Aspects Of Child Care Research Articles

Burnout, compassion fatigue and professional resilience in caregivers of children with disabilities in Ukraine

ABSTRACTThe disability and professional caregiving literature includes little descriptive data on the professional quality of life of the caregivers of individuals with emotional, intellectual, and physical disabilities in post-Soviet countries. The inherently stressful conditions in which caregivers’ practise has the potential to impact the compassion-ability of the caregiver as well as the quality of care for the individuals they serve. This study aims to bring insight into the professional experiences of those caregivers providing long-term care to children with disabilities in Ukraine. This exploratory study examined self-reported levels of compassion fatigue, professional burnout and compassion satisfaction, in a privately funded rehabilitation centre and a publicly funded orphanage. Results revealed that despite the difficult working conditions, caregivers experienced moderate levels of compassion fatigue, and above average levels of compassion satisfaction, suggesting that the positive aspects of caring for children with severe disabilities may be moderating the deleterious effects of the work.

Treatment of Multidrug-resistant Tuberculosis Infection in Children.

Treatment of Multidrug-resistant Tuberculosis Infection in Children.

Bringing the Real World Into Developmental Science: A Commentary on Weber, Fernald, and Diop (2017).

This article examines the parent intervention program evaluated by Weber etal. (2017) and argues that there are scientific and ethical problems with such intervention efforts in applied developmental science. Scientifically, these programs rely on data from a small and narrow sample of the world's population; assume the existence of fixed developmental pathways; and pit scientific knowledge against indigenous knowledge. The authors question the critical role of talk as solely providing the rich cognitive stimulation important to school success, and the critical role of primary caregivers as teachers of children's verbal competency. Ethically, these programs do not sufficiently explore how an intervention in one aspect of child care will affect the community's culturally organized patterns of child care.

Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care.

General and central nervous system anatomy and physiology in children is different to that of adults and this is relevant to traumatic brain injury (TBI) and spinal cord injury. The controversies and uncertainties in adult neurotrauma are magnified by these differences, the lack of normative data for children, the scarcity of pediatric studies, and inappropriate generalization from adult studies. Cerebral metabolism develops rapidly in the early years, driven by cortical development, synaptogenesis, and rapid myelination, followed by equally dramatic changes in baseline and stimulated cerebral blood flow. Therefore, adult values for cerebral hemodynamics do not apply to children, and children cannot be easily approached as a homogenous group, especially given the marked changes between birth and age 8. Their cranial and spinal anatomy undergoes many changes, from the presence and disappearance of the fontanels, the presence and closure of cranial sutures, the thickness and pliability of the cranium, anatomy of the vertebra, and the maturity of the cervical ligaments and muscles. Moreover, their systemic anatomy changes over time. The head is relatively large in young children, the airway is easily compromised, the chest is poorly protected, the abdominal organs are large. Physiology changes—blood volume is small by comparison, hypothermia develops easily, intracranial pressure (ICP) is lower, and blood pressure normograms are considerably different at different ages, with potentially important implications for cerebral perfusion pressure (CPP) thresholds. Mechanisms and pathologies also differ—diffuse injuries are common in accidental injury, and growing fractures, non-accidental injury and spinal cord injury without radiographic abnormality are unique to the pediatric population. Despite these clear differences and the vulnerability of children, the amount of pediatric-specific data in TBI is surprisingly weak. There are no robust guidelines for even basics aspects of care in children, such as ICP and CPP management. This is particularly alarming given that TBI is a leading cause of death in children. To address this, there is an urgent need for pediatric-specific clinical research. If this goal is to be achieved, any clinician or researcher interested in pediatric neurotrauma must be familiar with its unique pathophysiological characteristics.

Cancer care for infants, children and adolescents

The World Health Organization (WHO) defines pediatric palliative care as “the active total cares of the child’s body, mind, and spirit and also involves giving support to the family. It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease”. There are some unique aspects of caring for children and their families compared to adult patients that create a different set of challenges for care providers. In this chapter we will review some of the specific characteristics of caring for children and their families that must be considered to deliver optimal and effective pediatric palliative care. Ongoing efforts to raise awareness and educate more professionals about palliative care will hopefully dissolve some of the current barriers that hinder access to pediatric palliative care programs. With strong endorsement from the Academy of Pediatrics, it is hoped that all children with serious medical conditions can be offered concurrent palliative care support, focused on quality and quantity of life.

Improving Care in Pediatric Neuro-oncology Patients: An Overview of the Unique Needs of Children With Brain Tumors.

Brain tumors represent the most common solid tumors in childhood, accounting for almost 25% of all childhood cancer, second only to leukemia. Pediatric central nervous system tumors encompass a wide variety of diagnoses, from benign to malignant. Any brain tumor can be associated with significant morbidity, even when low grade, and mortality from pediatric central nervous system tumors is disproportionately high compared to other childhood malignancies. Management of children with central nervous system tumors requires knowledge of the unique aspects of care associated with this particular patient population, beyond general oncology care. Pediatric brain tumor patients have unique needs during treatment, as cancer survivors, and at end of life. A multidisciplinary team approach, including advanced practice nurses with a specialty in neuro-oncology, allows for better supportive care. Knowledge of the unique aspects of care for children with brain tumors, and the appropriate interventions required, allows for improved quality of life.

Family Centered Care versus Child Centered Care: The Malawi Context

Family Centered care is a model that is practiced and encouraged in child health care. It considers family as partners and collaborators in care of children. It aims at involving family in all aspects of child care. Family centered care also mentions involvement of child. However, emphasis is given more on family than child and does not take into account the older child’s capacity for independent decision making and right to privacy. As such, child’s needs are missed out. With child centered care, children are involved and supported at all levels of care based on their age and developmental stage. This paper aims to stress the importance of involving children within family centered care. Involving children in their care, makes them feel less threatened by the health care professional and their self esteem is promoted. Currently, no studies have been identified in Malawi that demonstrates full partnership between the family, child and the nurse. Furthermore, Family Centered Care and Child Centered Care as models are not fully practiced. It is therefore important to practice both family and child centered care in child health care if the needs of both family and children are to be addressed concurrently.

Nurses' Perceptions of the Practice of Restricting a Child for a Clinical Procedure.

Restricting a child for a clinical procedure has been linked to negative physical and psychological sequelae. The practice of restriction remains an implicit and unquestioned aspect of care for children during a clinical procedure. In this study we aimed to describe the practice of restricting a child's movement for a clinical procedure by conducting focus groups with children's nurses. Data were analyzed using a thematic network analysis framework. The findings show that nurses are likely to restrict children based on particular characteristics of the child; for example, the child's age. The findings indicate that there is no consistent approach to the practice of restricting a child for a clinical procedure, suggesting tension between nurses and other health care professionals, and nurses and parents, about this practice. The findings suggest the need for wider exploration of the practice of restriction at the organizational level and a need for children's nurses to feel more empowered to act as advocates for those in their care.

Mujeres cuidadoras en contextos de pobreza: el caso de los Programas de Transferencias Condicionados en Argentina

El artículo analiza el caso de los programas de transferencias condicionadas (PTC) en Argentina, desde un enfoque de género, prestando particular atención al vínculo de estas políticas con el trabajo de cuidado que realizan las mujeres en contextos de pobreza. En primer lugar, se propone efectuar una descripción de las concepciones subyacentes en torno a las mujeres en el diseño de estos programas, tomando como referencia dos casos emblemáticos de Argentina: el Plan Jefes y Jefas de Hogar Desocupados y el Programa Familias por la Inclusión Social. Luego, se propone explorar las estrategias de cuidado que llevan adelante las mujeres que recibieron PTC. Finalmente, se analiza la modalidad bajo la cual organizaciones comunitarias proveen de servicios de cuidado a amplios sectores de la población y se explora cómo las mujeres "beneficiarias" y cuidadoras experimentan diferentes aspectos relativos al cuidado infantil que efectúan en dicho ámbito.

Por mis hijos lo que sea... o casi. Identidades de madres y padres que han vivido un divorcio

From the discourses of divorced or separated (from generations born between 1965 and 1975), this article analyses the configuration of parental identities. Divorce involves reorganizing aspects of caring for children, encouraging reflection on self-parental identity. Our hypothesis problematizes the results of Solsona and Ferrer (2010), who emphasize the centrality of being mothers and fathers among the older generations. We highlight among the findings that men and women are redefining perceptions about their role as parents. Women displace motherhood at the same level of importance as other aspects of their life trajectories, while men tend to idealize parenthood.

Children with diabetes friendly services: A blueprint

AbstractChildren with diabetes, despite their small numbers, form a population with needs different from adult subjects with diabetes. This emphasizes the need to establish child- friendly standards in services rendered to these children. The care providers for children with diabetes are quite heterogeneous and include generalists, paediatric subspecialist and endocrinologists and care is delivered in various circumstances. Various aspects of caring for children need to be taken into account when a system is created for children with diabetes. This includes but is not limited to physical infrastructure of the system, qualified medical personal with experience in handling children and quality systems to maintain cold chains for insulin and laboratory reporting. The system should be able to reach out to other stake holders that include the community and family of children with diabetes. The system should be subjected to self audit, and performance on various key indicators should be assessed.

AUDIT OF RESUSCITATION PLANNING AND DOCUMENTATION AT A TERTIARY CHILDREN'S HOSPITAL OVER A 12 MONTH PERIOD

BackgroundResuscitation planning is a very important aspect of care for children with life limiting conditions.AimThis research aims to evaluate the practice of resuscitation planning at a major tertiary children's hospital.MethodsA...

The Ability of Adults and Children to Visually Identify Peanuts and Tree Nuts

To determine the ability of children and adults to visually identify and differentiate peanuts and tree nuts by displaying the nuts in commonly purchased and used forms.One thousand one hundred five self-selected adults and children (456 children aged 6–18 years) visiting an interactive children's science center.Participants were recruited to a nut display consisting of 19 numbered compartments displaying peanuts and 9 tree nuts in commonly purchased and used forms. Data on demographics, personal or family history of peanut or nut allergy, current or previous roles in child care, teaching, food preparation or serving, or patient care were collected. Participants were then asked to identify each nut in the display.There was a wide distribution of correct answers. The mean number of correct answers was 8.4 of 19; the responses of adults (11.1) were better than those of the children (4.6). The most common identifications included peanut in the shell 94.7% of the time, peanuts out of the shell 80.5% of the time, and cashews 76.7% of the time. The least common was hazelnut at 16.1%. Twenty-seven (2.4%) self-reported peanut or tree nut allergy; no differences in correct answers were seen between allergic and nonallergic participants or parents. Twenty of the 27 were able to name the nut to which they were allergic, but only 50% correctly identified all forms of those nuts. Fifteen of 20 parents of children with allergies were able to name the nut to which their children were allergic and 73.7% correctly identified the nuts. Those involved in some aspect of child care or health care did significantly better than those who were not, but those in the food industry did not do any better than those who were not in that industry.Both adults and children are not reliable at visually identifying most nuts.It is obvious from this and other studies that simply telling patients to avoid peanuts or tree nuts, or specific tree nuts, is not sufficient. Some education using pictures of nuts would appear to be minimal requirements. As the authors point out, this study was done in 1 city at 1 time and may not be generalizable to other cities, although there is nothing unique about the city or the setting that would suggest it would not apply to other areas. Furthermore, the study probably overestimated the abilities of the general population due to a selection bias among participants who thought they would do well. Perhaps those who did not think they were able to identify the nuts did not participate.

Initial assessment of young people in the emergency department

One of the most important aspects of care for children in emergency departments (EDs) is the initial assessment of their conditions and circumstances. Paediatric nurses, or other nurses who have had adequate training and skills in the care of children and younger people, should use the appropriate tools to undertake these assessments so that they can identify and manage children's physical, mental or social problems. This article discusses the use of such tools in the initial assessments of children at Ipswich Hospital NHS Trust ED, and how this use has improved practice while raising the profile of paediatric emergency care.

Data surveillance in child protection systems development: An Indonesian case study

Objectives Successful implementation of child protection program interventions and child and family welfare services is contingent upon the availability and use of good quality information, as emphasized by the recent Convention on the Rights of the Child's General Comment 13. Yet, the role of information within child protection is not well understood, and ongoing efforts to strengthen child protection systems have not systematically examined this critical function. Recognizing these shortcomings, the Government of Indonesia and UNICEF commissioned a study to identify a “road map” for a national child protection information system. Methods The used desk review, semi-structured interviews, focus groups and site visits to identify existing data collection practices, and analyze the appropriateness and efficiency of information management mechanisms from the national down to the community level. Results The results show that the prevailing situation in Indonesia is characterized by a lack of accurate information on all necessary aspects of child care and protection including magnitude of problems, causality analysis and impact of programmatic responses. There is no lead actor for child protection at the national level, and there are no agreed upon data collection priorities, procedures or methods for a shared data collection system. Conclusion The study suggests a need to reframe the dominant language from a “child protection information management system” to a “child protection surveillance system” to promote clearer data collection objectives and activities. Identifying a government ministry to lead child protection efforts and to forge closer partnerships among relevant actors will be required to support a national surveillance system. Additionally, addressing obstacles that limit child protection incident detection at the community level is critical. In addition to strengthening Indonesia's system, this study's approach and findings have the potential to help to inform ongoing child protection system development initiatives in other countries as well.

A symptom-based approach to palliative care in cystic fibrosis

Cystic fibrosis (CF) has been transformed in the twentieth century from a fatal disease of infants to a chronic, life-limiting illness of children, adolescents, and adults. The increase in life expectancy has been accompanied by an increase in both chronic and acute physical and psychological symptoms. Careful attention to symptom assessment and treatment should now be a routine aspect of care for children and adults with CF. Although life expectancy has increased dramatically, children and adults with CF will still die before their unaffected peers, and careful attention to issues in end-of-life care is still a part of CF care, with the often complicating factor of lung transplantation as a relatively recent arrival. This review will focus on a symptom-based approach to CF care for children and adults throughout the lifespan.

Care of the Child Assisted by Technology

1. Laurie J. Glader, MD* 2. Judith S. Palfrey, MD* 1. *Children's Hospital, Harvard University, Boston, Mass After completing this article, readers should be able to: 1. Describe children who are dependent on technology. 2. List common indications for and complications of gastrostomy tubes. 3. Define invasive and noninvasive mechanical ventilation. 4. Recognize the psychosocial effects of having a child dependent on technology. Over the past 30 years, care for children who have life-threatening conditions has become more sophisticated. As a result, a new population of children who have special health-care needs has evolved: those assisted by medical technology. By definition, such children have a chronic condition that requires daily assistance by a medical device to replace or augment a bodily function to sustain life. (1) Such technologies allow children who previously would have required highly specialized care in a hospital to live at home. Understanding the scope of this population, general concepts, trends, and complications associated with some of the technologies themselves, along with the psychosocial aspects of caring for children assisted by technology at home, is critical for the pediatrician providing a medical home for this growing population of children. Results of a recent national survey indicate that nearly 13% of children in the United States have special health-care needs. (2) These are children who “have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.” (3) Approximately 50% of these children (6.5% of children nationally) have a disability that impairs their functional daily living. Detailed statistics relating to children dependent on technology are more challenging to obtain; estimates indicate that they comprise 0.16% of the population. (4) The types of technologies on which children who have complex needs rely vary substantially. (5) Among the most common are forms of respiratory support, such as supplemental oxygen or …

Care of the Child Assisted by Technology

Care of the Child Assisted by Technology

Do we know the legal framework in child and adolescent mental health services? Survey of specialist registrars

Aims and MethodThis survey was conducted as part of the baseline assessment of trainees' needs concerning the legal aspects of child care and to evaluate the implications for the regional academic programme. A group of specialist registrars in child and adolescent psychiatry in the North Western Deanery completed a questionnaire-based survey.ResultsNone of the specialist registrars had experience in forensic child and adolescent psychiatry. With regard to the legislation: 13 (100%) mentioned the Mental Health Act 1983; 12 (92.3%) the Children Act 1989; 7 (53.8%) the Human Rights Act 1998. of those surveyed, 13 (100%) were aware of parental responsibility; 10 (76.9%) identified the Children Act as being less stigmatising as compared to the Mental Health Act. Five (38.4%) had written court reports, and eight (61.5%) felt fairly confident after the 1-day training course. Overall interest in becoming an expert witness was 69.2% (n=9).Clinical ImplicationsDeficits in knowledge about the legal framework, limited experience in forensic placements and lack of interest in becoming an expert witness need to be further explored.

Harmonising extended measures of parental childcare in the time-diary surveys of four countries - Proximity versus responsibility

Measures of childcare drawn from time-diary data are commonly based on the specific childcare activities a parent engages in throughout the day. This emphasis on activities has been criticised as it ignores the large quantity of time parents spend supervising their children. In order to provide more accurate estimates of childcare that incorporate supervisory childcare, researchers have turned to extended measures of care based on being i) in proximity to children or ii) responsible for children. There has been debate about the extent to which these approaches each measure the same aspect of childcare. In addition, it is thought they may be sensitive to the way surveys have been designed, which can affect the extent to which they can be compared crossnationally. We argue that measures of proximity and responsibility are conceptually interchangeable, and demonstrate that they can be harmonised and compared cross-nationally. Finally, we suggest ways in which these extended measures of childcare can be made increasingly comparable cross-nationally.