 244 children (kindergarten, 5th grade, and 9th grade) were used to explore differences in parent health knowledge and attitudes of cardiovascular risks among children and parental involvement in promoting healthy lifestyles relative to whether their children were identified as being overweight or at risk of being overweight. The knowledge, attitudes, and behaviors of the parents of children who were identified as being at risk or overweight were further examined based on their perceptions of their children's level of risk. Parents' reports demonstrated significantly greater parent encouragement and knowledge of issues related to eating healthier foods and ways to cut calories among parents of children who were identified as being at risk or already overweight. A significant portion of parents underestimated their children's weight risks. Differences in parents' appraisals of their children's overweight risks were associated with differences in their knowledge, attitudes, and behaviors. These findings illustrate the need to address inaccuracies in parents' assessments of their children's overweight risks to improve parent investment and involvement in children's health modification programs.     

Exploring the Link Between Parental Acceptance and Young Adult Adjustment

Two hundred and ninety-two university undergraduates participated in an investigation exploring the developmental antecedents of perceived acceptance. Students completed questionnaires concerning their psychological adjustment and perceptions of the acceptance they received from their parents. Questionnaires were mailed to both of the students' parents asking them to evaluate their children's positive and negative qualities. Regression analyses indicated that parents' views of their children's personal characteristics predicted children's perceptions of acceptance and reports of psychological adjustment. Perceived acceptance mediated the relationship between parents' views of their children and children's reports of psychological adjustment. Implications for a social–cognitive theory of acceptance are discussed.     

Self-reported knowledge and behaviors related to oral and dental health in Turkish children

AIM: The purpose of the study was to present oral- and dental health-related knowledge and behaviors of children who presented to Akdeniz University Medical Faculty Pediatric Outpatient Clinic between March 1 and May 1, 2006 for non-dental health reasons. METHOD: Data were collected from a total of 173 children. A survey which contained questions about the children's oral and dental health was completed using face-to-face interview technique. RESULTS: Forty-eight percent of the children were 5-6 years old and 68.8% were not going to school. It was determined that 43.3% of the mothers of the children in the study had a primary-school level of education and 74.6% were housewives. It also was determined that 49.1% of the children had never had a cavity, 43.4% stated that they brushed their teeth after meals, and 30.6% stated that they brushed at least once a day. More than sixty percent of the children spent their allowance on chocolate, chips, cola, candy, and other acidic drinks. A significant relationship was found between the children's ages and having a caries in this study. There also was a statistically significant relationship between the parents' tooth-brushing habit and the children's tooth brushing, and between the parents' frequency of tooth brushing and the children's frequency of tooth brushing. CONCLUSION: Based on the results of the study it is recommended that both children and their families be given education about oral and dental health.     

Young children's death concepts revisited

One hundred forty-one children, ages three to seven, were interviewed and presented with different play situations to assess their death concepts. Chi-square analysis and post hoc pairwise contrasts tests were used to examine differences in responses by parents' marital status and socioeconomic background The feasibility of a play activity involving puppets for assessing death concepts was also explored. It was concluded that there is no relationship between parents' marital status and young children's death concepts, that young children from different socioeconomic backgrounds are far more similar than different in their understandings of death, and that a play situation with undefined cause of death is a potentially useful supplementary means for assessing young children's death concepts.     

Health-related quality of life in Austrian elementary school children

BACKGROUND: Health-related quality of life (HRQL) is frequently used as an outcome criterion to evaluate the quality and effect of different therapies. However, little is known about the HRQL of the general population, the prevalence of specific HRQL problems and about which factors have an impact on HRQL assessments. OBJECTIVE: To examine children's HRQL from their own and their parents' perspectives. The study sample consisted of children attending the third and fourth grades of elementary school in the capital of Austria, Europe. METHODS: One thousand four hundred twelve children and 1185 parents completed child- and parent-versions of the Pediatric Quality of Life Inventorytrade mark (PedsQLtrade mark). In addition to the PedsQL questions, children and parents were asked a number of questions with regard to sociodemographic information and specific problems that were hypothesized to be associated with the children's HRQL. RESULTS: Altogether, the children demonstrated a good HRQL and their PedsQL scores were similar to those of children from other developed countries. About 15% of children showed a notably low HRQL, and two-thirds of these children were from financially less privileged families. Multivariate regression analyses identified the following factors associated with the children's HRQL: the family's perceived financial situation, parents' quality of life, children's school performance, medical and/or psychologic problems (eg, dyslexia, recurrent stomachache or headaches), chronic disease, a recent life-event (eg, divorce/separation of parents), and parents' satisfaction with school. CONCLUSIONS: Assessing children's HRQL may be helpful to take preventive action and to identify those who are in urgent need of special services.     

Revision of a parent satisfaction survey based on the parent perspective

Parent surveys typically ask about aspects of care nurses think are important. The Parent Satisfaction Survey at a 250-bed children's hospital was revised based on what parents thought was most important for a nurse to do for themselves and their children. This report is based on a retrospective review of 1,405 self-reported parent surveys collected as a performance improvement activity over a 12-month time period. Surveys were distributed to parents of hospitalized children and were returned anonymously to mailboxes on the units. Using content analysis, a group of pediatric nurses reviewed the parents' comments to determine major themes. The themes were caring, communication, safety, environment, and appreciation. The parent survey was revised to include the themes parents identified as important.     

护理干预对儿童远视性弱视疗效的影响研究

目的探讨护理干预对患儿远视性弱视疗效的影响。方法参照患儿及家长的意见,将70例远视性弱视患儿分成观察组37例和对照组33例,两组均予健眼遮盖法（双眼弱视两眼交替遮盖）和精细作业训练;对观察组患儿行集结成班式护理干预,对照组患儿在家中由家长督促遮眼及精细作业训练。结果两组单眼及双眼远视性弱视的疗效比较：观察组优于对照组,差异有统计学意义;两组低度及中度远视性弱视的疗效比较：观察组优于对照组;两组重度远视性弱视的疗效比较：差异无统计学意义;治疗显效率：观察组89．5％,对照组62．0％。结论集结成班式护理干预可以提高远视性弱视患儿的治疗效果。     

Paediatric day surgery: impact on Hong Kong Chinese children and their parents

Paediatric day surgery is a potentially stressful and threatening experience for children and parents. The purposes of this study were to investigate the effects of paediatric day surgery on anxiety level of Hong Kong Chinese children and their parents, and to examine the relationship between children's preoperative anxiety and their level of cooperation during induction and postoperative periods. A total of 112 children admitted for circumcision with their parents in a day surgery unit were recruited. The state anxiety level for both children and parents was assessed at the time of admission and again at 4 hours after operation. Children's level of cooperation during the induction and the postoperative periods were also assessed. The results showed that the preoperative anxiety level for both children and their parents was relatively high. Children with high preoperative anxiety levels were associated with lower levels of cooperation during induction and postoperative periods. The results also indicated that parents' high state anxiety was associated with their children's high state anxiety. This study designated that preoperative intervention to minimize children and parents' anxiety is crucial and that there is still room for improvement.     

Anxiety and postoperative pain in children who undergo major orthopedic surgery.

Anxiety and pain are major concerns not only for children who undergo surgery, but also for their parents and health care professionals. A convenience sample of 74 adolescents who underwent major orthopedic surgery for repair of idiopathic scoliosis and their parents was used to investigate the relationships among children's and parents' preoperative and postoperative anxiety and children's postoperative pain. Age-appropriate versions of Spielberger's State-Anxiety scales measured children's and parents' anxiety, and a visual analog scale assessed children's pain intensities. Children's state anxiety increased from preoperative to postoperative levels, and their postoperative anxiety levels positively related to their pain intensities on days 2 and 4 following the operation. Parents' anxiety decreased from preoperative to postoperative levels, and their postoperative anxiety positively related to their children's postoperative anxiety. Studying both parents and children helped to explain the variance in children's self-reported anxiety. Parents' emotional states are important indicators of children's emotional states and, subsequently, their pain experience. The results of this study suggest that allowing children to assist in the assessment of their postoperative pain may help health care professionals better understand the subjective component of pain. The findings also emphasize the importance of including parents in future studies in which the aim is to understand children's behavioral responses and recovery outcomes.     

Children's postoperative pain at home: family interview study

The purpose of this study was to: (i) describe the methods that are used in the identification and management of postoperative pain in children aged 1-7 years after minor outpatient surgery at home; (ii) to identify parents' perceptions regarding children's pain and pain medication; and (iii) to examine parents' perceptions of discharge advice. Family interviews with inductive content analysis were used to gather information from families of 17 Finnish children undergoing minor outpatient surgery at a university hospital in Finland. Versatile methods were employed by the parents in the identification and management of children's postoperative pain subsequent to discharge from the hospital. The children expressed that they had experienced pain relief through the administration of pain medication, eating ice-cream and playing. The results indicate a need for further research in order to identify what elements of parents' perceptions of children's pain and pain medication should receive additional attention. In addition, the content, methods of providing and timing of discharge advice need to be developed in order to help parents with their efforts to achieve maximum pain relief in children after surgery.     

Parents' perspectives of asthma crisis hospital management in infants and toddlers: an interpretive view through the lens of attachment theory

Interpretive phenomenology and attachment theory were used to discover the underlying concerns of parents and children during children's hospitalization for asthma. Home interviews were conducted with families of low income and with Latino and African-American infants and toddlers with severe persistent asthma. Narratives revealed that asthma crises were fearsome situations for parents and children. Hospital procedures escalated fear in children. Parents, agonized by their children's suffering, were embarrassed by feelings of helplessness. Results imply that effective, efficient care depends on addressing parents' fears, being aware of their sensitivity to the suffering of their children, and supporting their desire to alleviate it.     

门诊输液患儿家属的需求调查分析及对策

目的了解门诊输液患儿家属的需求,为患儿输液实施全方位服务提供理论依据。方法随机选择门诊输液患儿家属300例进行问卷调查。结果患儿家属渴望了解药物疗效和药物安全知识,了解患儿疾病的诊断、病程、预后和预防保健知识;在护理服务方面把对技术水平的需求放于首位,同时认为经常巡视、与患儿交谈消除患儿恐惧感,二者同样重要;提供适合儿童心理特点的治疗环境,完善环境设施。结论护士应了解患儿及其家属的需求,采取相应的对策,提供全方位的服务。     

Comparison of fears and coping strategies reported by Nepalese school-age children and their parents

This study explored the self-reported fears and coping strategies of Nepalese school-age children and their parents' perceptions of their children's fears and coping strategies. Seventy-nine healthy school-age children attending a private school in Nepal and 48 parents participated in the study. The scores on the Child Medical Fear Scale (CMFS) indicated that children had moderate levels of fear. On the Schoolagers' Coping Strategies Inventory (SCSI), children reported using coping strategies less frequently and found them less effective than those reported by their parents. No significant correlations were found between fear scores and coping strategies. Significant differences were found between level of fears reported by school-age children and parents. No significant difference was found between children's and parent's report of children's coping strategies. However, a significant difference was found between effectiveness of coping strategies reported by children and parents. Nurses need to gather information from children, as well as from parents, about fears and coping strategies. Nursing intervention should be culturally sensitive with an awareness of cultural influences impacting how children perceive fears and cope with their fears.     

Parents with first time major depression: perceptions of social support for themselves and their children

The aim of this study was to ascertain the perceptions of parents, with first time major depression, regarding the social support for themselves and their children. Eighteen parents, with children under the age of 19, were interviewed on admission to an inpatient unit and of these 16 were followed up 1 year later. In addition, the severity of parents' depression and their functional status was measured. The results showed that although the parents did regain their mental health and functional capacity to a certain extent, they nevertheless remained in a vulnerable position, increasing the strain on the whole family. The parents' and their children's social support was low and came mostly from outside the family. The parents were worried about their children, due to problems related to the depressive episode as well as ordinary teenage rebellion. Important questions concerned practical problems such as whether there was someone to take care of the children if the parent is incapable of doing so. There were also concerns pertaining to how the changed family situation might interfere with the child's natural development or whether depression was a question of heredity. This highlights the need to investigate the importance of social support for the family as a whole when one of them suffers from depression. There is a need for improved treatment of parental depression to reduce symptoms such as decreased functional status that may impair parenting. The study also emphasises the need for healthcare practitioners to assess multiple aspects of social support so that care planning will target all relevant domains.     

Lost children, living memories: the role of photographs in processes of grief and adjustment among bereaved parent

Drawing on recent developments in the conceptualization of grief (Klass, Silverman, and Nickman, 1996; Walter, 1996) that note the importance of talking about lost loved ones as part of maintaining a "continuing bond" between the living and the dead, this article considers the role of photographs in parents' adjustment to life without their child and in their negotiation of a more "comfortable"relationship with the deceased. The contributions that photographs and other memorabilia make to parents' opportunities to remember their children's lives (as opposed to their deaths), to facilitating conversations and reminiscences about their living relationships, and to parents' ability to introduce "lost" children to people who didn't know them, are explored using examples drawn from a series of case studies of bereaved parents. Photographs and other artifacts arising from their children's living can be perceived as the illustrations of a developing story in which previous and present relationships may be represented and interrogated for meaning. It is argued that visual representations of children's lives, no matter how brief, are a crucial feature of the process of coming to terms with both the fact of the loss and the reality of the life that has been lived.     

Children at risk of injury

This study examined the relationships between two groups of Canadian preschool children (injured and noninjured) and their parents' risk perceptions, safety behaviors, parenting stress, and children's risk behaviors. Data analysis revealed significantly higher numbers of injury behaviors in the group of injured children (t = -2.46, p =.015). Contrary to the investigators' hypothesis, parents' perceptions of risk and hazard were not found to be significantly less among those parents of injured children. However, the parents of injured children had a higher score for perceived dangers for their children (t = -2.38, p =.01) and less parent stress (t = 3.38, p =.001).