Journal of Child Health Care current issue

Taking a deep breath . . . or two ... or three?

Carter, B. — Thu, 27 Aug 2009 08:13:46 PDT

The perceptions and preferences of parents of children with tracheostomies in a study of humidification therapy

McNamara, D. G., Dickinson, A. R., Byrnes, C. A. — Thu, 27 Aug 2009 08:13:46 PDT

This article reports a grounded theory study which was the qualitative phase of a randomized-controlled trial in children with tracheostomies comparing two techniques for providing humidified inspired gases. Semi-structured interviews were conducted with eight mothers of children with tracheostomies recruited from the trial, one mother who was not involved in the trial and four experienced nurses. Data were analysed using open, selective and theoretical coding. A core category was identified of parents managing the child’s care in response to a set of problematic and constraining states. Parents were seen to utilize strategies of constant checking, becoming the expert, the family pulling together and electing to use preferred technology. The findings of this study mirror those of previous studies and reinforce the primacy of caregivers as managers of their child’s health care. Mothers elected to use or not use a given technology within this context, utilizing a process of balancing.

Improving hospital care for young children in the context of HIV/AIDS and poverty

Richter, L., Chandan, U., Rochat, T. — Thu, 27 Aug 2009 08:13:46 PDT

Paediatric wards in South African government hospitals are occupied predominantly by children with HIV and AIDS-related illnesses. Although access to anti-retroviral treatment for adults is being scaled up, it is likely to be many years before South Africa achieves anywhere near universal access for children. Currently, most children living with HIV or AIDS are identified only when they become acutely or chronically ill and/or hospitalized, if at all. In the absence of treatment, the stress of caring for ill and hospitalized HIV-positive children often results in emotional withdrawal among both health professionals and caregivers. The demoralizing cycle of repeated admissions, treatment failure and death also affect the quality of the care given to HIV-negative children in over-burdened wards. This article describes the development of simple, low-cost and context-relevant interventions to improve the care environment for young hospitalized children within the context of the HIV/AIDS epidemic and poverty.

Acute effects of Yakson and Gentle Human Touch on the behavioral state of preterm infants

Im, H., Kim, E., Cain, K. C. — Thu, 27 Aug 2009 08:13:46 PDT

Two weeks of touch intervention, either Yakson or Gentle Human Touch (GHT) have been shown to reduce the levels of stress hormones. This study evaluated the acute impact of both interventions on state during and immediately after touch. Forty preterm infants with a gestational age of ≤34 weeks received either Yakson or GHT for 15 days. A significantly greater sleeping state was identified in both groups after touch. This effect was significantly stronger with Yakson than GHT. During touch, about half the Yakson infants showed an arousal effect while the GHT infants showed little change. Both interventions left the babies calmer after touch. This calming effect is consistent with the previously observed effect on stress hormones and should be beneficial in terms of growth and development. Yakson had an arousing effect on a subset of the infants during touch, which possibly could be beneficial in terms of social development.

The specificity of post-concussive symptoms in the pediatric population

Falk, A.-C., Von Wendt, L., Soderkvist, B. K. — Thu, 27 Aug 2009 08:13:46 PDT

The study compared patterns of reported symptoms between a mild head injury group and a group of children with abdominal complaints visiting an emergency department. Children (0—15 years) admitted to an emergency department during a three-month period with a history of head injury and a comparison group of children were included. Medical records at the time of injury were reviewed and follow-up questionnaires focused on presumed symptoms related to concussion at three months post-visit. The comparison group reported significantly more change in behaviour than the head injury group. However, for the older children, higher intensity of symptoms was reported by the comparison group compared to the head injury group. Initial differences in the amount and presence of symptoms between the two groups did not reflect the findings at three months; both groups reported symptoms or changes at three months after the event. Evaluating children aged under five, their symptoms and recovery patterns after a head injury is recommended.

how do mothers and fathers who have a child with a disability describe their adaptation/ transformation process?

Pelchat, D., Levert, M.-J., Bourgeois-Guerin, V. — Thu, 27 Aug 2009 08:13:46 PDT

This qualitative study explored the adaptation/transformation process in mothers and fathers at the individual, parental, marital and extrafamilial levels, and the similarities and differences in their experience of living with a child with cerebral palsy. Interviews were conducted with 13 mothers and 13 fathers of children with cerebral palsy. The results show that mothers and fathers are more likely to view the situation differently than similarly. For both parents, the situation offers the potential for transformation. Complementarity between mothers and fathers is an important factor in each of the adaptation or transformation subsystems. Both parents embark on a journey that changes their beliefs about difference, apply their new knowledge to every aspect of their life, and endeavour to normalize their situation.

A self-harm training needs assessment of school nurses

Cooke, E., James, V. — Thu, 27 Aug 2009 08:13:46 PDT

Self-harm is acknowledged to be increasing and is especially prevalent in young people. School nurses are central to adolescent mental health, delivering initial and sustained intervention. However, few studies have considered their experiences and training needs in fulfilling this role. This training needs assessment explored the self-harm training needs of school nurses within one UK primary care trust by utilizing questionnaires and interviews developed specifically for the study. School nurses felt frustrated and inadequate when working with young people who self-harm. The majority had attended self-harm training, yet felt that it only helped a little. Nurses desired training, particularly in practical approaches when working with young people who self-harm, however, analysis suggested that they also needed underpinning theoretical knowledge. Therefore, this study highlights the need for self-harm training for school nurses, incorporating both practical approaches and theoretical knowledge, to ensure that young people who self-harm receive an effective, high-standard service.

Family--school connections and internalizing problems among children living with asthma in urban, low-income neighborhoods

Murdock, K. K., Robinson, E. M., Adams, S. K., Berz, J., Rollock, M. J.D. — Thu, 27 Aug 2009 08:13:46 PDT

Children with asthma living in urban environments are at risk for experiencing internalizing problems and difficulties at school due to social context and health-related stressors. Parent confidence and participation in the school and children’s attitudes about school were explored in association with children’s depressed mood and school anxiety. Forty-five parent—child dyads were recruited from urban community health centers. Most participants were members of ethnic minority groups. Hierarchical multiple regression analyses revealed that higher levels of parent confidence in the school were associated with fewer symptoms of school anxiety in children. Children’s attitudes toward school moderated the relation between parent participation in the school and children’s depressed mood. Specifically, lower levels of parent participation were associated with higher levels of depressed mood only for children with the least positive school attitudes. Although preliminary, these results suggest the importance of attending to family—school connections to optimize the school-related psychological functioning of children living with asthma in urban environments.

Risk-taking behaviour in adolescence: a literature review

Leather, N. C. — Thu, 27 Aug 2009 08:13:46 PDT

This article gives a review of the literature outlining risk-taking behaviour in the adolescent population, linking this to developmental tasks. The review includes reference to health, peers, parenting, self-esteem and quality of life issues. A theoretical overview of the research area in general is presented and links to social and society issues. The possible causes of risk-taking, including alcohol, drugs and violence, are considered and factors reviewed.