Behaviour and emotions of children and young people with congenital heart disease: A literature review.

Congenital heart disease (CHD) is one of the common types of birth defects. Children and young people (CYP) with CHD might exhibit behavioural and emotional changes related to undergoing different medical treatments and hospitalization. Therefore, a literature review was conducted from January 2000 to June 2017 that aimed to understand and evaluate current international literature focusing on CYP's behavioural and emotional status as patients with CHD. A comprehensive search of Medline, PsycINFO and CINAHL databases was undertaken. Eight quantitative studies were reviewed following strict eligibility criteria. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the reviewed studies. Parents provided proxy reports on their children's behaviour and emotions in all studies. Half of the reviewed studies presented the self-perceptions of children who were over seven years old. CYP with CHD exhibited internalizing and externalizing behavioural problems, withdrawal, depression, social, and attention problems. CYP with more severe CHD reported greater behavioural and emotional problems than CYP with less severe CHD. Moreover, younger children developed more problems than older children. Future more depth research using qualitative designs is required to explore the personal views of children younger than seven years old on the impact of CHD on their behaviour and emotions.

How 'The Daily Mile™' works in practice: A process evaluation in a UK primary school.

Over 75% children in the United Kingdom fail to achieve recommended levels of physical activity. Successful implementation of 'The Daily Mile™', a school-based physical activity intervention, could promote activity. We examined factors instrumental to replication and/or wider implementation of 'The Daily Mile' through application of a two phase multi-method process evaluation. Phase one: 75 children (mean age seven years eight months) from one East Midland primary academy trialled the intervention. Data collected were self-report logs, perceived exertion scores and structured observation. Phase two: a sub-sample of 18 stakeholders participated in focus groups which were analysed using framework method. Teachers delivered 'The Daily Mile' on 93.6% of school days. An average of 95.2% of students participated, 94.2% completed recommended 15 minutes, 94.3% to a moderate-to-vigorous level. Three themes emerged in focus groups; embedding 'The Daily Mile' into practice, creating the right physical environment and building relationships/promoting a supportive climate. With systematic organisation and planning, 'The Daily Mile' could emerge as an integrated means of increasing physical activity. A supportive climate and factors that promote resilience are key facilitators. Further research is needed to establish outcomes and cost-effectiveness.

A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital.

PURPOSE: The study aims were: (i) to convert the Research and Development Culture Index (a validated rating instrument for assessing the strength of organizational Research and Development culture) into electronic format (eR&DCI), and (ii) to test the format and assess the feasibility of administering it to the multidisciplinary (allied health professionals, doctors and nurses) workforce in a National Health Service Hospital (NHS) in the United Kingdom (UK) by trialing it with the workforce of the tertiary Children's Hospital within the organization. POPULATION AND METHODS: The eR&DCI was emailed to all professional staff (n=907) in the Children's Hospital. Data were analyzed using IBM SPSS Statistics 22. RESULTS: The eR&DCI was completed by 155 respondents (doctors n=38 (24.52%), nurses n=79 (50.96%) and allied health professionals (AHPs) n=38 (24.52%)). The response rate varied by professional group: responses were received from 79 out of 700 nurses (11%); 38 out of 132 doctors (29%) and 38 out of 76 AHPs (50%). Index scores demonstrated a positive research culture within the multidisciplinary workforce. Survey responses demonstrated differences between the professions related to research training and engagement in formal research activities. CONCLUSION: This is the first study to assess the feasibility of assessing the strength of an organization's multidisciplinary workforce research and development (R&D) culture by surveying that workforce using the eR&DCI. We converted the index to "Online Surveys" and successfully administered it to the entire multidisciplinary workforce in the Children's Hospital. We met our criteria for feasibility: ability to administer the survey and a response rate comparable with similar studies. Uptake could have been increased by also offering the option of the paper-based index for self-administration. Results of the survey are informing delivery of the research strategy in the Children's Hospital. This methodology has potential application in other healthcare contexts.

Fatalism, faith and fear: A case study of self-care practice among adults with Type 2 diabetes in urban Malaysia.

AIMS AND OBJECTIVES: To explore self-care and self-care support in patients with Type 2 diabetes in urban Malaysia. BACKGROUND: The prevalence of Type 2 diabetes in Malaysia and associated long-term and life-changing complications is increasing. With effective self-care and self-care support, severe complications of the condition can be avoided or reduced. Prior to this study, no evidence existed about Malaysian patients' management of the condition or support for self-care from the healthcare system. DESIGN: A single embedded qualitative case study. METHODS: Semistructured interviews with 18 patients with Type 2 diabetes aged 28-69 years, healthcare professionals (n = 19), observations (n = 13) of clinic appointments from two urban settings in Malaysia and a documentary analysis. Recordings were transcribed verbatim, field notes were made during observations and the data analysed and synthesised within and across case using Framework analysis. FINDINGS: Three main themes explained self-care and self-care support in Malaysia: fatalism, faith and fear. Patients were fatalistic about developing diabetes-they perceived it as inevitable because it is so common in Malaysia. However, faith in God, coupled with fear of the consequences of diabetes, motivated them to engage in self-care practices. The fear was largely induced by diabetes healthcare professionals working in overcrowded clinics, and stretched thinly across the service, who used a direct and uncompromising approach to instil the importance of self-care to avoid severe long-term complications. CONCLUSION: This study provided important insight on how people in Malaysia developed diabetes, their responses to the disease and the approach of healthcare professionals in supporting them to engage with self-care. RELEVANCE TO CLINICAL PRACTICE: Any future development of self-care programmes in Malaysia needs to recognise the factors that motivate patients to self-care and include components that build self-efficacy.

A qualitative evaluation of a pre-consultation guide intended to promote the participation of young people in asthma review consultations.

OBJECTIVE: Young people's (age range 14-19 years) participation in consultations with health professionals can be limited. There has been little research into pre-consultation support for young people. This study evaluated a pre-consultation guide developed to promote young people's participation in asthma review consultations. METHODS: A pre-consultation guide was evaluated in qualitative exit interviews with 24 young people and 9 primary care nurses in the United Kingdom. RESULTS: Young people found the guide to be reassuring and supportive; peer written content, particularly example questions, helped to develop confidence and an intention to participate. Nurses suggested the guide could be a useful tool to aid young people's communication of asthma-related experiences. CONCLUSION: Quotations from young people were highlighted as of particular value. Self-efficacy can be increased through observing how peers perform. Confidence and intention to change behavior are linked with actual behavior change. Future research should explore the impact of the pre-consultation guide on increased self-efficacy, developing an intention to change behavior and whether this is acted upon. PRACTICE IMPLICATIONS: Used as a tool in a consultation may support change in practice nurses' consulting style and enable young people's participation.