Parental attitude and adjustment to childhood epilepsy

Parenteral attitudes and adjustment to epilepsy were assessed for 50 parents of children aged 6 to 14 with epilepsy. Fishbein's Expectancy-Value Model of Attitude was used to assess parental attitudes. Parental adjustment was measured both by a self-report instrument and by an independent psychosocial assessment conducted by a psychiatric social worker. The major finding was a strong positive relationship (R = .67, p less than .001) between parental attitude and adjustment for the mothers. The attitude-adjustment relationship was not significant for the fathers. In addition, parental attitudes and perception of seizure control accounted for 60% of the variance in the mothers' adjustment scores. Seizure control was significantly positively related (p less than .05) to parental adjustment.     

Chronic sorrow and coping in families of children with epilepsy.

Epilepsy, a common problem in child neurology, affects the entire family. There is a potential for such psychosocial consequences as parental chronic sorrow and alterations in coping. In this study, 67 parents completed brief questionnaires about their sorrow and coping styles. Results demonstrated chronic sorrow as measured by the Adapted Burke Questionnaire (10.45 +/- 7.9). Interestingly, the total score was not significantly different between parents of children with refractory and nonrefractory epilepsy or parents of children with comorbid or without comorbid conditions. Selection of the individual item disbelief, however, was significantly increased in parents of children with nonrefractory epilepsy, and selection of the item anger was significantly increased in parents of children with comorbid conditions. Parental coping styles were similar to those reported in the normative data for the instrument used, the Coping Health Inventory for Parents (CHIP). The correlation between chronic sorrow and coping was significant between the grief component of sorrow and Coping Pattern II of the CHIP. Implications for practice include earlier identification of parental feelings of sorrow and coping styles, which may contribute to a positive outcome.     

Camp experiences and attitudes toward epilepsy: a pilot study.

Most healthcare providers report anecdotally that a camping experience helps children and adolescents with chronic health conditions to develop more positive attitudes toward their condition. However, children's and adolescents' perceptions have rarely been studied systematically. This pilot study of 20 campers with epilepsy who were 8-16 years of age was undertaken to examine the effect of a camp experience on their attitudes toward epilepsy. Attitudes, measured by the 13-item Child Attitude Toward Illness Scale (CATIS), were assessed before and after the camp experience. No pretest or posttest difference in attitude toward epilepsy was found in the total group. However, when attitudes were examined by seizure frequency, there was a trend for those with more frequent seizures to report a more positive attitude after the camp experience. Issues in evaluating camp experiences for youth with chronic conditions are reviewed, and recommendations are made for a comprehensive camp evaluation. Nurses are encouraged to assist families whose child is challenged by more frequent seizures to consider a camp experience.     

Transition experience of parents caring of children with epilepsy: a phenomenological study

BACKGROUND: Families who have a child with epilepsy show a significant impact on both the dynamics of the child's development and family systems in a social context. Knowledge of a family's lived experience in dealing with the early stages of their child's illness will provide a deeper understanding of their life and coping process. Most studies have focused on the child's developmental issues, parental attitudes, coping strategies and the child's adjustment. In order to assist families to cope with the early stage of having a child with epilepsy, nurses need to understand the nature of a family's lived experience. OBJECTIVE: The purpose of this study was to investigate the essence of the family health-illness transition experience from the parental perspective when a child is afflicted with epilepsy. DESIGN: Colaizzi's phenomenological approach was used. In-depth interviews were conducted with ten couples with regard to the first one and a half years after the diagnosis of epilepsy. SETTINGS AND PARTICIPANTS: Ten couples from two medical centers in Taiwan participated in the study. The age range of the children at diagnosis was 0.2-4.3 years. METHODS: Open attitude and imaginative variation techniques were used to investigate the meanings of the experience. This study used Colaizzi's method with both destructured and restructured analysis. Lincoln and Guba's trustworthiness criteria were employed to evaluate methodological rigor. RESULTS: Three concepts emerged: parents' psychological reactions, parental coping patterns and family resources. The parents' psychological reaction was that of being emotionally traumatized and physically exhausted. Parental coping patterns were vigilant parenting and aimed at reframing roles, facing the social challenge and assisting the child's social re-integration. The nature of family resources was family resiliency. The findings provide a scientific knowledge base for nurses when assisting parents and children during the health to illness transitional phase following a diagnosis of epilepsy.     

Satisfaction with care: a study of parents of children with congenital heart disease and parents of children with other diseases

AIM: We compared parents of children with congenital heart disease (PCCHD, n=1092) with parents of children with other diseases (PCOD, n=112) regarding satisfaction with their children's care (SCC). We also examined the association between parental/patient characteristics and SCC. METHOD: The parents completed a questionnaire about such areas as satisfaction with care, children's health status, and financial situation. The design was cross-sectional and data were gathered over 20 consecutive days. RESULTS: The univariate and multivariate analyses showed that PCCHD were more satisfied with their children's medical care and waiting period for treatment of their ill children than PCOD, although the difference was only modest. Furthermore, mothers were less satisfied with staff attitudes than fathers, with the lowest satisfaction among mothers of children with CHD. However, the multivariate analysis indicated that less satisfaction with care was more associated with decreasing child age, unemployment, financial burden of disease, social isolation and psychological distress than with children's diseases, their severity and parental gender. CONCLUSION: We corroborated some previous findings and may have provided new insights regarding determinants of SCC among parents. Interventions to improve SCC may need to address issues of parental psychological distress, socialization, and financial burden of illness. Possible ways of achieving this are discussed. Finally, research in a longitudinal format is needed to further scrutinize determinants of parental SCC.     

Identifying and relating nurses' attitudes toward computer use

The purpose of this study was to measure nurses' attitudes toward computer use based on an adaptation of Vroom's expectancy theory, and identify variables that may correlate with these attitudes. Content validity and reliability for internal consistency were determined for the developed attitude questionnaire. Nurses' individual characteristics and computer-use satisfaction, beliefs, and motivation were correlated. Data analysis revealed that nurses' attitudes were significantly related (satisfaction to beliefs, r = 0.783, p less than 0.001; satisfaction to motivation, r = 0.598, p less than 0.001; and beliefs to motivation r = 0.651, p less than 0.001), supporting the model based on Vroom's expectancy theory. Computer knowledge significantly related to computer-use beliefs (r = 0.229, p less than 0.05). Length of computer experience (r = -0.265, p less than 0.05) and nursing experience (r = -0.239, p less than 0.05) related negatively to nurses' computer-use satisfaction.     

The relationship between death anxiety and attitudes toward the elderly among nursing staff.

The purpose of this study was to investigate the relationship between death anxiety and attitudes toward the elderly among nursing staff in nursing homes. Questionnaires were distributed to all 310 full-time nursing staff members in six nursing homes; 159 usable questionnaires (51 percent) were returned. The self-administered packet consisted of Templer's Death Anxiety Scale to determine high and low death anxiety groups. Palmore's Facts on Aging Quiz to identify positive or negative attitudes toward the elderly, and a self-developed demographic data questionnaire. A t-test was used to compare the mean attitude toward the elderly scores of the high and low death anxiety groups. Nursing staff with high levels of death anxiety had significantly more negative attitudes toward the elderly than nursing staff with low levels of death anxiety (t = 2.52; p. less than .01). A correlation coefficient was also used to analyze the relationship between death anxiety and attitudes toward the elderly for the entire study sample. The relationship was significant (r = -.21; p less than .007). Findings indicated no significant differences in death anxiety or attitudes toward the elderly when compared with various demographic variables.     

The effect of knowledge on nursing students' attitudes toward individuals with AIDS

The purpose of this study was to determine if increased knowledge changes nursing students' attitudes toward individuals with AIDS. A pretest/post-test design was used to administer a questionnaire, developed and validated in the United States, and adapted for use in this study. Subjects were total population of first to fourth year baccalaureate undergraduate nursing students attending a 1-day AIDS workshop. Questions dealt with knowledge and fears concerning AIDS and caring for AIDS patients, and attitudes toward homosexuality and toward the terminally ill. With the level of significance set at (p less than .05), post-test results indicated that all groups of students displayed a knowledge gain (p = .000) and a more positive attitude toward caring for AIDS patients (p = .001), particularly by e, first and third year students (p = .001). Although positive, younger students and students who had cared for AIDS patients were less positive. In this study, AIDS education had a positive influence on attitudes of nursing students. This finding supports the use of education to foster positive attitudes toward AIDS and individuals with AIDS.     

Parental coping and activities during pediatric critical care.

OBJECTIVE: To investigate the relationship of locus of control, parental age, and state anxiety to parental coping and activities performed during hospitalization of a child in a pediatric critical care center. DESIGN: Cross-sectional. SETTING: Pediatric critical care center at a university medical center. PARTICIPANTS: A convenience sample of 47 parents of 47 children hospitalized in a critical care center. MAIN OUTCOME MEASURES: Parental coping strategies and activities performed during hospitalization in a critical care center. RESULTS: Older, more self-directed and less anxious parents were found to use coping strategies focusing on problem solving rather than on their emotional response to a child's hospitalization. Further, those who used the problem-focused coping modes were more likely to be involved in caring for the child, while parents who used emotion-focused coping modes participated less in care activities. CONCLUSIONS: Appropriate strategies to bolster coping and reduce stress of parents need to be constantly reassessed because coping mechanisms vary according to parental age, locus of control, anxiety level, and parental involvement in child-care activities. More research is needed in the changes of parental coping mechanisms with time and child-care activity, to assess the benefits of interventions planned to encourage a problem-focused approach.     

Readiness for discharge in parents of hospitalized children

Parental preparation for a child's discharge from the hospital sets the stage for successful transitioning to care and recovery at home. In this study of 135 parents of hospitalized children, the quality of discharge teaching, particularly the nurses' skills in "delivery" of parent teaching, was associated with increased parental readiness for discharge, which was associated with less coping difficulty during the first 3 weeks postdischarge. Parental coping difficulty was predictive of greater utilization of posthospitalization health services. These results validate the role of the skilled nurse as a teacher in promoting positive outcomes at discharge and beyond the hospitalization.     

Evaluation of a conceptual model based on Mishel's theories of uncertainty in illness in a sample of Taiwanese parents of children with cancer: A cross-sectional questionnaire survey

BackgroundThe prognoses of childhood cancers have improved over the last few decades. Nevertheless, parental uncertainty about the absolute cure and possible relapse pervades the entire illness trajectory. Despite illness-related uncertainty is significantly related to psychological distress, continual uncertainty may serve as a catalyst for positive psychological change and personal growth in the context of surviving cancer.ObjectivesThe purpose of this study was to examine a conceptual model that depicts coping and growth in Taiwanese parents living with the continual uncertainty about their child's cancer. The conceptual model was guided by Mishel's theories of Uncertainty in Illness. The impact of the child's health status, parents’ education level and perceived social support on parental uncertainty was analyzed. The mediating effect of coping as well as the influence of parental uncertainty and parents’ perceived social support on growth through uncertainty was incorporated in the model testing.MethodsThis study involved a sample of 205 mothers and 96 fathers of 226 children enrolled in a longitudinal cancer study in Taiwan. This study only analyzed the data collected at baseline. A cross-sectional design was utilized to examine the relationships among proposed variables. Parental uncertainty and growth through uncertainty were measured by the translated questionnaires originally developed by Mishel. Parents’ perceived social support and coping were measured by culturally sensitive instruments developed in Taiwan.ResultsThe full research model and its alternative models fit adequately to the data via structural equation modeling tests. Parental uncertainty and parents’ perceived social support were associated with growth through uncertainty which was mediated by coping. Child's health status and parents’ perceived social support would significantly predict parental uncertainty.ConclusionThis study suggests that parental uncertainty has negative impact on coping strategies such as interacting with family members while these coping strategies may help Taiwanese parents gain growth through uncertainty. Coping strategies of searching for spiritual meaning and increasing religious activities were not significantly influenced by parental uncertainty in this study. The two coping strategies may be relevant to growth through uncertainty due to Taiwanese cultural belief. Moreover, the availability of social support promotes growth through uncertainty by its impact on lowering parental uncertainty and encouraging more coping. The findings indicate that Taiwanese parents may gain growth through uncertainty while experiencing their child's cancer. The research model provides possible guidelines for oncology nurses to deliver more culturally competent health care for Taiwanese parents of children with cancer.     

Optimism, anxiety, and coping in parents of children hospitalized for spinal surgery

Optimistic expectations about outcomes have significant implications for behaviors. Knowing the role that dispositional optimism plays in parents' anxiety and coping responses during their child's surgical experience is essential to aid professionals in bolstering parents' coping and providing support. Parental optimism, anxiety and coping, and whether optimism moderated (changed) the anxiety-coping relationship preoperatively and postoperatively were the factors evaluated in this study. Parents (N = 60) primarily white of middle and upper middle class, were administered the Life Orientation Test to assess optimism, Spielberger's State Anxiety Scale and the Ways of Coping Questionnaire. Parental anxiety decreased significantly from preoperative to postoperative levels but remained high, indicating that parents continue to be emotionally distressed during their child's recovery. Reappraising the situation more positively (positive reappraisal) was the most often used emotion-focused coping strategy and seeking social support was the most often used problem-focused coping strategy. The preoperative and postoperative anxiety-coping relationships also depended on parents' levels of optimism. The use of emotion-focused coping strategies was not effective for reducing anxiety in highly optimistic parents. Recommendations include continually assessing the parents' need for reassurance and support throughout the surgical experience. Professionals can bolster parental coping by stressing the benefits of surgery and encouraging parents to be actively involved in the child's care and progress.     

Sexuality of the aged and the attitudes and knowledge of nursing students

Sexuality of the aged is one area of particular concern to nurse educators, because students' lack of knowledge and negative attitude can have far-reaching effects on nursing care of the elderly. This study examined the relationship of the dependent variables, attitude and knowledge, to the independent variables of ethnicity, age, experience in health care, family income, religious affiliation, religiosity, living arrangements, and level of education. One hundred fifty-eight female nursing students completed White's Aging Sexuality Attitude and Knowledge Scale. The study found that higher knowledge was related to more positive attitude scores (r = .25, P less than .004). Age was also significantly related to both positive attitude (r = .44, P less than .001) and higher knowledge (r = .54, P less than .001). Older students had a more positive attitude toward the elderly and were more knowledgeable about aged sexuality than younger students in the sample. One-way analysis of variance was used to test the significance between means of the dependent and independent variables. A statistically significant difference was found between ethnicity and attitude (f = 33.09, P less than .001) and ethnicity and knowledge (f = 18.36, P less than .001). Asian students in this study had a more negative attitude and were less knowledgeable about aged sexuality than Caucasian students. The study suggests that nurse educators need to pay special attention to the age and ethnicity of students when planning gerontological learning experiences designed not only to facilitate knowledge acquisition, but to promote positive attitudes toward the elderly.     

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.     

Facilitating attitude change toward the handicapped

Measurement in the shift of 424 normal children's perceptions of their handicapped peers was determined following their exposure to structured learning experiences of what it would be like to be handicapped. Attitude development and approaches used for attitude change are described. Significant positive shifts were found in children's perceptions of their handicapped peers' play capabilities, intelligence level, and self-concept. Attitudes toward mainstreaming remained unchanged. It is suggested that a viable receptivity exists in normal children's attitude development. The role of the occupational therapist in facilitating positive attitudes is discussed.     

Development of the PAAI as a Measure of Attitudes of Parents with Preschool Children Toward Substance Use and Abuse

Because parents have a major impact on their preschool children's development, the study of parental attitudes is crucial to understanding substance abuse behavior. This study examined the reliability of an instrument to measure attitudes of parents with preschool children regarding substance use and abuse. The sample consisted of a lower to middle socioeconomic, racially diverse population of 101 parents of preschool children. The Parent Attitude Assessment Instrument (PAAI) measured parents' attitudes toward substance use and abuse, parental role modeling, and substance abuse prevention with preschool children.     

Education of children with epilepsy and their parents by the modular education program epilepsy for families (FAMOSES)--results of an evaluation study

PURPOSE: The aim of the study was to evaluate the efficacy of the modular educational program for children with epilepsy and their parents (FAMOSES). This program was developed by an interdisciplinary project group to improve knowledge, coping, treatment outcome, emotional and practical adaptation to the condition. METHODS: A prospective, controlled, multi-center, pre-post study design was used to examine the efficacy of the program in the treatment group compared to the waiting group (control group). Questionnaires included epilepsy specific scales regarding knowledge, attitudes, restrictions in daily living, epilepsy related fears, coping with the chronic disease and generic instruments (quality of life, KINDL). 55 parents of the treatment group completed the questionnaires three months before the course and three months later; the corresponding waiting group included 48 parents. Respectively, 31 children, who participated in the program, completed the questionnaires immediately before the course and three months later; the corresponding waiting group included 19 children. RESULTS: Children, who attended the program, showed improvements in the domains perceived restrictions (significant, medium effect size), absence from school and seizure frequency. Not significantly greater compared to the control group were the improvements of knowledge, attitudes and fears regarding to the epilepsy. Parents of the treatment group showed significant enhancements in epilepsy specific knowledge (large effect size), attitudes toward the epilepsy, management of epileptic seizures and significant reductions of fears and restrictions of their child with epilepsy (small to medium effect sizes).