The ups and downs for children with chronic illnesses

Children with chronic illnesses have the same basic need for preventive care as their healthy peers. In Michigan a Medicaid Physician Sponsor Plan was established to provide that care for this special population. Incentives and barriers for both physicians and families were identified as well as the advantages to providing care in a managed care delivery system.     

Exercise and sports for children with specific chronic illnesses

Participation in sports activities as a team member has become an important developmental childhood task. This article provides specific guidelines for sports participation of children with convulsive disorders, asthma and allergies and insulin-dependent diabetes mellitus.     

Discontinuing treatment in children with chronic, critical illnesses

Decisions about optimal treatment for critically ill children are qualitatively different from those related to adults. Technological advances over the past several decades have resulted in myriad treatment options that leave many children chronically, critically ill. These children are often technology dependent. With new technologies and new patient populations comes the responsibility to understand how, when, and why these technologies are applied and when technology should not be used or should be withdrawn. Much has been written about ethical decision making in the care of chronically, critically ill adults and newborns. In this article, relevant factors about the care of children older than neonates are described: standards, decision makers, age of the child, and pain management. A case study is used as a mechanism to explore these issues. Dimensions of futility, discontinuing aggressive treatment, and a consideration of benefits and burdens are integrated throughout the discussion to inform nurse practitioner practice.     

Compliance with chronic illness regimens: school-aged children and adolescents

More chronically ill school-aged children and adolescents are surviving into adulthood due to recent medical advances and modern technology. However, noncompliance rates are higher among adolescents than adults. Noncompliance is costly, can lead to complications, and may be life-threatening. Several models of compliance are discussed. Variables described in recent research as related to noncompliance (personal, family, and illness factors) are discussed. Those factors that emerged as most important in adolescent compliance were self-esteem, social functioning, and perceived autonomy. It appears that psychological needs may compete and conflict with the need for adherence to illness regimens in adolescence.     

Self-concept: comparison between school-aged children with congenital heart disease and normal school-aged children

Aims and objectives. The aim of this study was to evaluate and compare the self‐concept of school‐aged children with congenital heart disease to those of normal school‐aged children. The primary objective was to analyse results of the Self‐Concept Scale questionnaire administered to children with congenital heart disease aged 9–12 years. Sixty‐four children with congenital heart disease (study group), and 71 without congenital heart disease (control group), completed the questionnaire. Background. Little attention has focused on school‐aged children with congenital heart disease who are in the important stages of developing self‐concept. Results. The mean score on the Physical self‐concept of the Self‐Concept Scale was significantly lower for the study group than the control group (P < 0.05). No significant differences were observed between children with congenital heart disease and normal children in terms of family self‐concept, school self‐concept, appearance self‐concept, emotional self‐concept and general self‐concept for the Self‐Concept Scale. Conclusions. Nurses should use the study findings to encourage positive self‐concept development and improve their patient education about physical activity before the child is discharged. Thus, children with congenital heart disease could leave the hospital with a clear understanding of their body and condition, and how it affects daily life. Relevance to clinical practice. The results of this study may provide more holistic views on self‐concept for clinical nurses working with children who have congenital heart disease and their families and for school nurses working with elementary school children.     

Health-related hardiness in individuals with chronic illnesses

The aims of this study were to (a) describe health stressors, health-related hardiness, perception of illness impact, self-perception of health status, and psychosocial adjustment to illness in individuals living with an inherited bleeding disorder; (b) determine relationships between health stressors, health-related hardiness, perception of illness impact, self-perception of health status, and psychosocial adjustment to illness; and (c) determine if perception of illness impact had a direct and/or mediating effect on the relationship between health stressors, health-related hardiness, and self-perception of health status and psychosocial adjustment to illness. A cross-sectional survey design was used. Sixty participants composed the sample. Participants completed five questionnaires. Higher health stressors were associated with higher perception of illness impact, lower perception of health status, and poorer psychosocial adjustment to illness. Individuals with higher perception of illness impact were associated with lower self-perception of health status and poorer psychosocial adjustment to illness.     

Responding appropriately to patients with chronic illnesses

A significant proportion of the population lives with chronic illness and nurses are likely to come into contact with these patients on a regular basis. However, health professionals do not always recognise or respond supportively to such patients. This article explores some of the negative responses that occur and suggests more appropriate ways to work with this group of patients.     

Leisure participation for school-aged children with Down syndrome

Purpose.?To describe leisure participation for school-aged children with Down syndrome and to investigate how factors, classified by the World Health Organisation's International Classification of Functioning, Disability and Health, influence their leisure participation.

Method.?Families in Western Australia with a child aged 5–18 years with Down syndrome were surveyed in a population-based study (n == 208) in 2004.

Results.?One-third of parents reported that their child with Down syndrome had no friends although half reported two or more friends. Factors affecting number of friendships included the child's functional ability, behavioural issues and parent's availability of time. Those children with higher functional independence scores in daily tasks were more likely to have two or more friends than those with lower functional independence scores (OR: 1.02, 95%% CI 1.01–1.04 for a single point increase in WeeFIM score). All children participated in predominantly solitary and sedentary leisure activities.

Conclusions.?Leisure participation was affected by complex factors both within and external to the child with Down syndrome. Further investigation of the relevance of these factors to leisure may enable more satisfying and meaningful participation in leisure for school-aged children with Down syndrome.     

Comparison of health-related quality of life among 10- to 12-year-old children with chronic illnesses and healthy children: the parents' perspective.

The purpose of this study was to evaluate mothers' and fathers' perception of their child's health-related quality of life (HRQOL) among 10- to 12-year-old Icelandic children with or without chronic health condition or illness. A total of 912 Icelandic parents (510 mothers and 402 fathers) and 480 children (209 boys and 271 girls) participated in the study. The Icelandic fathers of children who visited the school nurse over a period of 1 week perceived HRQOL of their children to be significantly lower than the mothers. A gender difference was found between the parents; mothers perceived their children to have significantly higher school functioning than fathers. Both mothers and fathers of children with chronic health condition/illness perceived their children to have significantly lower HRQOL than did the parents of children without a chronic health condition. The findings underline the importance for school nurses to develop and test interventions for school-age children with chronic health conditions or illnesses.     

Friendships and social interactions of school-aged children with migraine

We set out to evaluate the friendships and social behaviour of school-aged children with migraine. Concern exists regarding the impact of paediatric migraine on daily activities and quality of life. We hypothesized that children with migraine would have fewer friends and be identified as more socially sensitive and isolated than comparison peers. Sixty-nine children with migraine participated in a school-based study of social functioning. A comparison sample without migraine included classmates matched for gender, race and age. Children with migraine had fewer friends at school; however, this effect was limited to those in elementary school. Behavioural difficulties were not found. Middle-school students with migraine were identified by peers as displaying higher levels of leadership and popularity than comparison peers. Concern may be warranted about the social functioning of pre-adolescent children with migraine; however, older children with migraine may function as well as or better than their peers.     

学龄期恶性肿瘤患儿结束化疗后的心理体验

目的:探讨学龄期恶性肿瘤患儿结束化疗后回归家庭和社会的心理体验.方法:采用目的抽样法,选取2019年6月至2020年12月结束化疗后3～12个月的10例学龄期恶性肿瘤患儿进行半结构式访谈,应用colaizzi现象学7步分析法分析资料.结果:通过聆听、交谈、分析和提炼,归纳出学龄期恶性肿瘤患儿结束化疗后来院复查的复杂心情...     

Predictors of resourcefulness in school-aged children

Children need to develop appropriate cognitive-behavioral repertoires to maintain mental health and prevent depression. Resourcefulness is learned throughout life in the context of one's environment. However, environmental or situational factors and individual factors in children's development of resourcefulness have not been studied. This study examined the effects of the situational factors of family context (one or two parents, and number of siblings) and maternal characteristics (employment, learned resourcefulness, and adaptive functioning), and individual (child) factors (gender, academic performance, and automatic thoughts) on learned resourcefulness in school-aged children. A convenience sample of 122 fifth and sixth graders was recruited from four public schools. The child's automatic thoughts and maternal resourcefulness were predictors of child's resourcefulness. Further research is needed to examine additional factors that may promote resourcefulness in school-aged children, so that appropriate nursing strategies can be implemented.     

The effects of camp on health-related quality of life in children with chronic illnesses: a review of the literature.

Chronic illness in children may negatively affect aspects of health-related quality of life (HRQL). Over many years, camps have been organized to address the physical and psychosocial needs of children with various chronic illnesses, while providing a "normal" as possible camp experience. The aim of this study was to critically review all research examining the effect of camps on HRQL in children with chronic illnesses. The literature review yielded no randomized, controlled clinical trials; 8 pretest-posttest study designs with repeated measures; 9 pre-post studies; and 1 survey design. A total of 1270 children, ranging in age from 6 to 25 years, participated in the studies.