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Li X, Wang X, Wang T, Yu H, Zhou Y, Wang H, Shi X. Multimethod assessing the prognosis affecting factors of hospitalized children with burns in Zunyi, southwest China. Wien Klin Wochenschr 2020; 133:194-201. [PMID: 32435871 DOI: 10.1007/s00508-020-01676-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/04/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Burns are a common type of injury in children worldwide, which cause a large number of casualties each year. This study aimed to explore the clinical epidemiological characteristics and assess the prognosis affecting factors of hospitalized children with burns using multimethods. METHODS This was a cross-sectional study of pediatric burns in southwest China. Demographic characteristics and mechanism of burns were surveyed and clinical data, the length of hospital stay (LOS) and outcome were extracted from the medical records. The prognosis affecting factors of burns were analyzed by both logistic regression and path analysis. RESULTS A total of 111 children with burns were surveyed (63.06% males). The median age was 2.08 years (interquartile range, IQR 1.25-3.75), and most patients (69.37%) were under 3 years old. Hot liquid was the major etiology (79.28%) and most burns occurred at home (83.78%). The total body surface area (TBSA) was mainly less than 10% (56.88%) with deep partial thickness (59.63%); however, 55.86% children did not receive any first-aid measures after burns. Path analysis showed that skin grafting surgery could reduce LOS, while TBSA greatly prolonged LOS. Multivariate analysis showed that age (hazard ratio, HR = 1.65) and burn depth (HR = 13.49) were risk factors for scarring. The TBSA (HR = 3.52) and burn depth (HR = 10.52) were risk influencing factors for limb mobility. CONCLUSION In southwest China children under 3 years old, scald burns are most common, and most burns occur at home. It seems that TBSA, skin grafting, age and burn depth are best predictors of the prognosis in hospitalized children with burns.
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Affiliation(s)
- Xiahong Li
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Xue Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Tao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Huiting Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Yanna Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Haiyan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, 563006, Zunyi, Guizhou, China.
- Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
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Hou H, Ding G, Zhao X, Meng Z, Xu J, Guo Z, Zheng Y, Li D, Wang W. Comparisons between protocols and publications of case-control studies: analysis of potential causes of non-reproducibility and recommendations for enhancing the quality of personalization in healthcare. EPMA J 2019; 10:101-108. [PMID: 31258815 DOI: 10.1007/s13167-019-00165-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/08/2019] [Indexed: 01/16/2023]
Abstract
Background Selective reporting of results in published case-control studies has been widely suspected, but little comprehensive information on selective reporting is available with regard to case-control studies. We aimed to evaluate the concordance of findings between publications and the protocols of case-control studies and to assess the level of selective reporting of results in case-control studies. Methods The databases of Embase, Medline, Scopus, and Web of Science were searched to identify case-control study protocols published between January 1, 1990 and December 31, 2017. The numbers and characteristics of predefined exposures (or factors) were extracted from the protocols. The reported and unreported factors were both collected from the published studies and protocols. The frequency of selective reporting of results were estimated by identifying the discrepancies of factors between the protocols and the published studies. Study sample size and the extent of selective reporting of factors were measured by a Spearman correlation analysis. Results Fourteen protocols with 24 published studies and 159 factors were identified, of which eight protocols (57.1%) had discrepancies between the publications and protocols. The prevalence of incomplete reporting in published case-control studies was 42.9% (6/14), with participant characteristics, anthropometric and laboratory measurement variables more likely to be unreported. A total of 16,835 cases and 56,049 controls were recruited in the 14 protocols of case-control studies (sample size ranges from 428 to 52,596 per study). Sample size had no statistical significance with selective reporting of results (P > 0.05). Conclusion The study protocols should be publicly available prior to the completion of case-control studies so that the potential bias can be assessed by the readers. Our findings highlight the need for investigators, peer reviewers, and readers to exercise increased awareness and scrutiny due to the undesirable practice of selective reporting of results in medical sciences causing the loss of potentially important information, thus impacting quality of personalized attitude in healthcare in the context of the predictive, preventive, and personalized medicine.
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Affiliation(s)
- Haifeng Hou
- 1School of Public Health, Taishan Medical University, Taian, China.,2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Guoyong Ding
- 1School of Public Health, Taishan Medical University, Taian, China
| | - Xuan Zhao
- 1School of Public Health, Taishan Medical University, Taian, China
| | - Zixiu Meng
- 1School of Public Health, Taishan Medical University, Taian, China
| | - Jiangmin Xu
- 3School of Health Sciences, Winston-Salem State University, Winston-Salem, USA
| | - Zheng Guo
- 2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Yulu Zheng
- 2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Dong Li
- 1School of Public Health, Taishan Medical University, Taian, China
| | - Wei Wang
- 1School of Public Health, Taishan Medical University, Taian, China.,2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
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Kendrick D, Ablewhite J, Achana F, Benford P, Clacy R, Coffey F, Cooper N, Coupland C, Deave T, Goodenough T, Hawkins A, Hayes M, Hindmarch P, Hubbard S, Kay B, Kumar A, Majsak-Newman G, McColl E, McDaid L, Miller P, Mulvaney C, Peel I, Pitchforth E, Reading R, Saramago P, Stewart J, Sutton A, Timblin C, Towner E, Watson MC, Wynn P, Young B, Zou K. Keeping Children Safe: a multicentre programme of research to increase the evidence base for preventing unintentional injuries in the home in the under-fives. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BackgroundUnintentional injuries among 0- to 4-year-olds are a major public health problem incurring substantial NHS, individual and societal costs. However, evidence on the effectiveness and cost-effectiveness of preventative interventions is lacking.AimTo increase the evidence base for thermal injury, falls and poisoning prevention for the under-fives.MethodsSix work streams comprising five multicentre case–control studies assessing risk and protective factors, a study measuring quality of life and injury costs, national surveys of children’s centres, interviews with children’s centre staff and parents, a systematic review of barriers to, and facilitators of, prevention and systematic overviews, meta-analyses and decision analyses of home safety interventions. Evidence from these studies informed the design of an injury prevention briefing (IPB) for children’s centres for preventing fire-related injuries and implementation support (training and facilitation). This was evaluated by a three-arm cluster randomised controlled trial comparing IPB and support (IPB+), IPB only (no support) and usual care. The primary outcome was parent-reported possession of a fire escape plan. Evidence from all work streams subsequently informed the design of an IPB for preventing thermal injuries, falls and poisoning.ResultsModifiable risk factors for falls, poisoning and scalds were found. Most injured children and their families incurred small to moderate health-care and non-health-care costs, with a few incurring more substantial costs. Meta-analyses and decision analyses found that home safety interventions increased the use of smoke alarms and stair gates, promoted safe hot tap water temperatures, fire escape planning and storage of medicines and household products, and reduced baby walker use. Generally, more intensive interventions were the most effective, but these were not always the most cost-effective interventions. Children’s centre and parental barriers to, and facilitators of, injury prevention were identified. Children’s centres were interested in preventing injuries, and believed that they could prevent them, but few had an evidence-based strategic approach and they needed support to develop this. The IPB was implemented by children’s centres in both intervention arms, with greater implementation in the IPB+ arm. Compared with usual care, more IPB+ arm families received advice on key safety messages, and more families in each intervention arm attended fire safety sessions. The intervention did not increase the prevalence of fire escape plans [adjusted odds ratio (AOR) IPB only vs. usual care 0.93, 95% confidence interval (CI) 0.58 to 1.49; AOR IPB+ vs. usual care 1.41, 95% CI 0.91 to 2.20] but did increase the proportion of families reporting more fire escape behaviours (AOR IPB only vs. usual care 2.56, 95% CI 1.38 to 4.76; AOR IPB+ vs. usual care 1.78, 95% CI 1.01 to 3.15). IPB-only families were less likely to report match play by children (AOR 0.27, 95% CI 0.08 to 0.94) and reported more bedtime fire safety routines (AOR for a 1-unit increase in the number of routines 1.59, 95% CI 1.09 to 2.31) than usual-care families. The IPB-only intervention was less costly and marginally more effective than usual care. The IPB+ intervention was more costly and marginally more effective than usual care.LimitationsOur case–control studies demonstrate associations between modifiable risk factors and injuries but not causality. Some injury cost estimates are imprecise because of small numbers. Systematic reviews and meta-analyses were limited by the quality of the included studies, the small numbers of studies reporting outcomes and significant heterogeneity, partly explained by differences in interventions. Network meta-analysis (NMA) categorised interventions more finely, but some variation remained. Decision analyses are likely to underestimate cost-effectiveness for a number of reasons. IPB implementation varied between children’s centres. Greater implementation may have resulted in changes in more fire safety behaviours.ConclusionsOur studies provide new evidence about the effectiveness of, as well as economic evaluation of, home safety interventions. Evidence-based resources for preventing thermal injuries, falls and scalds were developed. Providing such resources to children’s centres increases their injury prevention activity and some parental safety behaviours.Future workFurther randomised controlled trials, meta-analyses and NMAs are needed to evaluate the effectiveness and cost-effectiveness of home safety interventions. Further work is required to measure NHS, family and societal costs and utility decrements for childhood home injuries and to evaluate complex multicomponent interventions such as home safety schemes using a single analytical model.Trial registrationCurrent Controlled Trials ISRCTN65067450 and ClinicalTrials.gov NCT01452191.FundingThe National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 14. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Denise Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Joanne Ablewhite
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Felix Achana
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Penny Benford
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Rose Clacy
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Frank Coffey
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Nicola Cooper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Carol Coupland
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Toity Deave
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
| | - Trudy Goodenough
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
| | - Adrian Hawkins
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mike Hayes
- Child Accident Prevention Trust, London, UK
| | - Paul Hindmarch
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stephanie Hubbard
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Bryony Kay
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Arun Kumar
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | | | - Elaine McColl
- Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Lisa McDaid
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Phil Miller
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Isabel Peel
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Richard Reading
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Norfolk Community Health and Care NHS Trust, Norwich, UK
| | - Pedro Saramago
- Centre for Health Economics, University of York, York, UK
| | - Jane Stewart
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Alex Sutton
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Clare Timblin
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Elizabeth Towner
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
| | - Michael C Watson
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Persephone Wynn
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Ben Young
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Kun Zou
- Division of Primary Care, University of Nottingham, Nottingham, UK
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Kendrick D, Majsak-Newman G, Benford P, Coupland C, Timblin C, Hayes M, Goodenough T, Hawkins A, Reading R. Poison prevention practices and medically attended poisoning in young children: multicentre case–control study. Inj Prev 2016; 23:93-101. [DOI: 10.1136/injuryprev-2015-041828] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/24/2016] [Accepted: 04/20/2016] [Indexed: 11/04/2022]
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Stewart J, Benford P, Wynn P, Watson MC, Coupland C, Deave T, Hindmarch P, Majsak-Newman G, Kendrick D. Modifiable risk factors for scald injury in children under 5 years of age: A Multi-centre Case-Control Study. Burns 2016; 42:1831-1843. [PMID: 27576925 DOI: 10.1016/j.burns.2016.06.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/18/2016] [Accepted: 06/24/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. METHODS Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, gender, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. RESULTS Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63 to 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12 to 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33 to 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30 to 2.75; PAF 26%). CONCLUSIONS Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children.
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Affiliation(s)
- Jane Stewart
- Nottinghamshire Healthcare NHS Foundation Trust, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, United Kingdom.
| | - Penny Benford
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Persephone Wynn
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Michael Craig Watson
- Faculty of Medicine and Health Sciences, University of Nottingham, School of Health Sciences, D1019, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom
| | - Carol Coupland
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
| | - Toity Deave
- Centre for Child & Adolescent Health, Faculty of Health & Life Sciences, University of the West of England Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Paul Hindmarch
- Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Gosia Majsak-Newman
- Norfolk and Norwich University Hospitals NHS Foundation Trust, NHS Clinical Research & Trials Unit, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Denise Kendrick
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
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Lindemann U, Schwenk M, Klenk J, Kessler M, Weyrich M, Kurz F, Becker C. Problems of older persons using a wheeled walker. Aging Clin Exp Res 2016; 28:215-20. [PMID: 26226859 DOI: 10.1007/s40520-015-0410-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Wheeled walkers (WWs) are used to improve mobility and for fall prevention in older persons, but not all users are satisfied with the usability of WWs. Intelligent WWs are being developed to improve the usability. AIMS The aim of this study was to support the development of intelligent WWs by investigating possible problems of using a WW. METHODS This study investigated 22 geriatric in-patients (median age 82 years) with and without their WW while opening a door against the direction of walking and passing through. Other possible problems when using WWs were identified by interview. RESULTS Walking through the door was faster without than with using the WW (8.71 versus 12.86 s, p < 0.001), while interference between door and WW was documented in 41 of 44 (93 %) cases. Backward walking performance was better when using a WW with regard to gait speed, step width and walk ratio (all p < 0.002). Most referred problems when using a WW were walking downhill (83 %) and uphill (77 %) and obstacle crossing in general (77 %). CONCLUSIONS Problems with opening a door against the direction of walking and the optimization of downhill and uphill walking as well as obstacle crossing should be regarded when developing an intelligent WW.
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Cooper NJ, Kendrick D, Timblin C, Hayes M, Majsak-Newman G, Meteyard K, Hawkins A, Kay B. The short-term cost of falls, poisonings and scalds occurring at home in children under 5 years old in England: multicentre longitudinal study. Inj Prev 2016; 22:334-41. [DOI: 10.1136/injuryprev-2015-041808] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/06/2016] [Indexed: 11/04/2022]
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Ablewhite J, McDaid L, Hawkins A, Peel I, Goodenough T, Deave T, Stewart J, Watson M, Kendrick D. Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years. BMC Public Health 2015; 15:983. [PMID: 26419449 PMCID: PMC4588674 DOI: 10.1186/s12889-015-2252-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 09/08/2015] [Indexed: 12/03/2022] Open
Abstract
Background Childhood unintentional injury represents an important global health problem. Many unintentional injuries experienced by children aged under 5 years occur within the home and are preventable. The aim of this study was to explore the approaches used by parents of children under five in order to help prevent unintentional injuries in the home and the factors which influence their use. Understanding how parents approach risk-management in the home has important implications for injury practitioners. Methods A multi-centre qualitative study using semi-structured interviews. A thematic approach was used to analyse the data. Sixty five parents of children aged under 5 years, from four study areas were interviewed: Bristol, Newcastle, Norwich and Nottingham. Results Three main injury prevention strategies used by parents were: a) Environmental such as removal of hazards, and use of safety equipment; b) parental supervision; and c) teaching, for example, teaching children about safety and use of rules and routine. Strategies were often used in combination due to their individual limitations. Parental assessment of injury risk, use of strategy and perceived effectiveness were fluid processes dependent on a child’s character, developmental age and the prior experiences of both parent and child. Some parents were more proactive in their approach to home safety while others only reacted if their child demonstrated an interest in a particular object or activity perceived as being an injury risk. Conclusion Parents’ injury prevention practices encompass a range of strategies that are fluid in line with the child’s age and stage of development; however, parents report that they still find it challenging to decide which strategy to use and when.
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Affiliation(s)
- Joanne Ablewhite
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Lisa McDaid
- Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK.
| | - Adrian Hawkins
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Isabel Peel
- Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK.
| | - Trudy Goodenough
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Toity Deave
- School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK.
| | - Jane Stewart
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Michael Watson
- School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK.
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
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Shields WC, McDonald EM, Pfisterer K, Gielen AC. Scald burns in children under 3 years: an analysis of NEISS narratives to inform a scald burn prevention program. Inj Prev 2015; 21:296-300. [DOI: 10.1136/injuryprev-2015-041559] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/17/2015] [Indexed: 11/03/2022]
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10
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Ablewhite J, Peel I, McDaid L, Hawkins A, Goodenough T, Deave T, Stewart J, Kendrick D. Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study. BMC Public Health 2015; 15:280. [PMID: 25885179 PMCID: PMC4392794 DOI: 10.1186/s12889-015-1547-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/16/2015] [Indexed: 11/25/2022] Open
Abstract
Background Childhood unintentional injury represents an important global health problem. Most of these injuries occur at home, and many are preventable. The main aim of this study was to identify key facilitators and barriers for parents in keeping their children safe from unintentional injury within their homes. A further aim was to develop an understanding of parents’ perceptions of what might help them to implement injury prevention activities. Methods Semi-structured interviews were conducted with sixty-four parents with a child aged less than five years at parent’s homes. Interview data was transcribed verbatim, and thematic analysis was undertaken. This was a Multi-centre qualitative study conducted in four study centres in England (Nottingham, Bristol, Norwich and Newcastle). Results Barriers to injury prevention included parents’ not anticipating injury risks nor the consequences of some risk-taking behaviours, a perception that some injuries were an inevitable part of child development, interrupted supervision due to distractions, maternal fatigue and the presence of older siblings, difficulties in adapting homes, unreliability and cost of safety equipment and provision of safety information later than needed in relation to child age and development. Facilitators for injury prevention included parental supervision and teaching children about injury risks. This included parents’ allowing children to learn about injury risks through controlled risk taking, using “safety rules” and supervising children to ensure that safety rules were adhered to. Adapting the home by installing safety equipment or removing hazards were also key facilitators. Some parents felt that learning about injury events through other parents’ experiences may help parents anticipate injury risks. Conclusions There are a range of barriers to, and facilitators for parents undertaking injury prevention that would be addressable during the design of home safety interventions. Addressing these in future studies may increase the effectiveness of interventions.
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Affiliation(s)
- Joanne Ablewhite
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Isabel Peel
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Lisa McDaid
- Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS, Foundation Trust, Norwich, NR4 7UY, UK.
| | - Adrian Hawkins
- The Great North Children's Hospital, Royal Victoria Infirmary, Newcastle Upon Tyne, NE1 4LP, UK.
| | - Trudy Goodenough
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Toity Deave
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Jane Stewart
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
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