Brief parenting intervention (Triple P) for families of children with eczema: a randomized controlled trial.

OBJECTIVE: To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema. METHODS: A randomized controlled trial design was used. Families attending the Queensland Children's Hospital and from the community (n = 257) were assessed for eligibility (child 2-10 years, diagnosed with eczema, prescribed topical corticosteroids). Families who consented to participate (N = 59) were assessed at baseline for clinician-rated eczema severity, parent-reported eczema symptom severity, and electronically-monitored topical corticosteroid adherence (primary outcomes); and parenting behavior, parents' self-efficacy and task performance when managing eczema, eczema-related child behavior problems, and child and parent quality of life (secondary outcomes). Families were randomized (1:1, unblinded) to intervention (n = 31) or care-as-usual (n = 28). The intervention comprised two, 2-hr Healthy Living Triple P group sessions (face-to-face/online) and 28 intervention families attended one/both sessions. All families were offered standardized eczema education. Families were reassessed at 4-weeks post-intervention and 6-month follow-up, with clinician-raters blinded to condition. Costs of intervention delivery were estimated. RESULTS: Multilevel modeling across assessment timepoints showed significant intervention effects for ineffective parenting (d = .60), self-efficacy (d = .74), task performance (d = .81), and confidence with managing eczema-related child behavior (d = .63), but not disease/symptom severity, treatment adherence or quality of life. Mean cost per participating family with parenting behavior (clinically) improved was $159. CONCLUSIONS: Healthy Living Triple P is effective in reducing ineffective parenting practices and improving parents' self-efficacy and task performance when managing children's eczema and eczema-related behavior difficulties. There was no effect on disease/symptom severity, treatment adherence, or quality of life. CLINICAL TRIAL REGISTRATION: ACTRN12618001332213.

Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self-efficacy of reporting suspected child abuse and neglect.

AIM: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. DESIGN: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. METHODS: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. RESULTS: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. CONCLUSION: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. IMPACT: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. REPORTING METHODS: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION: There is no patient or public contribution as the study only looked at nurses.

Factors that support children and young people to express their views and to have them heard in healthcare: An inductive qualitative content analysis.

Despite development of healthcare charters supporting Article 12 of The United Nations Convention on the Rights of the Child, children and young people remain largely silenced in discussions about their healthcare. This article is based on the premise that children and young people should be able to exercise their right to express their views and be heard in all matters that affect their lives. This study examined children's and young people's experiences of expressing their views and having them heard in an Australian healthcare context. Using child-centred inquiry and 'draw, write, and tell' methods, data were collected from 20 children and young people. Five factors that supported children and young people to express their views and have their views heard were identified: time, relationships with health professionals, communication, teamwork, and family support. By paying attention to these factors, clinicians and others in health settings can better facilitate child-centred practices and support children and young people to express their views and have those views heard.