Showing papers in "Children's Health Care in 1990"
TL;DR: This study examined several developmental and behavioral aspects of diabetes care in relationship to metabolic control in youngsters with diabetes, finding that older children knew more about diabetes, assumed more responsibility for self-care, but were less adherent with certain aspects of the treatment regimen.
Abstract: This study examined several developmental and behavioral aspects of diabetes care in relationship to metabolic control in youngsters with diabetes These included the degree to which youngsters assumed responsibility for diabetes care, their adherence with the treatment regimen, and youngsters' and parents knowledge about diabetes Youngsters and their mothers completed a test of diabetes knowledge, mothers rated children's involvement in several aspects of diabetes care, and medical staff rated youngsters adherence with the diabetes regimen Glycosylated hemoglobin (HbAI) levels indexed metabolic control Age differences were noted in that older children knew more about diabetes, assumed more responsibility for self-care, but were less adherent with certain aspects of the treatment regimen Preadolescents who assumed greater responsibility for glucose testing and measuring insulin were in poorer control than those whose families were more involved Moreover, among preadolescents, parents' knowledge of diabetes...
205Â citations
TL;DR: It seemed that often the nurses' need for control influenced the psychoemotional care they provided for parents.
Abstract: Twenty-five nurses were interviewed and asked to describe their perceptions of parent and nurse roles in caring for hospitalized children. Data were analyzed using content analysis. Six types of roles were identified: providing nonmedical care; providing technical and medical care; being a gatekeeper; being an advocate; providing psychosocial care; and providing general care. It seemed that often the nurses' need for control influenced the psychoemotional care they provided for parents.
82Â citations
TL;DR: The support of fathers appeared to protect mothers from the stress associated with cystic fibrosis, especially when fathers placed a high value on child-rearing activities.
Abstract: This study compared the adjustment of mothers and fathers who have a child with cystic fibrosis On most scales mothers, but not fathers, were found to have significantly poorer mental health than the general population Both mothers and fathers' perceptions of the stresses associated with rearing children with cystic fibrosos were related to their mental health Fathers mental health was also related to their wives' concerns about rearing children with cystic fibrosis The support of fathers appeared to protect mothers from the stress associated with cystic fibrosis, especially when fathers placed a high value on child-rearing activities.
58Â citations
TL;DR: ACCH has helped to shape these changes and will continue this leadership in addressing the challenges of the 1990's in child health care.
Abstract: In the last fifty years while there have been dramatic changes in the science and technology of pediatrics, there have also been major changes in the participation of families in child health care. Since its founding, ACCH has helped to shape these changes and will continue this leadership in addressing the challenges of the 1990's.
48Â citations
TL;DR: Despite the barriers to FCC, ACCH's eight essential elements can provide the basis for devising strategies for successfully implementing FCC in the critical care setting.
Abstract: Family-centered care (FCC) has been upheld as the standard for providing quality health care for children. However, some professionals question its applicability in the critical care setting. Despite the barriers to FCC, ACCH's eight essential elements of FCC can provide the basis for devising strategies for successfully implementing FCC in the critical care setting.
45Â citations
TL;DR: Analysis of Variance and subsequent multiple comparison tests disclosed numerous differences between parents and health care professionals and between mothers and fathers on the Parental Uncertainty, Annoyance, Child Discomfort, and Negative Emotional States Scales.
Abstract: This study compared mothers', fathers', nurses', and physicians' perceptions of parents' reactions to stressful stimuli when their children were hospitalized. Thirty-six mothers, 14 fathers, 27 nurses, and 23 physicians rated 36 stressful stimuli on an inventory the investigators developed. Analysis of Variance and subsequent multiple comparison tests disclosed numerous differences between parents and health care professionals and between mothers and fathers on the Parental Uncertainty, Annoyance, Child Discomfort, and Negative Emotional States Scales. Further analyses of ratings on individual items from the scales revealed the bases of the differences. Implications for health professionals and directions for further research are discussed.
43Â citations
TL;DR: In this paper, the authors examined burnout in full-time child life specialists and determined whether a relation existed between burnout and role stress (role ambiguity and role conflict) The relationship of individual and organizational variables to burnout were included as controls.
Abstract: The purpose of this research was to examine burnout in full-time child life specialists and to determine whether a relation existed between burnout and role stress (role ambiguity and role conflict) The relationship of individual and organizational variables to burnout were included as controls It was found that burnout exists for child life specialists, bur to a lesser degree than in other human service professionais Role ambiguity was a stronger predictor vanable of burnout than role conflict Additionally, the organizational variables contributed more to predicting burnout than the individual variables.
36Â citations
TL;DR: The need for health care professionals to make themselves available to parents and to negotiate roles with parents were key findings.
Abstract: A qualitative study based on interviews with nine families was implemented to explore the parental experience when a child is hospitalized for surgery Participant observation during the stress points identified in the literature and interviews with parents both in the hospital and in the home after the child was discharged were the major sources of data Sources of parental stress, parental roles during the child's hospitalization, coping strategies used by parents, and parents suggestions for health care professionals particularly nursing staff, were explored The need for health care professionals to make themselves available to parents and to negotiate roles with parents were key findings.
33Â citations
TL;DR: In this paper, the authors define autonomy as the capacity of an individual to take responsibility for their own behavior to make decisions regarding their own lives, and to maintain supportive social relationships.
Abstract: The development of autonomy is a major goal for individuals with a disabling condition This is particularly true in the transition from adolescence to adulthood The emphasis, in the past, has been upon independence from the assistance especially physical assistance, of others More recent developments in the fields of special education, adolescent development, and family systems suggest a need to redefine autonomy In the model offered here, autonomy is defined in terms of individuals' capacities to take responsibility for their own behavior to make decisions regarding their own lives, and to maintain supportive social relationships The development of autonomy is viewed as being dependent upon development of an internal locus of control, use of a set of coping strategies, maintenance of a support network, and development a reciprocal adult attachment These, in turn, are affected by aspects of the family system This model and its implications for individuals with a disabling condtion are described.
28Â citations
TL;DR: The psychosocial responses of school-age children to hospitalization was examined and no relationship was found between the length of hospitalization or the number of previous hospitalizations and their post hospital behavior.
Abstract: This study examined the psychosocial responses of school-age children to hospitalization. The subjects were 50 children, between 8 and 12 years of age, who were unscheduled admissions. The children's usual pre-hospital behavior was compared to their behavior during the first week following hospitalization and one month after dismissal. Repeated measure analysis of variance was used to demonstrate that there was no change in the school-age children's behavior following hospitalization. A moderate relationship was found between the children's usual prehospital behavior and the number of previous hospitalizations. Family function was related only to the children's behavior one week after dimissal. the children's usual prehospital behavioral problems were related to their behavior at all three times. No relationship was found between the length of hospitalization or the number of previous hospitalizations and their post hospital behavior.
26Â citations
TL;DR: Older children were more likely than preschoolers to give specific reasons for illness, but age groups did not differ in attributing illness to personal actions.
Abstract: Interviews and a drawing task were used to assess childrens concepts of health and sickness Older children were more likely than preschoolers to give specific reasons for illness, but age groups did not differ in attributing illness to personal actions Among children over 5 years, 72% identified germs with disease Preschoolers drew germs as faces or irregular shapes, whde 5- to 10-year olds typically drew monster-like figures and older children drew cell-like shapes Age differences in concepts of illness are interpreted as acquisitions of culturally accepted beliefs, rather than applications of operational logic.
TL;DR: Findings suggest that the coping interventions examined were cost efficient and appear promising in facilitating mothers' coping with NICU stresses.
Abstract: Thirty mothers of preterm infants requiring neonatal intensive care unit (NICU) hospitalization were assigned randomly to one of three groups to assess differences in treatment effectiveness of facilitating parental adaptation to the NICU stresses Groups consisted of (a) a treatment group receiving videotape training in active problem-focused coping strategies, (b) a treatment group receiving videotape training in emotion-focused strategies to help manage anxiety, and (c) a control group receiving promotional information about the hospital and the NICU On pretreatment measures most of the mothers exhibited little distress, a finding unlike those for the majority of NICU studies On posttreatment follow-up both the problemfocused and emotion-focused treatment groups were significantly less anxious than the controls and lower levels of depression were observed for the emotion-focused group Findings suggest that the coping interventions examined were cost efficient and appear promising in facilitating mothers...
TL;DR: Challenges to child-focused play and possible implications are derived from past events.
Abstract: Play, particularly unstructured and nondirective has been believed to lessen the negative impact of hospitalization through expression of feelings, reversal of roles, and control of materials, concepts, and actions Over time, however, changes in perspectives on play, hospital policies and practices, and the nature of illnesses of children have combined to influence the context for this form of play Challenges to child-focused play and possible implications are derived from past events.
TL;DR: Temperament theory is offered as a framework for systematically individualizing the psychosocial care of hospitalized children and three case studies show how the hospital environment was adapted to meet the individual child's needs and also how children impact on their caretakers.
Abstract: Temperament theory is offered as a framework for systematically individualizing the psychosocial care of hospitalized children. Empirical research on temperament is cited. An application of the theory is illustrated through a presentation of three case studies of children who have cystic fibrosis as their primary diagnosis. The discussion of the children demonstrates how their psychosocial responses to hospitalization were related to their temperaments. The case studies also show how the hospital environment was adapted to meet the individual child's needs and also how children impact on their caretakers.
TL;DR: The findings point to the need for understanding cultural barriers and the unique concerns of low income families living in rural areas, which has important implications for planning changes in the health care system for American Indian children with special needs.
Abstract: The national effort to improve services to children with special health care needs presents unique challenges for the delivery of services to American Indian families This study took place in New Mexico American Indian families whose children have special needs and health care providers were interviewed Their responses about obstacles to health care for their children and suggestions for improving services were examined Generally, both groups identified similar obstacles, although important differences between groups were noted The findings point to the need for understanding cultural barriers and the unique concerns of low income families living in rural areas This has important implications for planning changes in the health care system for American Indian children with special needs.
TL;DR: During the summer of 1985, the posthospitalization reactions of 85 adolescents hospitalized for an acute condition were examined and 22 original patients participated in a follow-up study on memories of hospitalization, significant learnings, and suggestions for changes in hospital environments.
Abstract: During the summer of 1985, the posthospitahzation reactions of 85 adolescents hospitalized for an acute condition were examined Results from this study have been previously reported (Denholm, 1989) Four years after hospital discharge, 22 original patients participated in a follow-up study on memories of hospitalization, significant learnings, and suggestions for changes in hospital environments.
TL;DR: A panel of experts, participating in a Delphi poll, identified significant issues facing psychosocial aspects of health care for children in the future.
Abstract: A panel of experts, participating in a Delphi poll, identified significant issues facing psychosocial aspects of health care for children in the future In three rounds of feedback and evaluation, ten top future issues were composited in rank order chronic illness and complex health care needs, sociogenic problems, unequal access to health care, lack of financial resources for psychosocial services, increased focus on prevention, children without primary caregivers, complex ethical questions, family-centered care, training of health care professionals, and interdisciplinary integration Implications of these issues are discussed.
TL;DR: The study identifies from the child's perspective the type of information and program delivery method most appropriate to meeting the psychosocial needs of children related to a planned hospital stay.
Abstract: This paper reports on the self-identification of hospital preparation learning needs of rural children, both before and after their hospital experience. Children who were scheduled for a hospital admission were interviewed in their home settings 1 to 2 weeks before their hospital admissions. The interviews were replicated 1 week after discharge from the hospital. Changes in knowledge acquisition and learning needs from the pre-hospital to the post-hospital state were examined. The study identifies from the child's perspective the type of information and program delivery method most appropriate to meeting the psychosocial needs of children related to a planned hospital stay.
TL;DR: Impact of the observation of a rapid succession of events occuring during the child's anesthetic induction on the parents' psychological stress and need for sound methodological research to identify viable approaches to parental participation are discussed.
Abstract: Discusses the impact of parental participation in the child's anasthetic induction on their mental health. Impact of the observation of a rapid succession of events occuring during the child's anesthetic induction on the parents' psychological stress; Explanation for the discrepancy between parents' verbal reports and non-verbal behavior; Need for sound methodological research to identify viable approaches to parental participation.
TL;DR: With the cooperative effort of the family and a multidisciplinary health team, a comprehensive home care program can be developed and the quality of life improved for the child dependent on a ventilator.
Abstract: Advances in medical technology have resulted in the survival of an increasing number of infants and young children who require longterm mechanical ventilation For some of these infants home care may be a viable and cost effective option to prolonged hospitalization With the cooperative effort of the family and a multidisciplinary health team, a comprehensive home care program can be developed and the quality of life improved for the child dependent on a ventilator.
TL;DR: The paper will examine how these laws model both the difficulties and benefits of trying to coordinate two separate yet complementary forces into a coherent solution to the problems of providing services to children with special needs.
Abstract: In 1986 P L 94-142 the Education of the Handicapped Act, was reauthorized and P L 99-457 was signed into law Many similarities exist between P L 99-457 and the maternal and child public health legislation of Title V in the provision of services to children with disabling conditions The focus of this paper is an examination of aspects of the troublesome mesh that has occurred between Title V and P L 94-142, the first designed to cover medical-health needs, the second, educational needs The paper was prepared in hopes that the experiences of implementing P L 94-142, especially in relation to coordination between the education system and the health care system, can provide guidance in implementing P L 99-457 The paper will examine how these laws model both the difficulties and benefits of trying to coordinate two separate yet complementary forces into a coherent solution to the problems of providing services to children with special needs.
TL;DR: Infants whose parents participated in either of the treatment groups that included the parent education class scored higher on the Bayley Mental Scale than the other groups of infants when the infants were 6 months of age.
Abstract: This study examined the effect of a parent training program and its two components on the development of 48 graduates of neonatal intensive care units When the infants were 6 months of age, infants whose parents participated in either of the treatment groups that included the parent education class scored higher on the Bayley Mental Scale than the other groups of infants All treatment group parents were rated by the babies' physicians as providing better nutrition for their infants The developmental assessment component of the training program was not found to enhance infant mental development lmplications for intervention, program development, and research are presented.
TL;DR: In this paper, the authors compared Hydrocephalic (H, n = 8), dyseidetic dyslexic and IQ-matched regular class children on intellectual, visual-perceptual, and spatial reasoning tasks and found that H had significantly lower WISC-R Performance IQ scores, compared to both other groups.
Abstract: Hydrocephalic children typically show lower nonverbal than verbal intellectual abilities visual deficits, and muscle incoordination One subgroup of learning disabled children, dyserdetic dyslexics, have the same relative nonverbal weakness, but not the other associated deficits The present investigation compared hydrocephalic (H, n = 8), dyseidetic dyslexic (D, n = 8), and IQ-matched regular class children (C, n = 8) on intellectual, visual-perceptual, and spatial reasoning tasks Univariate analyses indicated that, compared to both other groups, H had significantly lower WISC-R Performance IQ scores, F(2,21) = 6 14, p < 01, McCarthy Motor Scale scores, F(2,21) = 7 03, p < 01 and a significantly greater WISC-R VerbalPerformance discrepancy, F(2,21) = 4 79, p < 05 Hydrocephalic children had deficits large enough to be apparent even when compared to dyseidetic children known to have similar relative nonverbal weaknesses These deficits were present despite early surgical correction and present remission of th...
TL;DR: The primary informational labels of over-thecounter medications commonly-used by parents were examined for the frequency with which specific informational items were found and showed that not only was there great variability between medications, but also the actual percentage of suggested information was low.
Abstract: The primary informational labels of over-thecounter medications commonly-used by parents were examined for the frequency with which specific informational items were found The results showed that not only was there great variability between medications, but also the actual percentage of suggested information was low The implications of these data for understanding noncompliance by parents and teens are discussed.