Attitudes toward death education for young children

A state-wide study was conducted to determine early childhood educators' perspectives of death education for young children. The results of this study generally indicate that teachers are (a) convinced of the need for self-development, (b) willing to cooperate with parents of children who have experienced significant loss, (c) attempting to respond to children's concerns related to death, and (d) exploring the possibility of initiating a more systematic approach to death education as a component of the early childhood curriculum. There was no significant correlation between the respondents' attitudes and the variables of age, sex, race, teaching experience, income, religion, and education. Several experiences and concerns of early childhood educators are analyzed.     

Parental attitudes toward death education for young children

An exploratory study was conducted to ascertain perceptions of parents toward the role of early childhood educators in teaching young children about aspects of death education. A secondary objective was to contrast perceptions of parents with those of teachers toward death education for young children utilizing data from a previous study. Although parents of young children generally agreed with statements depicting the need for early childhood educators' self-development, communication with children, interaction with children's parents, and curriculum planning, they expressed significantly less support than teachers for death education as a part of early childhood education. Moreover, although parents acknowledged the importance of children acquiring an ecumenical understanding of and respect for others' beliefs about death, they did not wish teachers to share their personal philosophical or religious beliefs about death with young children. Parents also exhibited a more protective attitude than teachers relative to children's questions and expressed concerns about death.     

“Mister Rogers' neighborhood”: Dealing with death on a children's television series

Abstract

“Mister Rogers' Neighborhood,” the PBS children's television series, has provided a vehicle for death education. The program, produced in 1970 and repeated regularly, deals with some of the intellectual, emotional, and social aspects of death in a low-anxiety way. Mister Rogers discovered a dead goldfish in the tank, buried it, then discussed many childhood concerns about death in dialogue, songs, and through a puppet drama. This article outlines the primary considerations given in producing these segments. It also includes some dialogue from the programs and the reactions from some viewers.     

Concerns of Parents With Children Receiving Home-Based Pediatric Palliative Care

ContextCaring for a child who will die from a life-limiting illness is one of the most difficult experiences a parent may face. Pediatric palliative care (PPC) has grown as a specialty service to address the unique needs of children and families with serious illness. However, gaps remain between the needs of families in PPC and the support received.ObjectivesThe objective of this study was to explore the concerns of parents who have a child in home-based PPC.MethodsSemistructured interviews were conducted with 25 mothers and 10 fathers from 25 families shortly after their child's referral to home-based PPC. Children (57% male, M_age = 10.5 years, SD = 3.95, range = 4–18 years) had a range of diagnoses. Data were analyzed using inductive content analysis.ResultsParents' concerns clustered into four main themes: 1) ensuring that their child's remaining days were spent living well physically, emotionally, and socially; 2) uncertainty regarding their child's diagnosis, prognosis, and treatments; 3) their child's death (e.g., the process of dying and when it will occur); and 4) the family, including the impact of the child's illness and death on siblings and wanting to cherish as much time together with family as possible.ConclusionParents of children receiving home-based PPC expressed concerns across a range of domains, both about their seriously ill child and the broader family. These results highlight salient worries among parents of children in PPC and point to critical areas for intervention for seriously ill children and the broader family.     

Engaging Parents of Children Who Died From Cancer in Research on the Early Grief Experience

ContextBereaved parents provide an important perspective for improving care for patients and families throughout the illness and after a child's death. However, involvement of bereaved parents in research studies is fraught with concerns over inflicting psychological distress and issues with study recruitment. Data on research strategies to engage parents early in their bereavement are limited.ObjectivesTo describe involvement of bereaved parents in the development of a comprehensive survey, examine the response rates with varying recruitment strategies and describe participation experiences of parent participants.MethodsParents of children who endured the death of their child from cancer six to 24 months prior were invited to complete a 195-item survey examining their early grief experience.ResultsForty-nine of the 137 eligible parents from 36 different households completed the survey (response rate 36%). The respondents were predominantly white (N = 43; 88%), female (N = 32; 65%), and non-Hispanic (N = 43; 88%). The median length of time from child's death to survey completion was 11 months (range 7–26). Thirty parents (61%) indicated they were comfortable/very comfortable answering the survey, 40 (82%) answered that they experienced at least a little benefit from involvement, and 36 (73%) indicated they experienced at least some distress.ConclusionSome parents of children who died of cancer are willing to participate in research early in their bereavement, and although most experience some distress, they are comfortable answering questions about their experience and benefit from participation. Recruitment strategies including personal outreach may result in better response rates.     

Progeria: Medical aspects,psychosocial perspectives,and intervention guidelines

Abstract

This article discusses pogeria, a rare genetic childhood disorder that invariably results in the individual's death during early adolescence. The article begins by describing the major medical aspects of piogeria. This is, followed by a discussion of the psychosocial implications of the disorder with particular emphasis upon grief-triggered reactions. The article concludes with an overview, of psychosocial intervention guidelines for caregivers who work with, families of dying children and adolescents.     

Healthy Beginnings Trial Phase 2 study: follow-up and cost-effectiveness analysis

BackgroundIn 2007, we commenced the Healthy Beginnings Trial (HBT) Phase 1 study, which is the first randomised controlled trial (RCT) to test the effectiveness of an early childhood obesity intervention in children aged up to 2 years. The results were promising with significant improvements in infant feeding practices and a lower mean body mass index (BMI). The aims of this proposed Phase 2 study are to determine if the early intervention will lead to a lower mean BMI, lower screen time, improved dietary behaviours and demonstrated cost-effectiveness of the intervention, in children aged 3½ and 5 years.Methods/designIn Phase 1 of HBT 667 families participated in the RCT. No further intervention will be carried out in HBT Phase 2. In this study the intervention and control groups will be compared for children's outcomes at ages 3½ and 5 years. Primary outcome measures will be 1) BMI, 2) selected dietary measures using a validated survey tool, and 3) physical activity and screen time using a new generation of tri-axial accelerometers. Intention to treat principles will be used in the analysis. Multiple imputation will be used to impute outcomes for subjects lost to follow-up. A cost-effectiveness analysis (CEA) and cost-utility analysis for both HBT Phase 1 and 2 will also be conducted.DiscussionThis is the first time that a home-based early intervention strategy has been implemented to prevent the development of childhood obesity and obesity-conducive behaviours. The results of this trial will ascertain whether early intervention during the first 2 years of life is effective and cost-effective in preventing childhood overweight and obesity at 3½ and 5 years old.     

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUNDType 1 diabetes is one of the most common chronic diseases in childhood. The number of type 1 diabetes patients in China still ranks fourth in the world. Therefore, children with type 1 diabetes in China are a group that needs attention. The management of type 1 diabetes mellitus (T1DM) involves many aspects of daily life. It is extremely challenging for children and their families. T1DM children have complex medical care needs. Despite the continuous development of therapeutic medicine and treatment technologies, blood glucose control in children with T1DM is still not ideal. They and their parents need to acquire more knowledge and skills before being discharged.AIMTo explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness, quality of discharge education and blood glucose control level.METHODSIn total, 102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time. Fifty cases from February to June 2019 were selected as the control group, and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan. The Readiness for Hospital Discharge Scale, Hospital Discharged Education Quality Scale and children''s blood glucose metabolism indicators were used to compare the differences in discharge preparation, discharge education quality and blood glucose control between the two groups of children and their parents.RESULTSOn the day of discharge, the two groups of children had the following scores of readiness for discharge: The intervention group score was 225.34 ± 32.47, and the control group score was 208.68 ± 29.31. The P value was 0.007, and the difference was statistically significant. The discharge education quality scores were as follows: The intervention group score was 135.11 ± 19.86, the control group score was 124.13 ± 15.56, the P value was 0.002 and the difference was statistically significant. Three months after discharge, the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was (7.45% ± 1.04%), and that of the control group was (8.04% ± 1.27%), P = 0.012. Therefore, the improvement of parents'' readiness for discharge, quality of discharge education and blood glucose metabolism indicators (glycosylated hemoglobin, fasting blood glucose and postprandial blood glucose) in the intervention group were better than those in the control group (P < 0.05), and the difference was statistically significant.CONCLUSIONThe discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'' readiness for discharge, thereby improving children’s blood glucose control levels.     

Training maternal and child health nurses in early relational trauma: An evaluation of the MERTIL workforce training

BackgroundParents who experience relational trauma may inadvertently create contexts of care that undermine secure beginnings to life for their young children. Universal health services such as Maternal and Child Health (MCH) services offer a unique whole-of-population platform for prevention through early detection and intervention. To date however, relevant workforce training has been minimal.ObjectivesWe report on an evaluation of state-wide workforce training to support MCH nurses to identify and respond to early relational trauma within parent-child dyads.DesignProcess and learning evaluation data were obtained at baseline (N = 1450), exit (n = 734) and follow-up (n = 651).Settings and participantsSpecialist training was developed and delivered to 1513 MCH staff in Victoria, Australia, via a 20-hour program of online learning and clinical skills workshops.ResultsAt baseline, across eight measures of confidence in recognizing and responding to relational trauma, 30–49% of nurses rated their confidence as low. Significant increases in all areas of self-rated learning were found post-training. Three months post-training, gains in confidence and capability were sustained, with no significant variations by participant role or setting. Overall program satisfaction was >90%. Continuing concerns at follow-up focused on pragmatic concerns about inadequacy of referral networks and appropriate intervention pathways.ConclusionsIn this evaluation of a state-wide training program for nurses working with early relational trauma, we found excellent uptake and program satisfaction, and results support learning impact and retention. Findings are discussed with regard to translation potential across early childhood settings.     

Illness and death of a peer in a group of three-year-olds

Abstract

This paper details the experiences of teachers and children in a class of 3-year-olds following the illness and death of a class member. The children voiced many concerns as they tried to understand the relationship of Marjorie's illness and death to themselves and to their families. The teachers responded to this uneasiness in a variety of ways, always aware of the children's developmental needs and their conceptual understanding of death. The record of children's questions and comments is accompanied by a record of teachers responses, assessment of children's needs and rationale for choosing specific responses; providing an example for others to use in similar situations.     

A Review of: “Death and Grief: A Course for Nurses”

Abstract

The purpose of the study was to evaluate death attitude change among university students involved in a death education instructional unit within an introductory health education course. A quasi-experimental research design was employed. Pre-and post-tests of death attitudes, utilizing the Hardt Death Attitude Scale and the Watts-Andrews Death Attitude Questionnaire, were conducted in both the death education group (N = 39) and the control group (N = 40). A one-way analysis of covariance using pretest mean scores as the covariate showed significant posttest mean differences between the groups on both death attitude measures. Thus it was concluded that death-related attitudes can be favorably influenced as a result of a death education instructional unit within an introductory health education course.     

Impact of death education courses on emergency nurses' perception of effective behavioral responses in dealing with sudden death in China: A quasi-experimental study

BackgroundNurses in emergency departments have to provide rescue care and life support for moribund patients, but also emotional support to patients' relatives. On the other hand, emergency nurses are also the most vulnerable to the sudden death of patients. Nurses working in the emergency department were invited to participate in a death education course.ObjectiveTo explore the impact of a death education course on the emergency nurses' perception of effective behavioral responses in dealing with sudden death.DesignA quasi-experimental study.SettingsA level A tertiary general hospital in China.ParticipantsA total number of 34 emergency nurses who met the inclusion criteria were randomly selected from the emergency department.MethodsParticipants received a death education course of 20 credit hours based on dealing with a sudden-death model. The general data questionnaire and the Chinese version of the list proposed by Fraser & Atkins were completed before the intervention and six weeks post-intervention. The scores of each item in the effective behavioral response to the sudden death questionnaire of the emergency nurses before and after the intervention were compared.ResultsAfter the intervention, the nurses considered that 10 items were relatively helpful (above 4 points) and 2 items relatively less helpful (<3 points). The post-intervention average scores of all items were higher than the pre-intervention ones, and there were significant differences in the scores of the 13 items pre- and post-intervention.ConclusionThe death education course enhanced emergency nurses' perceptions of effective behavioral responses in dealing with sudden death, which contributes to the improvement of the quality of their work.     

The need to assess the impact of death education

Abstract

This paper focuses on the recent phenomenon of death education. Formal approaches to education in this field have been needed for a long time. Assessment needs by various groups are discussed, as are examples of death education inquiry and curricular concerns.     

Mentoring in nursing education: An essential element in the retention of new nurse faculty

BackgroundMentoring in nursing education is essential to retaining nurse faculty; whether they are new to academia or experienced, but new to the institution in which they teach. Furthermore, mentoring promotes awareness of faculty roles and responsibilities, decreases ambiguity and increases retention of qualified nurse faculty.PurposeThis study examined whether there was a relationship between nurse educator mentor's perception of their mentoring effectiveness and nurse educator mentee's perception of their mentor's effectiveness.MethodA Spearman's rho correlation was conducted on a convenience sample of 119 nurse educators who completed the Principles of Adult Mentoring Inventory (PAMI), which measured six core mentoring behaviors. A secondary analysis using an independent samples t-test was also performed.ResultsStatistically significant results were revealed in two of the six mentoring behaviors; relationship emphasis (p = 0.035) and confrontive focus (p = 0.043). The Mentor Role Competency Profile (MRCP), a measure accompanying the PAMI, indicated concerns that could be counterproductive within the mentoring relationship. A secondary analysis using a t-test confirmed concerns as identified in the initial analysis.ConclusionContinuous improvement and training are critical to acquiring and reinforcing effective mentoring skills. Requiring evaluation and follow up for mentors could result in increased satisfaction for both mentor and mentee and improve retention of new faculty in academia.     

“A stressful and frightening experience”? Children's nurses' perceived readiness to care for children with cancer following pre-registration nurse education: A qualitative study

BackgroundIn the UK children with cancer are cared for by children's nurses in a variety of settings, specialist and non-specialist. Whilst post-registration specialist education is available to some nurses, many nurses rely solely on pre-registration education to competently care for these children. This study explores whether nurses perceive that this adequately prepares them.ObjectivesTo explore the extent to which qualified nurses perceive that pre-registration nurse education prepares them to care for children with cancer; to consider the implications for children's nursing pre-registration curricula.DesignA small-scale qualitative study was undertaken using an interpretivist approach.MethodsSemi-structured interviews were conducted with six qualified children's nurses in two clinical areas - a specialist children's cancer inpatient ward, and a general children's ward where inpatients included children with cancer.ResultsFindings are discussed in relation to three emergent themes: Learning in Theory and Practice, Care of the Child and Family, and Resilience. Participants attached significance to the quantity and quality of practice experience. They reflected on barriers to specific and transferable theoretical learning and stressed the importance of integrating theory and practice. Understanding of family-centred care formed a significant part of their preparation. Preconceptions, communication with families and the emotional impact of this speciality were stressful. Improved pre-registration preparation may have developed participants' resilience.ConclusionThe complexities of caring for children with cancer and their families require well-prepared nurses. Participants' perceptions of preparedness were influenced by aspects of pre-registration education. Their experiences suggest that curricula should be practice-focused and include a range of placements. Specialist theoretical content must be integrated with practice and transferability of knowledge and skills made explicit. Reflection and problem-based learning may foster coping mechanisms and resilience that will equip them to care for children with cancer.     

Effects of a child bereavement training program for teachers

Abstract

A quasi-experimental design was used to evaluate a child bereavement training program for elementary and preschool teachers. The treatment group (n ? 10) received a four-hour workshop based on a model by Corr (1). When compared to a control group (n = 10), the treatment group gained significantly more knowledge of children's grief children's conceptions of death, and an awareness of teaching resources. No significant differences in comfort in discussing death with children was found between the two groups. Workshops that include skills training as well as knowledge were proposed as a way to increase teacher's comfort in discussing death with children.     

Examining knowledge and traditional practices of mothers with children under five in Turkey on diarrhoea according to education levels

BackgroundDiarrhoea still ranks among the top causes of the deaths of children under five years old in the world. In solving this important health problem, it is necessary and imperative to know the health-related knowledge levels of mothers who take care of the child individually and the traditional practices they perform when their children are sick, in order to provide effective health education.AimThis study aims to examine the knowledge levels and traditional practices of mothers with children younger than 5 years old regarding diarrhoea in relation to their education levels.MethodsWe conducted a cross-sectional web-based survey. The population of this cross-sectional study consisted of mothers with children under the age of 5 who lived in the metropolitan city Bursa in the South Marmara Region of Turkey. The survey was applied among the mothers of children under the age of 5 using the snowball sampling method via mobile platforms. The data were collected via Google Forms using a “Socio-Demographic Data Collection Form”, an “Information Form on Measuring the Knowledge Level of Mothers on Diarrhoea” and a “Form on Main Traditional Practices Used When Children Have Diarrhoea in Turkey” prepared by the researchers after a review of the relevant literature.ResultsIn the study, the mean total diarrhoea knowledge score of the participating mothers was found to be 22.01 ± 3.72 (high). Multiple linear regression analysis was used to determine the relationship between the total diarrhoea knowledge scores of the participants and other variables. The difference in the knowledge scores based on education levels was statistically significant (p < .001). The most prevalently preferred traditional practice in the case of children''s diarrhoea was “feeding the child banana” (92.5%).ConclusionMaternal education level is determined to be a significant variable that positively affects diarrhoea knowledge levels.

KEY MESSAGES

• Diarrhoea continues to be among the top five preventable causes of death in the world and Turkey among children under the age of 5.
• The knowledge level of mothers about diarrhoea plays an important role in diarrhoea management. The level of knowledge about diarrhoea differs according to the education level of mothers.
• Traditional practices have an important place in the management of diarrhoea by mothers.

     

Feeding swallowing difficulties in the first three years of life: A preterm and full-term infant comparison

ObjectiveTo assess the prevalence of feeding-swallowing difficulties (FSDs), and to examine which FSDs are the most common in young children.MethodsFSDs were defined as difficulties in sucking, food transitions, gastroesophageal reflux (GERD), food selectivity, salivary control issues, and poor growth. Mothers of children ≤3 years of age completed an online survey.ResultsTwenty-seven percent of our sample (n = 204) reported that their child experienced FSDs. Being born preterm increased the odds ratio of reporting an FSDs by 3.319. 10.90% of our sample reported having more than one FSD. GERD was significantly (p < .001) more reported than the other FSDs. Premature infants had significantly more sucking difficulties (p = .001), poor growth (p = .049), and received more early intervention (p = .033) compared to full-term infants.ConclusionFSDs are relatively common in early childhood (27%) with GERD being the most reported by parents. Preterm birth is a significant predictor of FSDs. These findings further motivate the need for more research on FSDs in childhood.