[The world is turned upside down: How parents of children with spina bifida experience transition. A qualitative study]

The world is turned upside down: How parents of children with spina bifida experience transition. A qualitative study Abstract: Background: The coming of age of a child with spina bifida (SB) requires the transition from child-centred to adult-centred health care. This transition process (TP) calls for adjustments to the parental role, while health professionals assume a central position in accompanying the families. It is unclear how parents experience the TP in times of complex change and what support needs arise in the process. Aim: To understand the experiences of parents at different stages of the TP and derive the resulting support needs. Method: The qualitative study used semi-structured, guided interviews to explore the experiences of parents with a child with spina bifida before and during the transition process as well as after the transfer. The ten interviews were analysed using open and axial coding based on grounded theory according to Strauss & Corbin (1996). Results: The TP must be considered in the context of health as well as school and family. Parents experience the TP on a continuum of reorientation. This is accompanied by ambivalent feelings caused by the conflicting impulses of giving up responsibility and protecting their child. Conclusions: Health professionals should recognize the extent of change associated with the TP as well as parents' ambivalent feelings and support them accordingly. Continuous support, coordination and information by advanced professionals are important for parents' sense of security.

Inventory of projects promoting HPV vaccination coverage in Germany

Since the first recommendation for HPV vaccination in Germany (2007), a rising number of projects aiming to increase HPV vaccination coverage in Germany have been conducted. From October 2019 to February 2020, we systematically searched for data (project description, evaluation reports) on projects in Germany that aimed to increase HPV vaccination rates. The aim was to provide a comprehensive overview of these projects (duration, implementing organisation, target group/addressees, setting, strategies, reach) and to gain insights for optimising future projects. The inventory of these projects shows that most of the projects focused on the education of children, adolescents and parents, as well as on the training of medical staff. The school was the main setting for education. Rarely were the recorded projects conducted on a long-term and comprehensive basis. It was not possible to make a statement about the impact of the different projects within the framework of this review, as evaluation reports were not available for most of the projects. To optimise the impact on increasing HPV vaccination rates, future projects should be planned on a long-term and nationwide basis. They should also be evaluated to improve the quality and effectiveness of the projects.

Corticosteroid fear in parents of children with atopic dermatitis

Background: Topical corticosteroids (TCS) are the mainstay of therapy for paediatric atopic dermatitis (AD). The use of TCS is often met with fear by parents. Assessing this parental TCS fear in clinical practice is still lacking. Aim: The aim was to assess parental fear and beliefs about TCS. Furthermore, we evaluated the quality of life (QoL) of the family and the disease severity of affected children. Methods: We conducted an observational study with a cross-sectional design. Inclusion criteria were children aged 0 to 5 years with a diagnosis of AD and outpatient treatment. The outcome measures were parental fears and beliefs about TCS, assessed with the "Topical Corticosteroid Phobia Score" (TOPICOP), parental QoL evaluated with the "Family Dermatology Life Quality Index", and disease severity, assessed with the "Scoring atopic dermatitis" (SCORAD). Descriptive statistic was used to analyse the data. Results: The current study found that in 40 affected children, 25 (62.5%), suffered from mild AD, 12 (30%) children had moderate AD, and 3 (7.5%) children had severe AD. TCS fear among parents was notable (mean TOPICOP score 18.1, standard deviation (SD) 7.1). The QoL was moderately affected (mean FDLQI score 6.5, SD 2.8). Conclusions: Our study indicates that fear of TCS is prevalent. Furthermore, our data indicate that severity of TCS fear varies markedly between parents, ranging from parents with almost no fear to parents with high levels of fear. For effective education in clinical practice, the individual level of fear must be recognized and taken into account.

[Use of support and relief services for parents of children in need of care: Results of the FamBer observational study]

Use of support and relief services for parents of children in need of care: Results of the FamBer observational study Abstract: Background: Parents of children in need of care in Germany can fall back on a variety of relief and support services. So far, however, there has been a lack of systematic studies and quantitative data on the use of such offers at the individual level of parents and other legal guardians. Aim: The study on the compatibility of care and work for parents with a child in need of care (FamBer; funding: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, Germany) examines the knowledge of relief and support services, their use and the perceived benefits of these offers. Methods: 1070 parents answered a multidimensional online questionnaire in the cross-sectional study that was developed based on the Kindernetzwerk Study 2 from 2013 and the German socio-economic panel (SOEP). In addition to descriptive analyses, group comparisons were carried out using Chi2, Mann-Whitney U or Kruskal-Wallis H tests. Results: 43 to 58% of parents are aware of the respective legal options for taking time off work, but only very few families make use of them. The other support offers differ significantly in terms of the level of knowledge and utilization; these vary primarily with the education of the parents and the care needs of the child. They assessed the used services for consultation and advice as only little helpful. Conclusions: Due to the study design, we cannot rule out that the findings are also based on personal characteristics of the parents and their living conditions. Nevertheless, a large number of problems (e.g. a lack of information, low using, ineffectiveness of support services) can be identified that need to be overcome.

[Sounds in intensive care units: Perspectives of patients and parents. A qualitative study]

Sounds in intensive care units: Perspectives of patients and parents. A qualitative study Abstract: Background: Sound levels in intensive care units exceed internationally recommended limits. This can have negative effects on patients, relatives, and staff. There is a lack of evidence on noise-reducing measures. Aim: The aim of the study was the implementation and evaluation of ward-specific noise management in intensive care units. In the present article, the question of the noise and stress experience of intensive care patients and parents of neonatal intensive care patients was explored. Methods: 33 semi-structured interviews with intensive care patients and parents of neonatal intensive care patients in three intensive care units were conducted and analysed. Results: Sounds in intensive care units can be stressful (especially alarms) but also be interpreted as meaningful. This is not only related to the context of the ICU, but also to individual experiences and the social aspects of the sounds. In order to avoid or reduce stress, participants apply individual noise (stress) management. In contrast, ward-related noise management had no specific effect on the participants. Conclusions: The findings offer indications for suitable measures to reduce the noise exposure of intensive care patients and parents of neonatal intensive care patients. Research about measures such as concepts for supporting the attribution and differentiation of sounds could follow.

[Effects of the COVID-19-Pandemic on the AffectiveWell-Being of Preschool Children]

The aim of this study was to determine the predictive value of corona-specific variables and post-traumatic stress symptoms associated with the COVID-19-pandemic, considering sociodemographic data and health-related quality of life, on the affective well-being of preschool children and to identify predictors of positive and negative affect. A secondary analysis of third-party assessment data by parents of three- to six-year-old preschool children from the Tyrolean COVID-19 Children's Study at two measurement time points (123 records at t₁ in summer 2020; 467 records at t₂ in winter 2020/21) was conducted. To answer the research question hierarchical multiple regression analyses were performed.The largest part of the variance explanation of affective well-being was explained by health-related quality of life: while self-esteem and psychological well-being were measurement-time-independent, effects of physical well-being, preschool, family, and friends were only significant in winter. Coronaspecific variables caused additional variance explanation due to subjective threat experience in winter; post-traumatic stress symptoms had an effect at both measurement-times. In times of crisis children's self-esteem, psychological well-being, and post-traumatic stress symptoms should be considered.Measurement-time-dependent results suggest that the pandemic course plays a decisive role regarding the influence on children's affective well-being. Everyday life and routines must be redefined accordingly and communicated to the children.

Patient navigation models for mental health of parents expecting or caring for an infant or young child: A systematic review

Patient navigation (PN) aims to improve timely access to healthcare by helping patients to "navigate" complex service provision landscapes. PN models have been applied in diverse healthcare settings including perinatal mental health (PMH). However, the practice models and implementation of PN programs vary widely, and their impact on engagement with PMH services has not been systematically investigated. This systematic narrative review study aimed to (1) identify and describe existing PMH PN models, (2) understand their effectiveness in improving service engagement and clinical outcomes, (3) review patient and provider perceptions, and (4) explore facilitators and barriers to program success. A systematic search of published articles/reports describing PMH PN programs/service delivery models targeting parents in the period from conception to 5 years postpartum was conducted. In total, 19 articles describing 13 programs were identified. The analysis yielded a number of commonalities and differences across program settings, target populations, and the scope of the navigator role. While there was promising evidence to support the clinical efficacy and impact on service utilization of PN programs for PMH, the current evidence base is sparse. Further research evaluating the efficacy of such services, and facilitators and barriers to their success, is warranted.

[Parental factors in internet and computer game addiction in adolescence: An overview]

Parental factors in internet and computer game addiction in adolescence: An overview Abstract. Objective: Internet-related disorders (IRD) in adolescents and young adults are closely linked to family factors. However, few research and review articles include the family. To this end, N = 87 scientific papers were integrated into the literature review. Method: The present work gives an overview of parental factors that can be involved in the development, maintenance, and reduction of symptoms. Results: The literature provides clear connections between the parent-child relationship and IRD in adolescents and young adults. The quality of parent-child communication appears to be a promising approach for influencing IRD symptoms. There are indications that, at least for some families, encouraging the time spent together could be helpful. Regarding educational aspects, a distinction should be made between different areas. Parental knowledge and control of internet use seem to be protective factors. The effect of rules and restrictions, however, is unclear. Conclusions: To change IRD symptoms, it makes sense to improve the parent-child relationship. However, the ways to achieve that have hardly been explored. Recommendations regarding parenting strategies (e. g., rules and restrictions) should be formulated very carefully, as the effects are still unclear. The integration of parents in prevention and intervention efforts is advocated by many researchers, but there only individual studies have considered parents in the context of interventions.

[Psychoeducation for Parents of Children with Learning Disorders: A Satisfaction Study]

Psychoeducation for Parents of Children with Learning Disorders: A Satisfaction Study The present study investigates the implementation of psychoeducation for conveying a diagnosis of specific learning disorders to the parents of affected children. It addresses the question of how such consultations are structured and which factors predict how satisfied parents are with the psychoeducation they receive. 167 parents of children with specific learning disorders from Germany were surveyed via an online questionnaire and asked about their experiences and satisfaction with the psychoeducational aspects of their individual consultation. The results show that the implementation of psychoeducation was strongly heterogeneous. For example, the duration of the consultation varied from 4 to 120 minutes and the child in question was only present in around half of the cases. The methodical diversity was rather limited and the causes of learning disorders were rarely discussed with the parents. 54 % of the parents were satisfied or very satisfied with the psychoeducation. The findings of a regression analysis show that the consultant's professional and emotional competence as well as the practical value significantly predicted the parents' satisfaction. Overall, this regression model is able to explain 81.8 % variance in parents' satisfaction. An open and empathetic atmosphere during the consultation as well as specific and practical tips on how to support their child are particularly important.

[Leisure Opportunities for Autistic Children and Adolescents: How Satisfied are Parents and what do they Think their Children Would Like?]

Leisure Opportunities for Autistic Children and Adolescents: How Satisfied are Parents and what do they Think their Children Would Like? Like all children and youth, autistic children and adolescents have the right to participate in cultural life including recreational, leisure and sporting activities. Therefore, arrangements have to be made to ensure access to these areas for these particular population (Art. 30 UN-BRK, §§76, 78 BTHG). Thus far, no research has been conducted that examines the need for leisure time facilities for autistic children and/or adolescents in Germany. Therefore, it is unclear if an equal participation in leisure time opportunities is provided. This study presents a first assessment of this topic based on an online-survey of parents of autistic children and adolescents (N = 327). The results indicate, that there is a substantial need for leisure opportunities. Parents of children with infantile and atypical autism show a greater need for more leisure opportunities than parents of children with Asperger Syndrome. In general, the findings show that an equal participation has not been achieved yet. Overall, there is a need for (small) group and sporting activities and especially younger parents asked for specific experiential environments. Possible approaches to a need-oriented organization of leisure facilities for autistic children and adolescents and for an enhancement of leisure opportunities are discussed. The paper further outlines the need for more research in order to provide an empirical basis for equal participation possibilities in public life for autistic children and adolescents.

Perceptions of Portuguese parents about the acceptability of a multicomponent intervention targeted at behavioral inhibition during early childhood

High and stable behavioral inhibition during early childhood is a risk factor for later anxiety disorders. The few available interventions targeted at behavioral inhibition have not yet been implemented in European countries. Evaluating intervention acceptability is essential when introducing interventions in new cultures. This study aimed to explore the perceptions of parents about the acceptability of the multicomponent Turtle Program in Portugal. Participants were 12 parents (from seven families) of children with a positive screening on the Behavioral Inhibition Questionnaire and no diagnoses of developmental disorders/selective mutism. Children's mean age was 55.86 months and most children were female and first-born. Parents and children participated in the eight-sessions Turtle Program. After each session, parents completed weekly satisfaction checklists. Following completion of the full intervention, parents were invited to participate in individual qualitative in-depth interviews. The thematic analysis revealed that both parents perceived the intervention objectives and contents as relevant. Both parents suggested the introduction of follow-up sessions, the discussion of practical experiences, the need to be sensitive to cultural differences in positive language, and the provision of more feedback about children's activities. These findings support prior research on the acceptability and cultural tailoring needed for parenting and child socioemotional learning interventions.

Storytelling als innovative Methode zur videobasierten Edukation für Eltern von Kindern mit atopischer Dermatitis

Storytelling as an innovative method of video-based education for parents of children with atopic dermatitis Abstract. Background: Atopic Dermatitis (AD) is the most chronic skin disease in children and affects up to 20 % of children in developed countries. Chronic inflammation of the skin, itching, redness, and non-dermatologic symptoms like sleep disturbance are frequent and have a negative impact on the child's quality of life and their family. Education is one of the most important aspects of managing AD. Aim: Production and evaluation of educational videos with the method storytelling for parents of children aged 0 to 5 years with atopic dermatitis. Methods: We produced the videos with the method of storytelling. The aim of storytelling is to help to recall important information more easily. A multi-professional team and parents of affected children tested the videos to ensure the understandability, the helpfulness and importance of the educational videos. Results: We created six different videos in all. The content of the educational videos includes information on the causes of AD, symptoms, skin care, treatment instruction and living with AD. We implemented the method of storytelling by two families with affected children who reported about their experience with the disease and the treatment. Three different specialists gave expert information. The evaluation showed that the information in the videos is simple, understandable and relevant. Conclusions: Evidence-based videos are an innovative, creative and modern method to support education. Storytelling is a user-friendly method to give simple and understandable information.

Zwischen Himmel und Hölle: Erfahrungen von Eltern mit einem kritisch kranken Kind mit extrakorporaler Membranoxygenierung (ECMO) - Eine qualitative-explorative Studie mit Paarinterviews

Between Heaven and Hell: Experiences of parents with a critically ill child with extracorporeal membrane oxygenation (ECMO) - A qualitative-explorative study with couple interviews Abstract. Background: It is a traumatic experience for parents when their child's severe illness necessitates a period of intensive care. This situation becomes even more challenging for parents if a highly technical therapy such as extracorporeal membrane oxygenation (ECMO) in the Pediatric Intensive Care Unit is required. Aim: The study explores the experiences of parents of critically ill children undergoing ECMO therapy with the aim of better understanding their needs and identifying courses of action for healthcare professionals. Method: The qualitative-explorative study was based on interviews with six couples whose critically ill child is or has been receiving ECMO during the last year, which were used to examine their experiences. The analysis of six such interviews was performed using intensive paraphrasing and inductive coding. Results: The parents' situation can be best characterised as ambivalent with simultaneous feelings of hope and fear. They recognize the danger to their child's life, leading to intense feelings of helplessness with strong emotional reactions. It becomes apparent that there is too little fit between the emotional world of the parents and the action patterns of the health care professionals. Conclusions: The health care professionals thinking logic is based on professional criteria, such as the life threat and risks of ECMO, which ignores the emotional needs of the parents. For this reason, it is important to be more sensitive to the parents and to share positive little signs about their child' s state of health and ability to suffer with them.

Herausforderungen und Bedürfnisse von Familien mit Neugeborenen mit Zwerchfellhernie - Musiktherapie als unterstützende Maßnahme?

Challenges and needs of families of newborns with congenital diaphragmatic hernia - Music therapy as a supportive intervention? Abstract. Background: Newborns with diaphragmatic hernia (CDH) spend the first weeks of their lives in intensive care, which is extremely stressful for them and their families. Music therapy is already used in neonatology for premature infants to stabilize the child, to support the parents and to strengthen attachment and bonding. However, the benefits for term infants receiving intensive care and their families has not yet been comprehensively investigated. Aim: The aim of this paper was to investigate the specific needs, challenges and experiences of children with CDH and their parents and to derive appropriate music therapy interventions. Methods: Using the CAQDAS software f4analyse 15 parents' reports were examined with a qualitative content structuring analysis. Music therapy aspects were illustrated using a hypothetical case example. Results: Parents suffer above all from organisational and emotional challenges. They want to take care of their child and seek to be close despite limited influence on health and treatment. They are supported by their social environment and the medical staff. Protective factors include successful self-care, detachment and trust in a positive outcome. Conclusion: Additional to medical aspects like the withdrawal, bonding and attachment and parental well-being are of great importance. Music therapy literature offers the description of interventions, which address these aspects.

[Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders]

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.

[Living with bandages: a mixed-methods-study on the view of families of children with epidermolysis bullosa]

Living with bandages: a mixed-methods-study on the view of families of children with epidermolysis bullosa Abstract. Background: Children with epidermolysis bullosa (EB) often need new bandages regularly due to sore skin and blistering. Aim: The question about the experiences of parents and children affected by EB with dressing materials is intended to identify starting points for effective support of families. Methods: In the first part of the sequential mixed-methods study, guideline-based interviews were conducted and evaluated with qualitative content analysis. Based on the results, a questionnaire was developed and implemented as an online survey. After analysis with descriptive statistics, these results were combined with the qualitative results. Results: In the "Find out what works" process, the cutting of the materials and the importance of flexibility come to the fore. The parents' confidence in their actions is particularly evident in the application of the bandages and in their knowledge of the materials. The removal of glued dressings is often associated with pain. Dirty bandages are the most common problem in everyday life. Both aspects relate to the wearability of the bandages. When bandages are integrated into everyday family life, the most important role is played by cost absorption and expertise in the organisation. Conclusions: Parents develop specific competences on EB, on their child and dressings. With counselling and education, nursing takes a central function within the multi-professional accompanying interventions to support and relieve families.

Cognitively-Based Compassion Training for parents reduces cortisol in infants and young children

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants' and young children's cumulative physiological stress.

[Strengthening Attachment Competencies in Parents with Mental Illness: Adaptation and Pilot Testing of the Mentalization-Based Lighthouse Parenting Program]

Strengthening Attachment Competencies in Parents with Mental Illness: Adaptation and Pilot Testing of the Mentalization-Based Lighthouse Parenting Program Mentalizing describes the imaginative ability to understand human behaviour in terms of mental states. Parents with mental illnesses and experiences of early maltreatment frequently show impairments in mentalizing, which negatively impact their caregiving competences for the child. A number of mentalization-based programs to strengthen parental competences have been developed and most of them have been positively evaluated with regard to their efficacy. However, approaches which specifically aim to reach highly impaired families with children from different age groups and which can be implemented in psychiatric settings are currently lacking. The newly adapted mentalization-based Lighthouse-Parenting Program aims to fill this gap and strengthen competences of parents with a mental illness. The specific MBT-based stance, the structure and content of this new program are outlined and first results of a pilot test are presented. The program is a promising approach, which can easily be trained and implemented in existing mental health care systems. The Lighthouse-Parenting Program aims to improve the relationship between parent and child, to reduce parental stress and in the long-term to promote the child's development. A randomized controlled trial to evaluate the program's effectiveness is currently being planned.

[The Need for Psychosocial Support in Parents of Chronically Ill Children]

The Need for Psychosocial Support in Parents of Chronically Ill Children Chronic illness in childhood and adolescence is associated with special requirements and demands on affected families. In particular, severe chronic diseases and rare diseases with a high level of health care needs or with progressive medical diagnoses permanently challenge the families' resources. The aim of this study was to assess the need for psychological, nursing, legal and organisational support from a parent's perspective. Using qualitative content analysis according to Mayring, data from 96 parents of 68 chronically ill children were evaluated. The findings suggest an increased need for psychosocial support, but, the ideas, needs, and goals of parents are very versatile. However, family-based psychosocial support programs, which are adapted to the specific family situations, are unanimously judged to be useful. Interventions should be flexible as well as tailored to the affected families' individual needs.

[Parents as co-producers in the healthcare system: Individual perspectives and consequences for educational concepts]

INTRODUCTION AND OBJECTIVES

In selected healthcare sectors and settings, patients and their relatives are now regarded as co-producers of the healthcare system. This is associated with modified patient roles and new relationship models. Physiotherapists also have to face them by including educational interventions into their traditional scope of practice. However, corresponding intervention concepts for physiotherapy do not yet exist. Therefore, the aim of this contribution is to initiate an empirically supported concept development.

METHODS

As part of a qualitative empirical study, interviews were conducted with 15 parents of children with life-limiting diseases in four federal states of Germany and then evaluated using the reconstruction method of the documentary method according to Bohnsack. The parents' experiences with the assumption of physiotherapeutic care were used as input for first reflections on an instructive intervention concept with reference to relevant learning theory approaches.

RESULTS

In the course of the data evaluation, three divergent orientations (parent types) were identified. Parent type A (autonomy) acts largely autonomously and requires only occasional support. Parent type B (understanding) and C (relief) need more intensive support. While parent type B requires education in order to satisfy their pronounced need for knowledge, parent type C generally questions why they should have to carry out physiotherapeutic task and delegates responsibility back to the professional help system.

DISCUSSION

Physiotherapeutic instruction should take into account the different types of parents with regard to the provision of care. Parents who are motivated to engage in learning processes would like to a) focus on central physiotherapeutic measures, b) be instructed face-to-face and c) be recognized as experts for their child and their situation.

CONCLUSION

Supplemented by the perspective of professionals, insights into the parents' perspective can serve as the basis for empirical impact analysis. The empirically validated intervention concepts for instructive action must be integrated into existing educational, training and further education courses in order to ensure systematic dissemination of knowledge into physiotherapy. In addition, a debate on professional policy must be launched in order to secure instructive action more strongly in the physiotherapeutic repertoire.

[Sleep and Psychological Functioning of Children and Adolescents - a Narrative Review]

Sleep and Psychological Functioning of Children and Adolescents - a Narrative Review Children and adolescents need sufficient and restoring sleep to improve their cognitive, emotional, social and behavioral performance. The present narrative review describes the associations between children's and adolescents' sleep patterns and a broad variety of topics; these topics were chosen at the authors' discretion and does not claim to be exhaustive. After a short introduction, we describe the associations between (adolescent) children's sleep in tight relation to the family functioning. Specifically, (adolescent) children's sleep and psychological functioning appears to be related to mothers' sleep and psychological functioning. Findings from longitudinal studies are reported, which underline that poor sleep at childhood increases the risk of poor sleep and somatic and psychological health issues later in life. Excessive screen time in the evening increases the risk of shorter sleep duration and increased daytime sleepiness; on the flip side, it also appears the excessive screen time might be a coping strategy to deal with symptoms of anxiety; further, using social media in the evening seems to be associated with the adolescents' need to stay in touch with their peers. While physical inactivity and sedentary behavior is a serious health concern, in children and adolescents, regular physical activity is associated with improved subjective and objective sleep and a broad variety of psychological health outcomes. Further selective topics are: While children and adolescents with repaired cleft did not show disadvantages in their sleep and psychological functioning compared to their counterparts without clefts, at the age of seven to nine years, very preterm children show unfavorable sleep patterns and psychological functioning, compared to typically developing children.

[Prediction of binge drinking in young adults: a cohort study over nine years]

Prediction of binge drinking in young adults: a cohort study over nine years Abstract.

OBJECTIVE

Which person characteristics and environmental factors predict binge drinking at age 21?

METHOD

A longitudinal observational study with a nine-year follow-up. A total of 5,176 adolescents from the German states Schleswig-Holstein and Saxony-Anhalt were surveyed in 2006 with paper-pencil questionnaires (mean age 12.6 years, SD = 0.6). A follow-up assessment was conducted in the year 2015. Baseline predictors were age, gender, school type, school performance, parenting style, early experience with alcohol, alcohol use of parents, alcohol use of friends, and sensation seeking. Primary outcome in 2015 was binge drinking at least once a month (six or more alcoholic drinks during one drinking occasion).

RESULTS

A subsample of 1,087 (20.9 %) of the former students could be surveyed nine years after baseline (mean age 21.6 years, SD = 0.8). One out of four (25.4 %) reported binge drinking at least once in a month. A multiple regression model revealed three significant predictors of binge drinking: male gender, early experience with alcohol and frequency of parental alcohol use at baseline.

CONCLUSIONS

Perceived frequency of parental alcohol use might be an important risk factor for children's alcohol use in early adulthood. Parents need to reflect their role as alcohol-specific socialization agents.

Adolescents' with congenital heart disease and their parents' experiences of a nurse-led transition program. An interpretive phenomenological study

Background: Up to 90 % of patients with congenital heart disease (CHD) now reach adulthood. To avoid lapses in care during the change from pediatric to adult care, a nurse-led transition program (TP) was implemented at a Swiss University Hospital. Aim: This study explored the experiences and expectations of adolescents with CHD and their parents regarding a nurse-led TP. Method: This qualitative study used an interpretive, phenomenological approach. Individual interviews were conducted with seven adolescent CHD patients in the transition period and their parents (six mothers, two fathers). Analysis followed an iterative process. Results: For most study participants, the transfer from pediatric to adult medicine as part of the TP went smoothly. They experienced the TP positively. Patients valued the provision of a constant contact person to provide CHD-related information; parents welcomed the support of an informed, neutral clinician for their children. To varying degrees, adolescents were willing to take over self-responsibility; conversely, parents found it difficult to turn their responsibility over to their children. Parents wished to give the adolescent as much time as needed to act responsibility on their own. Conclusions: A transition program is a key element for establishing a continuous care in adolescents with a chronic disease. It facilitates the parents' process of allowing their youths to assume increasing responsibility for their own health.

[Experiences and support needs of parents of hospitalized children with multiple disabilities: a qualitative study]

BACKGROUND

The hospitalisation of a multiple disabled child is stressful for parents because they continue to carry out demanding care procedures in hospital. Yet, systematic knowledge of the parental experience and of their support needs is missing.

QUESTION

How do parents experience the hospitalisation, and which support needs do they identify for this period? Methods: Twenty-six parents (24 mothers, 2 fathers) of 24 children with multiple disabilities have participated in this qualitative study. Between 1 January 2011 and 1 September 2013, semi-structured interviews were conducted in a children's university hospital. A qualitative content analysis formed the basis for the analysis.

RESULTS

“Concerns for the child's well-being” was central for the parents and focussed on the areas of “Pain”, “Complications” and “Development”. Perception of the child's well-being governs the extent of the “Parents' Work” and defines the parental “Support needs” to “Receive information and training”, “Be known and experience continuity”, “Be taken seriously and experience communion”, “Be accompanied by experienced nurses”, and “Be relieved and get organisational support”.

CONCLUSION

Parents work hard to safeguard the well-being of their hospitalised child with multiple handicaps. Care professionals can ease the parents' burden by promoting parental confidence in their child's welfare in hospital. This will be successful if continuity of care and competence are ensured, for instance if it is provided by nurses with Advanced Practice background.

[Transition - how adolescents with cystic fibrosis their parents experience the change from paediatric to adult care]

BACKGROUND

Cystic Fibrosis is the most common autosomal-recessive hereditary disease among white Europeans. The average survival of CF patients has increased to above 40 years and transition from paediatric to adult care has therefore become a significant issue.

AIM

With this study, experiences of adolescents with CF and their parents with the transition from the paediatric to the adult care were explored.

METHODS

At a Swiss university CF centre, six adolescents and their mothers were recruited. Twelve narrative interviews were conducted on how the phase of transition was experienced. The transcribed interviews were analysed according to the method of hermeneutic phenomenology.

RESULTS

Positive and negative experiences with long term routine care in the paediatric service, general themes of adolescence and the quality of the relationship with paediatric doctors influenced the families' experience during transition significantly. For mothers, insensitive information on the CF diagnosis might have influenced the transition experience. The adolescents welcomed an individualized and age appropriate care. Continuity in care, the announcement of, and involvement in the planning of the transfer were of great importance. The families particularly appreciated the timed adaptations of the transfer to individual needs.

CONCLUSIONS

Flexibility and a strong collaboration between paediatric and adult CF teams are most relevant in the care of families.