Psychosocial functioning of hospitalized Chinese adolescents and their families

Factors influencing fatigue among mothers with hospitalized children: A structural equation model

PURPOSE

The aim of this study was to identify the physiological, psychological, and situational factors affecting fatigue among mothers of hospitalized children.

DESIGN AND METHODS

This study used a cross-sectional descriptive design with a self-report questionnaire. Participants were 211 mothers with children younger than 6 years old who were admitted to general hospitals. Based on the theory of unpleasant symptoms, the physiological, psychological, and situational factors were tested using structural equation modeling.

RESULTS

Mothers' fatigue was influenced by physiological (β = .24), situational, and psychological factors (β = .17), and situational (β = .37) factors such as the mother's sleeping hours, the child's adaptation to hospitalization, anxiety and having support with their housework. These three factors explained 31.34% of the variance in fatigue. In particular, it was found that the psychological factors exacerbate the negative influence of the situational factors on fatigue. Moreover, the situational factors were most strongly related to mothers' fatigue, and they had an indirect effect via the psychological factors as a mediator.

PRACTICE IMPLICATIONS

It is necessary to implement a nursing intervention that targets the controllable factors such as anxiety and children's adaptation to hospitalization that were identified in this study. Pediatric nursing care should not be limited to treating children's illnesses, but should be extended to providing family-centered care.

Effectiveness of audiovisual interventions on stress responses in adolescents with ENT surgery in hospital: randomized controlled trial protocol

AIM

To investigate the circadian pattern of cortisol secretion and other stress indictors in association with audiovisual stimuli in adolescents having otorhinolaryngological surgery in hospital.

BACKGROUND

Hospitalization for surgery is a major stressful life event for adolescents causing negative consequences, including anxiety. Recent studies suggest that entertaining and educational interventions might be effective at reducing such adversities, but little is known about the pattern of these responses and effects.

DESIGN

Randomized controlled trial.

METHODS

Adolescents with otorhinolaryngological surgery in hospital without any contraindictions for salivary cortisol enzyme immunoassays will be recruited and randomly allocated to experimental, placebo and control. Stress indicators will be collected regularly for 5 days. Standard audiovisual interventions will be displayed for experimental and placebo groups including a simultaneous video-recording of facial and behavioural changes on the second afternoon postadmission and stress indicators will be collected pre- and three times with 20-minute interval postintervention. Follow-up will be conducted to evaluate the longer term effects at 2 weeks, 1-month and 3 months postadmission, respectively. Descriptive and comparative analyses of stress indicators will be performed to examine group differences. Competitive funding was obtained from the Independent Innovation Foundation of Shandong University for interdisciplinary research in 2012.

DISCUSSION

This study will help identify timeslots for interventions for integrating strength-building into stress response reduction in adolescents hospitalized for surgery.

A Spanish version of the Family Assessment Device

INTRODUCTION

This paper presents the results of a study on the psychometric properties of an authorized Spanish version of the McMaster Family Assessment Device, a self-report measure of family functioning.

MATERIALS AND METHODS

The study sample comprised 60 psychiatric patients and their family member and 60 controls, without mental health problems, and their family member.

RESULTS

Compared to other studies, all subscales displayed adequate temporal stability and acceptable reliability. While the instrument discriminated well between the two groups of families on all subscales, the results nevertheless indicated limitations in the inter-item discriminant capacity of the "Roles" subscale. Factor analysis resulted in a three-factor model that does not coincide with the established structure of this instrument.

CONCLUSION

Proposals to improve and adapt questionnaire are discussed with a view to make it applicable to cultures other than the one it was developed. Theoretical models relating to psychosocial aspects such as family functioning, albeit compatible in some areas, should be viewed with caution in cultures different to that in which the model originates.

Parents’ experiences of participation in the care of hospitalised children: A qualitative study

BACKGROUND

The introduction of unrestricted visiting hours has led to the encouragement of parents to stay with and participate in the care of their hospitalised child. In order to stay with the hospitalised child, parents have to be away from home or work, which in turn impacts on their personal and family life. However, no published study on parents' experiences of childcare participation during paediatric hospitalisation has been found for a Chinese population.

OBJECTIVES

This study explored Chinese parents' experiences of their participation in taking care of their hospitalised child.

DESIGN

A qualitative exploratory design was adopted to capture parents' experiences of participation.

SETTINGS

The study was conducted in four paediatric wards of a regional acute general hospital in the New Territories, a major geographical region of Hong Kong.

PARTICIPANTS

Nineteen parents (16 mothers and three fathers) who had a child hospitalised for more than 48 h and identified themselves as staying comparatively longer with the child than their counterpart were recruited.

METHODS

Data were collection by tape-recorded semi-structured interview.

RESULTS

Four major categories that illustrated parents' experiences of participation in childcare were identified: reasons for staying with the child, rescheduling of family's routine, expectations of nurses, and comments on facility provisions. The findings highlight parents' desire for participation in caring for their hospitalised child, their unexpressed needs for communication and concern about the non-monetary costs of participation.

CONCLUSIONS

Most parents viewed accompanying their hospitalised child as an unconditional aspect of being a parent and had a strong desire for participation. Parents' need for communication and emotional support during their participation of childcare in paediatric unit are universal. As Chinese parents are passive in seeking help, nurses should take the initiative in assessing their needs and offering them support accordingly.

Cultural variations in children's coping behaviour, TV viewing time, and family functioning

AIM

To examine children's coping behaviour, TV viewing hours and family functioning in four ethnic groups and factors related to children's coping behaviour.

METHODS

This study was part of two larger research projects investigating children's health behaviours in the United States and Taiwan. Fifty-six White American children of European ancestry, 66 Mexican American children, 68 Chinese American children and 95 native Taiwanese children were included in the analysis. Standardized instruments were used to measure coping strategies, children's TV viewing hours and family functioning.

RESULTS

There were significant differences in the types of stressor that children of different ethnicity reported. Similarities and differences were found in the four ethnic groups regarding the top five most frequently used and most effective coping strategies. Multiple regressions identified two variables that contributed significantly to the variance in the frequency of children's coping strategies--ethnicity and poorer behaviour control in the family. Ethnicity was the only variable found to contribute to the variance in coping effectiveness. Significant differences were found in the number of hours children spent watching TV.

CONCLUSIONS

Findings suggest that children of different ethnicity utilized different types of coping strategies and ethnicity is one of the important factors related to children's coping behaviour. These findings provide evidence for nurses to assess children's coping behaviour and TV viewing and provide children with healthier alternatives.

The symptom experience of hospitalised Chinese children and adolescents and relationship to pre-hospital factors and behaviour problems

PURPOSE

To describe the symptom experience of hospitalised Chinese children and adolescents and examine the relationship of symptoms to pre-hospital factors and child behaviour.

METHODS

Data were collected at two hospital sites in Hong Kong (HK) and at five hospitals in the Chinese Mainland (CM). A total of 307 hospitalised children and adolescents (ages 2-18) and their primary caregiver (e.g., mother, father or grandparent) participated in the study. Children and adolescents completed an age-appropriate symptom diary on one evening and subsequent morning early in their hospital stay. Parents completed the diary for the children less than 6 years of age. Parents also completed an age-appropriate Chinese version of the Child Behaviour Checklist.

RESULTS

Over 50% of the children and adolescents reported some degree of pain, 75% of them reported evening tiredness, and 21% reported gastrointestinal symptoms. The intensity of symptoms varied by age and region and symptoms often co-occurred. Greater symptom burden was predicted by previous surgery, higher level of worst pain prior to hospitalisation, parent report of child behaviour problems, and co-occurrence of other symptoms.

CONCLUSIONS

Hospitalised Chinese children manifest symptoms of pain, tiredness, and gastrointestinal distress that vary based on pre-hospital factors and are associated with child behaviour problems. Further research is needed to identify causes and treatments for children's symptoms.