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Oswald-McCloskey KA, Kubinec N, Johnson E, Coffey A, Heinrich KP. Teacher Perspectives of Pediatric Neuropsychology and Supporting Children With Chronic Health Conditions. Arch Clin Neuropsychol 2024:acae039. [PMID: 38783484 DOI: 10.1093/arclin/acae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/01/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The goal of the present study was to examine teachers' perceptions of neuropsychological reports broadly and their preparedness to support the educational needs of students with chronic health conditions. METHOD Teachers were selected from across the United States using stratified random sampling. 280 teachers (76.2% female; 58.4% public school; 53.9% rural setting) completed an anonymous electronic survey via Qualtrics. RESULTS Half of the teachers were familiar with neuropsychology and previously read a neuropsychological report, which the majority found useful with a preference toward shorter reports. Most found listed recommendations to be appropriate, but half of teachers identified limited resources as a barrier to implementation. Teachers reported limited education, training, and comfort for providing accommodations to children with chronic health conditions, which was significantly lower for cancer, congenital heart disease, and sickle cell disease. Older teachers, more years of experience, and special education teachers demonstrated significantly higher levels of education, training, and comfort. Frequency of implementing accommodations was significantly negatively correlated with perceived burden and positively correlated with perceived benefit across most accommodations. Teachers reported a preference for single-page handouts and speaking directly to neuropsychologists about the specific learning needs of students with chronic health conditions. CONCLUSIONS Results highlight areas for future research and intervention regarding teacher's preparedness for working with children with chronic health groups and opportunities to improve communication between neuropsychologists and teachers to ultimately improve access to educational supports and overall quality of life of students with chronic health conditions.
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Affiliation(s)
| | - Nicole Kubinec
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA
| | - Elizabeth Johnson
- Department of Behavioral Sciences, College of Arts, Sciences, and Letters, University of Michigan - Dearborn, Dearborn, MI 48128, USA
| | - Alice Coffey
- Department of Behavioral Sciences, College of Arts, Sciences, and Letters, University of Michigan - Dearborn, Dearborn, MI 48128, USA
| | - Kimberley P Heinrich
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA
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van Zwieten A, Kim S, Dominello A, Guha C, Craig JC, Wong G. Socioeconomic Position and Health Among Children and Adolescents With CKD Across the Life-Course. Kidney Int Rep 2024; 9:1167-1182. [PMID: 38707834 PMCID: PMC11068961 DOI: 10.1016/j.ekir.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 05/07/2024] Open
Abstract
Children and adolescents in families of lower socioeconomic position (SEP) experience an inequitable burden of reduced access to healthcare and poorer health. For children living with chronic kidney disease (CKD), disadvantaged SEP may exacerbate their considerable disease burden. Across the life-course, CKD may also compromise the SEP of families and young people, leading to accumulating health and socioeconomic disadvantage. This narrative review summarizes the current evidence on relationships of SEP with kidney care and health among children and adolescents with CKD from a life-course approach, including impacts of family SEP on kidney care and health, and bidirectional impacts of CKD on SEP. It highlights relevant conceptual models from social epidemiology, current evidence, clinical and policy implications, and provides directions for future research. Reflecting the balance of available evidence, we focus primarily on high-income countries (HICs), with an overview of key issues in low- and middle-income countries (LMICs). Overall, a growing body of evidence indicates sobering socioeconomic inequities in health and kidney care among children and adolescents with CKD, and adverse socioeconomic impacts of CKD. Dedicated efforts to tackle inequities are critical to ensuring that all young people with CKD have the opportunity to live long and flourishing lives. To prevent accumulating disadvantage, the global nephrology community must advocate for local government action on upstream social determinants of health; and adopt a life-course approach to kidney care that proactively identifies and addresses unmet social needs, targets intervening factors between SEP and health, and minimizes adverse socioeconomic outcomes across financial, educational and vocational domains.
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Affiliation(s)
- Anita van Zwieten
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Siah Kim
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Amanda Dominello
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Chandana Guha
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jonathan C. Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
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Wu M, Zhou W, Hu S, Peng F, Yang F, Zhang L. Parenting self-efficacy and parenting stress mediates the effects of the association of perceived social support and readiness for discharge among parents of children with primary nephrotic syndrome. J Pediatr Nurs 2024; 75:e93-e101. [PMID: 38199933 DOI: 10.1016/j.pedn.2023.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/12/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To investigate the level of readiness for discharge among parents of children with primary nephrotic syndrome and to explore the mediating role of parenting self-efficacy and parenting stress between perceived social support and readiness for discharge. DESIGN AND METHODS A cross-sectional study was conducted in five large tertiary general hospitals in Hunan, China. Data related to demographics, perceived social support, parenting self-efficacy, parenting stress, and readiness for discharge were collected from 350 parents of children diagnosed with primary nephrotic syndrome. Path analysis was used to determine the mediating roles of parenting self-efficacy and parenting stress in the relationship between perceived social support and readiness for discharge. RESULTS Parents of children with nephrotic syndrome in China experienced low perceived social support, low readiness for discharge, and high parenting stress. Factors influencing readiness for discharge include the child's age, duration of illness, first episode or relapse, parental literacy and marital status. Parenting self-efficacy and parenting stress mediated the effects of the association of perceived social support and readiness for discharge. CONCLUSION Perceived social support influences the readiness of parents of children with nephrotic syndrome. Parenting self-efficacy and parenting stress have a chain mediating effect of the association of perceived social support and readiness for discharge. PRACTICE IMPLICATIONS This study emphasizes the mediating role of the psychological state of the child's parents. Nurses should take steps to increase perceived social support and parenting self-efficacy of the child's parents and to reduce parenting stress in order to improve readiness for discharge.
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Affiliation(s)
- Mengyu Wu
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China; Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Wen Zhou
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Shengnan Hu
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China
| | - Fangrong Peng
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Fang Yang
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Liuyi Zhang
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China.
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