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Zuccotti G, Marsilio M, Fiori L, Erba P, Destro F, Zamana C, Folgori L, Mandelli A, Braghieri D, Guglielmetti C, Pisarra M, Magnani L, Infante G, Dilillo D, Fabiano V, Carlucci P, Zoia E, Pelizzo G, Calcaterra V. Leveraging User-Friendly Mobile Medical Devices to Facilitate Early Hospital Discharges in a Pediatric Setting: A Randomized Trial Study Protocol. CHILDREN (BASEL, SWITZERLAND) 2024; 11:683. [PMID: 38929262 PMCID: PMC11201467 DOI: 10.3390/children11060683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/24/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges. AIMS This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through the use of an easy-to-use mobile medical device (TytoCare™, TytoCare Ltd., Natanya, Israel). OUTCOMES This study aims to assess the effectiveness of telehomecare in achieving complete resolution of diseases without readmission, compare the length of stay between intervention and standard care groups, and gather user and professional experiences. METHODS A randomized open-label, controlled pilot study enrolled 102 children, randomly assigned to the telehomecare (TELE) group (n = 51, adopting early hospital discharge with continued home monitoring) or the standard-of-care (STAND) group (n = 51). Primary outcomes include complete disease resolution without readmission. Secondary objectives include recording a shorter length of stay in the intervention group. Surveys on user and professional experiences were conducted. A group of 51 children declining telemedicine services (NO-TELE) was also included. RESULTS In the TELE group, 100% of children achieved complete disease resolution without readmission, with a median duration of stay of 4 days, significantly shorter than the 7 days in the STAND group (p = 0.01). The telemedicine system demonstrated efficient performance and high satisfaction levels. The NO-TELE group showed no significant differences in demographics or digital technology competence. Perceived benefits of telemedicine included time and cost savings, reduced hospital stays, and technology utility and usability. CONCLUSIONS This study demonstrates that user-friendly mobile medical devices effectively facilitate early hospital discharges in a pediatric setting. These devices serve as a bridge between home and hospital, optimizing care pathways.
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Affiliation(s)
- Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; (D.B.); (V.F.); (G.P.)
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Marta Marsilio
- Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy; (M.M.); (C.G.); (M.P.); (L.M.); (G.I.)
| | - Laura Fiori
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Paola Erba
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Francesca Destro
- Pediatric Surgery Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.D.); (C.Z.)
| | - Costantino Zamana
- Pediatric Surgery Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.D.); (C.Z.)
| | - Laura Folgori
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Anna Mandelli
- Intensive Care Unit, Buzzi Children’s Hospital, 20154 Milan, Italy; (A.M.); (E.Z.)
| | - Davide Braghieri
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; (D.B.); (V.F.); (G.P.)
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Chiara Guglielmetti
- Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy; (M.M.); (C.G.); (M.P.); (L.M.); (G.I.)
| | - Martina Pisarra
- Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy; (M.M.); (C.G.); (M.P.); (L.M.); (G.I.)
| | - Letizia Magnani
- Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy; (M.M.); (C.G.); (M.P.); (L.M.); (G.I.)
| | - Gabriele Infante
- Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy; (M.M.); (C.G.); (M.P.); (L.M.); (G.I.)
| | - Dario Dilillo
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Valentina Fabiano
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; (D.B.); (V.F.); (G.P.)
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Patrizia Carlucci
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
| | - Elena Zoia
- Intensive Care Unit, Buzzi Children’s Hospital, 20154 Milan, Italy; (A.M.); (E.Z.)
| | - Gloria Pelizzo
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; (D.B.); (V.F.); (G.P.)
- Pediatric Surgery Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.D.); (C.Z.)
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (L.F.); (P.E.); (L.F.); (D.D.); (P.C.); (V.C.)
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Fabio RA, Mento C, Gangemi A, Picciotto G. ADHD Symptoms Increase Perception of Classroom Entropy and Impact Teacher Stress Levels. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1082. [PMID: 37371313 DOI: 10.3390/children10061082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/14/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder among school-age children, characterized by persistent behavioral patterns of inattention and/or hyperactivity/impulsivity. These behaviors can create stress for teachers and negatively affect teacher-student interactions. This study hypothesized that a high frequency of ADHD students in the classroom can increase internal and external entropy, ultimately resulting in a negative stress impact on teachers. The physical concept of entropy, which measures the degree of disorder in a system, was used to better understand this relationship. The study evaluated 177 primary school teachers in their response to interacting with students with ADHD, using the Measurement of Psychological Stress (MPS) to evaluate subjective stress levels and the QUEIs and QUEIp questionnaires to measure structural and personal entropy. Path analysis was applied to identify the factors associated with the total score of MPS. The hypothesis was confirmed, as the frequency of ADHD students had a negative impact on teachers' entropy levels and personal entropy was found to significantly increase stress levels. The study highlights the negative impact of ADHD symptoms on stress levels and personal entropy of teachers when interacting with students with ADHD. These findings suggest the need for interventions aimed at balancing the frequency of students with ADHD and promoting positive training on stress reduction for teacher-student interactions.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Economics, University of Messina, 98122 Messina, Italy
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy
| | - Antonio Gangemi
- I.R.C.S.S. Bonino Puleio, 98100 Messina, Italy
- Madonna della Consolazione Polyclinic Nursing Home, 89124 Reggio, Italy
| | - Giulia Picciotto
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
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Rodríguez EM, Kumar H, Alba-Suarez J, Sánchez-Johnsen L. Parental coping, depressive symptoms, and children's asthma control and school attendance in low-income, racially, and ethnically diverse urban families. J Asthma 2017; 54:833-841. [PMID: 28095072 DOI: 10.1080/02770903.2016.1274402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Low-income urban children of color are at elevated risk for poor asthma control. This cross-sectional study examined associations among parents' coping (primary control, secondary control, and disengagement), parental depressive symptoms, and children's asthma outcomes (asthma control and school attendance) in a predominantly low-income, racially/ethnically diverse sample of families. METHODS Parents (N = 78; 90% female) of children (33% female; 46% Black; 38% Latino) aged 5-17 years (M = 9.5 years) reported on their own coping and depressive symptoms, their child's asthma control, and full and partial days of school missed due to asthma. RESULTS Parents' secondary control coping (i.e., coping efforts to accommodate/adapt to asthma-related stressors) was negatively correlated, and disengagement coping (i.e. coping efforts to avoid/detach from stressors) was positively correlated, with their depressive symptoms. Secondary control coping was also correlated with fewer partial days of school missed. Primary control coping (i.e., coping efforts to change stressors) was not associated with depressive symptoms or asthma outcomes. Parents' depressive symptoms were also positively correlated with poorer asthma control and partial days of school missed. Regression models showed direct and indirect effects of secondary control and disengagement coping on asthma outcomes via depressive symptoms, after controlling for demographic factors. CONCLUSIONS Parents' secondary control and disengagement coping are related to children's asthma outcomes. Secondary control coping may support parents' mental health and children's asthma control in low-income urban families.
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Affiliation(s)
- Erin M Rodríguez
- a Department of Educational Psychology , University of Texas at Austin , Austin , TX , USA
| | - Harsha Kumar
- b Department of Pediatrics , Division of Pulmonary, Allergy and Sleep Medicine, University of Illinois at Chicago , Chicago , IL , USA
| | - Juliana Alba-Suarez
- a Department of Educational Psychology , University of Texas at Austin , Austin , TX , USA
| | - Lisa Sánchez-Johnsen
- c Departments of Psychiatry and Surgery , University of Illinois at Chicago , Chicago , IL , USA
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Perception of medical care systems and stress responses in preschoolers' caregivers at a pediatric emergency department in Taiwan. Pediatr Emerg Care 2012; 28:1197-202. [PMID: 23114246 DOI: 10.1097/pec.0b013e318271be4f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study was undertaken to understand caregivers' perception of medical care systems and their stress responses throughout their stay with preschoolers at a pediatric emergency department (ED). METHODS Overall, 201 preschoolers' caregivers in pediatric ED were recruited in this study. They were asked to answer self-made questionnaires regarding the perception of medical care systems and their stress responses immediately before preschoolers' release. RESULTS The results show that caregivers with a low education or low income level were prone to exhibit greater appreciation for the efficiency of medical care systems and greater degree of anxiety for their lack of treatment and care knowledge than those of caregivers with a high education or high income level. Interestingly, caregivers older than 38 years reported greater emotional responses and physical exhaustion than did younger caregivers. Immigrant caregivers had higher emotional reaction and lower concentration than did Taiwanese caregivers. Paradoxically, caregivers undergoing over 3-time pediatric ED visits for observation expressed stronger stress reactions as compared with caregivers with less observation experiences. Not surprisingly, caregivers reported the highest emotional responses when their preschoolers were diagnosed as having very urgent degree in triage classification. Finally, caregivers' perception of "lack of family support" and "lack of treatment and care knowledge" correlated positively with all aspects of the stress responses. CONCLUSIONS These results indicate that attention should be paid to the specific psychological weakness and need for the caregivers with certain demographic characteristics by the medical team in pediatric ED.
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Borhani F, Asadi N, Mohsenpour M. The experiences of mothers with asthmatic children: a content analysis. J Caring Sci 2012; 1:115-21. [PMID: 25276685 PMCID: PMC4161072 DOI: 10.5681/jcs.2012.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 02/09/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Having children with chronic diseases such as asthma creates conditions that cause emotional and behavioral problems in parents. In most families, the mother tends to have the first role in caring for her child and therefore mothers endure greater psychological pressure than other family members. These mothers' experiences and problems are different due to cultural and economic differences and the health services they receive. This study aimed to explore the experiences of mothers of an asthmatic child. METHODS In this qualitative study data was collected through unstructured, in-depth interviews with 10 mothers who had an asthmatic child. The Graneheim and Lundman's qualitative content analysis method was used for analyzing the data. RESULTS The analysis of data showed five main themes including constant concern, feeling of having an unusual life, the need for help from others, feeling of guilt, and the desire to constantly monitor the child. CONCLUSION The mothers of asthmatic children expressed feelings and experiences that demonstrated their need for support and empathy. Therefore, in addition to the necessity of developing strategies to support these mothers, future studies aiming to reveal methods to provide them with support are also required.
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Affiliation(s)
- Fariba Borhani
- PhD, Assistant Professor, Department of Nursing, Razi Faculty of Nursing and
Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Neda Asadi
- MSc, Instructor, Department of Nursing, Razi Faculty of Nursing and Midwifery,
Kerman University of Medical Sciences, Ker-man, Iran
| | - Mohadeseh Mohsenpour
- MSc, Instructor, Department of Nursing, Faculty of Nursing and Midwifery,
Sabzevar University of Medical Sciences, Sabzevar, Iran
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Kirk KD, Fedele DA, Wolfe-Christensen C, Phillips TM, Mazur T, Mullins LL, Chernausek SD, Wisniewski AB. Parenting characteristics of female caregivers of children affected by chronic endocrine conditions: a comparison between disorders of sex development and type 1 diabetes mellitus. J Pediatr Nurs 2011; 26:e29-36. [PMID: 21911316 DOI: 10.1016/j.pedn.2010.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 10/14/2010] [Accepted: 10/17/2010] [Indexed: 10/18/2022]
Abstract
Rearing a child with a chronic illness is stressful and can potentially affect parenting style, which may result in poorer outcomes for children. The purpose of this study was to compare parenting characteristics of female caregivers rearing children with a disorder of sex development (DSD) to female caregivers rearing children with type 1 diabetes mellitus (T1DM). Caregivers of both groups were matched according to age and compared on measures of stress and parenting practices. Both groups demonstrated significant levels of stress and negative parenting practices. Children with T1DM and male children with non-life-threatening DSD were perceived as more vulnerable by their caregivers. Better understanding of parenting experiences of female caregivers rearing children with DSD, particularly male children, will facilitate the development of individualized interventions to ameliorate negative parenting practices and stress, with the long-term goal of improved health outcomes for their children.
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Affiliation(s)
- Katherine D Kirk
- University of Oklahoma College of Nursing, Oklahoma City, OK, USA.
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Garro A. Coping patterns in Latino families of children with asthma. J Pediatr Health Care 2011; 25:347-54. [PMID: 22018425 DOI: 10.1016/j.pedhc.2010.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 03/19/2010] [Accepted: 04/11/2010] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Using the Coping Health Inventory for Parents (CHIP), this study examined coping behaviors in 26 Latino parents of children with asthma. METHODS Correlations and t tests were used to look at variables related to the parents' coping patterns and to compare their frequency of usage of these patterns. RESULTS The parents in this study were most likely to cope with their child's asthma by making active attempts to understand this condition, doing activities with family members, and maintaining an optimistic perspective. Child and family variables were not significantly associated with parents' usage of coping patterns. DISCUSSION These results shed light on coping in Latino families of children with asthma and contribute to a growing framework of research and practice regarding health problems in this population. The aforementioned results can enhance health care professionals' understanding of the experiences of these families and help develop and expand culturally sensitive interventions to positively affect their health and psychological needs.
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Swallow V, Macfadyen A, Santacroce SJ, Lambert H. Fathers' contributions to the management of their child's long-term medical condition: a narrative review of the literature. Health Expect 2011; 15:157-75. [PMID: 21624023 DOI: 10.1111/j.1369-7625.2011.00674.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Fathers' contributions to the management of long-term childhood medical conditions are under-represented in the literature; therefore, the full extent of their involvement is poorly understood by practitioners and researchers, so strategies for promoting their involvement have not yet been fully considered. OBJECTIVE To review studies of fathers' actual contributions in a wide range of conditions, the potential to optimize their contribution through additional interventions by health professionals and a direction for future research. DESIGN Narrative review of the literature. METHODS CINAHL, Medline, PsychInfo and ERIC databases were searched electronically between the years 1995-2008. The terms adherence, adjustment, child, chronic, compliance, concordance, condition, coping, disease, father, illness, information, long-term, management/intervention, mother, role, self-care and treatment were searched for separately and in combination. English language papers reporting primary research were selected and supplemented by hand-searching reference lists. Thirty-five papers (arising from 29 studies) met criteria and were selected for narrative review. RESULTS Five themes were identified: (i) the impact of long-term conditions on fathers' ability to promote their child's well-being, (ii) factors influencing fathers' involvement in health care, (iii) personal growth/beneficial effects for fathers, (iv) the impact of father's involvement on family functioning and (v) strategies that increase fathers' participation in their child's health care and in research investigating fathers' participation. CONCLUSIONS The review suggests that fathers' involvement in children's health care can positively impact on fathers', mothers' and children's well-being and family functioning. A range of strategies are identified to inform the promotion of fathers' contributions and future research investigating their input.
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Affiliation(s)
- Veronica Swallow
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
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Cheng SC, Chen YC, Liou YM, Wang KWK, Mu PF. Mothers' experience with 1st-3rd-grade children with asthma assisting their child's adaptation of school life in Taiwan. J Clin Nurs 2011; 19:1960-8. [PMID: 20920022 DOI: 10.1111/j.1365-2702.2009.03137.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study used purposive sampling through semi-structured interviews to obtain the experiences of mothers of 7-11-year-old children with asthma who were assisting their child's adaptation to school life. BACKGROUND Children with asthma often have problems with social adaptation, including school absenteeism, limits to their activity and bullying by peers. From kindergarten to elementary school, it is a transitional process where the child experiences multiple changes in the body, mind and social situations. It can be difficult for mothers of children with asthma to assist their children with their adaptation to school life. DESIGN A qualitative enquiry design was used. METHODS A total of 15 mothers having elementary school children with asthma in grades 1-3 were interviewed. Participants were contacted at the outpatient department of a medical centre in Taiwan. Verbatim transcriptions of the interviews were examined by the content analysis method. After analysis of the interview data of the 15 informants, no new themes had emerged. Lincoln and Guba's trustworthiness criteria were employed to evaluate methodological rigour. RESULTS There were four themes that formed part of the mothers' experiences. Those were: (1) being concerned about the child's adaptation to school life, (2) improving attitudes and relieving symptoms, (3) establishing the child's self-management abilities and (4) bearing role strain and normalising the life of the child. CONCLUSIONS The findings of this study should help health professionals and schoolteachers to understand the needs of families and mothers who have a child with asthma. The findings provide appropriate information and resources to assist the children's adjustment to school life. RELEVANCE TO CLINICAL PRACTICE The findings indicate that nursing professionals should provide child-focused and family-centred care that will assist parents of children with asthma to adjust to school life.
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Affiliation(s)
- Shu-Chen Cheng
- Department of Nursing, Tsu-Chi College of Technology, Taipei, Taiwan
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The role of parents in managing asthma in middle childhood: an important consideration in chronic care. Collegian 2010; 17:71-6. [PMID: 20738059 DOI: 10.1016/j.colegn.2010.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Asthma is a significant illness for Australian children and their families. In childhood, parents have the primary responsibility for managing asthma on a day-to-day basis, and therefore understanding the management of asthma by parents is important to nursing practice. Middle childhood (5-12 years) is an important time in the lives of children and families with asthma, as children commence school and spend increasing amounts of time away from direct parental care. In order to manage asthma during middle childhood, parents need to understand asthma as an illness, understand the treatment of asthma, be able to monitor and respond to changes in condition, manage other carers, manage asthma in the context of family life and guide the development of self-management responsibility in their child with asthma. While the scope of parent management in terms of asthma knowledge and treatment has been well explored in the literature, less is known about the process by which parents support the development of self-management responsibility in children with asthma.
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Commodari E. Children staying in hospital: a research on psychological stress of caregivers. Ital J Pediatr 2010; 36:40. [PMID: 20500854 PMCID: PMC2883985 DOI: 10.1186/1824-7288-36-40] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 05/25/2010] [Indexed: 11/25/2022] Open
Abstract
Background Having a child hospitalized is a stressful event for parents. Previous studies have found increased stress in families with children affected by different kinds of pathologies, and analyzed disease related objective variables producing stress. However, most of these studies recruited caregivers of children with chronic or serious illnesses, and focused on evaluation of objective environmental stressors and did not consider subjective "perception" of stress. The aim of this study was to investigate perception of acute stress in caregivers taking care of children without serious physical damage that were hospitalized for short periods. Moreover, some variables, such as recreational and school services offered to children, influencing perception of cognitive, physiological and behavioral state relating to the sensation of "being stressed" were analyzed. Methods This study was realized with a sample of caregivers of children hospitalized for mild acute diseases. Research was conducted using two standardized tests, PSM (Psychological Stress Measure) and STAI (State Trait Anxiety Inventory), whose characteristics of reliability and validity had been successfully established. Results Present data showed that caregivers of hospitalized children perceived high levels of stress and anxiety. Perception of stress was influenced by the degree of kindred with patients, length of hospitalization, and, notably, participation in some of the activities offered to children, mainly school services. Discussion Findings showed that child hospitalization is a stressful event for caregivers, even if hospitalization is for middle and transient pathologies. Perception of stress was influenced by length of hospitalization, and by degree of kindred. Findings even suggest that some services offered to children can modulate caregivers' perception of stress and impact of hospitalization. Caregivers whose children used school services describe themselves as less irritable and with higher emotional control compared to other caregivers. Considering the importance of education in a child's life, the possibility to continue school activities helped caregivers to feel less under pressure. In the light of this finding, amelioration of scholastic activities in pediatric departments may represent a critical point in order to provide a more agreeable hospital stay for children and their caregivers and, as a consequence, improve family involvement in care management.
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Affiliation(s)
- Elena Commodari
- Department of Educational Processes, Faculty of Education, University of Catania, Via Ofelia, Catania 95100, Italy.
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Ojmyr-Joelsson M, Nisell M, Frenckner B, Rydelius PA, Christensson K. A gender perspective on the extent to which mothers and fathers each take responsibility for care of a child with high and intermediate imperforate anus. J Pediatr Nurs 2009; 24:207-15. [PMID: 19467434 DOI: 10.1016/j.pedn.2007.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 08/22/2007] [Accepted: 09/14/2007] [Indexed: 11/18/2022]
Abstract
Imperforate anus is a malformation of the child's anus. Parents' experiences of responsibility for care of the child may differ. The aim of this study was to evaluate a gender perspective on the extent to which mothers and fathers each take responsibility for the care of a child with high and intermediate imperforate anus. Parents of children with imperforate anus and two control groups of children and parents participated. Data collection with questionnaires focusing on responsibility was performed. In conclusion, our study revealed additional evidence of unevenly divided parental responsibility for care of a child with a chronic condition. The mothers in this study were shown to be the primary caregiver.
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Affiliation(s)
- Maria Ojmyr-Joelsson
- Pediatric Surgery Unit, Department of Woman and Child Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
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Cashin GH, Small SP, Solberg SM. The lived experience of fathers who have children with asthma: a phenomenological study. J Pediatr Nurs 2008; 23:372-85. [PMID: 18804018 DOI: 10.1016/j.pedn.2007.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2007] [Revised: 07/31/2007] [Accepted: 08/01/2007] [Indexed: 10/22/2022]
Abstract
Asthma is a common chronic illness of childhood and a major cause of school absenteeism and hospitalization. When a child is diagnosed with asthma, parents become responsible for the long-term management of a chronic condition that is characterized by unpredictable and irregular episodes. Much of the research concerning parenting children who have asthma had focused on mothers. Paternal experiences in caring for a child with asthma have received little attention. In this phenomenological study, van Manen's (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. The Althouse Press: London, ON) method of inquiry was used to explore the lived experience of fathers who have children with asthma. Eight fathers with children aged between 7 and 11 years who had been diagnosed with asthma were interviewed. Five themes were identified: feeling relief in knowing the diagnosis, learning the ropes, being vigilant, living with concern, and being comfortable with asthma management. Understanding the experience of fathers who have children with asthma and gaining insight into their needs and concerns are essential first steps to providing supportive nursing care.
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Reichenberg K, Hallberg LRM. Allowing for the opposite: the parents of asthmatic children cooperate by making use of each other's differences. J Health Psychol 2008; 13:659-68. [PMID: 18519439 DOI: 10.1177/1359105307082451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article focuses on one of the interactive processes that parents use to cope with their child's asthma. The concept allowing for the opposite was developed in the course of a clinical project designed to improve consultation methods in pediatric allergy care. We examined material from 67 conversations carried out with 22 heterosexual couples held with two family therapists: one male pediatrician and one female social worker. We found that parents made use of each other's differences in personality and parenting style, allowing each other to take opposing positions on how to cope with their child's asthma. Disagreement should be added to the list of coping mechanisms used by parents in their cooperative efforts to handle their child's asthma.
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Affiliation(s)
- Kjell Reichenberg
- Nordic School of Public Health and Department of Public Health and Community Medicine, Göteborg University, Göteberg, Sweden, Halmstad University, Sweden.
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Mangan JM, Wittich AR, Gerald LB. The potential for reducing asthma disparities through improved family and social function and modified health behaviors. Chest 2008; 132:789S-801S. [PMID: 17998343 DOI: 10.1378/chest.07-1908] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The National Workshop To Reduce Asthma Disparities assembled a multidisciplinary group comprised of scientists, clinicians, and community representatives to examine factors related to asthma disparities. Attention was given to the importance of discerning family, social, and behavioral factors that facilitate or impede the use of health-care services suitable to the medical status of an individual. This review highlights select biopsychosocial factors that contribute to these disparities, the manner in which they may contribute or protect persons affected by asthma, and recommended directions for future research.
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Affiliation(s)
- Joan M Mangan
- Lung Health Center, University of Alabama at Birmingham, 618 20th S St, OHB 138, Birmingham, AL 35233-7337, USA.
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16
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Correlates of Maternal and Paternal Adjustment to Chronic Childhood Disease. J Clin Psychol Med Settings 2007. [DOI: 10.1007/s10880-007-9069-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Pelchat D, Lefebvre H, Levert MJ. Gender differences and similarities in the experience of parenting a child with a health problem: current state of knowledge. J Child Health Care 2007; 11:112-31. [PMID: 17494986 DOI: 10.1177/1367493507076064] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The birth of a child is a transitional situation that triggers stress in the family and each person has to use adjustment strategies allowing them to reposition gradually in relation to themselves and other members of the family, and to make space for the new arrival. When the child has a health problem, the stress on the parents is correspondingly greater. Research shows that fathers and mothers of a child with a health problem experience this ordeal differently. This article reports on the current state of knowledge about the experience of fathers and mothers of a child with a health problem, and suggests new directions for research to provide a fuller understanding of their experience.
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Gillespie CA, Woodgate RL, Chalmers KI, Watson WTA. "Living with risk": mothering a child with food-induced anaphylaxis. J Pediatr Nurs 2007; 22:30-42. [PMID: 17234496 DOI: 10.1016/j.pedn.2006.05.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Food-induced anaphylaxis (FIA) affects an increasing number of children and families encountered in a variety of nursing environments. Sensitive nursing care requires consideration of the psychosocial impact of the condition. The purpose of this phenomenological study was to arrive at an understanding of the mother's lived experience of parenting a child with FIA. Semistructured interviews were conducted with six mothers of children 6 to 12 years old considered at risk for FIA. Data analysis was carried out concurrently with data collection, revealing "Living with Risk" as the essence of the experience, supported by five themes: "Living with Fear," "Worrying About Well-Being," "Looking for Control," "Relying on Resources," and "It Is Hard But It Is Not." These findings should assist nurses in meeting families' education and support needs related to FIA.
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Abstract
Asthma is one of the most common chronic diseases in children and is frequently noted as the reason for school absences. The purpose of this pilot study was to determine the differences in demands and resources reported by African American (AA) and European American (EA) parents of school-age children with asthma. A convenience sample of 37 parents participated in the study. Data were collected from 19 AA and 18 EA parents. Family stress theory provided the framework for this study. All subjects completed a demographic questionnaire, the Care of My Child With Asthma Scale, and the Family Inventory of Resources for Management (FIRM). Descriptive statistics were used to analyze the data. The most time-consuming caregiving demand reported by EA parents was providing emotional support for the child. For AA parents, the most time-consuming caregiving demand was managing work or school outside the home and organizing asthma treatments at the same time. AA parents had limited resources in the area of extended family social support. The Mann-Whitney U test found no statistically significant differences between AA and EA parents in relation to demands and resources. Nursing implications are presented.
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Pelchat D, Lefebvre H, Levert MJ. L’expérience des pères et mères ayant un enfant atteint d’un problème de santé : état actuel des connaissances*. ENFANCES, FAMILLES, GÉNÉRATIONS 2006. [DOI: 10.7202/012536ar] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
La naissance d’un enfant est une situation transitionnelle qui suscite un stress au sein de la famille et implique la mise en oeuvre de stratégies adaptatives qui permettront graduellement à chacun de se resituer face à lui-même et face à l’autre et de faire une place à ce nouvel être. Lorsque l’enfant présente un problème de santé, le stress ressenti par les parents est d’autant plus important. Les recherches montrent que les pères et les mères d’enfant atteint d’un problème de santé vivent différemment cette expérience. Cet article vise à faire le point sur l’état actuel des connaissances de l’expérience des pères et des mères d’enfant atteint d’une problématique de santé et à proposer de nouvelles avenues de recherche permettant une meilleure compréhension de leur expérience.
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Affiliation(s)
- Diane Pelchat
- Faculté des sciences infirmièresUniversité de Montréal
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Hopia H, Paavilainen E, Astedt-Kurki P. The diversity of family health: constituent systems and resources. Scand J Caring Sci 2005; 19:186-95. [PMID: 16101846 DOI: 10.1111/j.1471-6712.2005.00340.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to explore changes in family health associated with child's chronic illness and hospitalization. The aim was to answer the following questions: (i) What kind of changes do families experience when a child in the family is afflicted by a chronic illness; and (ii) What kind of changes do families experience when their child is admitted to hospital? The data were collected in 2002 in interviews with 29 such families whose children were receiving treatment or who had previously received treatment on the paediatric wards of two hospitals in Finland. Data were collected until reaching theoretical saturation, in which no additional data are found. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Family health was formed out of two different dimensions: the constituent systems and the resources of family health. The constituent systems describe the impact of the child's chronic illness and period of hospitalization at the level of both individual family members and the family as a whole. These systems were described by five categories: (i) ill child at the centre of family attention, (ii) siblings in a minor role, (iii) the child's illness governs parental well-being, (iv) the roller coaster of the couple relationship and (v) the whole family is ill. The resources promoting and maintaining family health were divided into six different categories: (i) creative and maintaining mental images, (ii) active involvement, (iii) internal coping means, (iv) reinforcement of coping means, (v) awareness and change of values and (vi) social network shares emotional burden and responsibility for care. The results of the study show that family health is highly vulnerable when a child has to be admitted to hospital because of a chronic condition. They should help nursing staff gain a clearer picture of the depth and diversity of family health and support the resources that promote family health. Future research should study the methods of family nursing used in the care of families with children with chronic conditions.
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Affiliation(s)
- Hanna Hopia
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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22
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Garro A, Thurman SK, Kerwin ME, Ducette JP. Parent/caregiver stress during pediatric hospitalization for chronic feeding problems. J Pediatr Nurs 2005; 20:268-75. [PMID: 16030506 DOI: 10.1016/j.pedn.2005.02.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined changes in stress in 37 mothers/caregivers of children with chronic feeding problems. Stress was measured by the Parenting Stress Index-Short Form at three specific stages during pediatric hospitalization for treatment of chronic feeding problems. The relationship between caregiver stress and stage of hospitalization as well as that between stress and various child and family variables were investigated. Repeated-measures analyses of variance and t tests found that stress related to social isolation and self-perception and total parenting stress changed significantly in relation to the stage of hospitalization. Correlational analyses indicated that caregiver stress was positively related to the presence of mental retardation, oral-motor dysfunction, tonal abnormalities, or a pervasive developmental disorder in the hospitalized child. Caregiver stress was negatively related to coping strategies that involved understanding the child's medical situation. These results provide a more comprehensive picture of families of children with chronic feeding problems, a population that has received little attention in the research literature. Information regarding parent/caregiver stress during a child's hospitalization can enhance nurses' understanding of the experiences of these families, thereby contributing to more effective treatment planning. In addition, the results emphasize the need to examine a variety of child and family factors that may influence parenting stress as well as family involvement in intervention services.
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Affiliation(s)
- Adrienne Garro
- Department of Psychology, Kean University, Union, NJ 07083, USA.
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Abstract
AIMS This paper reports a study (a) to assess whether there are cultural and gender differences in parents' general well-being, sense of coherence and perception of family hardiness when they have a young child with asthma; and (b) to examine the effects of parents' sense of coherence and well-being on family hardiness. BACKGROUND Research on hardiness, a resilience factor that fosters adaptation over time, has been widely studied from an individual perspective, but less from the viewpoint of the family unit. In particular, no study was found that assessed how members of a couple interact to affect their family's hardiness. Consideration of this dyadic phenomenon may provide unique insight about how family members interact with each other faced with a challenge, such as the chronic illness of a child. METHODS A cross-sectional research design was used with a sample of 137 two-parent families [76 from Iceland and 61 from the United States of America (USA)]. Questionnaires measuring sense of coherence, parents' well-being and family hardiness were used, and demographic data were also collected. RESULTS The most striking differences in well-being were between mothers and fathers. In addition to a lower average on the total score for the well-being scale, mothers had poorer scores than fathers on the subscales of depression, self-control, vitality, and general health. Family hardiness differed between countries. The regression indicated that the individual's sense of coherence, depression and positive well-being (all actor effects), as well as the partner's anxiety (partner effect) all contributed significantly to family hardiness, as did nationality. CONCLUSION Focused interventions for families with young children with asthma should be developed to enable them to feel more confident in using their resources to meet their demands and increase parents' general well-being and family adaptation. Research is needed to develop and test such interventions, particularly with diverse participant samples, encompassing not only a variety of ethnicities, but also a range of children's ages.
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Martin SC, Wolters PL, Klaas PA, Perez L, Wood LV. Coping styles among families of children with HIV infection. AIDS Care 2004; 16:283-92. [PMID: 15203422 DOI: 10.1080/09540120410001665295] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The primary aim of this study was to examine coping strategies among families of HIV-infected children and how they relate to medical, central nervous system (CNS) and family environment factors. Caregivers of HIV-positive children (N=52) completed a family coping measure (F-COPES) and provided information regarding family environment. Data regarding medical and CNS status were obtained from patient records. Results indicated that families' passive coping and spiritual support were among the coping techniques used most often, and social support was used least often. Medical variables were unrelated to any coping styles. Families of children with CNS impairment endorsed more passive coping techniques than families of children with no apparent deficits. A trend was found for non-biological caregivers to seek out more community resources and support than biological caregivers. Findings suggest the need to target families least likely to utilize resources, and to teach them to effectively seek out and benefit from social and community supports.
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Affiliation(s)
- S C Martin
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD 20892, USA.
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Abstract
INTRODUCTION In this study, with use of the Coping Health Inventory for Parents (CHIP), coping behaviors were examined in 35 mothers/ caregivers of children with chronic feeding problems during hospitalization for treatment of these problems. Coping in families of children with these problems has not been addressed in research. This information is beneficial in planning and implementing treatment and follow-up services. METHOD Correlations and t tests were used to look at variables related to the mothers'/caregivers' coping patterns and to compare their frequency of usage of these patterns. RESULTS The mothers/caregivers in this study were most likely to cope with their child's feeding problems by making active attempts to understand the problems and by doing activities with family members. Several child and family variables were significantly related to maternal coping patterns. DISCUSSION These results suggest that it is important to provide a variety of resources to families of children with chronic feeding problems during their children's hospitalizations, including access to support and information groups. The results also suggest that it is beneficial for these families to acquire a thorough understanding of their child's medical situation because this understanding seems to help them in their ability to cope.
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Affiliation(s)
- Adrienne Garro
- Department of Psychology, Kean University, Union, NJ 07083, USA.
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