A new report published in 2015 by the global charity “Save the Children” aims to improve neonatal survival across the world. Entitled “Improving Newborn Survival: Saving the Lives of 3 Million” the...
For many years pediatric healthcare experts have debated how much benefit was derived by host nations from the well intentioned efforts of Pediatric Short-Term Medical Missions (STMMs). Most of the literature on STMMs, while limited, has focused on frameworks for the delivery of care. Today the focus of these endeavors is on the ethical implications. The purpose of this article is to describe how the focus of STMMs has changed over the past 15 years from delivery of care frameworks to ethical considerations.
The death of a child is a life-altering event for parents, leading to grief that is individual, intense, and long lasting. The grief experienced by parents following the death of their child can affect their relationships and as they sometimes see it, their role within society. Parents can find grief isolating, due to society’s lack of understanding of their grief experience. Gendered differences in grief reactions have also been noted. Theoretical understandings of bereavement, now acknowledge parental need “not to let go” but rather to reconstruct relationships with their deceased child in terms of a continuing bond. This narrative literature review draws together theory and research on the topic, highlighting current knowledge and suggesting ways in which children’s nurses can support parents as they live through the loss of their child.
"Children and Young People’s Nursing at a Glance, by Alan Glasper, Jane Coad, Jim Richarson (Eds.)." Issues in Comprehensive Pediatric Nursing, 38(4), pp. 300–301
Preserving and improving child health in the second decade of the 3rd millennium is proving to be challenging for many western and developing countries. Nations respond in differing ways, and in En...
At the dawn of the children’s hospital movement in the west, perhaps epitomized and exemplified by the opening of London’s Great Ormond Street Hospital (GOSH) on February 14, 1852, the plight of si...
Family caregivers play a critical role in caring for children living with HIV, however, there is little knowledge about their experiences. The aim of this study was to illuminate the family caregivers’ lived experiences of caring for a child when he or she has been diagnosed with HIV and enrolled to antiretroviral treatment. Qualitative interviews with 21 family caregivers of 21 children diagnosed with HIV were analyzed using an inductive design with a hermeneutic phenomenological approach. The caregivers' experience were articulated in 5 subthemes under the main theme of “Surviving overwhelming challenges”: “Committed care-giving,” “Breaking the family life,” “Caring burdens,” “Confronting conflicts,” and “Living with worry.” Despite the difficult situation the family caregivers experienced with extensive worry, caring burdens, and disrupted family and social networks, they were committed caregivers. They were empowered by their belief in God but also by their strong belief in the child’s treatment and support from healthcare workers. The healthcare system needs to consider possible ways to support the family caregivers during child’s HIV diagnosis and treatment initiation as part of a continuum of care.
As all human beings are consumers of health care provision across the life span and in receipt of care delivered by accountable health care professionals, all should have the right to be involved in shaping the future of their own health care. Rights-based participation, when applied successfully, has the potential to inform and influence the delivery of child health care, the child's experience of health care, plus children's nursing education (Coyne & Gallagher, 2011). The "right" of every child and young person to participate in research that relates to their own health care is also sustained by the author's lead position as a Senior Lecturer in Higher Education for pre-registration children's nursing in Northern Ireland and the appreciation of their voice when practicing as a registered children's nurse and ward sister. The report provides an insight into seminal work on human and child rights; the historical context of children in Western society, and the evolution of children's nursing amid the child's right to participate in shaping their own health care.
The stress parenting responsibilities place on parents increases in situations involving pediatric illness, and therefore can potentially interfere with the normal family life. The present review examines sources of parenting stress across a wide spectrum of illnesses, using three illness groups as exemplars: Congenital heart disease, pediatric cancer, and Autism Spectrum Disorder. A systematic review of the literature using PubMed, CINAHL, Scopus, and PsycINFO databases yielded 66 observational studies investigating sources of parenting stress in parents of young children with congenital heart defects, cancer, and Autism Spectrum Disorder. Quality assessment, using the STROBE and COREQ quality indexes, was further conducted for the included studies. Stressors were categorized, and then analyzed in light of the diagnostic characteristics of the populations in focus. Findings indicate that parents across all illness groups experience increased levels of parenting stress. Several categories were identified in accordance to the parenting stress model as follows: illness-related factors, parental factors, child characteristics, familial factors, and social factors. Further analysis has revealed distinct parental concerns within the groups deriving from the diagnostics, care demands, or social responses specific to each group. Theoretical and practical implications for Family-Systems Nursing Practice were further discussed. Future research and assessment of parenting stress should account for the illness course and address family needs within the specific context of the illness.
Most families can access a range of health information and advice. Information and advice sources often include nurses, the Internet, social media, books, as well as family and friends. While the immediate aim may be to find information, it can also be to assist with parenting skills, solve parenting problems or as part of decision-making processes about their child's health. These processes are strongly influenced by the parent's level of health literacy. Health literacy describes a person's capacity to obtain and utilize health related information. Although there are numerous health literacy definitions all have clearly defined steps. These steps are: obtaining relevant information; then understanding this information; and finally being able to use the information to achieve the expected outcome. Previous research has linked low levels of parental health literacy with poorer child health outcomes. Given this link, increasing health literacy levels would be advantageous for both families and health services. Nurses working with families are in a position to support the family to increase their health literacy through the use of a variety of strategies. This article outlines how health literacy can influence the way parents seek help when they are concerned about child health issues, the relevance of parental health literacy for nurses and suggests some tools that could be used to support the increase of health literacy.
Key policies at national and international levels have called for the increased involvement of children in their healthcare. This reflects a growing recognition of the sociology of childhood and of children as social agents. However, it seems that the involvement agenda has met with mixed results, with children often being left marginalized as a result of professional, parental, and other factors. A need for further research into children and health professional's attitude towards child involvement has been identified by research in this area. In this article we review the current literature on children's involvement in care, noting the differences between professional views and those of children themselves. To do this we used a literature review, incorporating electronic database searching and snowballing techniques. We found that children and health professionals are in general agreement that children should be involved in their healthcare; however there is some disagreement over the extent of involvement. Many children experienced exclusion due to many factors including parental role, in that there may be a belief among adults that children cannot act in their own best interest. The involvement of children in their healthcare may be considered transitory and dependent upon competing factors. It may be helpful to view child involvement in healthcare in the context of children's status in their society. Health professionals should aim to empower children with appropriate information about their healthcare.
Low levels of literacy in early childhood can have lasting effects on children’s educational and intellectual development. Many countries have implemented newborn literacy programs designed to teach parents pre-literacy promoting activities to share with their children. We conducted 2 quasi-experimental studies using 1) a pre-test/post-test design and 2) a non-equivalent control group design to examine the effect of newborn literacy programs on parents’ self-reported literacy intentions/behaviors, values toward literacy, and parent-child interactions. Parents were recruited from 3 provinces, 2 with newborn literacy programs (intervention) and 1 without (control). Parents in the intervention group completed prenatal and postnatal (after participation in program) questionnaires. Parents in the control group completed 1 questionnaire. Questionnaires were designed to capture parents’ literacy intentions (prenatal), behaviors (postnatal), values, and parent-child interactions (postnatal). A total of 98 parents were included in study one and 174 were included in study two. Parents’ self-reported prenatal intentions and values were higher than their postnatal behaviors and values. Parents in the intervention group exhibited higher literacy behaviors and values and greater enjoyment reading to their children than parents in the control group, though they also reported reading to their children less frequently. Parents in the intervention group had significantly higher Positive Interactive scores than controls. Overall, we found participation in newborn literacy programs positively impacted parenting behaviors and attitudes. Lower postnatal within-group scores (intentions and values versus behaviors and values) may have been the result of participants’ high expectations. Given our findings, we recommend that these programs continue.
The National Health Service Institute for Innovation and Improvement was established to help the NHS to improve healthcare by rapidly developing and disseminating knowledge and evidence about new ways of working. One example is the Emergency and Urgent Care Pathway for Children and Young People which focused on providing high quality and safe healthcare for children and young people requiring urgent or emergency treatment for the most common illnesses and injuries. Monkey's Guide to Healthy Living and NHS Services was developed to increase awareness of acute health services in primary school-aged children. This free resource was posted to every primary school in England. A process and impact evaluation was undertaken to explore how the resource was being utilized during 2013-2014. A small number of in-depth case studies were developed involving classroom-based observations and teacher interviews along with a much larger online survey which was emailed to all primary schools in England. On the whole, the resource was viewed as useful, engaging, and informative; with children, teachers, and other professionals particularly valuing the monkey puppet, video clips, and teacher resources. The National Evaluation highlighted that most respondents integrated the materials into the curriculum, used them as a one-off lesson, or developed their own innovative and strategic approaches to make the best use of the resources; almost two-thirds of schools who responded to the survey felt the resources led to pupils knowing about the available NHS services and healthy lifestyles; over half felt pupils were now more informed about the most appropriate services to use.
In the literature, there is evidence about the importance of ensuring a Family-Centered approach for foreign patients to provide culturally competent care. The Italian context shows a lack of studies concerning nurses' perceptions regarding factors that influence foreign patients' daily care. In addition, the number of pediatric patients coming to Italian hospitals to be cured has increased dramatically in the last few years. This study aims to investigate the pediatric nurses' perception of the factors influencing nursing care for foreign pediatric patients who have undergone a stem cell transplant (SCT) and their families. A qualitative approach is used. Semi-structured interviews were recorded, transcribed verbatim, and analyzed using qualitative techniques for recurrent themes. Italian SCT pediatric nurses were interviewed until data saturation was achieved. Four themes emerged from the analysis: "Respect for other cultural traditions,'' "Different roles,'' "Communication,'' "Equal treatment and different opportunities.'' Communication was seen as a barrier in caring for foreign patients. Nurses perceived a lack in their training and knowledge when caring for foreign patients. The hospital supports nurses when caring for foreign patients. We found that pediatric nurses do not feel they are caring for foreign patients in the same way as they do for Italians, but adopt strategies to improve their relationships with them. Semi-structured interviews proved to be useful in highlighting the nurses' perceptions. These data were confirmed by the results of the audit conducted with the "Children and Young People's Audit Policy Tool,'' The tool suggests specific interventions when foreign patients are admitted.
Preschool is an important period for the development of healthy lifestyle behaviors. Parents have a great influence upon a child developing healthy lifestyle behaviors. The purpose of this study was to determine the self-efficacy perceptions of parents related to their preschool children's healthy eating and physical activity behaviors. This study was conducted with a research population of 425 parents of 3- to 6-year-old children. The data collection tools included Demographic Information Form, and The Parental Self-efficacy Questionnaire (PSQ). Also, the weight and height of the children and their parents were measured. There was a positive correlation in parental self-efficacy score between parents' educational status and economic status and there was a significant negative correlation between children's body mass index and parental self-efficacy scores. The understanding of the effect of parental self-efficacy perception in the development of preschool children's healthy eating and physical activity behaviors is one of the first important steps in effective health promotion interventions.
This article examines the culture of family-centered care (FCC) in the pediatric intensive care unit (PICU) using focused ethnography. Data collection strategy was participant observation, fieldwork, and interviews with main actors of the PICU, namely supervisors, nurses, and parents. This study took place in one PICU in a hospital in Tehran, Iran. The results were in the main named as paternalism and were presented as five themes: "nonpossessed environment,'' "separation of the children from their parents,'' non-interactive communication,'' "limited participation,'' and "affection and sympathy combined with superiority.'' In conclusion, the prevailing atmosphere in care was paternalistic as there was a huge gap between conceptually or theoretically accepted application of FCC in PICU and what is practically administrated. Bridging such a gap between theory and practice can be helpful in improving social, environment, and organizational culture for the children, their parents, and health care providers as well as their performance in the context of PICU.
Pivotal to healthy adulthood is a supportive and nurturing environment that enables successful progression through the developmental tasks of childhood and adolescence. For many children there are events that disrupt this development. Illness, injury, painful medical interventions, and hospitalization have been reported by children and families as causing medical trauma and psychological stress. Frequently pediatric health professionals focus primarily on achieving positive physical treatment outcomes. Creating an environment that will support the developmental tasks of childhood and limit the trauma and distress associated with illness and treatment is also required. Strategies and practices to deliver holistic and comprehensive pediatric care are well established in many Western settings. Opportunity exists to broaden the focus of pediatric care in developing healthcare systems such as the United Arab Emirates (UAE) to encompass psychological well-being. The study focused on two key objectives, firstly to assess healthcare professionals’ awareness of the stressful and potentially traumatic nature of healthcare settings and treatment for children. Second the study explored the views of healthcare participants regarding possible strategies to minimize medically induced stress and trauma for children and adolescents in UAE healthcare settings. The study utilized a mixed methods design in which participants views were examined through administration of a survey comprised of close-ended questions that were analyzed quantitatively and open-ended questions analyzed qualitatively. One hundred and seventeen healthcare professionals from a range of disciplines in two government hospitals completed the survey. Data revealed that one third of the participating healthcare professionals were unaware of or did not think that their healthcare settings could provoke stress for pediatric patients. Respondents suggested three main strategies to minimize stress for children and parents while receiving treatments, specifically; providing focused information for both children and healthcare providers, adapting the environment and systems to fit children’s needs, and, improving the interpersonal skills and attitudes of healthcare professionals. The findings from this study could inform the development of standards for pediatric services and policy directions in regard to post-graduate training for health professionals working in pediatric healthcare settings.
Pediatric care has greatly evolved during the past 30 years, moving from a traditional, medically oriented approach to a more consultative, interactive model. In the literature, the concept of partnership has been explored and presented in various terms, including presence, collaboration, involvement, and participation. The models of partnership that have been proposed have rarely been evaluated, and do not take the unique environment of ambulatory care into account. Based on a literature review, strong clinical experience with families, and previous research with parents and health professionals, both the conceptual and empirical phases of a new model are described. This model can be adapted to other pediatric health care contexts in either primary or tertiary care and should be evaluated in terms of efficacy and usefulness.
Most studies of childhood asthma management use data from a single family reporter and fail to capture the parent-child dyadic influences. In this descriptive exploratory study with 183 parent-child dyads, data were collected from both parents and children. Using structural equation modeling, the relationships of parents' and children's asthma knowledge, self-efficacy to manage asthma, and asthma management on the child's quality of life were examined. Direct significant relationships from knowledge to self-efficacy to asthma management were found for each member of the dyad. The associations between parents' and children's self-efficacy and asthma management were not statistically significant. Only the children's self-efficacy to manage asthma was significantly associated with children's asthma-related quality of life.
