The Nurse's Role in Educating Pediatric Patients on Correct Inhaler Technique: An Interventional Study.

The prevalence of pediatric respiratory diseases in Spain is 23%. Inhalation is the preferred route of administration but there are frequent errors in the performance of the inhalation technique leading a poor control of the disease. The aim of this research was to detect errors in the execution of the inhalation technique at a Pediatric Pulmonology Unit in a hospital of Aragón (Spain). In order to improve the administration of inhaled medication, an educational intervention for 1 year by nursing was conducted. This interventional study, including children aged 1 to 15 years with an inhalation therapy and who attended the Pediatric Pulmonology Unit, was conducted between September 2017 and September 2018. Logistic Regression models were conducted in SPSS. This study involved 393 children (61.1% boys). Before the intervention, 39.4% achieved a correct inhalation technique increasing up to 62.1% after the intervention. Those who had their first visit to the Unit, young children and girls had a higher risk of incorrect performance than those with subsequent visits, older children, and boys, respectively. The most common errors in the inhalation technique were not performing adequate apnoea after inhaling and not rinsing the mouth at the end of the procedure. The education given by nurses to pediatric patients improved the inhalation technique, achieving better control of the disease and use of the health system.

Hipocalcemia neonatal precoz por déficit de vitamina D materna. Replanteando la suplementación / A neonatal hypocalcemia due to maternal vitamin D deficiency. Reviewing supplementation

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La experiencia de enfermedad en los hermanos de niños en cuidados paliativos / The illness experience in siblings of children in palliative care

ANTECEDENTES: El diagnóstico de una patología limitante para la vida en un niño supone un gran impacto para la familia y especialmente para los hermanos, pudiendo tener sobre ellos consecuencias tanto positivas como negativas. OBJETIVO: Se pretende explorar varios aspectos de la vida de los hermanos de pacientes pediátricos en cuidados paliativos. MÉTODO: Elaboración de una metasíntesis de textos de la literatura cuyo interés son los hermanos de los pacientes con una patología limitante para la vida. RESULTADOS: La experiencia de enfermedad del niño despierta en los hermanos una serie de sentimientos, tanto positivos como negativos, que deben considerarse normales y que no significa que tengan dificultades. Pueden sentir miedo y preocupación por la enfermedad del niño y por la posibilidad de su muerte, así como dolor y sufrimiento. Pero también pueden tener sentimientos de aislamiento, soledad y de celos y rivalidad hacia su hermano. Como consecuencia de la reorganización de su vida familiar y social a causa de la enfermedad, los hermanos pueden experimentar pérdidas, pero también ganancias emocionales y físicas. Además, los hermanos tienen necesidad de atención, así como de información acerca de la patología del niño enfermo y de participar en su cuidado. Por otro lado, necesitan desarrollar actividades propias e independientes del niño enfermo. Los hermanos generalmente son resilientes y cuentan con factores protectores para el desarrollo de estrategias adaptativas y habilidades de afrontamiento. Por otro lado, existen factores de riesgo que pueden limitar la adaptación y conducir a problemas emocionales, sociales o escolares, que se deben intentar prevenir mediante intervenciones tempranas psiocológicas, familiares o sociales. CONCLUSIONES: Los profesionales de la sanidad deben estar preparados para atender las necesidades de los hermanos de los pacientes en cuidados paliativos, así como para apoyar y aconsejar a los padres para que observen sus sentimientos y cubran sus necesidades

BACKGROUND: The diagnosis of a life-limiting pathology in a child causes a great impact for the entire family and especially for siblings. OBJECTIVE: This text aims to explore several aspects in the siblings of pediatric patients in palliative care. METHOD: Elaboration of a meta-synthesis of literature texts related to aspects of the siblings of children with a life-limiting pathology. RESULTS: The experience a child's illness may make in his or her siblings may cause various feelings, both positive and negative, which should be considered normal and do not mean that they are having difficulties. They may feel fear and concern about the child's illness and the possibility of his/her death, as well as pain and suffering. But they may also have feelings of isolation, loneliness, and jealousy and rivalry towards their sick sibling. As a result of a reorganization of their family and social life because of the disease, siblings can experiment emotional and physical losses, but also gains. In addition, siblings need care, as well as information about the pathology of the sick child, and to participate in their care. On the other hand, they need to develop their own and independent activities. Siblings are generally resilient and have protective factors for adaptive strategies and coping skills. On the other hand, there are risk factors that can limit adaptation and lead to emotional, social or school problems, which should be prevented by early psychological, family or social interventions. CONCLUSIONS: Health professionals must be prepared to meet the needs of siblings of pediatric palliative care patients to support and advise parents on how to observe their feelings and meet their needs