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1.
J Pak Med Assoc ; 74(5 (Supple-5)): S1-S4, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-39221787

RESUMO

OBJECTIVE: To determine the influence of parenting type on the anxiety level of hospitalised children. METHODS: The cross-sectional, observational study was conducted in June 2021 at the paediatric ward of Arifin Ahmad General Hospital, Pekanbaru, Riau, Indonesia, and comprised inpatients and their parents. The Data analyses was performed with SPSS 16.0. Statistical test results were considered significant at a p <0.05 level when 95% confidence intervals did not include zero. A personal Chi-Square test was applied to determine the influence of parenting type on the anxiety level of hospitalised children. RESULTS: There were 25 children with mean age 4.04±4.84 years, while the mean age of 25 parents was 34.87±36.89 years. Among the parents, 15(60%) were mothers. A significant influence was found between the type of parenting and the anxiety levels in hospitalised children (p=0.037; odds ratio:2.750; 95% confidence interval: 1.33-18.89). CONCLUSIONS: Good parenting patterns during treatment could reduce anxiety levels in hospitalised children.


Assuntos
Ansiedade , Criança Hospitalizada , Poder Familiar , Humanos , Feminino , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Masculino , Poder Familiar/psicologia , Criança Hospitalizada/psicologia , Pré-Escolar , Criança , Adulto , Indonésia/epidemiologia
2.
Front Public Health ; 12: 1364854, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39286743

RESUMO

Background: Bronchiolitis and pneumonia are both significant lower respiratory tract infections with a profound impact on children's health. The purpose of this study is to explore the economic burden and related influence factors of pediatric patients with bronchiolitis and pneumonia in China. Methods: A face-to-face interview was employed for the investigation of hospitalized patients (≤5 years old) with bronchiolitis and pneumonia, along with their guardians from January to October 2019. Demographic and costs were collected from Shanghai, Zhengzhou, and Kunming, representing three regions with different levels of economic development in China. Multiple linear regression analysis was used to explore factors associated with the economic burden of the diseases. Results: A total of 338 patients with bronchiolitis and 529 patients with pneumonia were included in the analysis. The average hospitalization and total cost for patients with bronchiolitis are 4,162 CNY and 5,748 CNY, respectively, while those with pneumonia are 6,096 CNY and 7,783 CNY. Patients from Shanghai, both bronchiolitis and pneumonia, exhibited the lowest cost expenditures, with average total costs of 3,531 CNY and 3,488 CNY, respectively. Multiple regression analysis indicated that, among bronchiolitis patients, factors such as region, medical insurance, relationship, loss of work time, and length of stay were found to be significantly associated with both hospitalization cost and total cost (p < 0.05). For pneumonia patients, the hospitalization cost and total cost were significantly impacted by region, medical insurance, and length of stay (p < 0.05). Conclusion: Bronchiolitis and pneumonia in children put substantial economic burden on families of affected children. The financial strain varies significantly across different regions, with families in underdeveloped areas and those dealing with pneumonia facing particularly daunting challenges. Targeted policies to reduce healthcare costs and improve insurance coverage, especially in economically disadvantaged regions are needed.


Assuntos
Bronquiolite , Efeitos Psicossociais da Doença , Hospitalização , Pneumonia , Humanos , China/epidemiologia , Bronquiolite/economia , Pneumonia/economia , Masculino , Feminino , Pré-Escolar , Lactente , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Criança Hospitalizada/estatística & dados numéricos
3.
J Med Virol ; 96(9): e29916, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39262102

RESUMO

Hand, foot, and mouth disease (HFMD) is an acute infectious illness primarily caused by enteroviruses. The present study aimed to describe the epidemiological characteristics of hospitalized HFMD patients in a hospital in Henan Province (Zhengzhou, China), and to predict the future epidemiological parameters. In this study, we conducted a retrospective analysis of general demographic and clinical data on hospitalized children who were diagnosed with HFMD from 2014 to 2023. We used wavelet analysis to determine the periodicity of the disease. We also conducted an analysis of the impact of the COVID-19 epidemic on the detection ratio of severe illness. Additionally, we employed a Seasonal Difference Autoregressive Moving Average (SARIMA) model to forecast characteristics of future newly hospitalized HFMD children. A total of 19 487 HFMD cases were included in the dataset. Among these cases, 1515 (7.8%) were classified as severe. The peak incidence of HFMD typically fell between May and July, exhibiting pronounced seasonality. The emergence of COVID-19 pandemic changed the ratio of severe illness. In addition, the best-fitted seasonal ARIMA model was identified as (2,0,2)(1,0,1)12. The incidence of severe cases decreased significantly following the introduction of the vaccine to the market (χ2 = 109.9, p < 0.05). The number of hospitalized HFMD cases in Henan Province exhibited a seasonal and declining trend from 2014 to 2023. Non-pharmacological interventions implemented during the COVID-19 pandemic have led to a reduction in the incidence of severe illness.


Assuntos
COVID-19 , Doença de Mão, Pé e Boca , Hospitalização , Estações do Ano , Humanos , Doença de Mão, Pé e Boca/epidemiologia , Doença de Mão, Pé e Boca/virologia , China/epidemiologia , Pré-Escolar , Masculino , Feminino , Estudos Retrospectivos , Lactente , Estudos Longitudinais , Criança , COVID-19/epidemiologia , Incidência , Hospitalização/estatística & dados numéricos , Criança Hospitalizada/estatística & dados numéricos , Adolescente , Hospitais/estatística & dados numéricos , SARS-CoV-2 , Recém-Nascido
4.
Clin Lab ; 70(9)2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39257114

RESUMO

BACKGROUND: Influenza A (H1N1) is a contagious respiratory infection caused by the influenza A virus. In the majority of cases, H1N1 influenza is benign. However, it can be dangerous for infants and children with underlying chronic diseases. The severity of influenza depends on various factors, including the virulence of the virus strain, preexisting immunity level, and individual health conditions. The aim of this study is to describe the clinical profile of H1N1 influenza in hospitalized infants and children. METHODS: This is a prospective and descriptive study conducted from November 1, 2018, to January 31, 2024. In this study, we included all children under 14 years old hospitalized for suspected severe lower respiratory infection who had gone through virological testing. We used a multiplex polymerase chain reaction (PCR) kit: the Film Array-Respiratory Panel. Due to the depletion of multiplex PCR kits, this study continued using rapid influenza diagnostic tests based on immunochromatographic technique. RESULTS: We report 45 confirmed cases of H1N1 influenza, collected during the period from November 1, 2018, to January 31, 2024. The average age was 2 years and 4 months. The main reason for admission was respiratory distress found in all patients. In 53% of the cases, there was an associated comorbidity, including asthma (17 cases), prematurity (2 cases), congenital adrenal hyperplasia (2 cases), cystic fibrosis (1 case), undetermined etiology bronchial dilation (1 case), and Basedow's disease (1 case). The clinical presentation included viral bronchiolitis (17 cases), moderate asthma exacerbation (10 cases), severe asthma exacerbation (7 cases), pneumonia (9 cases), bronchial dilation exacerbation (1 case), and flu-like syndrome with adrenal insufficiency (1 case). Fever was present in 31 patients. Gastrointestinal symptoms such as diarrhea and vomiting were present in 20 cases. Three patients required intensive care, with 2 children being intubated and ventilated (one severe acute asthma and one severe viral bronchiolitis). Two cases were treated with oseltamivir. The average length of hospital stay was 7.5 days, ranging from 3 to 20 days. All cases showed favorable evolution. CONCLUSIONS: We conclude that preventive measures remain crucial, and influenza vaccination is highly recommended in cases of underlying morbidity.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana , Humanos , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/virologia , Influenza Humana/epidemiologia , Influenza Humana/complicações , Pré-Escolar , Feminino , Masculino , Lactente , Estudos Prospectivos , Criança , Hospitalização , Adolescente , Criança Hospitalizada , Antivirais/uso terapêutico
5.
Front Cell Infect Microbiol ; 14: 1424554, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39220288

RESUMO

Background: Mycoplasma pneumoniae (MP) is a significant cause of community-acquired pneumonia with high macrolide resistance rates. Various COVID-19 pandemic restrictions have impacted the prevalence of MP. Objective: To assess the changes in the pattern of MP infections among children before, during, and after the COVID-19 pandemic. Methods: A total of 36685 enrolled patients, aged 0-18 years, diagnosed with pneumonia and admitted to Children's Hospital of Chongqing Medical University from January 2019 to December 2023, were retrospectively reviewed in this study. The epidemiological characteristics of pediatric MP infection were analyzed. Results: Among 36685 patients, 7610 (20.74%) tested positive for MP. The highest positive rate was observed among children aged over 6 years (55.06%). There was no gender disparity in MP infection across the three phases of the COVID-19 pandemic. Hospital stays were longest for children during the COVID-19 pandemic (P <0.001). MP infection was most prevalent in the summer (29.64%). The lowest positive rate was observed during the pandemic, with the highest rate found after easing the measures across all age groups (P <0.001). There was a surge in the positive rate of MP in the third year after the COVID-19 pandemic. Regression analyses demonstrated a shift in the age range susceptible to MP infection, with children aged 3.8 to 13.5 years post-pandemic compared to the pre-pandemic range of 5.3 to 15.5 years old. Additionally, the average macrolide resistance rate was 79.84%. We observed a higher resistance rate during the pandemic than in the pre- and post-pandemic phases (P <0.001). Conclusion: The restrictive measures implemented during the COVID-19 pandemic have influenced the spread of MP to some extent and altered demographic and clinical characteristics, such as age, age group, season, length of stay, and macrolide resistance. We recommend continuous surveillance of the evolving epidemiological characteristics of MP infection in the post-pandemic period when restrictions are no longer necessary.


Assuntos
COVID-19 , Mycoplasma pneumoniae , Pneumonia por Mycoplasma , SARS-CoV-2 , Humanos , Criança , COVID-19/epidemiologia , Pré-Escolar , China/epidemiologia , Feminino , Masculino , Lactente , Adolescente , Pneumonia por Mycoplasma/epidemiologia , Mycoplasma pneumoniae/efeitos dos fármacos , Mycoplasma pneumoniae/isolamento & purificação , Estudos Retrospectivos , Recém-Nascido , Prevalência , SARS-CoV-2/isolamento & purificação , Hospitalização/estatística & dados numéricos , Pandemias , Macrolídeos/uso terapêutico , Farmacorresistência Bacteriana , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Criança Hospitalizada/estatística & dados numéricos , Estações do Ano , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia
6.
Pediatr Ann ; 53(9): e337-e344, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39240180

RESUMO

It has long been established that the environment in which a child grows and develops shapes their social and health outcomes. After all, collecting social history is a key component of a health care visit. In recent decades, the importance of social determinants of health (SDOH) has been rediscovered, and the impact of adverse childhood experiences has garnered great attention. Estimates show that health outcomes are influenced more by factors outside of health care, such as our patients' SDOH. Addressing SDOH is fundamental for improving health and reducing longstanding inequities in health. While understanding that SDOH needs to be addressed through the continuum of pediatric care, this article will focus on SDOH in the pediatric inpatient setting. [Pediatr Ann. 2024;53(9):e337-e344.].


Assuntos
Criança Hospitalizada , Determinantes Sociais da Saúde , Humanos , Criança , Criança Hospitalizada/psicologia
7.
Curr Microbiol ; 81(10): 337, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39223408

RESUMO

Human enteric and some respiratory viruses are identified to be involved with acute gastroenteritis that can be shed in feces of infected persons into the environment. Understanding the abundance of these viruses in wastewater is significant when assessing the public health impacts associated with discharge of wastewater into the environment. This study aimed to investigate the prevalence and seasonal variation of human enteric adenovirus (HAdV), Aichi virus (AiV-1), bocavirus (HBoV), and respiratory syndrome coronavirus 2 virus (SARS-CoV-2) in wastewater as well as their prevalence among hospitalized children with acute gastroenteritis. The viruses were detected and quantified with real-time PCR. HAdV was the most detected virus in raw sewage (88.5%), treated sewage (28%), and stool gastroenteritis (74%), followed by HBoV (45.8% for raw sewage, 14.6% for treated sewage, and 55.3% for stool samples). The detection rate of AiV-1 was 59.4%, 19.8%, and 62.6% in raw sewage, treated sewage, and stool samples, respectively. The rate of SARS-CoV-2 detection in raw sewage, treated sewage, and stool samples was 33.3%, 7.3%, and 20.6%, respectively. The viral concentrations ranged between 4.50 × 101 and 8.75 × 107 GC/ml in raw sewage samples, 1.20 × 101 and 5.43 × 106 GC/ml in treated sewage samples, and 4.80 × 101 and 9.88 × 108 GC/gram in stool samples. The overall log means of virus reduction during the wastewater treatment process ranged from 1.68 log10 (HAdV) to 3.31 log10 (AiV-1). The peak prevalence of the four viruses in raw sewage samples occurred during the winter season. This study showed the high detection rates of the four targeted viruses in wastewater and demonstrated that virological surveillance of wastewater in local wastewater treatment plants is a suitable model for epidemiological monitoring of diarrheal and respiratory diseases in middle- and low-resource countries.


Assuntos
Fezes , Gastroenterite , Estações do Ano , Esgotos , Águas Residuárias , Humanos , Gastroenterite/virologia , Gastroenterite/epidemiologia , Águas Residuárias/virologia , Prevalência , Esgotos/virologia , Criança , Fezes/virologia , Pré-Escolar , Criança Hospitalizada , Lactente , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Vírus/isolamento & purificação , Vírus/classificação , Vírus/genética , Kobuvirus/isolamento & purificação , Kobuvirus/genética , Bocavirus Humano/isolamento & purificação , Bocavirus Humano/genética , Masculino
8.
PLoS One ; 19(8): e0306511, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39121076

RESUMO

Antimicrobials are the most frequently prescribed drug in pediatrics, with an estimated 37% of infants and 61% of hospitalized children having received them. Approximately 20-50% of prescriptions have been shown to be potentially unnecessary or inappropriate. The World Health Organization (WHO) estimates that the continued increase in antimicrobial resistance by the year 2050 will lead to the death of 10 million people per year. This paper describes a protocol to be used in a future study to evaluate the implementation of a quarterly syndromic antibiogram, aimed to improve the use of antibiotics for the treatment of pediatric bacterial infections at the Maputo Central Hospital, Mozambique. This study uses implementation science methods framed by the Dynamic Adaption Process (DAP) and RE-AIM conceptual frameworks to develop a multi-phase, mixed-methods evaluation utilizing qualitative and quantitative approaches. The pediatric inpatient services at HCM consist of approximately 18 physicians and 60 nurses. Additionally, the microbiology laboratory consists of eight laboratory technicians. We anticipate analyzing approximately 9,000 medical records. Qualitative methods include in-depth interviews with clinicians, laboratory technicians, and administrators to explore current knowledge and practices around antibiotic decision making, facilitators and barriers to intervention implementation, as well as acceptability and satisfaction with the intervention roll-out. Qualitative analysis will be performed with NVivo 12 software. Quantitative methods include extracting data from existing records from the pediatric ward of Hospital Central de Maputo (HCM) guided by the RE-AIM framework to explore intervention utilization and other factors influencing its implementation. Quantitative descriptive and inferential statistical analysis will be performed using R Studio statistical software. The findings from this evaluation will be shared with hospital administrators and relevant national policymakers and may be used by the Ministry of Health in deciding to expand this approach to other hospitals. The expected results of this research include the development of standard operating guidelines for the creation, distribution, and use of a quarterly syndromic antibiogram for antibiotic decision making that is informed by local epidemiology. Findings from this study will be used to develop a larger multi-site trial in Mozambique.


Assuntos
Antibacterianos , Ciência da Implementação , Humanos , Moçambique/epidemiologia , Antibacterianos/uso terapêutico , Criança , Criança Hospitalizada , Testes de Sensibilidade Microbiana , Lactente , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Pré-Escolar , Prescrições de Medicamentos/estatística & dados numéricos
9.
Adv Skin Wound Care ; 37(9): 480-488, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39162379

RESUMO

BACKGROUND: Current pediatric pressure injury (PI) prevention measures are based on risk factors related to PI development in adults. Children offer a unique concern for PI development because their bodies are still developing, and their skin responds differently to external pressure. OBJECTIVE: To explore risk factors for the development of full-thickness PIs in children aged 21 weeks' gestation to 21 years. METHODS: This retrospective, observational, correlational study included 799 hospitalized children who developed a PI. The pediatric and adult PI risk factors used in the study were identified from the International Pressure Ulcer Prevention and Treatment Guideline. A stepwise multivariate logistic regression model was used. RESULTS: Multivariate analyses revealed that risk factors for predicting a full-thickness PI varied by age. For children aged 38 weeks to 12 months, risk factors included tissue perfusion and oxygenation: generalized edema, conditions of the OR, and nutrition deficits. For children aged 1 to 7 years, fragile skin status was a risk factor. For youth aged 8 to 21 years, the two risk factors were tissue perfusion and oxygenation: decreased oxygenation and extracorporeal membrane oxygenation. Across the total sample, extracorporeal membrane oxygenation, tissue perfusion and oxygenation: decreased oxygenation and malnutrition were risk factors for predicting a full-thickness PI. CONCLUSIONS: Full-thickness PI risk factors differ among the ages of pediatric patients.


Assuntos
Úlcera por Pressão , Humanos , Úlcera por Pressão/prevenção & controle , Úlcera por Pressão/etiologia , Úlcera por Pressão/epidemiologia , Criança , Estudos Retrospectivos , Adolescente , Pré-Escolar , Feminino , Masculino , Lactente , Fatores de Risco , Adulto Jovem , Recém-Nascido , Hospitalização/estatística & dados numéricos , Modelos Logísticos , Fatores Etários , Criança Hospitalizada/estatística & dados numéricos
10.
ANS Adv Nurs Sci ; 47(3): 248-262, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39093934

RESUMO

This study aimed to describe the meaning of aesthetics in nursing practice as experienced by children during hospitalization. A hermeneutic phenomenological approach was used. Fifteen children who met the inclusion criteria participated in the study conducted from June to August 2021. Data were collected by drawing and interviewing. Kongsuwan's approach was used to analyze the data. Six thematic categories that revealed aesthetics in nursing practice were identified, namely, Enjoyment; Kindness; Creating impressive care; Appreciation of safeness; Intention to know children; and Connecting to others. The study findings present useful knowledge to inform nurses regarding special approaches to implementing aesthetic nursing care for children.


Assuntos
Estética , Humanos , Feminino , Masculino , Criança , Filipinas , Relações Enfermeiro-Paciente , Hospitalização/estatística & dados numéricos , Criança Hospitalizada/psicologia , Pesquisa Qualitativa , Pré-Escolar , Cuidados de Enfermagem/psicologia , Adolescente
11.
J Med Virol ; 96(8): e29855, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39119991

RESUMO

Non-pharmaceutical interventions (NPIs) implemented to control SARS-CoV-2 have significantly influenced the activity of respiratory pathogens. This study investigated epidemiological changes among hospitalized patients with respiratory syncytial virus (RSV) before (2017-2019) and during (2020-2022) the COVID-19 pandemic in Hangzhou, China. We also examined viral load distribution across demographic and temporal variables. Nasopharyngeal swabs were collected and RSV loads were quantified using reverse transcriptase polymerase chain reaction (RT-qPCR). RSV epidemic characteristics, seasonal dynamics, and viral load distributions were compared between pre- and pandemic years. General linear models were employed to assess associations between viral loads and age. Among 19 742 cases, 1576 and 2092 tested positive during the pre- and pandemic years, respectively. From February to July 2020, the implementation of NPIs led to the cessation of RSV circulation. However, after these measures were relaxed, RSV cases resurged over two consecutive seasons during the pandemic, notably affecting older children compared to those in the pre-pandemic years (1.00 years, IQR: 0.50-2.00 vs. 0.58 years, IQR: 0.27-1.00, p < 0.001). Specifically, in 2021-2022, an off-season resurgence of RSV began earlier (mid-June), lasted longer (40 weeks), and involved more positive cases (1238 cases) than both 2020-2021 and pre-pandemic years. Viral load distribution demonstrated a clear age-related relationship in both pre- and pandemic years, with younger children consistently showing higher viral loads, independently of gender and season (all p-values for trends <0.001). These findings highlight the impact of NPIs on RSV epidemiology and underscore the need to prioritize RSV infection prevention in younger children from the perspective of viral load.


Assuntos
COVID-19 , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , SARS-CoV-2 , Estações do Ano , Carga Viral , Humanos , China/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , COVID-19/epidemiologia , COVID-19/virologia , Lactente , Pré-Escolar , Masculino , Feminino , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Criança , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Hospitalização/estatística & dados numéricos , Recém-Nascido , Criança Hospitalizada/estatística & dados numéricos , Adolescente , Nasofaringe/virologia
12.
Hosp Pediatr ; 14(9): 701-713, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39099438

RESUMO

OBJECTIVES: Data on US caregiver perceptions on coronavirus disease 2019 (COVID-19) and COVID-19 vaccination are limited. We identified trends in and associations with COVID-19 vaccine hesitancy in caregivers of hospitalized children. METHODS: Cross-sectional surveys on pediatric COVID-19 disease and vaccine attitudes, behaviors, and beliefs were administered across study years (December 8, 2020-April 5, 2021, November 30, 2021-March 15, 2022, and October 26, 2022-March 15, 2023). English and Spanish-speaking caregivers of hospitalized children ages 6 months to 11 years were included. General vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines survey. RESULTS: Of 1268 caregivers from diverse backgrounds, one-third vaccinated or intended to vaccinate their child. Half endorsed fear of their child receiving the COVID-19 vaccine and were concerned the vaccine was new. Over time, more believed "the COVID-19 vaccine does not work" and fewer agreed "children who are otherwise healthy can die from COVID-19." Study season (2022-2023), older child age, higher income, child receipt of influenza vaccine, caregiver receipt of COVID-19 vaccine, and not being worried about vaccine novelty were positively associated with child vaccination. Intent to vaccinate was negatively associated with study season (2022-2023), Parent Attitudes about Childhood Vaccines score ≥50, lack of child influenza and caregiver COVID-19 vaccination, lack of fear of their child "getting COVID-19" and being "worried that the COVID-19 vaccine is new." The majority who intended to vaccinate were willing to immunize before discharge. CONCLUSIONS: Vaccine novelty and perceived lack of need were associated with refusal. Caregiver COVID-19 and child influenza vaccine acceptance were positively associated with COVID-19 vaccine acceptance. The inpatient setting offers the opportunity to improve vaccine uptake.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Cuidadores , Criança Hospitalizada , Hesitação Vacinal , Humanos , Criança , Masculino , Vacinas contra COVID-19/administração & dosagem , Feminino , Estudos Transversais , Pré-Escolar , Hesitação Vacinal/psicologia , Cuidadores/psicologia , Criança Hospitalizada/psicologia , Lactente , COVID-19/prevenção & controle , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Estados Unidos
14.
Hosp Pediatr ; 14(9): 714-721, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39099437

RESUMO

OBJECTIVE: Hospitalized children are a potentially underimmunized population. We sought to determine the proportion of patients admitted to our pediatric medicine inpatient units who are underimmunized or unimmunized and to identify barriers to immunization faced by families of children admitted to hospital. METHODS: We conducted a prospective study of children aged 2 months to 18 years admitted to our pediatric medicine inpatient units between July 2021 and October 2022. Immunization and demographic data were collected from electronic medical charts. Immunization status of each child was categorized as up-to-date if they had received all eligible vaccine doses in accordance with the provincial immunization schedule. Caregivers completed a survey on barriers to immunizations; results were compared between caregivers of children whose vaccines were up-to-date and those who were not. RESULTS: Hospitalized children were missing more doses of the preschool vaccines than the general population based on published provincial data. Only 142 of 244 (58.2%) of study patients were up-to-date on all their immunizations. Caregivers of children whose immunizations were not up-to-date reported significantly more barriers to vaccination in all survey categories: access to shots, concerns about shots, and importance of shots. CONCLUSIONS: There is a disparity in immunization status between children admitted to hospital in a Canadian setting compared with national targets and community immunization rates. Caregivers of underimmunized hospitalized children cited significantly more barriers to immunization when compared with hospitalized children who are up-to-date. Pursuing a hospital-based immunization strategy could lead to improved immunization status for hospitalized children.


Assuntos
Criança Hospitalizada , Humanos , Pré-Escolar , Lactente , Criança , Masculino , Estudos Prospectivos , Feminino , Criança Hospitalizada/estatística & dados numéricos , Adolescente , Cuidadores/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Imunização/estatística & dados numéricos , Esquemas de Imunização , Hospitalização/estatística & dados numéricos , Canadá , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos
16.
Hosp Pediatr ; 14(9): 758-765, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39193635

RESUMO

BACKGROUND AND OBJECTIVES: Individualized, weight-based opioid dosing poses safety risks and contributes to inefficient medication delivery processes. Dose banding is a patient safety strategy to reduce dosing errors through standardized doses based on weight ranges. Study objectives were (1) determine the frequency of dosing deviation from reference ranges of common intravenous (IV) and oral opioid medications, (2) evaluate the differences in dosing deviations by age, and (3) determine the potential reduction in dose variation that could be achieved by dose banding. METHODS: We conducted a cross-sectional analysis of hospitalized children ≥2 months to ≤24 months old who received IV morphine, oral methadone, or oral oxycodone at a single center. Dosing was categorized as no dosing deviation (within ±5% of the reference range), negative dosing deviation (>5% below the reference range), or positive dosing deviation (>5% above the reference range). Descriptive and bivariate analyses were conducted. RESULTS: A total of 3361 opioid doses met the inclusion criteria. A total of 2663 (79.2%) had no dosing deviation, 214 (6.3%) demonstrated negative deviations, and 484 (14.4%) demonstrated positive deviations. Dosing deviations were more frequent among subjects ≥2 months to ≤6 months old for oral methadone and oxycodone (P < .0001) and more frequent among older age group for IV morphine (P < .0001). Dose banding has the potential to reduce the number of unique doses prescribed for all medications by 75% while eliminating unintended dosing deviations. CONCLUSIONS: A total of 20% of opioid doses prescribed to children ≤24 months of age are outside the recommended ranges. Dose banding represents a promising method for simplifying opioid prescribing in the pediatric inpatient setting.


Assuntos
Analgésicos Opioides , Morfina , Oxicodona , Humanos , Analgésicos Opioides/administração & dosagem , Lactente , Masculino , Estudos Transversais , Feminino , Morfina/administração & dosagem , Oxicodona/administração & dosagem , Metadona/administração & dosagem , Erros de Medicação/prevenção & controle , Pré-Escolar , Administração Oral , Criança Hospitalizada , Relação Dose-Resposta a Droga
17.
PLoS One ; 19(7): e0305101, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39052600

RESUMO

OBJECTIVE: To explore the effectiveness of family participatory clown therapy in venipuncture in hospitalized children. METHODS: We recruited 104 children aged 3 to 6 years for a non-randomized controlled trial from March to December 2022. All participants required peripheral venepuncture infusions for treatment. The children were assigned to either the control group (n = 52) or the experimental group (n = 52).Standard care was utilized in the control group. In the experimental group, two clown nurses and a parent provided family participatory clown therapy for 35-45 minutes per child before, during, and after venipuncture. We assessed children's pain (FLACC and W-B FPS), anxiety (VAS-A), medical fear (CFS), crying incidence, compliance, parental anxiety (S-AI), and parental satisfaction. RESULTS: At venipuncture, the FLACC score was lower in the experimental group (4.46±2.053) compared to the control group (5.96±2.441), the W-B FPS score was also lower in the experimental group (4.96±2.392) than in the control group (6.35±2.266), with a statistically significant difference (P<0.05).The children in the experimental group had lower levels of anxiety, medical fear, crying, and parental anxiety than the control group. In addition, child compliance and parent satisfaction were higher in the experimental group than in the control group, with statistically significant differences (P<0.05). CONCLUSION: Family participatory clown therapy can reduce pain, anxiety, medical fear, and crying during venipuncture in children. It can also improve venipuncture compliance, reduce parental anxiety, and increase parental satisfaction.


Assuntos
Ansiedade , Criança Hospitalizada , Terapia do Riso , Flebotomia , Humanos , Flebotomia/psicologia , Masculino , Feminino , Criança , Pré-Escolar , Criança Hospitalizada/psicologia , Ansiedade/psicologia , Ansiedade/terapia , Terapia do Riso/métodos , Pais/psicologia , Choro/psicologia , Medo/psicologia , Dor/psicologia
18.
Child Care Health Dev ; 50(4): e13287, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38958339

RESUMO

BACKGROUND: Children have a right to participate in matters affecting their lives. With increasing regularity, children's perspectives are being sought regarding their health and health care experiences. Though there is evidence that children find play to be one of the 'best' aspects of hospitalisation, studies rarely focus on children's perspectives on play in hospital. METHODS: This qualitative study explored children's lived experiences of play during hospitalisation. Over five months, ethnographic observations were conducted on a paediatric oncology ward as well as interviews with 16 children ages 3-13 years. RESULTS: Using interpretative phenomenological analysis, children's expressions and experiences illuminated three key points: safety and comfort are integral to children feeling able to play in hospital; the value and efficacy of play is decided by children; and that play is a way for patients to be (and be treated as) children first. CONCLUSION: Hospitals can only be child-friendly if children find them friendly. Listening to and integrating children's perspectives in the discourse around the importance of play in hospital is essential for respecting children's rights and delivering person-centred paediatric healthcare.


Assuntos
Criança Hospitalizada , Jogos e Brinquedos , Pesquisa Qualitativa , Humanos , Criança , Masculino , Feminino , Jogos e Brinquedos/psicologia , Pré-Escolar , Adolescente , Criança Hospitalizada/psicologia , Hospitalização
19.
J Infus Nurs ; 47(4): 224-232, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38968585

RESUMO

The objective of this study was to operationally define the concept of success in peripheral intravenous catheterization in children considering the Walker and Avant model. This is a methodological study, carried out through the following steps: concept selection, the definition of the analysis objective, identification of possible uses of the concept, determination of critical or essential attributes, construction of a model and opposite case, and identification of antecedents and consequences. The study was carried out based on a search in international databases from January to March 2021. The sample consisted of 47 studies conducted in 17 countries between 2008 and 2021. Five attributes, 20 antecedents, 10 consequences, and an empirical reference of the studied concept were identified. Also, 2 cases, model and opposite, were elaborated, and an operational definition of the concept was developed. The Walker and Avant method enabled the operationalization of the concept of success of peripheral intravenous catheterization in children based on attributes, antecedents and consequents, and model and opposite cases.


Assuntos
Cateterismo Periférico , Criança Hospitalizada , Humanos , Cateterismo Periférico/métodos , Criança , Pré-Escolar , Lactente
20.
BMC Pediatr ; 24(1): 421, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38956539

RESUMO

INTRODUCTION: The stay of a critically ill child in a pediatric intensive care unit (PICU) is a significant experience for the family. Thus far, little is known regarding the impact of this stay on parents and their healthy children for whom no continuous aftercare services are offered. This study aimed to capture the post-stay experience and needs of parents after this traumatic event so that they could return to family and everyday life. METHODS: This qualitative descriptive study was conducted in collaboration with four pediatric intensive care units in Switzerland. It included parents whose children had fully recovered after a stay and who did not require continuous medical follow-up. All children were hospitalized in the PICU for at least 48 h. Data were collected through narrative pairs (n = 6) and individual interviews (n = 8). Interviews were audio recorded, transcribed, coded inductively according to Saldaña, and analyzed. RESULTS: The results showed three related phases that influence each other to restore normality in daily life: Trust and inclusion in the treatment process during the stay (1), processing after the stay (2), and returning to everyday life (3). CONCLUSION: Follow-up meetings should be available to all parents whose children have been hospitalized in the PICU. In particular, it should also be available to parents whose children have fully recovered and no longer have any medical disabilities.


Assuntos
Unidades de Terapia Intensiva Pediátrica , Pais , Pesquisa Qualitativa , Humanos , Pais/psicologia , Masculino , Feminino , Criança , Pré-Escolar , Estado Terminal/psicologia , Suíça , Adulto , Lactente , Criança Hospitalizada/psicologia , Entrevistas como Assunto , Adolescente
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