Statistical Methods for Health Care Research

Evidence suggests that participation in physical activity may support young people’s current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects. The objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2–5 years of age), children (6–11 years of age) and adolescents (12–18 years of age). A systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents. A total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6–18 years (effect size 0.173, 95% confidence interval 0.106–0.239, p < 0.001, percentage of total variability attributed to between-study heterogeneity [I2] = 11.3%). When the analyses were performed separately for children and adolescents, the results were significant for adolescents but not for children. Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behavior and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents. Evidence on preschoolers was nearly non-existent. Findings from the meta-analysis suggest that physical activity interventions can improve adolescents’ mental health, but additional studies are needed to confirm the effects of physical activity on children’s mental health. Findings from observational studies suggest that promoting physical activity and decreasing sedentary behavior might protect mental health in children and adolescents. PROSPERO Registration Number: CRD42017060373.

Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis.

CONTEXT: Numerous faces scales have been developed for the measurement of pain intensity in children. It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity, reliability, feasibility, and preference. OBJECTIVES: To summarize and systematically review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility. METHODS: Five major electronic databases were systematically searched for studies that used a faces scale for the self-report measurement of pain intensity in children. Fourteen faces pain scales were identified, of which 4 have undergone extensive psychometric testing: Faces Pain Scale (FPS) (scored 0–6); Faces Pain Scale–Revised (FPS-R) (0–10); Oucher pain scale (0–10); and Wong-Baker Faces Pain Rating Scale (WBFPRS) (0–10). These 4 scales were included in the review. Studies were classified by using psychometric criteria, including construct validity, reliability, and responsiveness, that were established a priori. RESULTS: From a total of 276 articles retrieved, 182 were screened for psychometric evaluation, and 127 were included. All 4 faces pain scales were found to be adequately supported by psychometric data. When given a choice between faces scales, children preferred the WBFPRS. Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS. CONCLUSIONS: For clinical use, we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use. For research use, the FPS-R has been recommended on the basis of utility and psychometric features. Data are sparse for children below the age of 5 years, and future research should focus on simplified measures, instructions, and anchors for these younger children.

A Systematic Review of Faces Scales for the Self-report of Pain Intensity in Children

Background Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts

Aims  This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills

Methods  Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking

Findings  Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition This skill acquisition is best accomplished through teaching–learning attention to self-regulation learning theory A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts

Conclusions  Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts

Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self‐regulated learning theory

https://cmapsconverted.ihmc.us/rid=1MCY0CLZ4-1HDF60Q-15R8/Case%20Studies.pdf

Promotion of critical thinking by using case studies as teaching method

Many parents confront the NICU environment as medical staffs are busy with the physical aspects
of care by ignoring other important needs and omitting physicians’ view.
Aim: Identify essential factors in communication process that tend to increase stress among the
NICU parents.
The Study Design: Eighteen NICU parents from different hospitals in the city of Isfahan were
selected for in-depth interviews. Qualitative content analysis included open coding, categorization and abstraction of data.
Results: Data analysis identified stress provoking factors for NICU parents in four categories as
confusion in nurse-parent, nurse-physician communication, negligence in physician-parent
communication, inappropriate nurse-physician communication, and the medical diagnosis
communication process.
Conclusion: Our findings indicated that NICU parent presence was very low. It is necessary for
the hospital management and NICU staff to develop communication skills training sessions for less
stressful parent experiences in NICU. Moreover, the Ministry of Health should authorize policy
development and guidelines to improve relationship between medical staff, physicians, nurses and
NICU families aimed at better neonatal outcomes.

Neglecting the Parent in Neonatal Intensive Care Unit: The Communicational Factors that Increases the Iranian Parents' Stress

Adolescent is a time of profound biologic, intellectual, psychological, ‎and socioeconomic change that he will face a crisis. So compatibility may be ‎exposed to many hazards, such as depression, anxiety and other emotional ‎problems. But a planned regular exercise enhances physical and mental health ‎of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional ‎reactions of female adolescents with Type I diabetes.‎ This study was a quasi-experimental research conducted in Endocrine and ‎Metabolism Research center. A total of 72 patients who were randomly allocated ‎in two groups. The intervention group did aerobic exercise for 45 minutes. ‎Whereas control group did not aerobic exercise. Data were collected using a ‎SCL-90 questionnaire.‎ Data were analyzed and using descriptive and inferential statistics methods and ‎SPSS software. ‎ The result showed the mean score for physical symptoms, depression, ‎obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ‎ideation, psychosis and anxiety in the experimental group after intervention than ‎before intervention significantly reduced. The average score in the control group ‎did not differ. The average total score of emotional reactions in the test group ‎after the intervention than before intervention significantly decreased (p = 0 / ‎‎001). But in control groups, the mean scores did not differ (p = 0 / 97).‎ The findings showed that having regular exercise is effective on emotional ‎reactions of adolescent females with type 1 diabetes.‎ Key-words: Aerobic exercise- affective symptoms- female adolescents - ‎type 1 diabetes mellitus.‎

The effect of exercise on affective responses in female adolescents with type 1 diabetes

/pdf/impact-of-language-barriers-on-patient-education-a-scoping-37dvpzd42g.pdf

Impact of Language Barriers on Patient Education: A Scoping Review

Background
In recent decades, health care systems has greatly influenced by the technology development. The technology is helpful to enhance quality of care, reduce costs and improve patient care if appropriate training be applied for technology users. Technology user’s training has been studied in some quantitative studies; however, a few investigators have studied the challenges which nurses’ experienced in this regard.

Technology User's Training Is a Waif.

Background: The integration of paediatric palliative care into the Iranian health system is essential. Aims: The aim of this study was to identify the challenges of palliative care in the paediatri...

Marzieh Hasanpour

Papers

Neglecting the Parent in Neonatal Intensive Care Unit: The Communicational Factors that Increases the Iranian Parents' Stress

The effect of exercise on affective responses in female adolescents with type 1 diabetes

Impact of Language Barriers on Patient Education: A Scoping Review

Technology User's Training Is a Waif.

Challenges of paediatric palliative care in the intensive care unit during the COVID-19 pandemic.