Firearm ownership among female physicians in the United States

BACKGROUND: Physicians have been called upon to counsel patients about firearm safety, but the personal prevalence of firearm ownership among physicians is poorly established. METHODS: We examined responses to the question "Do you keep a gun/firearm in your home?" from the Women Physicians' Health Study, a nationally representative survey of US female physicians (n = 4,501). RESULTS: Among female physicians, 16.5% reported having a firearm in their homes. Those who were older, married, practicing in a rural region, and residing in the South Central or Mountain states were more likely to report having a firearm in the home. Emergency medicine specialists, Protestants, physicians reporting a history of depression, and those on call more than six times per month were also more likely to report keeping a firearm in their home. Female physicians residing on the East Coast, Hindus, and Jews were least likely to report keeping a firearm in the home. CONCLUSIONS: In the United States, the proportion of female physicians who report having a firearm in the home was about half that reported by other women and one third that reported by men. This observation may have important implications for encouraging female physicians to counsel their patients about firearm ownership and storage.     

Guns in the home: nurses' roles

Firearms in the home are an increasing concern for parents and health professionals alike. A number of professional groups have begun to speak out about firearm safety and children. Both the American Academy of Pediatrics (AAP) and the Society of Pediatric Nurses (SPN) have position statements on the issue. The AAP recommends that pediatricians incorporate questions about guns into patient histories and also urge parents who possess guns, especially handguns, to remove them from the home. The SPN (1998) says that "[p]ediatric nurses, employed in a variety of settings, have the opportunity to educate parents and children about gun violence and prevention of firearm injuries." Nurses and other professionals can easily access information and strategies to address firearm safety with families. See Table 1 for a list of resources that are available online.     

Parental perceptions of the preschool obese child

Childhood obesity is a serious public health problem today with many potential complications and adverse outcomes for children. How parents view their children's weight is an important consideration for nurses. The purpose of this study was to increase staff understanding of parents' views so that interventions could be developed to achieve improved outcomes in attenuating the rate of weight gain in obese children. A questionnaire was administered to 200 parents, mostly Hispanic, of obese children to determine the parents' perceptions of their child's obesity. The study revealed that 35% of parents did not believe their obese child was overweight and 53% had no problem controlling what their child eats. However, 78% of parents expressed concern about heart disease as a consequence of childhood obesity. The study demonstrated that parents acknowledge some health risks of obesity but that interventions in treating childhood obesity need to begin with the understanding of parents' perceptions of their own child's obesity.     

Children with Developmental Disabilities and Sleep Problems: Parental Beliefs and Treatment Acceptability

Background This exploratory study investigated the relationships between illness beliefs and treatment acceptability among parents of children with a developmental disability living at home who had sleep onset or maintenance problems. Materials and Methods A within‐subject correlational design was employed. The parents of 58 children each completed questionnaires assessing their beliefs and attributions towards the sleep problem and the acceptability of two common treatments (behavioural and melatonin). Results Parents believed sleep problems to be chronic, to have negative consequences, yet to be potentially curable/controllable. They rated behavioural treatment and melatonin similarly in terms of acceptability. Behavioural treatment acceptability was related to how long parents believed the sleep problem would last and to a number of causal attributions. The acceptability of melatonin was related to how severe the consequences of the sleep problem were believed to be and to a specific causal attribution. Parents who preferred melatonin to behavioural treatment believed that their child’s sleep problem had more negative consequences on their child’s life. Conclusions Specific beliefs held by parents about their child’s sleep problems might influence treatment acceptability and treatment choice. Parents are split between those who would prefer behavioural treatment and those who would prefer melatonin. However, as the sleep problem becomes more severe, it seems more likely that parents would choose the pharmacological treatment.     

Parent or nurse? The experience of being the parent of a technology‐dependent child

AIMS: This paper reports a study exploring parents' experiences of caring for a child who is dependent on medical technology, and in particular of performing clinical procedures on their own children. BACKGROUND: A group of children with a continuing need for the support of medical technology have emerged in community settings as a result of medical advances and government policies. Caring for these children has a significant social and emotional impact on parents, because of their specialized and intensive care needs. Obtaining appropriate and coordinated home support services is problematic. METHODS: Grounded theory techniques were used, and in-depth interviews were conducted with the parents of 24 children. FINDINGS: Parents' accounts revealed that their constructions of parenting were shaped by the nature of their role in caring for their child and by the transformation of their homes by medical equipment and personnel. They described themselves as having a role that had both parenting and nursing dimensions. Parents managed this tension and defined their role and relationship to their child to be primarily one of parenting by differentiating parental care-giving and its underpinning knowledge from that of professionals, particularly nurses. CONCLUSIONS: Parenting a technology-dependent child alters the meaning of parenting. Professionals need to recognize that providing care has a substantial emotional dimension for parents, and that they need opportunities to discuss their feelings about caregiving and what it means for their parenting identity and their relationship with their child. A key professional nursing role will be giving emotional support and supporting parents' coping strategies. Parents' perceptions of nurses raise questions about whether nurses' caregiving is individualized to the needs of the child and family, and whether parental expertise is recognized.     

Parents' perceptions of their child's acute pain experience

Painful procedures, experienced by many pediatric patients early in their admission, have been identified by parents in our clinical practice as a source of stress. The purpose of this study was to examine parents' perceptions and concerns about their child's acute pain experience. A convenience sample of 71 parents of 62 children was given a questionnaire that focused on the child's pain intensity, the behaviors that indicated the child was in pain, and the parents' preparation for and involvement in the child's pain experience. The majority of parents were asking for more information about and greater participation in procedures that caused their child pain.     

Comparing Psychological Adaptation to having a Disease Gene in Affected Individuals and Unaffected Carrier Parents

Health care professionals are in an ideal situation to help families inform their children about genetic conditions. In families where there is a child with a known genetic condition, parents make decisions about when and how to convey information to their children, however, little is known about how parents make these decisions. The purpose of this qualitative analysis was to examine parents' beliefs and strategies related to sharing information with their children. The sample consisted of 139 parents of children with sickle cell disease, phenylketonuria, cystic fibrosis, Marfan syndrome, neurofibromatosis, hemophilia, and von Willebrand disease. Audio recorded, semi-structured interviews were transcribed verbatim, processed, and coded using the ATLAS.ti software. Thematic analysis found: parents share information and develop specific strategies within a context of normalizing the child's life; parents' decisions to share information are based on a developmental framework; parental strategies for sharing information with children may differ when the child has a potentially life-limiting genetic condition. Findings emphasize the need to use a family developmental perspective when working with families of children with genetic conditions. These findings will provide new information about how families manage information and provide direction for care of families in which a child has a genetic condition.     

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。     

Continuity of care and caring: what matters to parents of children with life-threatening conditions

This article presents parents' perceptions regarding continuity and coordination of care of children with life-threatening conditions as revealed through qualitative analysis of interviews with 36 bereaved parents of children who died after receiving care at three geographically dispersed teaching hospitals in the United States. Parental concerns about and experience of continuity of care were framed primarily in terms of the quality and continuity of relationships with healthcare providers throughout a child's illness and death and the continuity and consistency of information that they received about their child's condition and care. Continuity in relationships was perceived as key in ensuring that clinicians knew and cared about the child and parents, which in turn contributed to parents' confidence that their child would receive the best possible care. In the absence of continuous, caring relationships with staff, parents reported frustration, hypervigilance, and mistrust about the quality of care that their child received.     

Optimism bias and parental views on unintentional injuries and safety: improving anticipatory guidance in early childhood

The purpose of this integrative literature review is to improve anticipatory guidance in early childhood by reviewing the influence of optimism bias on parents' views about safety and beliefs about their children's risk for unintentional injuries. This article reviews the theory of optimism bias and recent research utilizing optimism bias to explain parental health-related behaviors. The three articles in this literature review find a link between optimism bias and parents' failure to implement safety behaviors. Currently, there is no tool to measure a parent's level of optimism bias concerning the risk of unintentional injury to his or her child. It is important for primary care providers to try and identify optimism bias in parents and address it as a barrier to implementation of safety recommendations. More research should be dedicated to developing screening tools to identify optimism bias in parents and interventions to help them accept their children's vulnerability.     

Parental guidance and counselling by doctors and nursing staff: parents' views of initial information and advice for families with disabled children

This paper describes changes that have taken place, over a period of 10 years, in the way physicians and nursing staff in Finland give initial information and advice to the parents about their child's disability. It also discusses the association between quality of information given and parents' feelings of insecurity or helplessness. In the study, we compared the experiences of parents of older (aged 12-17) disabled children with those of parents with younger (aged 7-9 years) disabled children. There were 85 children, whose disabilities were either learning or physical, or, in a few cases, both. Parents completed a questionnaire and were interviewed by a social worker. According to these reports, the initial information and advice received by the parents with younger children about their child's disability and its treatment, and on coping with the child at home, was better than that received by the parents of the older children. The parents of the younger children also reported feeling better prepared to take care of their child. Those parents who reported having received little information and practical advice on coping with their child at home experienced feelings of insecurity and helplessness five times as often as those who were satisfied with the information and advice.     

The experience of stress in parents of children hospitalized with long-term disabilities

This paper discusses parents' perceptions of their stress when their children are hospitalized with long-term disabilities. The study used a qualitative method. Data were collected with 40 parents through in-hospital interviews, and were analysed using the method of constant, comparative analysis. Parents' own interpretation of their stress experience is considered in relation to their perception of their role. The data suggest that the hospitalization of a child requires parents to make changes in their usual parenting role. In describing the nature of the changes required, parents identified the need to understand the illness experience; become familiar with the hospital environment; adapt to their changing relationship with the child and other family members; and negotiate with health professionals about their child's care. Verbatim accounts are used in this paper to illustrate parents' interpretations of their hospital experience. Parents perceive their role in their hospitalized child's care differently than health professionals do, and it would appear that much parental stress is attributable to the 'space' between health care workers' understanding of parents' experience, and parents' own comprehension. If nurses understood parents' own perception of their hospital-related stress better, more effective nursing care could be developed. Further research is needed in this important area.     

Parents' perceptions of their 1-6-year-old children's pain.

BACKGROUND OF THE STUDY: Parents' perceptions of children's pain may have influence on how children's postoperative pain is alleviated at home after discharge from hospital. PURPOSE OF THE STUDY: To describe parents' perceptions of 1-6-year-old children's pain. METHODS: Mothers (N=201) and fathers (N=114) whose child had undergone a day surgery in 10 Finnish central hospitals between October 2000 and September 2001 filled in a questionnaire including statements of pain perceptions, a Visual Analogue Scale to assess children's pain intensity and Parents' Postoperative Pain Measure (PPPM) to measure children's pain behaviours. RESULTS: Most of the parents suggested that adults have the responsibility to alleviate child's pain and that alleviation of child's postoperative pain prevents the child's fears during future visits in child welfare clinic. However, majority of parents described that postoperative pain decreases every day or that pain is always a part of surgery. Differences in parents' perceptions were found by both parents' and children's background variables. Parents' perceptions of children's pain were related to children's pain intensity and pain behaviours after surgery. CONCLUSIONS: Parents' perceptions of children's pain were related to children's pain after surgery at home. Adequate information of children's pain should be provided to the parents before discharge to promote children's pain alleviation at home. Special attention should be paid on parents' expectations of boys' higher pain tolerance.     

Are we getting it right? Parents' perceptions of hospice child bereavement support services

OBJECTIVE: To determine parents' experiences and perceptions of a support service for families with bereaved children, provided by a UK charity for cancer patients in seven hospices in the UK. METHOD: Individual interviews with 25 purposively selected parents. RESULTS: Parents used the service for: advice and reassurance; support for their children while they grieved; and advice on ameliorating behavioural difficulties at home and school. Non-service users did not think formalised support was necessary or had other sufficient support. Nevertheless, important to parents in both groups was that the service existed so their children's needs were being or could be addressed. Children and their parents benefited from talking to a non-family member, and being involved in social events that reduced feelings of isolation. CONCLUSION: The hospice child bereavement service was offered as an integral part of palliative cancer care support. Future research could explore collaborative work between counsellors and other professionals.     

Parental views from rural Cambodia on disability causation and change

Purpose.?This study explored the beliefs of Cambodian parents of children with cerebral palsy regarding disability causation and their perceptions of the effectiveness of interventions in bringing about change in their child.

Results.?Beliefs around disability causation were mixed, with equal numbers of participants attributing their child's disability to biomedical causes as to traditional causes incorporating elements of Theravada Buddhism, animism and Brahmanism. While many participants had initially sought traditional interventions for their child, few found them to be effective and most had subsequently utilised medical and rehabilitation services. Parents whose children were moderately or severely impaired perceived both traditional interventions and rehabilitation to be less effective than parents of children with mild impairments. Participants generally judged the effectiveness of interventions based on functional changes in their child.

Conclusions.?The complexity of Khmer belief systems was reflected in the range of participants' perceptions of the cause of their child's disability, yet beliefs around disability causation did not appear to have determined their care-seeking behaviour or their perceptions of effectiveness of interventions.     

Firearm-related personal and clinical characteristics of US medical students

BACKGROUND: Firearm injuries are the second leading cause of fatal injury in the US, and several medical specialty societies encourage patient counseling about firearm injury prevention. Because personal choices. influence physicians' willingness to counsel, it would be valuable to know how frequently guns are kept in the homes of physicians-in-training, as well as their perceptions and current rates of counseling about firearm injury prevention. METHODS: At a nationally representative sample of 16 medical schools, we surveyed the class of 2003 at freshman orientation, entrance to wards, and during senior year. RESULTS: A total of 2,316 students provided data (response rate = 80.3%). Among freshmen, 16% reported living in a home with a firearm, 13% did so at entry to wards, as did 14% of seniors (14% overall, women = 9%, men = 19%). Only 34% of seniors reported counseling their patients more often than "never/rarely" about firearm possession and storage. CONCLUSIONS: US medical students reported substantially lower rates of household gun ownership than the general population, but their participation in firearm-related counseling is also low.     

An examination of the needs of parents of hospitalized children: comparing parents' and staff's perceptions

The needs of parents of hospitalized children have received some attention in the health literature, but few studies have compared parents' perceptions of needs with staff's ideas about parents' needs. The aim of this study was to examine differences between the perceptions of the needs of parents of hospitalized children held by staff - nurses, doctors and allied health staff, and parents in a 150-bed paediatric hospital in Sweden. The convenience sample comprised 132 staff - nurses, doctors and allied health staff and 115 parents of children admitted to all the wards except intensive care. Kristjánsdóttir's "needs of parents of hospitalized children" questionnaire (NPQ) was the instrument of choice and was modified slightly for use with staff. Results indicated significant differences in perceptions of the importance of different needs of parents, of how well they were being met in the hospital and how much help the parents needed to have them filled. Differences between parents' and staff's perceptions of the importance of parental needs were found in areas relating to psychosocial needs, but in general, in that hospital, the needs were being adequately met. The main differences between staff's and parents' results were in the degree of independence shown by parents in requiring help to have their needs met. This demonstrates either that parents are much more independent than appraised by staff, or, that parents are sometimes unaware of the level of assistance available.     

A descriptive study of the extent to which self-perceived needs of parents are met in paediatric units in Iceland

The purpose of this study was to identify the extent to which parents of 2-12-year-old hospitalized children perceive their needs to be met in paediatric units, what variables influence parents' perception, and whether parents need help from the hospital to meet their needs. Parents perceived that most of their needs were met fully or to some extent. The need to be able to stay with the child 24 h a day was perceived as fully met by all parents. Needs perceived as important but poorly met were as follows: written information about the child's health status, information about financial assistance and follow-up after discharge. Independent variables identified as being related to the extent to which individual needs were met were as follows: parents' age (p < or = 0.05), distance between home and hospital (p < or = 0.05), parents' education (p < or = 0.05), length of hospital stay (p < or = 0.01) and severity of child's illness (p < or = 0.01). Most parents perceived that they needed help from the hospital to meet their needs. These findings call for identification of effective interventions to meet parents' needs.     

Parents' perceptions of care-giving to a child with attention deficit hyperactivity disorder: an exploratory study

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral childhood disorder in which parental care-giving is found very stressful. Limited qualitative research is found on their care-giving experiences. This study aimed to explore Chinese parents' experiences of care-giving to a child with ADHD at home. It was conducted at one Child and Adolescent Mental Health Unit in Hong Kong using qualitative exploratory approach. A purposive sample of 12 parents was recruited. Semi-structured interviews were conducted, each lasting about one hour. Content analysis was used to analyze the data. From the interview data, four themes were identified, including: concept of the illness, barriers to child care in ADHD, psychological effects in care-giving, and positive aspects of care-giving. The parents indicated a variety of life problems and health concerns in care-giving. The findings may help nurses understand the perceptions and barriers towards parental care of a child with ADHD in a Chinese population and consider parents' educational needs in care-giving.     

Co-sleeping as a window into Swedish culture: considerations of gender and health care

The purpose of this study is to examine the Swedish practice of co-sleeping and relate it to the cultural discourse on the gendered family and health. The Swedish study, part of the International Study of Parents, Children and Schools, focuses on some Western parents' ideas about health, child development, child-rearing goals and parental practices. It also addressed specific questions regarding parents' theories about the nature, gender and frequency of co-sleeping in Swedish families. Quantitative and qualitative data were collected with five cohorts of parents and their 60 children who ranged in age from 6 months to 8 years. The sample was balanced for sex and birth order. Parents completed batteries of standardized questionnaires and they were interviewed about their beliefs and practices related to child rearing and child development. A questionnaire about co-sleeping was sent post hoc to the families. The results showed that Swedish children often co-sleep with both their parents until school age, when more boys than girls cease the practice. This is an important finding, because much of the literature suggests that this practice exists primarily for infants in non-Western cultures who co-sleep with their mothers. Co-sleeping in Sweden is perceived as a normal family activity, which differed from the other societies studied. Thus, the study of practice has important methodological implications. When a family practice is studied, carefully documented and understood in its many dimensions, it provides a window into the culture in which the practice is embedded and may explain how gender relates to the practice. For health-care professionals who encounter families from diverse cultural backgrounds, this methodological approach illustrates how parenting practices relate to health-care issues.