Psychosocial experiences in youth with Tourette syndrome: a systematic review and meta-synthesis.

Suffering from Tourette syndrome (TS) disrupts the daily lives and interpersonal relationships of patients. The psychosocial experiences of young people with TS are not yet clear. The aim of the systematic review is to identify and synthesize the psychosocial experiences of young people with TS. A meta-synthesis was conducted. PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Chinese Electronic Periodical Services databases were searched for articles published from their inception to February 2023. This review followed the Joanna Briggs Institute's Guidelines for Systematic Reviews according to a previously developed protocol. We used the confidence of synthesized qualitative findings (ConQual) approach to evaluate the credibility and dependability of the synthesized findings. This review included 12 qualitative studies from Western and Asian countries published between 2005 and 2019, representing 190 young people with TS. We identified five synthesized findings: affliction by intractable TS, TS was negatively perceived in the social and cultural context, self-adjustment in response to social interaction, response to receiving various interventions, and positivity in promoting self-acceptance. The ConQual grade for each generated synthesized finding ranged from low to moderate. The psychosocial experiences of youths living with TS are unique and are influenced by their interpersonal relationships, social context, and cultural framework. The findings recommend that healthcare providers assist young people in developing personalized symptom management strategies and provide guidance and care that meets the needs of each individual.

Factors associated with Tourette syndrome among adolescents in Taiwan: A cross-sectional correlational study.

PURPOSE: Adolescents with Tourette syndrome (TS) may suffer from learning difficulties (attention-deficit/hyperactivity disorder), challenges in interpersonal interactions (especially with peers), disruptions of daily routines (disruptive behavior disorders), and increased psychosocial stress, which can result in internalizing and externalizing behavioral problems, such as venting depression and stress through self-harm. The aim of this study was to investigate peer attachment in adolescents with TS and associated risk factors. DESIGN AND METHODS: Adolescents with TS aged 13-18 years were recruited from the outpatient departments of 2 hospitals in Taiwan. Participants completed a basic data sheet, the Beck Depression Inventory-II, the Chinese version of the State-Trait Anxiety Inventory, and the Chinese version of the Youth Self-Report. Descriptive statistics were performed. Structural equation modeling was used to verify the model proposed in this study and to analyze the overall fit and internal structure. RESULTS: A total of 452 adolescents with TS aged 10-19 years participated in this study, which aimed to investigate factors affecting peer attachment, depression, anxiety, and psychosocial maladaptation and to explore causal relationships between these factors. Peer attachment was significantly associated with grade point average (rs = -0.240, p < .001), birth order (rs = -0.118, p = .012), parental marital status (rs = -0.111, p = .018), parenting style (rs = -0.138, p = .003), family monthly income (rs = 0.124, p = .008), and weekly hours on the internet (r = -0.164, p < .001). CONCLUSIONS: These results suggest that depression, anxiety, and peer attachment affect psychosocial development. PRACTICAL IMPLICATIONS: The findings may help clinical staff manage adolescents' severe emotional distress and psychosocial maladaptation.

Effects of a Moodle-based E-learning environment on E-collaborative learning, perceived satisfaction, and study achievement among nursing students: A cross-sectional study.

BACKGROUND: Studies suggest that e-learning environments (ELEMs) in nursing education may be more effective than traditional face-to-face teaching, as they lead to learning outcomes that equal or exceed those of face-to-face teaching. OBJECTIVES: To determine whether using ELEM for educational applications can significantly improve e-collaborative learning, perceived satisfaction, and study achievement among nursing students in a paediatric nursing course. DESIGN: Nonrandomized pretest-posttest quasi-experimental research design. SETTINGS: A medical college in northern Taiwan. PARTICIPANTS: Eighty-four students (52 in the non-ELEM group and 32 in the ELEM group) completed both the pretest and posttest. METHODS: Third-year nursing students were recruited and nonrandomly assigned to an experimental group (ELEM) and a nonexperimental group (non-ELEM) of their choice. Students in the former group received traditional classroom teaching without the use of Moodle-based ELEMs, while those in the latter completed the course through Moodle-based ELEMs and classroom lectures. RESULTS: Regarding perceived satisfaction, e-collaborative learning, and study achievement, the overall test results indicated a significant difference in the posttest between the two groups (F (1,82) = 10.622, P = 0.002), (F (1,82) = 9.481, P = 0.003), (F (1,82) = 59.301, P < 0.001, respectively). The explanatory power η2 reached 11.5 %, 10.4 %, and 42.0 %, respectively. CONCLUSION: The students who used Moodle-based ELEMs combined with classroom teaching showed significantly higher levels of e-collaborative learning, perceived satisfaction, and study achievement in the paediatric nursing course. ELEMs for educational purposes can serve as effective complementary learning tools for paediatric nursing courses.

Prevention and management of hospital-acquired pressure injury among patients with lung disease in a hospital: a best practice implementation project.

OBJECTIVES: The aim of this project was to promote evidence-based practice in the prevention and management of pressure injury in lung disease patients. INTRODUCTION: Pressure injury is a crucial quality indicator for hospital care of patients. The pressure injury incidence threshold in the chest wards has been exceeding that of the general ward (0.128%), which may extend patients' hospital stay. METHODS: Clinical audits were performed using the JBI Practical Application of Clinical Evidence System and Getting Research into Practice (GRiP) audit and feedback tool. Twelve audit criteria representing best practice recommendations for preventing and managing pressure injury among lung disease patients were used. A baseline audit was performed to measure the degree of consistency between existing practice and best practice. This project used the GRiP analysis and multiple strategies to develop care protocols for pressure injury prevention and management. A follow-up audit was conducted to measure changes in clinical practice and pressure injury incidence. RESULTS: Postimplementation audit compliance rates improved for the following criteria: skin assessment for identifying pressure injury indications (from 31 to 81%), identification of pressure injury risk score/category (from 19 to 88%), employment of nutritional assessment tools (from 8 to 93%), and provision of information regarding oral nutritional supplements (from 23 to 84%). Furthermore, patients learning the pressure injury care protocols (from 48 to 93%), the receipt of additional skin protection measures, and repositioning of vulnerable areas to relieve pressure increased to 100 and 93%, respectively. After project implementation, the monthly pressure injury incidence decreased markedly from 0.075 to 0.021%. CONCLUSION: The success factors of this project are attributable to leadership, open communication, multiple learning-by-doing strategies, regular audits, and the promotion of patient and family engagement.

Psychosocial stress, self-esteem, and social adjustment: A moderated mediation analysis in Taiwanese adolescents with Tourette syndrome.

PURPOSE: Recent studies have shown that tics and related comorbidities can cause poorer social adjustment, lower self-esteem, and higher psychosocial stress among adolescents with Tourette syndrome. This study explored the role of self-esteem in mediating the relationship between psychosocial stress and social adjustment among adolescents with Tourette syndrome, and the role of comorbidities in moderating the relationship between self-esteem and social adjustment. DESIGN AND METHODS: In this descriptive cross-sectional study, 118 Taiwanese adolescents with Tourette syndrome aged between 12 and 20 years old were recruited via convenience sampling. Their demographic information, Yale Global Tic Severity Scale, stress index for children and adolescents with Tourette syndrome, social adjustment scale for adolescents with Tourette syndrome, and Self-Esteem Scale results were collected. Moderated mediation analysis of the study data was performed with the Hayes's PROCESS macro. RESULTS: Our results revealed that the self-esteem of adolescents with Tourette syndrome fully mediates the relationship between their psychosocial stress and social adjustment (B = -0.0703, 95% CI, [-0.0176, -0.001]), while comorbidities moderates the relationship between their self-esteem and social adjustment (B = -0.8416, 95% CI, [-1.4529, -0.2302]). The relationship between self-esteem and social adjustment was more pronounced in adolescents without comorbidities than those with comorbidities. CONCLUSIONS: Psychosocial stress correlates negatively with social adjustment and self-esteem, and indirectly influences social adjustment through self-esteem, while comorbidities (particularly their absence) moderates the relationship between self-esteem and social adjustment. PRACTICE IMPLICATIONS: Different self-esteem strengthening programs to enhance social adjustment for adolescents with Tourette syndrome may be developed in future studies.

Living with tics: Nursing care of pediatric tourette syndrome.

Tourette syndrome (TS) is a neurodevelopmental movement characterized by abrupt, rapid, repetitive, and non-rhythmic tics. While TS is not life-threatening, such tics and comorbidities affect a children's physical and mental health and social interactions. Treatment is necessary when the children experience physical discomfort, functional dysfunction, and poor interpersonal interaction and mental health. Common management strategies for TS include psychological interventions and pharmacological treatment. Additionally, it is important to consider the individual needs of youths with TS and reassess the treatment outcomes and the need to receive continuous treatment regularly. This review summarizes the symptom management and nursing care measures for youths with TS. Understanding and listening to the healthcare problems of youths with TS can help providers develop healthcare interventions tailored to the youths' needs. Providing the youths with strategies to reduce the tics' interference with their learning outcomes and helping them develop strategies to cope with diverse interpersonal interactions at school are also important. Further, enhancing acceptance given by parents, teachers, and peers, as well as improving the general public's understanding of TS are important measures that promote the youths' social adjustment as well as their ability to coexist with TS.

Effects of three-dimensional holograms on the academic performance of nursing students in a health assessment and practice course: A pretest-intervention-posttest study.

BACKGROUND: Traditional teaching approaches are generally teacher-directed, and students are taught in a manner that is conducive to sitting and listening. Using three-dimensional (3D) holograms has many benefits in a higher education environment. However, relevant studies on this topic are very limited. OBJECTIVES: To confirm the efficacy of 3D holograms for educational purposes to support the academic and practical performance of nursing students. DESIGN: A randomly allocated pretest and posttest quasi-experimental design. SETTINGS: Mackay Medical College in Taiwan. PARTICIPANTS: Ninety third-year nursing students at a medical school in Taiwan. METHODS: The data were collected between January and May 2020. The participants were randomly allocated to an intervention group and a control group. The learning method used in the intervention group was a combination of a 3D hologram learning module and classroom lectures. The control group was exposed to classroom lectures without 3D holograms. The tool included hardware (Windows Mixed Reality Helmet and VR Remote Control) and software (Health Assessment® and Patient First Patient Condition VR System®). The Health Assessment and Practice Knowledge Assessment tool and the Health Assessment and Practice Techniques Performance tool were used to evaluate the effects of the study intervention on the knowledge and techniques of the students. RESULTS: A total of 79 participants (40 in the intervention group and 39 in the control group) were included in the final statistical analysis. The response rate was 88%. Statistically significant differences in knowledge and practical learning in the health assessment and practice course were observed between the intervention group and the control group (p < .05). The η2 effect level was 0.134. CONCLUSIONS: After attending classroom lectures, the students who also attended the 3D hologram-based laboratory courses had significantly higher knowledge and practical learning scores. This approach may be used as a complementary learning tool in higher education.

Experiences of Family Resource Utilization Among Taiwanese Parents of Children with Developmental Delay.

PURPOSE: To describe the experiences of the utilization of family resources by parents of children with developmental delay (DD) when receiving early intervention (EI) services. DESIGN AND METHODS: A Descriptive phenomenological approach was applied to conduct this study. Purposive sampling was utilized to select 17 parents of children with DD from a teaching hospital in northern Taiwan. Data were collected from January 2015 to March 2016 through face-to-face interviews that lasted between 55 and 80 min. Data analysis was performed using Giorgi's phenomenological method. RESULTS: Four themes emerged: parents receiving EI services feel as if they are admitting that their child has an abnormality; parents' dedication in helping their children to progress; parents feel that they are needing to extend their resources in an already limited environment; and lastly, parents expressed that they are facing an uncertain future. CONCLUSIONS: The findings highlight the dedication of parents in utilizing family resources to help their children progress. Constrained by the environment and an uncertain future, parents utilized family strengths to help them respond to stressful family situations and maintain family functions. PRACTICE IMPLICATIONS: Health professionals could assist by providing more EI resources to parents to help cope with family stress arising from having children with DD. It's recommended that health professionals pay attention to Taiwanese culture and how it influences family acceptance for EI services, and work toward establishing friendly EI environments that meet the needs of these children and their families.

Experiences of parents providing kangaroo care to a premature infant: A qualitative systematic review.

Parents who give birth to an unexpected preterm infant not only suffer a psychological impact, but, in addition, their roles as parent are full of uncertainty. As part of family-centered care, kangaroo care is an important way to support premature infants and their family. This review synthesizes qualitative studies on the experiences of parents who have used kangaroo care for preterm infants in neonatal intensive care units. English and Chinese databases were searched for relevant studies from 1970 to July 2018. The findings of qualitative studies were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 731 studies were screened, and 9 were included. Five synthesized findings were identified: sense of emptiness of the parent's role, barriers in the translation of parental roles in kangaroo care, preparation enhances parental role expectations, kangaroo care enhances parental competency, and encouragement and support from family and friends. Through the implementation of kangaroo care, nurses are able to help prepare and guide parents, fit parents' needs, and help improve their ability and self-confidence in their parental roles.

Development and Validation of the Social Adjustment Scale for Adolescents with Tourette Syndrome in Taiwan.

PURPOSE: The aim of this study developed the psychometric properties of the social adjustment scale for adolescents with Tourette syndrome (SASATS). DESIGN AND METHODS: A cross-sectional study design was conducted. 346 adolescents with Tourette syndrome (TS) were purposively sampled from pediatric outpatient departments at two hospitals in Taiwan. The scale was developed through a phenomenological study of adolescents with TS and by reviewing the literature. The reliability analysis of the SASATS was performed using the corrected item-total correlations coefficients, Cronbach alpha coefficients, and test-retest correlations. An exploratory factor analysis and confirmatory factor analysis were used to examine the construct validity. RESULTS: The content validity index of 0.89 was obtained, and acceptable model fit was achieved according to the explanatory factor analysis and confirmatory factor analysis. The final scale had 17- items and four factors: relationship between self and TS, academic performance, family relationship, and peer interaction. Acceptable values of 0.81 and 0.87 were obtained for the test-retest and internal consistency reliabilities, respectively. CONCLUSIONS: The SASATS is a reliable and valid instrument for evaluating social adjustment status in TS adolescents. PRACTICE IMPLICATIONS: The SASATS is easy to use and offers an effective scale for nurses and healthcare providers in clinical and academic settings. It can quickly measure and detect the psychological functioning of the social adjustment of adolescents with TS during interpersonal interactions. Moreover, interventions can be provided to improve adolescents' social adjustment and promote their mental health.

Social adjustment experiences of adolescents with Tourette syndrome.

AIMS AND OBJECTIVES: To explore and describe the experience of social adjustment of adolescents with Tourette syndrome in Taiwan. BACKGROUND: Although Tourette syndrome is a non-life-threatening disease, the inherent difficulties in controlling tics and comorbidities can cause long-term physical and psychological issues, as well as social maladjustment among adolescents. Good social adjustment can promote mental health among adolescents. Currently, it is not clear how adolescents with Tourette syndrome can self-adjust and maintain harmonious social interaction with others. DESIGN: Descriptive phenomenological approach was used in this study. Four criteria were applied to establish the trustworthiness or methodological rigour. METHODS: Sixteen adolescents with Tourette syndrome were recruited by purposive sampling from a medical centre in Northern Taiwan. Semistructured one-on-one interviews were performed from March 2014-April 2015 for data collection. Every participant was interviewed once or twice, and each interview lasted for duration of around 60-90 min. Data were analysed with Giorgi's phenomenological method for data analysis. RESULTS: Three themes were identified from the adolescent' interviews. The themes were included visible and invisible destitution, moulding a socially acceptable self and coexisting friends and foes. CONCLUSIONS: Adolescents with Tourette syndrome experienced that tics are often not understood nor accepted during social interactions with others. However, with age and autonomy of adolescents, they were able to adjust and develop a socially acceptable body image and maintain amicable social interactions with others. Accompanied by positive thinking, support from friends and families, the adolescents could achieve good social adjustments for living with Tourette syndrome. RELEVANCE TO CLINICAL PRACTICE: The experiences and feelings highlighted in this study can bring awareness to nurses and healthcare professionals for developing interventions that promote healthy social adjustment and mental health for adolescents with Tourette syndrome.

Effectiveness of coffee for postoperative ileus in patients following abdominal surgery: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The purpose of this systematic review is to critically appraise, synthesize and present the best available evidence concerning the effects of coffee on postoperative ileus following abdominal surgery. The review will consider the effect of coffee and decaffeinated coffee on recovering gastrointestinal function, time to first bowel movement, time to first flatus, time to tolerance of solid food, postoperative complications and length of hospital stay.

'Living with tics': self-experience of adolescents with Tourette syndrome during peer interaction.

AIMS AND OBJECTIVES: To describe the essence of the self-experience of adolescents with Tourette syndrome in the context of peer interaction. BACKGROUND: Tourette syndrome has an adverse impact on adolescents' physical, psychological and interpersonal interactions. Peers provide adolescents with social interactions that are crucial to the formation of self-identity. Studies exploring the self-experience of adolescents with Tourette syndrome in the context of peer relationships are lacking. DESIGN: A qualitative, phenomenological research design was used. METHODS: A total of 12 adolescents with Tourette syndrome from the Taiwan Tourette Family Association were selected by purposive sampling. Data were collected using open-ended questions in one-on-one in-depth interviews that lasted 60-90 minutes. Giorgi's phenomenological methods were applied to analyse the data obtained. Four criteria were employed to evaluate methodological rigour. RESULTS: The findings showed that the self-experience of adolescents with Tourette syndrome during peer interaction reflected their lived experiences of peer identity, social identity and self-identity. Themes included: (1) the inexplicable onset of tics during encounters with other people, (2) sources inspiring the courage for self-acceptance and (3) strategies of self-protection in response to changes in situation. CONCLUSIONS: The self-experience of peer interaction among adolescents with Tourette syndrome is a dynamic and interactive process characterised by the symbolic meanings conferred on the tics by the interacting adolescents. The adolescents with Tourette syndrome obtain self-identity through peer responses and recognition, while the tolerance, respect and support of parents and teachers spark the adolescents' courage for self-acceptance. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers who assist adolescents with Tourette syndrome must understand that tics occur in the context of peer interaction and how this affects the adolescents' relationships with their peers in various life situations. Furthermore, healthcare providers should provide support, respect and offer coping strategies regarding peer interaction based on an understanding of the social dynamics of such peer interactions.

The experiences of family members in the year following the diagnosis of a child or adolescent with cancer: a qualitative systematic review.

BACKGROUND: Research shows that it is stressful for family members when a child or an adolescent within the family unit is diagnosed with cancer and this stress continues over the course of the year after the diagnosis. Qualitative studies have been conducted aimed at exploring parental, siblings' and other family members' experiences when facing health-illness transition-related stress during the first year after the child is diagnosed with cancer. This study integrates the research findings of relevant existing qualitative studies on this topic in order to provide empirical evidence-based suggestions for clinical care. OBJECTIVES: This study intent is to obtain an understanding of the family members' experiences over the course of the following year after learning that a child or adolescent within their family unit has been diagnosed with cancer. TYPES OF PARTICIPANTS: The participants of interest are family members of a child or adolescent with cancer who verbally describe the whole experience and/or report on the impact of the diagnosis and disease on their lives. In this systematic review, there were no restrictions on the type, severity and prognosis of cancer. Studies investigating the experiences of the family of a child or adolescent with cancer that were reported verbally and the opinions of others external to the family (e.g. nurses) were excluded from the review. PHENOMENA OF INTEREST: The phenomena of interest were the self-reported experiences over the course of the following year of family members of a child or adolescent with cancer and the impact on the whole family of the child or adolescent receiving a cancer diagnosis. The settings included acute care, home and community settings with any cultural context. Research on other phenomena, such as experiences related to social support intervention for the family, the long-term coping experience of the family, the bereavement experiences of children with cancer, the experiences of a child or adolescent with cancer and experiences more than one year after the diagnosis was excluded from the review. Types of studies: This review considered studies that used qualitative methods to examine the experiences of families of a child or adolescent with newly diagnosed cancer; these included but were not limited to designs such as qualitative research, phenomenology, hermeneutic phenomenology, grounded theory, ethnography, action research, focus groups and narrative research. The search was limited to studies published in English or Chinese because the reviewers were fluent in both of these languages. SEARCH STRATEGY: The search strategy sought to find both published and unpublished studies. CINAHL, PUBMED, ProQuest Dissertations and Theses and Chinese electronic periodical services were used to search for articles. METHODOLOGICAL QUALITY: Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise the methodological quality of the articles. Any disagreements that arose between the reviewers were resolved through discussion, or via a third reviewer. DATA EXTRACTION: Qualitative data were extracted from papers for inclusion in the review using the standardized data extraction tool from JBI-QARI. DATA SYNTHESIS: Qualitative research findings were extracted and pooled using JBI-QARI. RESULTS: A total of eight qualitative papers were included in the review (two grounded theory, four phenomenology and two qualitative inquiries). Five syntheses were derived: (1) family loss and the turmoil that surrounds the diagnosis of cancer; (2) a sense of courage and hope for mutual responsibility inspired by the changes in circumstances; (3) family support enhancing family members' resilience; (4) health professional-patient communication that provide a deeper understanding of the illness and their own situations; and (5) a positive attitude towards the illness and planning for the future. CONCLUSIONS: The research findings should help health professionals understand the nature of the experiences of family members of a child or adolescent with cancer. It is critical to assess the family member's level of preparedness in the face of the psychological stress associated with the potential loss of their healthy child. Health professionals should enhance family coping strategies in order to promote normal family life. This can be done by inspiring positive attitudes and empowerment aimed at caring for the child and helping the family to build the necessary health-related communication capacities in order to clarify the child's condition. IMPLICATIONS FOR PRACTICE: Clinical guideline suggestions for health professionals working with families of children or adolescent diagnosed with cancer within the first year following the diagnosis were identified. Health professionals must listen to and accept the emotions of shock, anger and loss by the family members who are facing the potential loss of their healthy child together with the upheaval in their lives and disruptions to their plans for the future. Health professionals should be encouraged to provide clear information to the whole family in relation to the treatment plan and caring strategies for the child. Nurses should provide family members with strategies to help with the normalization of their life and a return to their previous pre-cancer lifestyle. The medical team should exhibit professionalism and skills when treating the cancer in order to enhance the child's and his/her family members' trust and sense of safety in the medical care environment. Encouraging the family members of children with cancer to develop positive thinking and to plan for their future life should be a priority of the nursing care plan.

Body image of children and adolescents with cancer: a metasynthesis on qualitative research findings.

Children and adolescents with cancer are confronted with many challenges. This review considered studies that used qualitative methods to examine the body image experience of children and adolescents with cancer. A systematic literature search of English and Chinese databases was undertaken, covering the period between 1960 and October 2010. Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Eight papers met the inclusion criteria. The derived four metasyntheses included being distanced from the body, loss of self-identity, self-protective strategies and support, and getting rid of the shackles of the body. In conclusion, children and adolescents with cancer also experience various problems associated with changes in their body image. Repeated courses of treatment lead to loss of a normal, orderly life, and might even result in changes in interpersonal interactions. In response to body image change, individuals with cancer develop self-protective, coping strategies. Children and adolescents who experience life-threatening cancer come to face body image change positively, and might hold a confident attitude toward their future.

The experience of body image of children and adolescents with cancer: A meta-synthesis.

EXECUTIVE SUMMARY: Objectives: The objective of this study was to describe the body image experience of children and adolescents with cancer. INCLUSION CRITERIA: This review considered studies that utilised qualitative methods to examine the experience of children and adolescents with cancer. The phenomena of interest were experiences of children and adolescents with cancer living in acute care, home, and community settings of any cultural context. The research was limited to studies published in Chinese or English only. SEARCH STRATEGY: The search strategy sought to find both published and unpublished studies. CINAHL, MEDLINE, Mednar, Scius, ProQuest Dissertations and Theses, electronic theses and dissertations system and Chinese electronic periodical services were used to search the articles.Methodological quality: Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise the methodological quality of the articles. Any disagreements that arose between the reviewers were resolved through discussion with a third reviewer. DATA EXTRACTION AND SYNTHESIS: Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. RESULTS: Eight papers were included in the review. Four meta-syntheses emerged from the analysis: (1) Being kept away from body: Clinicians should be aware that children and adolescents with cancer feel that they are kept away from normal body, (2) Loss of self-identity: Clinicians should be aware that children and adolescents with cancer feel that they have lost their self-identity, (3) Self-protective strategies and support: Clinicians should understand the protective strategies that children and adolescents with cancer develop and utilise with support from family and friends, and (4) Getting rid of shackles of the body: There should be a strategy to facilitate the development of positive attitudes toward the illness and body image change in children and adolescents with cancer. CONCLUSION: Children and adolescents with cancer also experience various problems associated with body image change. Repeated courses of treatment lead to loss of a normal orderly life, and may even result in changes in interpersonal interactions. In response to body image change, self-protective coping strategies are developed. Children and adolescents who experience life-threatening cancer come to face body image change positively and may hold a confident attitude towards future life.The implications for practice include: (1) Clinicians should be aware that children and adolescents with cancer feel that they are kept away from normal body; (2) Clinicians should be aware that children and adolescents with cancer feel that they have lost their self-identity; (3) Clinicians should be understand the protective strategies that children and adolescents with cancer develop and utilise with support from family and friends; (4) There should be a strategy to facilitate the development of positive attitudes toward the illness and body image change in children and adolescents with cancer.The research tools concerning social support and guidance can be further developed in the future to increase the confidence and capacity of children and adolescents with cancer to face body image change and reduce psychological stress.

Solid-phase synthesis of azidomethylene inhibitors targeting cysteine proteases.

An efficient strategy for the solid-phase synthesis of azidomethylene inhibitors targeting cysteine proteases is described. The method is highlighted by its compatibility with readily available building blocks, as well as its ability to accommodate different functional groups. A 249-member library has thus far been successfully synthesized, characterized, and screened against Caspase-1, -3 and -7.

Parenting stress and related factors in parents of children with Tourette syndrome.

The objective of this study was to assess the stress of parents and its influencing factors in caring for children with Tourette syndrome. A total of 150 subjects, either fathers or mothers of children diagnosed with Tourette syndrome between the ages of 6 and 12, were recruited by purposive sampling from the membership roster of the Taiwan Tourette Family Association. Study tools included a Parenting Stress Index Form and Social Support Index Form. The standardized score for parent perception of parenting stress was 83.5. The main stressor of parents of children with Tourette syndrome was found to be child care difficulties. A correlation was found between parenting stress and child gender, age, school situation and disease severity; parent age and family income. A significant negative correlation (r=-.459, p<.01) was found between social support and parenting stress. It was revealed that social support had a significant effect on parenting stress in this study. Multiple linear regression analysis found disease severity and family income to be the variables with the greatest predictive power for parenting stress, explaining 42% of total variance. Results showed that factors affecting parenting stress included family income and disease severity. These findings should help clinical professionals develop more effective health care strategies to address the needs of children with Tourette syndrome and their parents.