PARENTS' AND HEALTHCARE PROVIDERS PERSPECTIVES ABOUT HOSPITALISED CHILDREN BEING VISITED BY OTHER CHILDREN IN NAIROBI, KENYA

BACKGROUND

Throughout history, visitation of the hospitalised child has always been restricted. The subject of whether hospitalised children should be visited by other children has been accorded minimal attention.

OBJECTIVE

To determine the current status of visitation of the hospitalised children and the parents and healthcare providers'views on hospitalised children being visited by other children.

DESIGN

A descriptive study carried out using quantitative and qualitative methods in two phases

SETTING

All paediatric wards at Kenyatta National Hospital and Gertrudes Children's Hospital.

SUBJECTS

Nurses, paediatricians and parents of hospitalised children.

RESULTS

A total of 161 parents participated in phase I of the study whereas 11 nurses not specialised in paediatric nursing, 13 paediatric nurses, 12 nurse managers, fur paediatricians and13 parents participated in phase II of the study. The study established that visiting of the hospitalised child by family members especially children aged below twelve years is severely restricted particularly in the public hospital. Despite this, however, majority of the healthcare providers and the parents acknowledged the importance of the hospitalised children being visited by other children. This is because it promotes healing, gives the sick child psychological satisfaction and relieves anxiety in the hospitalised child, the accompanying parent and the other children. The risk of exposing the visiting children to infection was cited as the main reason for the restrictions.

CONCLUSION

Both the healthcare providers and the hospitalised children's parents appreciate the importance of the hospitalised child being visited by other children. There is a need to review healthcare policies to make provision for hospitalised children to be visited by other children.

The dynamics and processes of social support: families' experiences coping with a serious paediatric illness

A large body of research has revealed that social support helps buffer the negative consequences of stressful life events. Yet research also suggests that social support exchanges involve complex interpersonal dynamics. Using in-depth interview data from 76 parents of paediatric cancer patients in the US, the findings demonstrate that parents experienced difficulty sustaining support after the diagnosis crisis, uncertainty about how to ask for the support they needed and challenges managing support efforts. Given these complexities in negotiating social support, this article examines the mechanics of effective social support exchanges. The findings show the importance of the nature of the pre-existing relationship between the support recipient and provider, as well as the interactions throughout the period of support. For example, parents found support efforts that involved frequent interactions and involvement in families' daily lives (such as help with childcare) most effective when the support provider was a close network member. In contrast, support offered from members of extended networks was most effective when the effort required little marshalling from the parents, did not need to be asked for and did not intrude in the families' private lives. These findings contribute to the medical sociology and social support literature by analysing the conditions under which effective support efforts are marshalled.

A qualitative description of the development and evaluation of our voice, a health promotion magazine created by pediatric patients for hospitalized pediatric patients

OBJECTIVES

To facilitate a peer-developed health promotion magazine that provides health education and engages hospitalized pediatric patients during a hospital admission. To evaluate patient satisfaction with the content and layout of the magazine and its impact on patients' attitudes toward healthy living.

METHODS

A pediatric resident-led multidisciplinary team collaborated with the Children's Council at The Hospital for Sick Children to create a health promotion magazine for inpatients. Articles included a scavenger hunt, healthy recipes, physical activities, hospital staff interviews, and patient stories. Patients 7 to 18 years of age admitted to Pediatric Medicine or Respirology were invited to read the magazine and complete a questionnaire 24 hours later on their satisfaction with the magazine and their attitudes regarding healthy living.

RESULTS

Thirty-seven patients received a copy of the magazine, and 24 patients completed the questionnaire (mean 13.4 years, 54% female, 25% overweight/obese). Eleven of 24 (46%) read the entire magazine, and 19 of 23 (83%) reported learning. The exercises, recipes, and patient stories were most liked. Ten of 24 (42%) participants performed the exercises; the most common reason for not trying an exercise was pain. After reading the magazine, 15 of 24 (65%) patients reported that they will try to be more active, and 11 of 23 (48%) reported that they will try to eat more fruits and vegetables. Eighty-three percent were interested in a future edition.

CONCLUSIONS

A health promotion magazine created by patients for patients changed patient-reported attitudes about healthy living. Peer-led interventions in the inpatient setting may be an important opportunity to promote healthy lifestyles and require further study.

Evaluation of a coping kit for children with challenging behaviors in a pediatric hospital

This study attempted to answer the question, "Do nurses perceive coping kits to be effective at meeting the needs of hospitalized children with developmental disabilities who are at increased risk for challenging behaviors?" A cross-sectional post-test survey study design was used, with a convenience sample of 24 registered nurses at a Midwestern free-standing children's hospital. A coping kit with simple communication cards, social script book, and distraction items (toys) was developed to enhance communication and distract children with developmental disabilities (including autism spectrum disorder) undergoing procedures in the hospital. A modified version of Hudson's (2006) intervention effectiveness survey was used to measure the nurse's perception of the effectiveness of the coping kit. Nurses perceived the coping kits to be effective for decreasing their patient's anxiety, calming the child's behavior, and increasing cooperation during procedures. The nurse can develop a plan of care that includes a coping kit to help gain cooperation with the hospitalized child with challenging behaviors.

[Allowing parents to enter the recovery room]

At Necker-Enfants malades hospital, the presence of the parents alongside the child during the immediate postoperative period has been allowed and encouraged for a number of years. In order to standardise the practices in terms of allowing parents to enter post-anaesthetic recovery rooms, nurses have drawn up a procedure to follow. In parallel, a study and a satisfaction survey have been carried out in order to measure the benefits of this approach for parents and for the child undergoing the operation.

[Pain in children, using the right words]

Verbal communication is an essential element in the prevention and treatment of pain in children and adolescents. It is essential to take into account existing knowledge and recommendations relating to verbal communication in the caregiver's relationship with a child in pain. Developing the nurse's ability to adapt to diverse situations and carrying out research concerning the effects of speech on the child are priorities.

An integrative review of literature examining psychometric properties of instruments measuring anxiety or fear in hospitalized children

Anxiety and fear are among the most frequently reported emotional responses to hospitalization and are known to be contributing factors to pain and other negative patient outcomes. The first step in confronting unnecessary anxiety and fear is to identify valid and clinically feasible assessment instruments. The purpose of this paper is to review and evaluate instruments that measure children's fear or anxiety associated with hospitalization or painful procedures. A search was conducted of published English-language literature from 1980 through 2010 with the use of Ovid Health and Psychosocial Instruments, Medline, Nursing/Academic Edition, Cinahl, and Google Scholar. Inclusion criteria specified that the self-report instrument: 1) was developed in English; 2) was developed for and/or widely used with hospitalized children or children undergoing medical procedures or treatment; and 3) had research evidence of psychometric properties from at least five different studies. A comprehensive review of the literature revealed only five fear or anxiety instruments with adequate testing for evaluation of reliability and validity. Although all instruments have beginning psychometric adequacy, no one tool stands out as superior to the others. Therefore, we recommend that researchers and clinicians exercise caution in choosing assessment instruments, balancing potential strengths with reported limitations. Using more than one tool (triangulating) may be one way to achieve more credible results. Knowledge of credible existing instruments alerts us to what is possible today and to the imperative for research that will improve communication with children tomorrow.

[Parental presence during treatment of injured and acutely ill children]

This review studies the literature on the effects of parental presence during treatment of injured and acutely ill children. Parents wish to stay with their child, and clinicians increasingly find it beneficial, probably correlated with increased experience. Studies indicate that the treatment of the child is not compromised by parental presence but only a few quasi-randomised, quantitative studies have been published, and many circumstances concerning parental presence have not been investigated sufficiently.

The perceived effectiveness of a pre-admission visit for children (and their parents) undergoing day surgery procedures

The purpose of this paper is to present the findings of an evaluation study which examines the perceived effectiveness of a pre-admission visit for children (and their parents) undergoing day surgery procedures in the Republic of Ireland. This follow on paper provides the findings of an evaluation study subsequent to the pre-admission, practice development initiative published in the Journal of Perioperative Practice, June 2010, 20 (6) 203-206.

[An adapted relational approach to hospitalised adolescents]

The treatment of an adolescent hospitalised in paediatrics often poses difficulties. The relational aspect of the nurse's work in this period of development between childhood and adulthood remains delicate in a context of institutionalisation. What is the interaction between the relational approach and the adolescent's experience of hospitalisation in paediatrics?

Social connectedness through ICT and the influence on wellbeing: the case of the CareRabbit

The CareRabbit has been introduced as a technological innovation in the care for children, enabling family and friends to stay in touch while the child is hospitalized. This study addresses influence of this innovation on the wellbeing of the children, and uses the validated KINDL questionnaire, eliciting information from children and parents at the end of hospitalization. A baseline and an experimental measurement are compared. The children in the CareRabbit group scored slightly higher on the KINDL questionnaire than children in the control group. For young children (age 4-7) the difference was large. Initial findings indicate that CareRabbit has a positive influence on wellbeing, although sample size and measured differences limit the support for this conclusion. The measured difference suggests that CareRabbit may be more valuable for younger children.

[Impact of hospitalization of an infant during breast-feeding: mother-child investigation]

A real health priority for governments, breastfeeding has prompted WHO and UNICEF to create the "Baby-Friendly Hospital Initiative" for maternity units respecting the "ten steps to successful breastfeeding". This effort does not include pediatric departments. However, as the properties of breast milk enhance recovery of the infant, it is also important to promote breastfeeding in this branch. Furthermore, few studies have analyzed the constraints of hospitalization on the breastfeeding process. The aim of this study is to identify the constraints imposed by hospitalization on the process of breastfeeding in infants aged 29 days to 6 months suffering from acute disease, during hospitalization and within a week following their return home. This prospective study was conducted between October 1st and December 31st, 2008 in a pediatric department through interviews and questionnaires from breastfeeding mothers and health professionals. 51 mother-infant pairs and 35 caregivers were included in the study. During hospitalization; direct breastfeeding was interrupted for 31 mothers. After hospitalization, 3 mothers had weaned their babies, 12 went from exclusive breastfeeding to mixed feeding and 13 had experienced difficulties. Caregivers partially meet WHO's recommendations. The hospitalization of an infant disrupts the continuation of breastfeeding. To overcome this, actions must be taken in relation with hospitals, departments and professionals. The study's small sample does not prove that the original training of caregivers influence theirs practices.

[Music in the hospital]

Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy.