The experiences of children, adolescents and their parents in isolation in a Danish paediatric unit: A qualitative study.

BACKGROUND: Previous studies on adult patients in hospital isolation show that it can be highly stressful, with some patients affected by depression and anxiety. This study aimed to explore how children, adolescents, and their parents perceive isolation and how it affects them physically, psychologically, and socially. METHODS: A qualitative approach was used comprising semi-structured interviews, participant observations, and field notes. FINDINGS: Two adolescents and 13 parents were selected to participate in the interviews, while three children and their parents participated in participant observation. Besides the participant observation one of the adolescents and one parent also participated in interviews. The children and adolescents were isolated at the hospital due to bacterial or viral infections or were carriers of an antibiotic resistant bacteria. After performing a thematic analysis to identify patterns in the data, four themes emerged: 1. Differing information provided about bacteria, virus, hygiene precautions, and isolation, 2. Dependence on healthcare professionals, 3. Impact of the environment, and 4. Coping and psychological reactions on isolation. DISCUSSION: The participants conveyed positive and negative experiences and emotions during isolation in relation to daily activities, psychological well-being, and social life. Adolescents and their parents requested clear comprehensible and consistent information on isolation from healthcare professionals. APPLICATION TO PRACTICE: To improve hospital isolation for children, adolescents, and their parents, well-written information on isolation and hygiene precautions is crucial, as are evolving strategies to minimise social exclusion and the emotional impact of isolation.

Pain is frequent in children with cerebral palsy and negatively affects physical activity and participation.

AIM: The aim was to identify the prevalence of long-lasting pain among children with cerebral palsy (CP) and to investigate the association between pain and participation in physical leisure activities. METHODS: This is a cross-sectional study based on data from the National Danish Clinical Quality Database of children with CP. The study population consisted of 960 children aged 2-11 years across all Gross Motor Function Classification System (GMFCS) levels. Data were collected at children's regular clinical visits in 2016 or 2017. Information about pain and participation in physical leisure activities were obtained. The association was estimated as odds ratios (OR) and 95% confidence intervals (95% CI) by logistic regression adjusted for age and sex. RESULTS: We included data from 817 children (59% boys) median age 6 years, 52% classified as GMFCS level I. A total of 36% reported pain, and the most frequent pain locations were hips, feet and knees. Children reporting pain had lower odds for participation in physical leisure activities (OR 0.71, 95% CI 0.53-0.96). CONCLUSION: A large proportion of children with CP reported pain. There is an indication that long-lasting pain influences participation in physical leisure activities. Pain-relieving interventions are important to decrease pain-related suffering and facilitate participation.

Long-term results after weight loss intervention in knee arthroplasty patients with obesity.

INTRODUCTION: Obesity is a well-known problem in patients undergoing total knee arthroplasty (TKA). We have previously shown that it is feasible and safe to implement an intensive weight loss programme shortly before TKA. Preoperatively, the programme produced an average weight loss of 10.7 kg while also improving body composition and reducing cardiovascular risk factors. One year after TKA, the patients in the weight loss programme managed to maintain their weight loss, whereas no change was observed in the control group. Both groups showed major improvements in health-related quality of life (QoL) and knee function. The aim of this study was to investigate the long-term effect of a weight loss intervention in patients with obesity undergoing TKA. METHODS: This was a seven-year follow-up study from a randomized controlled trial. Body weight, blood pressure and waist circumference were measured. Additionally, data on patient-reported outcome, range of knee motion (ROM), hypertension and diabetes status were collected. RESULTS: Forty-nine patients were examined at the follow-up. No differences were found between the intervention and the control group on body weight, hypertension, diabetes, waist circumference or knee ROM. The intervention group had increased their mean weight significantly more than the control group (difference = 3.1, 95% confidence interval: 1.3-4.8). 66% had hypertension and 38% had Type 2 diabetes. Pain, function and QoL were improved for both groups. CONCLUSION: The patients in the intervention group were unable to maintain their preoperative weight loss when measured seven year after TKA. FUNDING: none. TRAIL REGISTRATION. not relevant.