Children at risk of injury

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

Quality of Life in Pediatric Patients with Cystic Fibrosis

In order to assess quality of life, we administered the Child Health Questionnaire (CHQ) to 43 pediatric patients diagnosed with cystic fibrosis (CF). Statistical analyses demonstrated that girls with CF perceive themselves to have better general health and report greater optimism regarding their future health than do boys with CF. Findings also revealed that age negatively correlated with general health perception, such that patients report worse general health as they become older. In addition, we administered the parent version of the CHQ to one of each patient's parents for the purpose of comparing their perceptions to those of their children. Results indicated that in each of the domains assessed parents perceive their children to experience greater impairment than that reported by patients. Finally, comparisons of parents' perceptions of the quality of life (QOL) of their children with CF versus parents' perceptions of the QOL of their children who have other chronic illness revealed variable patterns of impairment.     

Parenting stress and parents' willingness to accept treatment in relation to behavioral problems of children with attention-deficit hyperactive disorder

The purpose of this research was to explore parenting stress and parents' willingness to accept treatment in relation to the behavioral problems of children with Attention-Deficit Hyperactive Disorder (ADHD). A total of 100 subjects, either fathers or mothers of children with ADHD, were recruited by convenience sampling from southern Taiwan. The results of this research were: (1) the standardized score for parents' perception of the behavioral problems of their ADHD children was 67.09. (2) The standardized score for parents perception of parenting stress was 62.00. (3) The parents who were most willing to accept treatment were those in the parent training group. (4) The behavioral problems of ADHD children were significantly related to parenting stress (p .001). (5) ADHD children's behavioral problems and parental self-awareness of psychological and emotional problems were the two variables most influential on parenting stress, and recognition of the pathological cause was the most influential factor in willingness to accept treatment. Through this research we also found that the parents hoped that a parent training group would be established. Therefore, nursing personnel can try to develop parent training groups in order to relieve parents' parenting stress.     

The quality of parental consent for research with children: a prospective repeated measure self-report survey

BACKGROUND: Researchers have ethical and legal responsibilities to ensure that individuals give informed consent to participate in research. The few studies of parental consent for paediatric research suggest there may be inadequate competence, information, understanding, or voluntariness for valid consent to occur. OBJECTIVES: To determine parents' level of understanding of the research study requirements and satisfaction with the informed consent process. PARTICIPANTS: English literate parents of children actively involved in research studies. METHODS: A repeated measures self-report survey was conducted to measure parent understanding (actual and perceived) of the study consented for and satisfaction with the informed consent process. Relationships between parents understanding of the research and their satisfaction with the consent process were explored and changes in parent understanding or satisfaction over time were described. RESULTS: Questionnaires from 109 parents were returned, representing 25 different studies. Parents demonstrated a high level of knowledge of information essential for informed consent, such as the purpose, benefits, and participant rights. Nervousness or inability to concentrate, and reading ease of the information sheet were found to relate to parents' knowledge and their perceptions of the adequacy of the consent. Parents overall reported high satisfaction with the consent process. CONCLUSIONS: These findings support and extend previous research on parental consent for research with children. They suggest areas where further research is indicated, including: the value and use of information and consent documents given to parents, the views and concerns of parents for whom English is not their first language, and further exploration of the concerns of the few dissatisfied parents. Current practices of obtaining informed consent for research lack supporting research evidence and may not be ethically justifiable.     

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

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

Parents' support and satisfaction with their child's postoperative care

It is recognized that parents' presence during their child's hospitalization is of benefit to the parents and the child. However, the level of parental involvement in their child's care may be influenced by many factors, such as the amount of support nurses provide for parents. This article reports on two themes from the findings of a larger study on parental involvement in children's postoperative pain management - parental support and parents' satisfaction with their child's postoperative pain management. The aim of the larger study was to explore both nurses' and parents' perceptions of parental involvement in their child's postoperative pain management. The methods used were both qualitative and quantitative. The qualitative method of phenomenology was used to guide 20 nurse and 20 parent interviews. Quantitative methods involved surveying the nurses and parents on their perceptions of how supportive the nurses were towards the parents. The charts of 20 children were reviewed for pain-related data. This article reports on the issues of parent support from the results of the survey, and on satisfaction relating to their child's postoperative pain management from the parent interviews. The findings demonstrated that nurses perceived that parents were receiving more support from them than that which parents felt they were receiving. Parents were more satisfied with their child's pain management and children received more analgesia when they were cared for by a lower grade nurse.     

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.     

Evaluation of a clinic-based parent education program to reduce the risk of infant and toddler maltreatment

Community-based parent education programs are a common component of service plans for abusive and potentially abusive parents. Despite their widespread use, few studies have evaluated the effect of such programs to change actual parenting behavior even though this is a key intervention goal. The purpose of this study was to evaluate whether a relatively brief and inexpensive clinic-based education program could benefit parents of infants and toddlers by alleviating parental stress and improving parent-child interaction. Participants were 199 parents of children 1 through 36 months of age who were at risk for parenting problems and child maltreatment due to serious life stress including poverty, low social support, personal histories of childhood maltreatment, and substance abuse. Program effects were evaluated in terms of improvement in self-reported parenting stress and observed parent-child interaction. Positive effects were documented for the group as a whole and within each of three subgroups: two community samples and a group of mothers and children in residential drug treatment. Additional analyses illustrated a dose-response relationship between program attendance and magnitude of gain in observed parenting skills.     

Parent perspectives of occupational therapy using a sensory integration approach.

This qualitative study explored parents' points of view regarding their children's participation in occupational therapy using a sensory integration approach. Data were collected through parent interviews and were analyzed using grounded theory methods. The parents' perceptions of the benefits of therapy for their children were categorized into three interrelated constructs: abilities, activities, and reconstruction of self-worth. For themselves, parents valued understanding their children's behavior in new ways, which facilitated a shift in expectations for themselves and their children, having their parenting experience validated, and being able to support and advocate for their children. Implications for family-centered intervention and future research are proposed.     

Bereaved parents' outcomes 4 to 60 months after their children's deaths by accident,suicide, or homicide: a comparative study demonstrating differences

In this article, the authors revisit a controversial issue in the bereavement field: Does one violent cause of death of a child influence parents' outcomes more than another? To address this question, we observed 173 parents prospectively 4, 12, 24, and 60 months after their children's deaths by accident, suicide, or homicide. Quantitative and qualitative research methods were used to examine the influence of three types of a child's violent death and time since death upon 4 parent outcomes (mental distress, post-traumatic stress disorder [PTSD], acceptance of the child's death, and marital satisfaction). The results showed a significant interaction for the bereavement Group x Time effect for acceptance of death, a significant main effect for time for all four outcomes, and a significant main effect for group (homicide) for PTSD. Nearly 70% of the parents reported that it took either 3 or 4 years to put their children's death into perspective and continue with their own lives; however the child's cause of death did not significantly influence parents' sense of timing in this regard. Clinical and research implications of the findings are discussed.     

Children's postoperative pain at home: family interview study

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

Parents' perceptions of their newborn following structured interactions

A study of 57 married couples and their normal-term firstborn infants investigated (a) if parents' perceptions are related to behavior of infants and (b) if a structured interaction of parent with infant positively influences parents' perceptions of their infant. Mothers, fathers, or parents in three experimental groups participated in a structured interaction with their infants. Parents and infants in a control group received no structured interaction. The interaction consisted of the parents assessing their infant using the Mother's Assessment of the Behavior of Her Infant (MABI). Infants' behaviors were measured with the Neonatal Behavioral Assessment Scale (NBAS) and parents' perceptions with the Neonatal Perception Inventories (NPI). There was no relation between infant behavior and parental perception. The factor structure of NBAS items was similar to that found by other investigators. The structured interaction differentially affected perception scores of mothers at Time 2 (F 3, 53 = 3.96, p = .013). Perceptions of mothers and fathers achieved some congruence over time (Time 1, r = .18, p = .189; Time 2, r = .45, p = .001; Time 3, r = .41, p = .002). Seven other variables contributed more to variance in mothers' than fathers' perceptions.     

Children's feelings toward parents in the context of parental disability

The purpose of the study was to examine the influence of parents' disability on children's feelings toward their parents. The paper focuses on the comparison of children's feelings toward their parents among school-age children with disabled parents (research group, n=45) and without disabled parents (control group, n=46). A two-dimensional approach was used. This approach is based on the assumption that positive and negative dimensions coexist relatively independently, rather than being polar opposites. The results show that positive and negative feelings toward parents coexist among most of the children in both the groups, but the general intensity of feeling toward parents and the discrepancy between the positive and the negative feeling were higher in the research group than in the control group. The research group was found to express more positive and ambivalent feelings and fewer negative and indifferent feelings than the control group. Moderator effects of age on these feelings in both groups were found as well. The implications of the research findings are discussed and future research is recommended.     

A study of the effectiveness of a pain management education booklet for parents of children having cardiac surgery.

Parents need education about pain so they can support their hospitalized child and manage their child's pain at home. The purpose of this study was to examine the effectiveness of a pain booklet on parental pain support to children experiencing postoperative pain. A randomized, repeated measures, experimental design using a pain education booklet and a standard care comparison group was used to study parents of 51 children (3 to 16 years of age) having cardiac surgery. Measurement techniques used to assess differences in parental pain management included: attitudes about pain medication, child and parent pain ratings (Oucher), opioids used, recovery, satisfaction, and comfort in communication. Results indicate that children do report moderate levels of pain postoperatively. Parents who were exposed to the pain assessment and management for parents education booklet preoperatively significantly increased their knowledge and attitudes toward pain medication scores from pre- to post-test, whereas those in the control group remained stable. Post-test scores were not significantly different between groups. Child and parent pain ratings were significantly and positively correlated. Practice implications include the use of an educational booklet about pain with parents before surgery to increase their knowledge about and attitudes toward pain management. Additionally, a parent may provide an alternative pain report when a child is unable to or unwilling to self-report their pain.     

Parents' perceptions of staff competency in a neonatal intensive care unit

* The aim of this study was to explore and describe parents' perceptions of staff competency in a neonatal intensive care unit (NICU). The study set out to use a grounded theory approach that was modified because of a number of constraints. Eight parents whose babies met a number of inclusion criteria were interviewed using focused conversational interviews. They were then transcribed and thematically analysed. The research approach was modified as the study developed because of practical and ethical access reasons: the sampling strategy and lack of opportunity to exploit fully the constant comparative method. * Four key themes which conceptualize competency as caring emerged from the data: parents are facilitated to integrate into the unit and do not feel a burden; parents feel in control whilst in the unit; parents have a choice to opt out from observing tasks and procedures on their baby; parents and the interprofessional team communicate well and provide appropriate information. These are discussed in the context of available literature. * In conclusion, the results of the study serve to highlight how parents' perceptions of competence in a professional are not based solely on skills and tasks but on many caring behaviours. The grounded theory approach has generated a number of areas for exploration, in particular, ideas about the conceptual basis of caring in an NICU context and its links to competence. The caring behaviours involve learning to share responsibility with families. The findings suggest that when there is 'a handing over' of control to parents and a greater emphasis on parent support, they feel less like 'guests'. These ideas are supported by the available literature. A number of methodological issues are raised.     

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.