Effectiveness of a Preoperative Preparation Program on Children's Emotional States and Parental Anxiety.

PURPOSE: The study was conducted to examine the effects of a preoperative preparation program on children and their parents in a pediatric surgery outpatient clinic. DESIGN: A quasiexperimental design was used. METHODS: Seventy-three children and their primary caregivers were included in the study (intervention = 36, control = 37). Data collection tools included the Characteristics of Children and Caregivers Data Form, the PedsQL Health Care Parental Satisfaction Scale, the State Anxiety Inventory, and the children's Koppitz Human Figure Drawing Test. Data were collected on the day before surgery and the day of surgery. The program comprised verbal and written information about the process that was given to families and children, and a medical play doll was used for therapeutic communication with children in the intervention group. FINDINGS: The satisfaction level of parents in the intervention group was found to be significantly higher than in the control group (intervention = 100, control = 50; P < .05). During the preoperative and discharge periods, the anxiety scores of parents in the intervention group were significantly lower than the control group (P < .05). According to the Koppitz Drawing Test, the children in the control group's emotional state was higher than the intervention group regarding impulsiveness, anxiety, and anger on discharge (P < .05). CONCLUSIONS: The preoperative preparation program was found to have a positive effect on the children and their parents. Nurses should use drawings of children as a therapeutic communication technique to evaluate the emotions of children.

A structural equation model of CFIR inner and outer setting constructs, organization characteristics, and national DPP enrollment.

BACKGROUND: The National Diabetes Prevention Program (DPP) has made great strides in increasing accessibility to its year-long, evidence-based lifestyle change program, with around 3000 organizations having delivered the program. This large dissemination effort offers a unique opportunity to identify organization-level factors associated with program implementation and reach (enrollment) across diverse settings. The purpose of this study was to quantitatively examine the relationships among Consolidated Framework for Implementation Research (CFIR) Inner Setting and Outer Setting constructs and the implementation outcome of reach. METHODS: This study analyzed data from a 2021 cross-sectional online survey with 586 National DPP Staff (lifestyle coaches, master trainers, program coordinators) with information about their organization, implementation outcomes, and responses to quantitative CFIR Inner Setting and Outer Setting construct items. Structural equation modeling was used to test a hypothesized path model with Inner and Outer Setting variables to explore direct and indirect pathways to enrollment. RESULTS: The CFIR items had good internal consistency and indicated areas of implementation strength and weakness. Eight variables included as part of the CFIR structural characteristics and one organization characteristic variable had significant direct relationships with enrollment. The length of delivery, number of lifestyle coaches, number of full-time staff, large organization size, and organizations delivering in rural, suburban, and/or urban settings all had positive significant direct relationships with enrollment, while academic organizations and organizations with only non-White participants enrolled in their National DPP lifestyle change programs had a negative association with enrollment. CONCLUSIONS: Participant reach is an important implementation outcome for the National DPP and vital to making population-level decreases in diabetes incidence in the USA. Our findings suggest that to facilitate enrollment, program implementers should focus on organizational structural characteristics such as staffing. Strengths of this study include the use of adapted and newly developed quantitative CFIR measures and structural equation modeling. Health prevention programs can use the methods and findings from this study to further understand and inform the impact of organization factors on implementation outcomes.

Clinical significance of cell factors in serum samples of hand-foot-mouth disease / 中国综合临床

Objective To study the clinical significance of cell factors in plasma samples of hand?foot?mouth disease. Methods Sixty?nine cases hand?foot?mouth diseases children who were treated in Fifth People’ s Hospital of Wuxi from July to December 2014 were selected as research objects,and divided into normal hand?foot?mouth disease group with 48 cases and severe hand?foot?mouth disease group with 21 cases. Twenty healthy children were selected as healthy control group. Serum samples were collected from 3 groups of subjects. The lev?el of IgA,IgG and IgM were detected by immune turbidity method. The level of IFN?γ, IL?10, IL?13 and IL?2 were detected by flow cytometry. Results The level of serum IgG,IgA of severe hand?foot?mouth disease group patients were (12. 33±8. 58) g/L,(0. 78±0. 55) g/L,significantly lower than control group((7. 09±6. 36) g/L,(0. 61±0. 36) g/L) and the normal hand?foot?mouth disease group((7. 41±5. 07) g/L,(0. 57±0. 41) g/L),the differences were significant(P0. 05) ,and there was no significant difference in term of the level of IgM among the three groups( P>0. 05) . The level of serum IFN?γ,IL?2,IL?13 of severe hand?foot?mouth dis?ease group were (0. 95±0. 67) ng/L,(1. 07±0. 64) ng/L,(1. 25±0. 46) ng/L,significantly lower than normal hand?foot?mouth disease group((2. 72±1. 15) ng/L,(2. 07±1. 53) ng/L,(2. 31±1. 35 ) ng/L) and the control group((1. 83±1. 12 ) ng/L,(1. 61±1. 37) ng/L,(1. 99±0. 75) ng/L),the differences were significant(P<0. 05). The level of serum IL?10 of normal hand?foot?mouth disease group was (2. 69±1. 33) ng/L,significant?ly higher than severe hand?foot?mouth disease group ( ( 1. 54 ± 1. 23 ) ng/L ) and control group ( ( 1. 35 ± 1. 12 ) ng/L) ,the differences were significant( P<0. 05) . Conclusion The level of serum cytokines can reflect the ge?netic profile status,understand the development trend of the disease,provide a reliable index for early clinical in?tervention.