Cooperation between parents and school nurses in primary schools: parents' perceptions

Introduction: Cooperation between pupils’ parents and school nurses is an important part of health promotion in primary schools. Developing frank and trusting relationships contributes to easy and uninhibited cooperation. Cooperation between parents and school nurses has not been widely researched internationally. Aims: This article reports on parents’ views on cooperation with school nurses in primary schools. The study aims at contributing to school nurses’ work so that instead of focusing only on the children, family nursing approaches could be improved. Methods: Nineteen parents from 13 families from southern Finland were interviewed for the study in 2004. The data were analysed by grounded theory and the constant comparative method was utilized. Findings: Six concepts describing parents’ views on cooperation were generated on the basis of the data. Cooperation consists of supporting the child’s well‐being. School nurses take children’s and parents’ concerns seriously and intervene effectively if the child’s health is threatened. School nurses’ expertise is not very visible within school communities. Hoping to receive information and desiring parental involvement are important concepts of cooperation with the school nurse. The child’s family is not sufficiently known or taken holistically into consideration when the child’s health is promoted. Parents are the initiators of cooperation within school health care and parents describe this by the concept of one‐sided communication. Conclusions: Parents do not know about school nurses’ work and school health services. They would like to be more involved in school nursing activities. When developing children’s health services, parents’ expertise in their children’s well‐being should be paid more attention. This study enhances the knowledge of family nursing by describing Finnish parents’ perceptions of cooperation with school nurses. The findings facilitate the understanding of cooperation in school health services.     

家长对幼儿意外伤害的认知及防护能力的调查分析

目的探讨家长对幼儿意外伤害的认识程度及其防护能力与幼儿意外伤害发生率的相关关系。方法采用非实验设计的描述性相关性研究方法,对广州市东山区的120名幼儿的家长应用自编调查问卷调查家长对幼儿意外伤害的认知及防护能力进行问卷调查。结果120名幼儿意外发生率为66．7％,其中67．5％的意外伤害发生于家中,引起意外伤害发生的前2位原因是跌伤和烧烫伤。85％的家长接受安全教育的机会贫乏,对幼儿意外伤害的认知不够全面以及意外伤害防护措施不够完善。家长对幼儿意外伤害的认知程度及日常防护能力与幼儿意外伤害的发生率均呈负相关关系,对幼儿意外伤害的防护能力呈正相关关系。结论幼儿意外发生率较高,家长对幼儿意外伤害的认知及防护能力还有待加强;提高对儿童意外伤害的认知程度可以促进其对儿童安全防护能力,进而可以降低儿童意外伤害的发生率。     

Being there: parenting the child with acute lymphoblastic leukaemia

Aims and objectives. To gain insight into the lived experience of parenting a child with leukaemia during treatment. Background. Diagnosis of leukaemia in children leads to an existential shock for parents and a reversal of normal family life. Today, in the Netherlands, after diagnosis, children stay at home most of the time. Therefore, their parents face considerable responsibilities for administering home‐based treatment and for the support of their child during illness and treatment. Methods. A grounded theory study was undertaken at a Dutch University Hospital and involved one‐time individual in‐depth interviews with 12 mothers and 11 fathers (n = 23) of 12 children. Findings. ‘Being there’, was identified as the core concept. It means: ‘I’ll be there for you; I will never let you down’. ‘Being there’ is described as a parental response to the perceived vulnerability of the child and the parental need to give meaning to parenthood. It serves two purposes: protection and preservation. Protection means guarding the child against the negative aspects of illness and treatment. Preservation refers to the way parents influence the child’s perception of his/her life, thus contributing to his/her coping and willingness to undergo treatment, to maximise the chances for survival. Six aspects were identified: a trusting relationship, presence, emotional support, advocacy, routines and rituals and effacing oneself. Conclusions. The concept provides a theoretical frame for parenting the child with cancer. It clarifies the actions and reactions of parents and increases insight into the underlying force that enables parents to provide continuing care despite their personal burden. Relevance to clinical practice. The concept offers an essential insight into parenting the child with acute lymphoblastic leukaemia and has relevance for nursing practice and education. Understanding of the concept would improve the ability to understand, communicate and work pro‐actively in partnership with parents.     

Negotiation of parental roles within family-centred care: a review of the research

Aims and objectives. To review research published in the past 15 years about how children's nurses’ negotiate with parents in relation to family‐centred care. Background. Family‐centred care is a basic tenet of children's nursing and requires a process of negotiation between health professionals and the family, which results in shared decision‐making about what the child's care will be and who will provide this. The literature highlights inconsistencies in the degree to which nurses are willing to negotiate with parents and allow them to participate in decisions regarding care of their child. There is need to explore further the extent to which nurses communicate and negotiate shared care with children and their parents. Conclusions. Three themes emerged from this review of the literature relating to whether role negotiation occurred in practice, parental expectations of participation in their child's care and issues relating to power and control. Parents wanted to be involved in their child's care but found that nurses’ lack of communication and limited negotiation meant that this did not always occur. Nurses appeared to have clear ideas about what nursing care parents could be involved with and did not routinely negotiate with parents in this context. Relevance to clinical practice. For family‐centred care to be a reality nurses need to negotiate and communicate with children and their families effectively. Parents need to be able to negotiate with health staff what this participation will involve and to negotiate new roles for themselves in sharing care of their sick child. Parents should be involved in the decision‐making process. However, research suggests that a lack of effective communication, professional expectations and issues of power and control often inhibit open and mutual negotiation between families and nurses.     

Mommy first

Parents of children with special health care needs are often required to assume responsibility for the complex care of their children. It is important for pediatric nurses to remember these parents are, first and foremost, the child's parents and primarily responsible for loving their child, providing a safe and secure home, and fostering their child's development as a person. Pediatric nurses should support the parents in the medical/nursing care of their child in whatever way possible so the parents have more time to parent. This account from a mother of a child with developmental delay helps remind us of our need to help support parents in being "parents first."     

A pedagogical framework for facilitating parents’ learning in nurse–parent partnership

Nursing work increasingly demands forms of expertise that complement specialist knowledge. In child and family nursing, this need arises when nurses work in partnership with parents of young children at risk. Partnership means working with parents in respectful, negotiated and empowering ways. Existing partnership literature emphasises communicative and relational skills, but this paper focuses on nurses’ capacities to facilitate parents’ learning. Referring to data from home visiting, day‐stay and specialist toddler clinic services in Sydney, a pedagogical framework is presented. Analysis shows how nurses notice aspects of children, parents and parent–child interactions as a catalyst for building on parents’ strengths, enhancing guided chance or challenging unhelpful constructs. Prior research shows the latter can be a sticking point in partnership, but this paper reveals diverse ways in which challenges are folded into learning process that position parents as agents of positive change. Noticing is dependent on embodied and communicative expertise, conceptualised in terms of sensory and reported channels. The framework offers a new view of partnership as mind‐expanding for the parent and specifies the nurse's role in facilitating this process.     

Emergent admission to the pediatric intensive care unit: parental concerns

To identify parental concerns when a child is suddenly admitted to the pediatric intensive care unit, 17 parents of ten critically ill children were interviewed using a structured format between 20 and 36 hours after admission about their concerns around the time of admission and at the time of interview using the Parental Concerns Scale. The individual concern items receiving the highest ratings were the child's survival, the possibility of mental or physical impairment, the child's diagnosis, and the amount of pain experienced by the child. Total concern scores decreased over time for both mothers and fathers when the child's prognosis was good and, for mothers only, when the child had an infectious illness rather than accidental injuries. Implications for nursing practice are discussed.     

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations

Title. Solution‐focused conversations: a new therapeutic strategy in well child health nursing telephone consultations Aim. This paper is a report of a study to explore well child nurses’ perceptions of outcomes resulting from the use of solution‐focused conversations in their telephone consultations with clients. Background. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem‐solving approach used to address physical issues is less effective for various non‐physical concerns, where different communication strategies may be helpful. Method. In this qualitative, action‐oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called ‘solution‐focused conversations’, during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. Findings. The nurses considered that the solution‐focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. Conclusion. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution‐focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.     

Pediatric liver transplant patients’ transition to adulthood: Patient and parent experiences

This qualitative research study describes the experiences of child and adolescent liver transplant recipients and their parents during the patients’ transition to adulthood. Data were collected from pediatric liver transplant recipients and their parents during individual interviews, and these were later analyzed using conventional content analysis. Seven main themes emerged: coping, self‐management, body image, social relationships, academic life, work life, and live donors. Study results revealed that the patients who received liver transplants during their childhood and adolescence used both effective and ineffective strategies to cope with the difficulties they faced during the transition period into adulthood. The parents experienced many problems: on learning of their child's need for a transplant, parents were advised that they should consider becoming a live donor. This very difficult decision was a source of great stress and required serious consideration. After transplantation the parents wanted their children to have autonomy but could not encourage them because of concerns for their health.     

Parental influence on models of primary prevention of cardiovascular disease in children.

BACKGROUND: Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children. OBJECTIVE: To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children. METHODS: Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002. RESULTS: Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender. CONCLUSIONS: A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.     

Parent perceptions of the psychological functioning of their children diagnosed with pediatric motility disorders and that of family members.

The aim of our study was to characterize the parental perceptions of the behavioral and emotional functioning of their children and families coping with gastrointestinal motility disorders. The American Pseudo-obstruction and Hirschsprung's disease Society sponsored an educational meeting for parents of children afflicted with a variety of pediatric gastrointestinal motility disorders. During the conference, parents completed a questionnaire pertaining to the behavioral and emotional functioning of the afflicted child and other family members. Parents perceived that the child's illness was more difficult on the parents than on the affected child or their siblings. Also, parents perceived support from professionals, family, and friends increased after the children were diagnosed with pediatric gastrointestinal motility disorders. Parents worried most about the health and medical management of their afflicted child. The most common behavioral problem of the afflicted children was fear of separation, whereas the most common behavioral problem of their siblings was jealousy. The majority of referrals to mental health professionals resulted from parental emotional problems or marital discord.     

Developing a conceptual model of pediatric inpatient safety accidents: A mixed methods approach

Given that injuries to children during periods of hospitalization can lead to more serious health conditions in vulnerable children, preventing pediatric inpatient injuries should be a priority for the pediatric health care profession. This study was conducted to develop a conceptual model of factors affecting pediatric inpatient safety, including all injuries, not just fall injuries, in pediatric units. An explorative sequential mixed methods design was used. Qualitative interviews were conducted with 13 nurses working in pediatrics units and 17 parents of hospitalized children, and then 200 nurses in pediatrics units and parents of hospitalized children completed a self‐report questionnaire. Based on the integration of both qualitative and quantitative data using building and weaving narrative integration, the Pediatric Inpatient Safety Accidents (PISA) model was proposed. The PISA model contains two main domains, the immediate and mediating domain and encompasses the six factors explain of the elements affecting the occurrence and prevention of pediatric inpatient safety accidents. The PISA model can serve as a model to understand child accidents in hospitals as well as to plan customized nursing interventions to prevent child accidents.     

Transition to early parenthood,and family functioning relationships in Japan: a longitudinal study

Greater knowledge of the process by which postpartum parents acquire further awareness of their child and fulfill parental roles will likely lead to an understanding that creates a new approach to nursing. This study explored the transition to parenthood and the relationship between parenthood and family functioning in first‐time mothers and fathers. Seventy‐eight parents (41 mothers, 37 fathers) participated in the study and completed the Scale of Early Childrearing Parenthood and Family Assessment Inventory at birth and at 1, 3, 6, and 12 months postpartum. The levels of parental role attainment and awareness of the child rose dramatically between birth and 3 months postpartum, thereafter stabilizing up to 12 months postpartum. Parenthood and family functioning showed a moderately positive correlation, which gradually became more positive over time. Appropriate nursing interventions might be necessary for parents who show difficulty in accepting their parental roles and have low levels of awareness of their child after 3 months postpartum. Such intervention might be necessary for not only the parents, but also the family unit.     

Wonders and worries of parenting a child with Asperger syndrome & nonverbal learning disorder

PURPOSE: To describe the prevalent joys and pressing concerns of parents of children with Asperger syndrome (AS) and nonverbal learning disorder (NLD). DESIGN AND METHODS: An exploratory study of written responses of 103 matched couples from survey data gathered in a larger study that examined the parental experiences of raising a child with AS and NLD. Participants were recruited from two national Internet Web sites for parents of children with AS and NLD. Data were qualitatively analyzed to develop categories and themes. RESULTS: Prevalent joys of mothers and fathers included child characteristics such as personality traits of the child, observing their child happy, and watching him/her grow, mature, and succeed. Parents' most pressing worries focused on adulthood and the future of their child. CLINICAL IMPLICATIONS: The findings of this study can inform the care given by nurses in the pediatric, family, and mental health settings. Family nurses are in a unique position to assess and respond to the special adaptive needs of families of children with learning disorders such as AS/NLD. As part of routine health screening and well-child visits, providers can ask about the joys and assess the beliefs and worries parents have; this could lead to reinforcement of their strengths and motivations and better meeting of their needs.     

Home Visitors' Beliefs and Practices Regarding Childhood Injury Prevention

Abstract Injuries are the leading cause of death for children under age 19. Prevention efforts focus on eliminating hazards or changing individuals' behavior. Few interventions address psychosocial factors that contribute to injuries. Home visiting programs target families' functioning and help parents overcome barriers that inhibit their readiness and ability to address injury prevention. This study, a telephone interview with 87 public health nurses and social workers, assessed home visitors' preparedness to address childhood injury prevention, their practices and factors influencing their ability to undertake injury prevention activities. Results showed that 41% of home visitors talked to parents about injury prevention during visits. To identify hazards, most visitors (81%) assessed the home environment as they did other things: 51% never used a home safety checklist. Most home visitors discussed hot water temperature (82%). smoke detectors (76%), and firearms (50%). To respond to hazards, most relied on verbal education. Other priorities and time constraints were major barriers to injury prevention activities. Home visitors' beliefs in the importance of injury prevention and willingness to implement strategies suggest that home visiting can be an effective delivery strategy for injury prevention. It is imporatant to consider how to include, in a systematic manner, injury prevention in home visitor training.     

家长参与护理对小儿内科患者治疗依从性和睡眠质量的影响分析

目的:研究家长参与护理对小儿内科患者治疗依从性和睡眠质量的影响.方法:选取2018年1 月至2019年1 月厦门市妇幼保健院儿内科一区收治的小儿内科患者60例作为研究对象,随机分为观察组和对照组,每组30例,对照组给予常规护理,观察组在常规护理的基础上加入家长参与辅助护理,比较2组患儿不同护理模式下治疗依从性与睡眠质量的变化情况.结果:观察组患儿与对照组患儿在住院过程中对诊疗的配合度分别为96.67%,80.00%;观察组患儿与对照组患儿护理后睡眠质量评分分别为(5.25 ±0.28)分,(8.55 ±0.76)分;2组患儿的依从性与护理后睡眠质量评分比较,差异有统计学意义(P<0.05).结论:家长参与护理作为常规护理的辅助手段能够帮助小儿内科患者治疗依从性的提高及睡眠质量的改善,值得借鉴推广.     

The needs of parents of pediatric oncology patients during the palliative care phase

The death of a child is considered one of the greatest stresses a parent can experience. It has been suggested that death from childhood malignancies is more stressful for parents than death due to other chronic diseases. The purpose of this qualitative study is to identify parents' perceptions of their needs while their child was dying of cancer. Twelve parents of eight children, who died of various types of cancer 1 to 3 years ago, were interviewed by the primary investigator. These children died either in hospital or at home. Interviews were tape recorded, transcribed and analyzed by the investigators. Three needs were identified: (1) The need to have the child recognized as special while retaining as much normality within the child's and family's lives as possible; (2) The need for caring and connectedness with health care professionals; and (3) The need to retain responsiblity of parenting their dying child. Findings suggest that parental needs are similar regardles of where the death occurred. Implications for nursing practice and areas for further research were identified.