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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210040, 2022. graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1339880

RESUMO

Resumo Objetivo analisar a percepção dos pais sobre as práticas de educação em saúde desenvolvidas pelos enfermeiros na Unidade Neonatal que facilitaram a aquisição de competências parentais para uma tomada de decisão fundamentada. Método estudo exploratório e descritivo, com abordagem qualitativa. Participaram 13 pais com filhos internados, pela primeira vez, em uma Unidade Neonatal portuguesa. Os dados foram colhidos entre fevereiro e agosto de 2020, por meio de grupos focais, processados no software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires, através da Classificação Hierárquica Descendente e da Análise de Similitude. Resultados da Classificação Hierárquica Descendente, emergiram quatro classes: "Necessidades de informação", "Lacunas na informação", "Disponibilidade para informar"; "Práticas facilitadoras da educação em saúde". Conclusão e implicações para a prática os pais consideraram como práticas facilitadoras da educação em saúde a tecnologia digital aliada à disponibilidade dos enfermeiros para informar e explicar, bem como propiciar um ambiente empático e informal. Tal resultado pode subsidiar o desenvolvimento de intervenções de enfermagem de educação em saúde para pais na Unidade Neonatal, com recurso à tecnologia digital.


Resumen Objetivo analizar la percepción de los padres sobre las prácticas de educación en salud desarrolladas por enfermeras de la Unidad Neonatal que facilitaron la adquisición de habilidades parentales para la toma de decisiones informada. Método estudio exploratorio descriptivo, con abordaje cualitativo. Participaron 13 padres con hijos hospitalizados, por primera vez, en una Unidad Neonatal Portuguesa. Los datos fueron recolectados entre febrero y agosto de 2020, a través de grupos focales, procesados en el software Interface de R pour Multidimensionnelles de Textes et de Questionneires, a través de la Clasificación Jerárquica Descendente y el Análisis de Similitud. Resultados surgieron cuatro clases de la Clasificación Jerárquica Descendente: "Necesidades de información"; "Brechas de información"; "Disponibilidad para informar"; "Prácticas facilitadoras de la educación para la salud". Conclusión e implicaciones para la práctica los padres consideraron prácticas facilitadoras para la educación en salud la tecnología digital combinada con la disponibilidad de enfermeras para informar y explicar, además de brindar un ambiente empático e informal. Este resultado puede apoyar el desarrollo de intervenciones de enfermería de educación para la salud para los padres en Unidad Neonatal, con el uso de tecnología digital.


Abstract Objective to analyze parents' perception of health education practices developed by nurses in a Neonatal Unit that facilitated the acquisition of parenting skills for an informed decision-making. Method this is an exploratory, descriptive and qualitative study. We included 13 parents with children hospitalized for the first time in a Portuguese Neonatal Unit. Data were collected between February and August 2020, through focus groups, processed in the software Interface de R pour Multidimensionnelles de Textes et de Questionneires, through Descending Hierarchical Classification and Similitude Analysis. Results four classes emerged from the Descending Hierarchical Classification: "Information needs"; "Information gaps"; "Availability to inform"; "Facilitating health education practices". Conclusion and implications for practice parents considered digital technology combined with nurses' availability to inform and explain, as well as provide an empathetic and informal environment as facilitating practices for health education. These results can support health education nursing interventions for parents at the Neonatal Units using digital technology.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Adulto , Pais/psicologia , Unidades de Terapia Intensiva Neonatal , Educação em Saúde , Letramento em Saúde , Enfermeiras e Enfermeiros , Folhetos , Comunicação , Tomada de Decisões , Pesquisa Qualitativa , Tecnologia Digital , Tempo de Internação , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/psicologia
4.
Nat Commun ; 12(1): 5765, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34599167

RESUMO

Socioeconomic gaps in child development open up early, with associated disparities in parental investments in children. Understanding the drivers of these disparities is key to designing effective policies. We first show that parental beliefs about the impact of early parental investments differ across socioeconomic status (SES), with parents of higher SES being more likely to believe that parental investments impact child development. We then use two randomized controlled trials to explore the mutability of such beliefs and their link to parental investments and child development, our three primary outcomes. In the first trial (NCT02812017 on clinicaltrials.gov), parents in the treatment group were asked to watch a short educational video during four well-child visits with their pediatrician while in the second trial (NCT03076268), parents in the treatment group received twelve home visits with feedback based on their daily interactions with their child. In both cases, we find that parental beliefs about child development are malleable. The first program changes parental beliefs but fails to lastingly increase parental investments and child outcomes. By contrast, in the more intensive program, all pre-specified endpoints are improved: the augmented beliefs are associated with enriched parent-child interactions and higher vocabulary, math, and social-emotional skills for the children.


Assuntos
Desenvolvimento Infantil , Cultura , Relações Pais-Filho , Pais/psicologia , Instituições Acadêmicas , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Classe Social , Inquéritos e Questionários
5.
PLoS One ; 16(10): e0256642, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673809

RESUMO

Varicella infection is a highly contagious disease which, whilst mild in most cases, can cause severe complications. Varicella vaccination is available privately in Sweden and is currently being reviewed for inclusion in the Swedish Public Health Agency's national immunisation program (NIP). A cross-sectional study of parents of Swedish children aged 1-8 years (n = 2212) was conducted to understand parental acceptance, beliefs and knowledge around varicella infection and vaccination. Respondents generally viewed varicella infection as a mild disease, with only a small proportion aware of potential severe complications. While 65% of respondents were aware of the vaccine, only 15% had started the course of vaccination as of February 2019. Further, 43% of parents did not intend to vaccinate, most commonly due to lack of inclusion in the NIP, but also due to perception of mild disease. Nevertheless, if offered within the NIP, 85% of parents would be highly likely to vaccinate their child. A number of statistically significant differences in awareness and behaviours were observed between sociodemographic subgroups. In general, women were more aware of vaccination (72%) compared to men (58%). Among unemployed or respondents with elementary school education, awareness was below 43%, and among respondents with high income the awareness was above 75%. Similarly, among unemployed or respondents with a low income the vaccination rate was as low as 30% compared with at least 57% among respondents with a high income. Respondents from metropolitan areas, those with university degrees and respondents with a higher income were more likely to be aware of the varicella vaccine and to have vaccinated their child. Whilst inclusion in the NIP is clearly the main driver for uptake, these identified knowledge gaps should inform educational efforts to ensure that all parents are informed of the availability and benefits of the varicella vaccine independent of socioeconomic status.


Assuntos
Vacina contra Varicela/administração & dosagem , Varicela/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Recusa de Vacinação/psicologia , Vacinação/estatística & dados numéricos , Atitude Frente a Saúde , Vacina contra Varicela/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Herpesvirus Humano 3/imunologia , Humanos , Lactente , Masculino , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia , População Urbana
6.
PLoS One ; 16(10): e0246725, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34699530

RESUMO

BACKGROUND: Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. METHODS: We used data from the Indonesia National Health Survey 2013, including 46,315 children 6-59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting. RESULTS: Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%). CONCLUSIONS: Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.


Assuntos
Estatura/fisiologia , Pais/psicologia , Pré-Escolar , Estudos Transversais , Escolaridade , Feminino , Transtornos do Crescimento/psicologia , Inquéritos Epidemiológicos , Humanos , Indonésia , Lactente , Masculino , Estado Nutricional/fisiologia , Prevalência , Angústia Psicológica , Fatores de Risco , População Rural , Fatores Socioeconômicos
7.
PLoS One ; 16(10): e0258358, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34714832

RESUMO

BACKGROUND: Worldwide, strict infection control measures including visitation regulations were implemented due to the COVID-19 pandemic at Neonatal Intensive Care Units (NICUs). These regulations gave restricted access for parents to their hospitalized infants. The consequence was limited ability to involve in the care of their infants. At Oslo University Hospital entry to NICU was denied to all except healthy mothers in March 2020. The absolute access ban for fathers lasted for 10 weeks. The aim of this study was to explore parental experiences with an infant hospitalized in the NICU during this absolute visitation ban period. METHODS: We invited post discharge all parents of surviving infants that had been hospitalized for at least 14 days to participate. They were interviewed during autumn 2020 using an explorative semi-structured interview approach. Data were analyzed via inductive thematic analysis. RESULTS: Nine mothers and four fathers participated. The COVID-19 regulations strongly impacted the parent's experiences of their stay. The fathers' limited access felt life-impacting. Parents struggled to become a family and raised their voices to be heard. Not being able to experience parenthood together led to emotional loneliness. The fathers struggled to learn how to care for their infant. The regulations might lead to a postponed attachment. On the other hand, of positive aspect the parents got some quietness. Being hospitalized during this first wave was experienced as exceptional and made parents seeking alliances by other parents. Social media was used to keep in contact with the outside world. CONCLUSIONS: The regulations had strong negative impact on parental experiences during the NICU hospitalization. The restriction to fathers' access to the NICU acted as a significant obstacle to early infant-father bonding and led to loneliness and isolation by the mothers. Thus, these COVID-19 measures might have had adverse consequences for families.


Assuntos
COVID-19/psicologia , Unidades de Terapia Intensiva Neonatal , Pandemias , Poder Familiar/psicologia , Pais/psicologia , Feminino , Humanos , Lactente , Masculino , Pesquisa Qualitativa , Quarentena/psicologia , Inquéritos e Questionários
8.
PLoS One ; 16(10): e0258306, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618867

RESUMO

BACKGROUND: Exploring the cultural context of intergenerational continuity of warm and harsh parenting informs parents motivations to adopt specific parenting behaviours. OBJECTIVE: Parents' perceptions of being parented in the past and their current parenting as well as adolescents' perceptions of current parenting were explored applying a multi-method approach. METHODS: Following written informed consent, a total of 24 interviews with 10 families (dyads of 14 parents and ten adolescents) from Udupi taluk in southern India was conducted. In the first stage, in-depth interviews were conducted with parent participants (Generation 1 (G1)) and in the second stage, adolescents (Generation 2 (G2)) participated in the photovoice component. Multiple forms of data including photographs, journals and interviews facilitated using the SHOWeD model were collected and were analysed thematically using ATLAS.ti(v.8). RESULTS: Subtle changes in reinforcing culture-specific gender norms between generations were elicited. Differences in communication, granting autonomy to female adolescents, and in disciplining methods between G1 and G2 were observed. Warm parenting was transmitted between generations while harsh parenting in G1 in the presence of external social support was discarded in favor of warm parenting in G2. CONCLUSION: We provide evidence for perceptions of parenting and adolescent behaviors across two generations. Transmission of warm parenting and interruption in the cycle of harsh parenting in the presence of external social support were significant findings. Related theoretical and methodological applications are discussed.


Assuntos
Comportamento Infantil , Educação Infantil , Relação entre Gerações , Poder Familiar , Adolescente , Comportamento do Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Punição
9.
Pan Afr Med J ; 39: 249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34659622

RESUMO

Introduction: coping strategies are specific efforts that individuals use to tolerate or minimize stressful events. Most caregivers´ of children with disabilities must adjust to their social life to cope with the responsibility of caring for a child with disabilities. This study was carried out to assess caregivers´ coping strategies in raising a child with a disability in a resource-poor country. Methods: a researcher-administered questionnaire adapted from the standard COPE (Committee on Publication Ethics) inventory was used on consenting respondents recruited from a designated special education school. Coping responses were graded on a five-point Likert scale and data were analyzed using computer software SPSS version 22. Results: the mean age of the respondents was 42.75 years. Males constituted 30% (12/40) whereas females constituted 70% (28/40). The diagnosed disorders amongst their children/wards were speech and hearing impairment (32.5%), cerebral palsy (12.5%), learning disability (10%), autism (10%), Down's syndrome (15%), epilepsy (20%). Most caregivers exhibited active coping (MNR 3-4) especially in areas of planning and seeking professional help. Turning to religion and acceptance of the situation (MNR 4-5) were common emotional coping strategies noted but most of these had no significant relationship with gender or income. Caregivers with lower earnings tend to pay more attention to the child´s disability than concentrating on other activities. Conclusion: the findings support that religious belief provides endurance and resistance to people dealing with stress while low socioeconomic status negatively affects the ability to focus on other activities during stress.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Crianças com Deficiência , Pais/psicologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Educação Especial , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Nigéria , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
10.
Pan Afr Med J ; 39: 137, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34527153

RESUMO

Introduction: after a pilot phase, Senegal is the first country in West Africa to introduce cervical cancer vaccine into its Expanded Program on Immunization. Despite the gratuity and availability of the vaccination, coverage was low. The purpose of this study was to identify factors associated with HPV vaccination coverage in girls . Methods: we conducted a case-control analytical study from 4th to 20th January 2020 in Dakar. The study population consisted of parents or guardians of girls aged 9 to 10. We performed cluster sampling, direct structured interviews and a literature review. Socio-demographic features, parents/guardians' knowledges and information about vaccination procedure were collected using a standardized questionnaire. Logistic regression was used to estimate the odds ratio. Results: during this study, 510 cases and 510 controls and 1020 parents/guardians were interviewed. Significant factors associated with vaccination of girls were: parents/guardians' education (OR=1,97; [1,81-2,25]), knowledge of the disease (OR=3,05; [2,75-4,53], high household income (OR=1,21; [1,13-1,85]), fear of side effects (OR=0,35;[ 0,27-0,44]), reception of messages via internet/social networks (OR=0,54; [0,41-0,92]) and vaccination schedules for the community (OR= 2,12 [1,59-2,64]). Conclusion: vaccination of girls can be improved by strengthening parents' knowledge through appropriate channels and a better organization of health services.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Pais/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Imunização , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Senegal , Inquéritos e Questionários , Neoplasias do Colo do Útero/virologia , Cobertura Vacinal
11.
J Environ Public Health ; 2021: 9924621, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34475960

RESUMO

Lavender and tea tree essential oils are traditionally considered to be mild, gentle, and safe for pediatric populations and are ubiquitous in personal care products. Recent case reports have proposed a potential association between exposure to these ingredients and endocrine disruption, but these reports contain misclassification bias. The purpose of this study is to develop a reliable and valid measurement instrument for the accurate classification of exposure to aromatic plant ingredients in personal care products to be used in epidemiological studies. This study tested the Aromatic Plant Ingredients and Child Health Survey (APICHS) for validity and reliability, contrasting it with the current approach used in clinician's offices. The APICHS was found to have exceptional sensitivity and specificity (100% and 92.86%, respectively) with a positive predictive value of 97.22%, far exceeding the sensitivity and specificity of the method currently in use. The APICHS is a valid, reliable tool for accurate classification of exposure to aromatic plant ingredients in personal care products and should be used for the avoidance of misclassification.


Assuntos
Cosméticos , Exposição Ambiental , Inquéritos Epidemiológicos , Viés , Criança , Exposição Ambiental/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Rememoração Mental , Pais/psicologia , Reprodutibilidade dos Testes
12.
Z Psychosom Med Psychother ; 67(3): 329-350, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34524058

RESUMO

Objective: To review and synthesize existing psychoanalytic literature on the psychological impact of stillbirth on mothers and fathers. Method: This qualitative systematic review followed, as far as possible, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Psychoanalytic Electronic Publishing Archive, the Single Case Archive, and PsycINFO (1999-2019) were searched to identify relevant articles published between 1999-2019 that report clinical material or theoretical considerations concerning the psychological effects of stillbirth on parents, as emerging during classical analytic or psychoanalytic therapy session/journey. A thematic synthesis was performed. Results: 46 articles were identified, providing data on the parents' experiences of grief and gender differences, the detrimental effects on the parental couple's relationship, the mother's identification with the dead baby, the importance for mothers to meet and care the stillborn baby, the mothers' drive for another pregnancy and the fear of further loss, the mothers' ambivalence toward subsequent pregnancy and child, the potential negative effects of unresolved bereavement on subsequent baby, and the replacement of a stillborn child. Conclusion: Our findings reveal there is some psychoanalytic literature providing insight into the psychological dynamics of parents after a stillbirth, with observations that could be used to improve psychological health care practices. One of the main therapeutic tasks was to facilitate parents to create a psychic space where they can bring to life, psychically, their lost and never- really-known stillborn baby, and to let him or her to be part of the on-going family narrative.


Assuntos
Luto , Pais/psicologia , Natimorto , Pai , Feminino , Pesar , Humanos , Lactente , Masculino , Gravidez
13.
Lancet Psychiatry ; 8(10): 909-918, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34537101

RESUMO

Guidance is scarce on whether and how to involve parents in treatment for anxiety and depressive disorders in children and young people. We did a scoping review of randomised controlled trials of psychological interventions for anxiety and depressive disorders in children and young people, in which parents were involved in treatment, to identify how parents and carers have been involved in such treatments, how this relates to both child and broader outcomes, and where research should focus. We identified 73 trials: 62 focused on anxiety and 11 on depressive disorders. How parents were involved in treatments varied greatly, with at least 13 different combinations of ways of involving parents in the anxiety trials and seven different combinations in the depression trials. Including parents in treatment did not impair children's and young people's outcomes, but the wide variability in how they were involved prevents clarity about why some trials favoured parent involvement and others did not. Studies must consider the long-term and wider benefits beyond children's and young people's mental health, such as enhanced engagement, family wellbeing, and economic gains.


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Pais/psicologia , Adolescente , Criança , Humanos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
J Infect Dev Ctries ; 15(8): 1054-1058, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34516410

RESUMO

INTRODUCTION: Coronavirus disease (COVID-19) is caused by a newly discovered coronavirus and has resulted in a global pandemic. The World Health Organization recommended avoiding any delay or disruption of immunization services, as this could result in increases in outbreak-prone vaccine-preventable diseases. This study aimed to determine the impact of the COVID-19 pandemic on parents' behaviour towards their children's scheduled vaccinations. METHODOLOGY: This web-based cross-sectional study recruited 1,143 parents/guardians of children below six years of age living in Saudi Arabia between May 1 and May 30, 2020 via social media platforms. A self-developed online questionnaire consisting of eight items was used. Simple and multiple binary logistic regression was used to determine the factors associated with vaccine delay during the COVID-19 pandemic. RESULTS: The parents/guardians were aged 20-60 years; 82% were aged between 20 and 39 years. It was found that 26% of parents did not vaccinate their children on time according to the national immunization schedule in regular situations, and 38% of parents reported delaying vaccination due to the COVID-19 pandemic. The multiple logistic regression analysis found that having two or more children, living in Riyadh or the Western region or not vaccinating children during regular situations were associated with an increased risk of vaccine delay during the COVID-19 pandemic. CONCLUSIONS: Delaying children's vaccinations during the COVID-19 pandemic was influenced most by living in regions with high COVID-19 prevalence and having two or more children.


Assuntos
COVID-19/psicologia , Controle de Doenças Transmissíveis , Comportamentos Relacionados com a Saúde , Esquemas de Imunização , Pais/psicologia , Vacinação/psicologia , Adulto , COVID-19/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Arábia Saudita/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
Isr Med Assoc J ; 23(9): 569-575, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34472232

RESUMO

BACKGROUND: Aerodigestive clinics are run by interdisciplinary medical and surgical teams, and provide complex care coordination and combined endoscopies. OBJECTIVES: To describe the design and patient population of the first pediatric aerodigestive center in Israel. METHODS: A retrospective single-center cohort study was conducted describing patients followed in the aerodigestive clinic of Schneider Children's Medical Center of Israel, a tertiary pediatric hospital, between its inception in January 2017 and June 2020. RESULTS: During the study period, 100 patients were seen at the combined respiratory and digestive (NoAM) clinic, with a total of 271 visits. Median age at first assessment was 29.5 months (range 3-216). Fifty-six patients (56%) had esophageal atresia and tracheoesophageal fistula. Thirty-nine patients had an identified genetic disorder, 28 had a primary airway abnormality, 28 were oxygen dependent, and 21 were born premature. Fifty-two patients underwent triple endoscopy, consisting of flexible bronchoscopy, rigid bronchoscopy, and gastroscopy. In 33 patients, esophageal dilatation was necessary. Six patients underwent posterior tracheopexy at a median of 6 months of age (range 5 days to 8 years) all with ensuing symptom improvement. The total mean parental satisfaction score on a Likert-type scale of 1-5 (5 = highest satisfaction) was 4.5. CONCLUSIONS: A coordinated approach is required to provide effective care to the growing population of children with aerodigestive disorders. The cross fertilization between multiple disciplines offers a unique opportunity to develop high quality and innovative care. Outcome measures must be defined to objectively measure clinical benefit.


Assuntos
Doenças do Sistema Digestório/terapia , Endoscopia/métodos , Equipe de Assistência ao Paciente/organização & administração , Assistência ao Paciente/métodos , Doenças Respiratórias/terapia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Doenças do Sistema Digestório/fisiopatologia , Hospitais Pediátricos/organização & administração , Humanos , Lactente , Israel , Pais/psicologia , Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/normas , Satisfação do Paciente , Qualidade da Assistência à Saúde , Doenças Respiratórias/fisiopatologia , Estudos Retrospectivos , Centros de Atenção Terciária/organização & administração
16.
J Dev Behav Pediatr ; 42(7): 532-539, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34518496

RESUMO

OBJECTIVE: To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown. METHOD: Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed. RESULTS: Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness. CONCLUSION: Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.


Assuntos
Sintomas Comportamentais/psicologia , COVID-19 , Comportamento Infantil/psicologia , Relações Pais-Filho , Pais/psicologia , Funcionamento Psicossocial , COVID-19/prevenção & controle , Criança , Feminino , Humanos , Masculino , Apego ao Objeto , Quebeque
17.
PLoS One ; 16(9): e0257888, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591898

RESUMO

Parents play a primary and crucial role in emotional socialisation processes in children where individuals learn the expression, understanding and regulation of emotions. Parenting practices and dimensions of the parent-child relationship have been associated with social and emotional processes in children. As criticism involves negative emotional reactions and emotion regulation, the parent-child relationship is likely to influence an individual's perception and response to criticism. Hence, the present study investigated the relationship of parental bonding and the perception and response to criticism in three different countries-Singapore, Italy and USA. Adult participants (n = 444) completed the Parental Bonding Inventory (PBI) and measures of criticism. Parental care, overprotection and country were found to be significant predictors of a tendency to perceive criticism as destructive. Higher levels of parental care predicted a lower tendency to perceive criticism as destructive while higher levels of parental overprotection predicted a higher tendency to perceive criticism as destructive. US American participants were found to have a significantly higher tendency to perceive criticism as destructive compared to Italian and Singaporean participants. The findings align with past research on the role of the parent-child relationship in the socio-emotional development of children as well as providing insight into a specific aspect in social interaction; perception and response to criticism, being affected. Future studies can look to investigate this relationship further in different countries in light of cultural variation in parenting styles and emotion experience, expression and regulation.


Assuntos
Apego ao Objeto , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Adulto , Comparação Transcultural , Regulação Emocional , Feminino , Humanos , Itália , Masculino , Percepção , Singapura , Estados Unidos , Adulto Jovem
18.
Clin Nutr ; 40(10): 5399-5406, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34571239

RESUMO

BACKGROUND & AIMS: Although nutritional care is a cornerstone in the management of pediatric intestinal failure (IF), little is known about feeding difficulty (FD) prevalence. The aim of this study was to determine the frequency of FD and associated factors and to characterize eating behaviours in two pediatric IF rehabilitation centres (Hôpital-Necker Enfants Malades (NEM), France and Alberta Children's Hospital (ACH), Canada). METHODS: Parents of children (aged 1-18 years) on home parenteral nutrition (PN) for >3 months followed at NEM and ACH completed two validated tools: Montreal Children's Feeding scale for severity of FD, Child Eating Behaviour Questionnaire and a pediatric IF-specific questionnaire for FD associated risk factors. RESULTS: In the entire cohort (n = 59, median 5.2 years), 15% had mild, 19% had moderate and 25% had severe FD. No FD was seen in 53% vs 11% and severe FD was seen in 20% vs. 39% of the NEM and ACH cohorts respectively (p = 0.003). Current ETF was less common at NEM vs. ACH (3% vs. 50%, p < 0.001). The FD score was associated with current enteral tube feed (ETF) use (p = 0.04). Compared to healthy reference children, the NEM cohort did not differ for the enjoyment of food, whereas the ACH cohort's enjoyment was lower (p < 0.0001). The ACH cohort scored higher for food avoidance behaviours: food fussiness (p < 0.02), satiety responsiveness (p < 0.0001), and slowness in eating (p < 0.0001) while the NEM cohort was not different from healthy reference children. In the entire cohort, according to parental recall, 60% were reported to be NPO for >12 weeks in the first 6 months of life, and late introduction of purees (>9 months) and lumpy textures (>1 year) were found in 40% and 58%, respectively. Parent-recalled ETF differed between NEM and ACH in the first 6 months of life (45% vs 76%, p = 0.03). CONCLUSIONS: Feeding difficulty and associated risk factors, including early ETF, prolonged NPO and delays in achieving feeding milestones were frequently reported in pediatric IF. Feeding medicalization with the use of ETF may inadvertently contribute to FD and eating disorder behavioural characteristics. This study highlights the need for FD prevention and an increased focus on establishing healthy eating. Future prospective study of FD, associated risk factors and clinical outcomes are merited.


Assuntos
Comportamento Alimentar , Apoio Nutricional , Síndrome do Intestino Curto/terapia , Canadá/epidemiologia , Criança , Pré-Escolar , Diarreia/terapia , França/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Pseudo-Obstrução Intestinal/terapia , Pais/psicologia , Inquéritos e Questionários
19.
PLoS One ; 16(9): e0255400, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34543301

RESUMO

A growing number of studies suggest that the frequency of numeracy experiences that parents provide at home may relate to children's mathematical development. However, the relation between home numeracy practices and children's numerical skills is complex and might depend upon both the type and difficulty of activities, as well as the type of math skills. Studies have also argued that this relation may be driven by factors that are not systematically controlled for in the literature, including socio-economic status (SES), parental math skills and children's IQ. Finally, as most prior studies have focused on preschoolers, it remains unclear to what extent there remains a relation between the home numeracy environment and math skills when children are in elementary school. In the present study, we tested an extensive range of math skills in 66 8-year-olds, including non-symbolic quantity processing, symbolic number understanding, transcoding, counting, and mental arithmetic. We also asked parents to complete a questionnaire about their SES, academic expectations, academic attitudes, and the numeracy practices that they provide at home. Finally, we measured their arithmetic fluency as a proxy for parental math skills. Over and above differences in socio-economic status, parental arithmetic fluency, child's IQ, and time spent with the child, we found a positive relation between the frequency of formal numeracy practices that were at or above grade level and two separate measures of mental arithmetic. We further found that the frequency of these advanced formal numeracy practices was related to parents' academic expectations. Therefore, our study shows that home numeracy experiences predict arithmetic skills in elementary school children, but only when those activities are formal and sufficiently challenging for children.


Assuntos
Aprendizagem/fisiologia , Matemática/educação , Relações Pais-Filho , Pais/psicologia , Atitude , Criança , Feminino , Humanos , Masculino , Inquéritos e Questionários
20.
PLoS One ; 16(9): e0252981, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34506502

RESUMO

BACKGROUND: Parental misperception and underestimation of their child's weight are documented in studies. Demographic factors like age and gender have been linked to misclassification. However, modifiable factors that could potentially frame future intervention and prevention strategies have not been explored. This study aimed to assess factors that could predict parental misclassification of their preschool child's weight. METHODS: This was a cross-sectional study with 198 parents and their 2- to 5-year-old children who attended standalone preschools or childcare centers with preschools. Parents completed a questionnaire that asked about demographic features, personal and family health, and the assessment of their child's weight using the three most frequently utilized measures. Logistic regression was conducted to assess the association between parental factors and child weight classification status. Instruments included the Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children Scale (PSEPAD), the Obesity Risk Scale (ORK-10), and the Adolescent Obesity Risk Scale (AORK). Analyses included frequencies, chi-square tests, Kappa coefficients, and logistic regressions. RESULTS: Parents were least accurate (35.9%) identifying child weight when selecting a picture (κ = -.028, p = .42). The pictorial and Likert method (κ = -.032, p = .37) showed parental agreement with child weight was not significantly better than chance. Statistically, a significant agreement was found in the weight-reporting method (κ = .21). Two of the three HBM-related measures were significantly related to accurate classification. Logistic regression showed child sex, PSEPAD scores, and ORK-10 scores were statistically significant predictors in the Likert method. The model had no statistical significance for the pictorial or weight-reporting method. CONCLUSION: Results indicate parents support intervening if aware of child weight problems. However, parents do not accurately recognize healthy versus unhealthy weights and report that health providers are not informing them of weight deviations. Further, important relationships between the HBM variables were identified. Results show barriers (self-efficacy) mediate the impact of perceived severity (knowledge) regarding the parental ability to assess child weight accurately. These relationships and incorporation of the HBM principles of barriers and severity into prevention/intervention strategies need further exploration.


Assuntos
Peso Corporal , Pais/psicologia , Autoeficácia , Adulto , Índice de Massa Corporal , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Modelo de Crenças de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Modelos Logísticos , Masculino , Inquéritos e Questionários
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