Child-Friendly Hospital Research Articles

Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar.

"Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.

Avaliação da implantação do fornecimento de leite humano para prematuros em unidade de terapia intensiva neonatal

Abstract Objectives: to assess the supply of human milk exclusively to prematures in a Neonatal Intensive Care Unit and the influence of external and organizational contexts on the degree of implementation of this intervention. Methods: this is an implementation evaluation with analysis of the external context (sociodemographic situation of mothers, support network and industry marketing) and organizational context (belonging to the hospital unit). To define the degree of implementation, the Analysis and Judgment Matrix was used, considering the compliance dimension, and the availability and technical-scientific quality sub-dimensions. The data used were obtained through interviews, semi-structured questionnaires and analysis of documents from the institution. Results: the degree of implementation of the intervention was 80.74%, proving to be satisfactory, with emphasis on the technical-scientific quality sub-dimension. Conclusions: the success in the supply of human milk is linked to public policies, the support and guidance offered to mothers in the hospital unit, presence of a support network, knowledge of mothers about the benefits of breastfeeding, adequate infrastructure and availability of supplies. The prematures being hospitalized in a child-friendly hospital contributed to the implementation of the intervention.

Compliance with the criteria of the Child-Friendly Hospital Initiative pre and during the COVID-19 pandemic

Objective: to analyze compliance with the criteria of the Baby-Friendly Hospital Initiative in the periods before and during the COVID-19 pandemic. Method: quantitative study with 12 Baby-Friendly Hospitals in Paraná. Secondary data from 2019 and 2020, available in the monitoring system of the Baby-Friendly Hospital Initiative, were used, with analysis of association with the Yule Coefficient. Results: 156 items were analyzed, of which 25 presented changes, of which 12 were fulfilled in 2019 and not fulfilled in 2020, and 13 were not and were now fulfilled. There was a slightly positive impact of the COVID-19 pandemic on the fulfillment of Steps 1, 2, 7 and 8, and a negative impact on Steps 3, 5 and 9. Conclusion: This scenario raises a design of measures to protect and encourage breastfeeding by institutions, professionals and health managers in order to develop strategies to support and provide maternal and childcare in accordance with public health policies.

Pediatric Care in the Age of COVID-19.

Two pediatricians share perspectives on patient experience and delivery, future health care encounters, and social implications during the coronavirus 2019 pandemic. Collateral effects may comprise the most significant impacts on children, from limitations on hospital visitors, to closures of child-friendly hospital playrooms during this pandemic, to an alarming decrease in vaccination rates. Educational disparities will also likely widen, especially among those with limited access to technology at home. [Pediatr Ann. 2020;49(9):e403-e404.].

Inicjatywa Szpital Przyjazny Dziecku (WHO, aktualizacja 2018 r.) na oddziale intensywnej terapii noworodka

Inicjatywa Szpital Przyjazny Dziecku (WHO, aktualizacja 2018 r.) na oddziale intensywnej terapii noworodka

Determinants of exclusive breastfeeding in low birthweight infants under six months of age

The study aimed to assess factors associated with exclusive breastfeeding in low birthweight infants under six months of age in 64 Brazilian municipalities. This cross-sectional study included the 2,745 low birth weight infants under six months of age in the Survey on Prevalence of Breastfeeding (2008) in Brazilian municipalities. The outcome was exclusive breastfeeding. Individual determinants included socioeconomic characteristics (infants' age and sex), maternal characteristics (age bracket, work status, and parity), and characteristics of health services (birth in a Child-Friendly Hospital; place of outpatient follow-up; type of delivery). Two contextual determinants were also included: "number of Human Milk Banks per municipality per 10,000 live births" and "municipal human development index". The individualized effect of the study factor on the outcome was assessed by multilevel Poisson regression with level of significance under 5%. Exclusive Breastfeeding was more prevalent in low birth weight infants whose mothers were 20-35 years of age, who were not working away from home or were on maternity leave, who had given birth in a Child-Friendly Hospital, and who lived in municipalities with more human milk banks per 10,000 live births. The result of the positive and independent effect of strategies that were already part of the National Breastfeeding Policy (birth in a Child-Friendly Hospital, living in a municipality with more human milk banks, and adopting laws that guarantee maternity leave) on exclusive breastfeeding in low birth weight infants points to the need to expand the coverage of these measures in order to meet the breastfeeding targets proposed by the World Health Organization.

Amamentação em lactentes nascidos pré-termo após alta hospitalar: acompanhamento durante o primeiro ano de vida

breastfeeding, anthropometric measurements, social and family information. The proportion of breastfeeding during follow-up was calculated. Survival analysis was conducted to estimate breastfeeding duration. In total, 242 of the 258 infants (93.7%) returned to follow-up; 170 (69.9%) at 6 months and 139 (57.2%) at 12 months (adjusted age). A history of miscarriages (27.5%), stillbirths (11.7%), neonatal deaths (9.5%) and preterm births (21.1%) was noted in 65.5% of women. At hospital discharge: 5.5% received exclusive breastfeeding, 65.8% breastfeeding and formula, 28.6% formula. At month 1, 81.3% received breastfeeding, decreasing to 68.5% at month 2, 62.4% at month 3, 48.1% at month 4 and 22.4% at month 6 (adjusted age). The median of breastfeeding duration was 4 months. Breastfeeding occurred up to four months adjusted age in almost half of the population. Despite the need to improve these rates, the results could reflect the profile of the Child-Friendly Hospital Initiative Unit. Maintaining breastfeeding amongst preterm infants following hospital discharge is still a challenge, for both mothers and health professionals.

Breastfeeding of premature infants at a child-friendly hospital: from hospital discharge to home

Objective: to verify the prevalence of breastfeeding of preterm infants in neonatal units. Methods: an exploratory, cross-sectional study was performed at a Child-Friendly Hospital with 21 premature infants and their mothers. Interviews and a survey of medical records were performed using a form to collect data, which were analyzed through descriptive statistics. Results: the onset of milk feeding and breastfeeding was, respectively, 61.7 hours and 17.2 days on average. At hospital discharge, 47.6% of the preterm infants were breastfed; 47.6% were on exclusive breastfeeding; and 4.8% were on artificial milk feeding. At home, there were no changes in feeding patterns at seven to fifteen days after hospital discharge. Conclusion: it is necessary to strengthen actions for promotion, protection and support that encourage the practice of breastfeeding.

Factors Associated with Early Weaning According to the Report of Mothers in a Child Friendly Hospital Initiative

Objective: To determine the prevalence and factors associated with early weaning according to the report of mothers in a Child Friendly Hospital Initiative. Material and Methods: This is an observational, cross-sectional study with a sample of 252 mother/child binomials, participants in a maternal and childcare program, in a Child Friendly Hospital Initiative in Teresina, Brazil. A semi-structured questionnaire was used as the data collection instrument, administered to the mothers in individual interviews, with questions about socioeconomic conditions, breastfeeding, period, reason and way of weaning; and non-nutritive sucking habits. Early weaning was considered when the supply of breast milk was interrupted before the six months of life. For data analysis, descriptive and bivariate analyses were performed (Pearson's Chi-Square Test and Fisher's Exact Test), with a level of significance of 5%. Results: The prevalence of early weaning was 11.9%. The reasons given for interrupting breastfeeding by the mothers were: 23,% attributions of the mother; 46.% attributions of the infant; 23.3 % organic deficiency of the mother; 6.7% influence of others; and 4.8% of the mothers were still breastfeeding. The finger and/or pacifier sucking habits (p=0.002), and the use of a bottle (p=0.003) were associated with early weaning. A significant association between the total weaning period and the socioeconomic variables was not observed (p>0.05). Conclusion: The prevalence of early weaning was low. The main factors were related to “infant attributions”, associated to children with non-nutritive sucking habits, bottle use, first tooth erupted with less than 6 months and whose mothers had formal employment.

Amamentação no período de transição neonatal em Hospital Amigo da Criança

The objective of this study was to learn the breastfeeding rates in the neonatal transition period at a child-friendly hospital. A quantitative, exploratory, cross-sectional study was developed with 342 mother-baby pairs. Data were collected by means of interviews and analysis of medical records. Low breastfeeding rates were identified in the first hour of life of the newborns or neonatal reactivity period (53.2%). In the second transition period the rate was 20.7%, and 20.5% in the third period. Encouragement to breastfeeding is not appropriate for the phases of the neonatal transition period, as the rates for the first hour of life were expected to be higher than 90%, considering low risk newborns and births that occurred in a child-friendly hospital. Our findings indicate a need for adopting care strategies that favor the early contact and training of professionals at maternity hospitals toward the adequacy of breastfeeding to the neonatal transition period.

O processo de avaliacao da Iniciativa Hospital Amigo da Crianca sob o olhar dos avaliadores

OBJETIVOS: identificar a opinião dos avaliadores do Brasil que atuam na Iniciativa Hospital Amigo da Criança (IHAC) quanto à confiabilidade das informações coletadas pelo sistema de avaliação. MÉTODOS: estudo descritivo, transversal, quantitativo, baseado em dados primários através de questionários semiestruturados enviados por meio eletrônico. Critério de inclusão: avaliadores com experiência de participação em pelo menos uma avaliação global e/ou uma reavaliação no período de 2006 a 2011. Foram respondidos 35 questionários, os dados foram analisados no software Epi Info Windows 2.000 versão 3.5.1. RESULTADOS: 77% dos avaliadores responderam que os resultados do processo avaliativo da IHAC correspondiam parcialmente à realidade dos hospitais avaliados. Perguntas extensas, pouco claras, repetidas, com linguagem formal, o conhecimento técnico sobre certos procedimentos para profissionais que não os praticam e a definição temporal do contato precoce no parto foram os pontos fracos apontados do instrumento. CONCLUSÕES: o resultado do processo avaliativo da IHAC é parcialmente confiável e não reflete a realidade dos hospitais avaliados. Seria necessário promover adequações no instrumento de coleta de dados de modo a torná-lo mais claro e conciso, organizar um quadro de avaliadores melhor preparados, com recrutamento mais focado no perfil desejado e o fortalecimento do processo de qualificação dos mesmos.

Social spaces for young children in hospital

In the last number of years heightened interest has been attributed to the impact of hospital environments on children's psychosocial well-being. With policy largely built around adult assumptions, knowledge about what constitutes a child-friendly hospital environment from young children's perspectives has been lacking. If hospital environments are to aspire to being child friendly then the views of younger aged children must be taken into account. The current study investigated young children's perspectives of hospital social spaces to inform the design of the built environment of a new children's hospital. An exploratory qualitative participatory design was employed. Data were collected through semi-structured interviews (one-to-one and group workshops) which incorporated art-based activities to actively engage young children. Fifty-five young children aged 5 to 8 years with various acute and chronic illnesses were recruited from inpatient, outpatient and emergency departments of three children's hospitals. Young children want a diversity of readily available, independently accessible, age, gender and developmentally appropriate leisure and entertainment facilities seamlessly integrated throughout the hospital environment. Such activities were invaluable for creating a positive hospital experience for children by combating boredom, enriching choice and control and reducing a sense of isolation through enhanced socialization. When in hospital, young children want to feel socially connected to the internal hospital community as well as to the outside world. Technology can assist to broaden the spectrum of children's social connectivity when in hospital - to home, school and the wider outside world. While technology offers many opportunities to support children's psychosocial well-being when in confined healthcare spaces, the implementation and operation of such services and systems require much further research in the areas of ethics, facilitation, organizational impact and evaluation.

Alimentação láctea e prevalência do aleitamento materno em prematuros durante internação em um hospital amigo da criança de Ribeirão Preto-SP, Brasil

Despite the advantages identified in the literature and recommendations of national and international organizations the prevalence of breastfeeding (BF) is still low for the preterm infants (PTI). The purpose of the present study was to identify the type of feeding, the administration route and the techniques used for the first oral feeding prescribed to PT and the prevalence of BF on the occasion of hospital discharge. A retrospective study was carried out at a child-friendly hospital in Ribeirão Preto-SP. Two hundred fourteen PTI were attended between 09/2003 and 08/2004. We surveyed the files of 116 of them, who attended to the following inclusion criteria. Milk feeding was started at an early stage with mother’s milk administered by gavage. Upon discharge from hospital, 76.72% of the PTI were being breastfed. The results corroborate with the literature regarding the use of breast milk as the first dairy food and the influence of weight, gestational age and hospitalization time on the type of milk offered upon hospital discharge. Despite the improvements in BF rates at the institution, as a result of the team’s efforts, exclusive BF rates at the time of discharge are still distant from those expected.

Sense and Sensibilities: In Search of the Child-Friendly Hospital

Sense and Sensibilities: In Search of the Child-Friendly Hospital

Pacifier use and its relationship with early weaning in infants born at a Child-Friendly Hospital

Pacifier use and its relationship with early weaning in infants born at a Child-Friendly Hospital