Psychological and Socioeconomic Burdens Faced by Family Caregivers of Children With Asthma: An Integrative Review.

INTRODUCTION: Asthma affects nearly 1 in every 12 children in the United States. Caring for a child with asthma poses significant challenges for the parent or caregiver. The purpose of this integrative review was to identify the psychological and socioeconomic burdens faced by family caregivers of children with asthma. METHOD: An integrative review was conducted to review and appraise 80 studies. RESULTS: Psychosocial burdens included decreased mental health, quality of life, sleep, family stress, educational deficits, cultural and health disparities, and health care communication challenges. Socioeconomic burdens included poor access to care, as well as work and financial challenges. Studies demonstrated a link between family caregiver health and child health outcomes. Facilitators included education and empowerment, social support, and use of technology. DISCUSSION: As the family caregiver's health directly affects the asthmatic child's health, addressing the burdens of family caregivers should be a key consideration in pediatric asthma care.

Healthcare Providers' Experiences with Gaps, Barriers, and Facilitators Faced by Family Caregivers of Children with Respiratory Diseases.

PURPOSE: The purpose of this study was to identify healthcare providers' experiences of the gaps in the healthcare system, barriers to obtaining care, and facilitators that promoted safe, quality care for family caregivers of children with respiratory diseases. DESIGN AND METHODS: A qualitative, descriptive design was used with 13 pediatric healthcare providers. FINDINGS: Gaps included themes of 1) fragmented healthcare system and 2) lack of asthma management knowledge. Barriers included themes of 1) poor access to healthcare and medications, 2) non-adherence, and 3) linguistic diversity and poor health literacy. Facilitators of optimal respiratory management included themes of 1) education, 2) improved communication, and 3) peer support. CONCLUSIONS: Through better understanding the gaps, barriers, and facilitators, pediatric nurses will be able to more effectively anticipate and address the needs of the caregivers. PRACTICE IMPLICATIONS: The nurse is in a pivotal role to empower caregivers with the skills and resources to address challenges and connect them with providers for optimal respiratory management.

Medication Adherence of Latino Children and Caregivers: An Integrative Review.

INTRODUCTION: There are significant disparities in medication adherence among underserved minority groups such as Latinos. Adherence to medication is a primary determinant of treatment success. Little is known about medication adherence among Latino children. This integrated review aims to describe what is known about medication adherence among Latino children and explore barriers and facilitators to medication adherence. METHOD: This review was guided by Whittemore and Knafl's method of integrative review and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. RESULTS: Of the 20 articles reviewed about medication adherence among Latino children, the analysis of these articles revealed four major themes: (1) low adherence, (2) low adherence associations, (3) child outcomes, and (4) effective interventions. CONCLUSION: Health practitioners should consider medication adherence associations and interventions when collaborating with the family caregiver to improve child outcomes.

Perceptions of pregnant adolescents on the antenatal care received at Ndirande Health Centre in Blantyre, Malawi.

Background: Rates of adolescent pregnancies in Malawi remain high at 29%. Early childbearing is a major health issue because of its increased risk for adverse pregnancy outcomes compared to older women. Although antenatal care is believed not to directly reduce maternal mortality, comprehensive antenatal care, especially in developing countries, may promote safe motherhood as actual and potential problems related to pregnancy are identified and treated in a timely manner. While antenatal services in Malawi are meant to provide antenatal care for adolescents, much of the care provided seems to be limited. The purpose of this study was to explore views of pregnant adolescent girls about the antenatal care they received at Ndirande clinic. Understanding adolescents' views about the care they receive may provide an opportunity to identify gaps in the care and ultimately improve the care for pregnant adolescent girls. Methods: We conducted a cross-sectional exploratory study on pregnant adolescent girls' perceptions of the antenatal care received at Ndirande Health Centre in Blantyre, Malawi, from 7 to 28 October 2011. We interviewed 15 purposively selected pregnant adolescents aged 14 to 19 years using a semi-structured interview guide. All the interviews were audiotaped, transcribed verbatim and translated from Chichewa into English. Data were analyzed using thematic content analysis. Findings: Two major themes emerged from the findings: a) caring b) motivation for attending antenatal care. The findings indicate that pregnant adolescents view the establishment of a clinic as acceptable and feasible. However, the care was inadequate, as it did not meet the expected standards and the needs of the pregnant adolescents. Conclusion: The antenatal care adolescent girls received at Ndirande clinic is inadequate as it does not meet their needs. Innovative models of care that embrace the principles of youth friendly services should be employed.

Evaluation of a Safe Motherhood project in Ntcheu district, Malawi.

PURPOSE: This study evaluated knowledge and practices of childbearing women on key childcare practices within the Safe Motherhood project, administered by the Ntcheu District Health Office in the Republic of Malawi. The study excluded men and elderly women. METHODS: The design was cross-sectional, and utilized quantitative and qualitative data collection and analysis procedures. Data were also collected through review of participant health records. RESULTS: Although the findings showed that all participants (100%, n=400) had general knowledge on maternal and child health care, they did not have comprehensive information, and few mothers were practicing the recommended key child health care practices. Only 42.4% (n=170) knew the appropriate number of visits a woman should make to the antenatal clinic, and very few knew the appropriate time at which to access antenatal care. Only 55% (n=220) of participants breastfed their babies exclusively. Some participants introduced supplementary feeds as early as a month after birth, and not all women delivered at the health facility. Failure to actively involve men and elderly women in maternal and child health issues had a negative impact on women's ability to fully implement key maternal and childcare practices. CONCLUSION AND RECOMMENDATIONS: There is a need to actively involve men and elderly women in maternal and child health issues since, in the ideal Malawian context, a child is raised not just by the mother, but also by all who live in the village. Additionally, elderly women are the guardians of members of the childbearing group, and are a traditional reservoir of experience into which young women can tap. There is also a need to engage Community Nurse-Midwives in facilitating women's groups that provide comprehensive antenatal information to mothers, who may then put knowledge into practice.