Quality assurance in day surgery: do we do enough for the parents to prevent stress?

In order to identify and analyse the factors associated with stress for the parents during day surgery, we performed a survey analysis of 568 parents whose children underwent surgery consecutively during an 18-month period. Of 368 parents who returned the questionnaire, (follow up rate=65%), 16% experienced the stress associated with day surgery as moderate to severe. The following factors had a significant positive association with the amount of stress: feeling of insufficient preparation (odds ratio; 95% confidence interval) 3.34 (1.36–8.26; P=0.002), insecurity in nursing care at home 3.36 (1.43–11.01; P=0.01), problems at home such as fever, vomiting, sleep disorders and others 3.15 (1.72–5.8; P=0.0007), problems with postoperative pain at home 2.43 (1.38–4.3); P=0.008), speaking a foreign language 2.28 (1.08–4.78); P < 0.0001) and no previous surgery 1.31 (0.76–2.27); P=0.03). Analysing these factors showed that often not the problems per se, but rather the insecurity in dealing with them contributed to the experienced stress. Conclusion In order to improve the quality of health care, more pronounced attention has to be given to the parents needs and expectations. Received: 5 January 1999 / Accepted in revised form: 23 June 1999     

A comparison of the effects of parental risk markers on pre- and perinatal variables in multiple patient cohorts with fetal alcohol syndrome, autism, Tourette syndrome, and sudden infant death syndrome: an enviromic analysis

The prevalence and magnitude of effect of individual risk markers for specific developmental disorders vary widely across diagnostic category. The four study cohorts for this project were patients from four diagnostic registries in North Dakota for fetal alcohol syndrome (FAS), autism, sudden infant death syndrome (SIDS), and Tourette syndrome. These four cohorts were used to estimate prevalence and magnitude of effect of parental risk markers in patients with developmental disabilities. Cases with North Dakota birth certificates were matched with controls. Using birth certificate data, we then examined five parental risk markers for each cohort and estimated direct and indirect effects for each risk marker by cohort. The authors found two significant paternal risk markers (age in SIDS and education in FAS). Significant maternal markers were age in SIDS, education in FAS, autism, and SIDS. Marital status was a significant risk marker in FAS. Effect sizes were estimated using paired t tests, odds ratios, and population attributable risk (PAR) for both direct and indirect effects for each marker. We estimated both direct and indirect effects to allow for direct comparisons of the differential effect estimates of each of these markers. The direct effect of parental markers differs across diagnostic cohorts of patients. Use of cohorts from similar denominator populations obtained from prevalence studies is a useful methodological tool for estimating the prevalence and magnitude of effect of risk markers.     

Small bowel capsule biopsy in children: parents' opinions on children's discomfort

This questionnaire study asked the parents of 62 children undergoing small bowel capsule biopsy for their reactions to the discomfort experienced by their children. The children were randomized to receive sedation with midazolam either intravenously or intranasally. With regard to the biopsy procedure the parents of 94% of the children had no objections. The parents of 3% of the children found the biopsy very unpleasant and another 3% suggested that the biopsy should be performed under general anaesthesia. The proportion of parents with negative reactions to the biopsy procedure did not differ significantly between the intravenously and intranasally sedated children. With regard to the sedation given, the parents of 79% of the children did not think that their children were in any discomfort at all. Ten percent of the children had obvious signs of nasal discomfort using the intranasal administration. In the remaining 11% of the children the parents reported various symptoms.     

浅谈家长参与听觉口语康复

近年来,听觉口语法的康复模式逐渐得到国内专业机构和家长的认可。随着这一模式的出现,家长的角色地位也在发生改变。本文从听觉口语法的原则出发,讨论了家长作为拥护者和伙伴参与听觉口语康复的重要意义。     

Assessment of mother and father concern in childhood hydrocephalus

Introduction Parental concern can play an important role in overall management of children with serious chronic illness. We quantitatively assessed the concerns of parents of children with hydrocephalus, using the Hydrocephalus Concerns Questionnaire for parents (HCQ-P). Methods Over a 12-month study period, parents of 332 children with hydrocephalus (mean age 11.7 years, SD 3.8) attending a routinely scheduled out-patient clinic at the Hospital for Sick Children, Toronto, completed the HCQ-P. Results HCQ-P scores were widely distributed, with mean maternal (N = 283) and paternal (N = 137) scores of 0.53 (SD 0.30) and 0.51 (SD 0.29), respectively (0 = least concerned, 1 = most concerned). Based on a multivariable regression model (adjusted R ² = 0.49), important associations with greater maternal concern were: Worse child cognitive health (p < 0.001) and worse child social-emotional health (p < 0.001). Identified important associations with greater paternal concern based on a multivariable model (adjusted R ² = 0.45) were: Worse child cognitive health (p = 0.03), worse child social-emotional health (p = 0.03), frequent child seizures (p < 0.001), younger child age at first surgery (p = 0.03) and having had an endoscopic procedure for the child’s hydrocephalus treatment (p = 0.04). Based on the adjusted multivariable models, less than 5% of parents were considered to have extreme levels of concern (either very high or very low). Conclusion This study confirms that parental concern is highly variable in this population. Much of the parental concern can be appropriately explained by child health factors.     

青少年及其家长生殖健康知识、交流技能培训效果评价

目的评估学生及其家长进行生殖健康知识、交流技能培训的效果。方法采用整群抽样方法选取天津市3所中学的初二学生及其家长分别进行生殖健康知识、交流技能培训,在培训前后采用定量和定性方法(问卷调查和焦点人群座谈)分别进行调查,并与对照组(家长未培训)进行比较。结果培训后,学生和家长的生殖健康知识、交流能力有明显提高,与对照组比较有统计学意义(P<0.05)。结论对青少年开展性与生殖健康教育的同时,组织家长进行性与生殖健康知识、、交流技能的培训效果更显著。     

初中生自我中心与父母教养方式的相关研究

目的探索初中生自我中心与父母教养方式的关系。方法运用自我中心与父母教养方式量表对276名初中学生进行调查。结果①初中生自我中心在性别、是否独生上均不存在显著差异。②初中生假想观众与父母过分干涉、过分保护呈显著正相关。③初中生的个人神话水平与父、母情感温暖理解,父亲偏爱有显著正相关。结论国内初中生自我中心与其父母教养方式之间存在密切关系。     

北京三家医院患儿家长抗生素知识的调查

目的：通过对患儿家长抗生素知识的调查,了解他们对抗生素知识的掌握情况。方法随机选取2011年8~10月在北京三家医院就诊的1500名患儿家长,进行有关抗生素知识的问卷调查,回收有效回卷1416份。结果被调查者中46.00%知道细菌感染时要用抗生素,34.20%认为病毒感染要用抗生素。儿童普通伤风感冒(鼻塞、流涕及打喷嚏)时,认为需要使用抗生素的人占16.83%,一般咽炎或扁桃体炎(非化脓性)时该比例为36.92%,气管炎时为51.13%,肺炎时为68.90%。男性家长与女性家长答题的正确率分别为41.27%、42.55%,两者相比无明显差异(Χ2=40.059,P=0.021)。三级医院与二级医院患儿家长的答题正确率分别为43.44%、40.52%。两者相比差异有显著性(Χ2=82.969,P<0.01)。结论目前抗生素仍存在一定程度滥用情况,患儿家长对于抗生素应用指征认知不足,需进一步加强对于患儿家长抗生素知识的教育工作。     

KNOWLEDGE AND ATTITUDE OF PARENTS OR CARETAKERS REGARDING TRANSMISSIBILITY OF CARIES DISEASE

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.     

心理干预对儿童精神分裂症患者父母应付方式的影响

目的探讨心理干预对儿童精神分裂症患者父母心理健康状况及应对方式的影响。方法对入组的30例精神分裂症患儿的父母进行心理干预,采用症状自评量表(SCL--90),应对方式问卷在干预前后进行心理卫生状况评定。结果1心理状况方面:心理干预前与国内常模比较SCL—90总分及各因子分差异有显著意义(P<0.01),干预后SCL-90总分及各因子分较干预前差异有显著意义(P<0.01),2应对方式方面:儿童精神分裂症的母亲消极应对方式评分比父亲高,经心理干预后,其父母退避及自责消极应对方式减少,求助及解决问题的积极应对方式增加,差异有显著意义(P<0.05)。结论儿童精神分裂症患者父母存在较多的心理问题,心理干预能有效提高其心理健康水平,改变消极的应对方式。