[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.

[Associating children with contemporary visual arts in the hospital]

In 2008, for 3 months, a visual artist in residence at the Margency children's hospital (Val d'Oise) made sculptures for the bandstand situated in the hospital's park. By bringing people together this experience helped to create a bond between the artists, the hospitalised children and the healthcare workers.

Setting up pre-admission visits for children undergoing day surgery: a practice development initiative

The hospital experience can bring about a range of negative emotions for children. The literature clearly states that children who are prepared for surgery recover faster and have fewer negative effects. Pre-admission programmes seek to prepare children (and their parents) for surgery. This paper describes in detail how a pre-admission programme was established for children and their families who were scheduled for day case surgery.

Nurse practitioner role in preparing families for pediatric outpatient surgery

Due to medical advances in surgery and anesthesia and cost of hospital stays, more elective pediatric surgical procedures are being performed in outpatient settings. One proposed advantage of outpatient surgery is decreased anxiety or a shorter period of anxiety for pediatric patients and their families because they are able to go home shortly after the surgery. A literature review was conducted to describe anxiety experienced by pediatric patients and their families in the outpatient surgery setting and to explore ways to decrease that anxiety. Both children and parents reported not feeling emotionally and educationally prepared for outpatient surgery. Developmentally appropriate pre-surgical educational programs and parental involvement in the surgical experience can help alleviate the anxiety of both children and parents during the pediatric surgical experience. Nurse practitioners (NPs) are currently being used in pre-operative outpatient settings to conduct physical examinations and provide pre-op education. Pre-op education programs provided by NPs are beneficial in decreasing the anxiety state among children and parents prior to surgery.

Magic as a therapeutic intervention to promote coping in hospitalized pediatric patients

Magic as a therapeutic intervention is used in an innovative, hospital-based program to address the psychosocial issues children and adolescents often experience as a result of illness and hospitalization. A child life specialist and a magician with an MBA collaborated, blending clinical expertise with business acumen and professional-level magic skills to create the program. The program has two distinct components: (1) magicians using interactive, close-up magic and humor as a technique to promote socialization, enhance self-esteem, and increase opportunities for choice and control, and (2) magicians providing the personal instruction and materials that enable chronically ill and long-term patients to learn and perform magic to promote a sense of empowerment and feelings of mastery. Positive responses from patients, families, and staff to the program at one hospital led to the creation of Open Heart Magic, a non-profit children's foundation that maintains and staffs bedside, interactive therapeutic magic programs in five hospitals in the Chicago metropolitan area.