Worry In Children Research Articles

마음챙김이 초등학생의 불안에 미치는 영향

Objectives This study aim to explore the relationship between mindfulness and anxiety and the mediating effects of emotion regulation and worry on the relationship between mindfulness and anxiety. Methods The data were analyzed from 289 elementary school children in Seoul. Reliability analysis, technical sta-tistics, correlation analysis, and mediating effect analysis of each scale were conducted using the SPSS 18.0 and PROCESS Macro Model 4.2. Results Research results were as follows. First, the correlation between mindfulness and anxiety were significant, and regression analysis showed that mindfulness significantly predicted anxiety. Second, the mediating effect of emotion regulation and worry were significant in the relationship between mindfulness and anxiety. Conclusions This study was verified that children's mindfulness is a useful variable that directly affects anxiety re-duction and indirectly through emotional control and worry. It also provides useful information for making mindful-ness-based interventions. Considering the results that the indirect effect through worry was greater than the di-rect effect of mindfulness on anxiety, it suggests the need to include mindfulness activities on children's worry.

Parents’ Evaluation of Changes in Parents’ and Children’ Physical and Psychological Health Status in COVID-19 Pandemic

Introduction: People’s social activities were restricted by COVID-19 pandemic measures such as blocking access to cities, suspending schools. For normal psychological development and well-being of children, social interaction is an essential component. COVID-19 crisis has affected the psychological well-being of both parents and children through parental job loss, income loss, caregiving burden and terror of infection. 
 Materials & Methods: This research was done in the 2020-2021 academic year. Snowball sampling method is used, and 100 participants were reached during a 4-week time interval after ethical approval. Survey was created as an online form and its link was distributed via social media platforms. Survey composed of demographic questions and topic related questions about COVID-19 to both parents and children. Questionnaire was designed for parents to fill out. For data analysis, Chi-Square test was used.
 Results: The mean age of participants was 40.36 ± 6.463 and mean age of participants’ children was 11.69 ± 3.390. 93% of participants indicated that internet usage of their child increased during the pandemic. 91.9% of the parents stated that they have fears/concerns about the coronavirus becoming pandemic in the world. 52% of the parents stated that their child gained weight during the pandemic process. Significant association was found between the child's weight gain and the increase in the child's fears/worries (p= .006). A significant relationship was found between the presence of COVID-19 cases in or around the family and the increase in the fears/worries of the children (p= .024). 
 Conclusion: According to parents’ perspective, 93% of participants’ child internet usage increased during pandemic. 73% of the parents reported that there has been an increase in the fears/ worries of children. On the other hand, 96% of the participants have stated that they have concerns of being negatively affected economically due to coronavirus pandemic. Significant relationship between fears/worries of parents’ and children was not found. In our study, there has been a significant relationship between fears/worries of children and their weight status. Parents of children who stated an increase in the worries of their child also stated that their children gained weight. Also, significant relationship was found between the presence of COVID-19 cases in or around the family and the increase in the fears/worries of the children.

Still worried? Parental control and academic competence as antecedents of middle school students' post-transition worries.

This study examined whether parental psychological control reported by children before the transition to middle school, in the second semester of the fourth grade, is associated with children's worries after the transition to middle school, in the first semester of the fifth grade. We also evaluated the mediating role of children's post-transition perceived academic competence and the moderating role of physical transition (changing schools) on these relations. 370 Romanian early adolescents participated at both time points, with 30% of them having changed schools. Path analysis showed that the relation between children's perceptions of dependency-oriented psychological control and post-transition worries was mediated by academic competence and moderated by physical transition. Educational and counseling implications are discussed.

Parental anxiety and depression are associated with adverse mental health in children with special needs during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has led to restrictions in various areas of life, including social life, work, leisure, health, and education. Vulnerable groups, such as children with special needs and their parents, may be at increased risk of experiencing exacerbated mental health problems during stressful periods such as the COVID-19 lockdowns. Telephone interviews were conducted with 954 parents of children with special needs. We assessed parental levels of generalized anxiety and depression using the validated GAD-7 and PHQ-8 scales. Parents were asked to rate family burden and their worry about the COVID-19 crisis, as well as their children's adverse mental health symptoms and health behaviors. Parents also reported their children's worries about the COVID-19 crisis. We conducted regressions to examine the relationship between parents' mental health problems and their children's adverse mental health symptoms and health behaviors. Qualitative data from open-ended questions were coded thematically and major themes of parental worry about the COVID-19 crisis were identified. Parental anxiety and depression symptoms predicted adverse mental health symptoms and behaviors in children with special needs. Criteria for current depression were met by 7.9% of parents of children with special needs, whereas 4.7% of the general population in Vorarlberg met the criteria for current depression according to data from the Austrian Health Interview Survey in 2019. Parental self-ratings of both depression and anxiety were highly correlated. The majority of parents reported being burdened (79.1%) or worried (67.8%) about the COVID-19 crisis. The main themes of parental worry about the COVID-19 crisis included COVID-19 infection (40.6%), economic situation (13.1%), uncertainty (8.4%), lack of social contact with family and friends (8.1%), family health status (7.5%), and school life (7.5%). Mental health symptoms in parents of children with special needs were strongly associated with increased adverse mental health symptoms and health behaviors in their children. Parents of children with special needs were more likely to be depressed during the COVID-19 pandemic than adults in 2019. We call for additional mental health support to reduce the mental health burden in families with children with special needs.

Characterising the Educational Experiences and Mental Health of Children with Pre-Existing Learning Difficulty or Specific Learning Disorder (SLD) during the COVID-19 Pandemic

This prospective study sought to characterise the educational experiences, mental health, and behavioural functioning of Australian children with a pre-existing learning difficulty or specific learning disorder (SLD) during the COVID-19 pandemic. The study also evaluated the potential role of parent psychological distress as a risk factor for poorer child functioning in this high-risk population. Using a prospective longitudinal design, the study involved 58 parents of children and adolescents with a pre-existing learning difficulty or specific learning disorder (M age = 11.9 years; range 7–17 years) who were initially referred to a state-wide diagnostic centre for specific learning disorders in Melbourne, Victoria, Australia. Child outcomes were assessed using the COVID-19 Wellbeing and Mental Health Survey (a modified version of the CoRonavIruS Health Impact Survey [CRISIS] tool), the Strengths and Difficulties Questionnaire (SDQ), and the Emotional Distress Scale from the Patient-Reported Outcomes Measurement Information System (PROMIS). Parents’ mental health was assessed using the CRISIS tool and the Kessler Psychological Distress Scale (K10). In keeping with initial predictions, a large proportion of parents expressed significant disruption to child educational experience and routines, including challenges related to child engagement in remote learning platforms during COVID-19. Compared to pre-pandemic mental health symptom ratings, children experienced significantly higher symptoms of worry, negative thoughts, loneliness, agitation, and aggression during the pandemic period (all p < 0.05). As expected, higher levels of parent distress predicted greater child worry symptoms (p = 0.003) and more frequent child behavioural difficulties (p = 0.004). These results help elucidate the specific psychological and educational challenges faced by children with pre-existing learning difficulty or SLD during the COVID-19 pandemic. Family-centred intervention and/or supports may help to address the unique educational and psychological needs of young people with pre-existing learning differences and their families during future global pandemics.

Comparison of Animation Distraction Versus Local Anesthetic Application for Pain Alleviation in Children Undergoing Intravenous Cannulation: A Randomized Controlled Trial.

Background Medical procedures induce behavioral discomfort, fear, and worry in children and their families, worsening their agony. Reading, playing video games, and watching television lessen anxiety and discomfort. This study aims to compare the pain reduction in children using animation distraction and two percent lignocaine with the control group undergoing intravenous (IV) cannulation using the Visual Analogue Scale (VAS) at a tertiary care hospital inKolenchery, Kerala, South India, and to study the clinico-social factors influencing pain reduction in children undergoing IV cannulation. Materials and methods This is an open-label, randomized controlled trial study of 60 children admitted in a pediatric ward, Intensive Care Unit (ICU), or emergency department randomly assigned to either two percent lignocaine application, animation distraction, or control during intravenous cannulation. Children aged six to twelve years requiring IV cannulation for different illnesses were included. Twenty children were randomly assigned to the lignocaine group, twenty to the distraction group, and twenty to the control group. The visual analogue scale was used to measure the subjective pain intensity of the children during IV cannulation. We did statistical analysis using SPSS software version 21 (IBM Corp., Armonk, NY). Results Age, gender, previous history of cannulation, site, and size of the cannula were not significantly different between the groups. We did not relate the education of the mother to the VAS scores. The mean VAS score for pain at zero, one, and five minutes was lower in the distraction group compared to the lignocaine and control groups. The mean VAS score for pain at zero, one, and five minutes was not superior among the lignocaine group compared to the control group. Conclusion Based on the findings, animation distraction is preferable to lignocaine to alleviate pain in childrenrequiring IV cannulation for a variety of disorders.Distraction is one of the nonpharmacological techniques that seek to alleviate pain by encouraging the patient to focus on something other than the current procedure. In addition to reducing pain and anxiety during excruciating invasive interventions, distraction techniques reduce the number of interventions required and allow for the completion of interventions in less time.

Virtual Reality dalam Menurunkan Kecemasan dan Ketakutan pada Anak Usia Sekolah dan Remaja yang Dirawat

This study aims to identify the effect of virtual reality on the anxiety and fear of school-age children and adolescents when receiving treatment at the hospital. The method used is a systematic review of nine searched articles through the Proquest, Science Direct, Scopus, Pubmed, and Springer Link databases, and through hand searching, with article inclusion criteria using virtual reality interventions involving school-age children and adolescents in hospital settings, published between 2013-2022 in English and Indonesian, can be accessed in full text. The results of the study show that the use of virtual reality can reduce anxiety and fear in school-age children and adolescents who are hospitalized. In conclusion, distraction using virtual reality effectively reduces stress and worry in school-age children and adolescents who are hospitalized, so it can be the intervention of choice for nurses in providing nursing care to manage anxiety and fear.
 
 Keywords: Children, Anxiety, Fear, Hospitals, Virtual Reality

Child and Maternal Mental Health Before and During the COVID-19 Pandemic: Longitudinal Social Inequalities in a Brazilian Birth Cohort

ObjectiveThe coronavirus disease 2019 (COVID-19) pandemic has caused major stress for families and children, particularly in the context of prolonged school closures. Few longitudinal studies are available on young children’s mental health, including data both before and during the pandemic. This study examined experiences that might increase risk for mental health problems among caregivers and young children during the COVID-19 pandemic and inequalities driven by pre-pandemic disadvantage.MethodThis prospective, population-based birth cohort study in Pelotas, Brazil, analyzed 2,083 children and caregivers with data from before the pandemic in 2019, when children were 4 years old, and again in 2020, when schools were closed for a long period during the pandemic. Child conduct problems, emotional problems, and hyperactivity-inattention problems were assessed using the Strengths and Difficulties Questionnaire. Family financial hardship, relationship difficulties, caregiver mental health, parenting practices, and child fears and isolation were considered as potential risk factors.ResultsAcross the whole population, the only significant increase in mental health problems from before to during the pandemic was found for maternal depression. However, poorer families were at far greater risk of experiencing serious financial problems, food shortages, increased conflict in adult relationships, parenting problems, and child worries about food availability during the pandemic. In turn, these difficulties were associated with increases in multiple mental health problems for both caregivers and children. Increased child mental health problems were most strongly associated with concurrent maternal anxiety (b > 0.20, p < .001, for each of child conduct, emotional, and hyperactivity problems), maternal depression (b = 0.26, p < .001, for child emotional problems), partner criticism (b = 0.21, p < .001, for child conduct problems), and harsh parenting (b > 0.20, p < .001, for both child conduct and hyperactivity problems). Child worry about COVID-19 was associated with increased emotional problems (b = 0.14, p < .001), but children’s isolation was not associated with their mental health.ConclusionOverall, the impact of the COVID-19 pandemic on mental health is a mixed picture, but for families in poverty, marked material and interpersonal difficulties were associated with increases in mental health problems among children and caregivers.

Children's anxiety, academic self-efficacy, and intergenerational transmission of worries regarding the transition to middle school.

Worries about school transition were related to poor academic adjustment during middle school. However, limited studies simultaneously investigated individual and contextual factors that may shape the children's reaction related to transition. The first aim of this present study was to assess how children's anxiety and academic self-efficacy, including the parents' worries about school transition, are related to children's worries regarding the transition from primary to middle school. Our second aim was to explore the moderating role of children's academic self-efficacy in the relation to children's anxiety symptoms and children's worries. A sample of 292 fourth-grade children (Mage =10.43; 53.4% girls) completed scales assessing their anxiety, academic self-efficacy and worries about the transition to middle school. Parents also filled out a scale assessing the worries regarding their children's transition from primary to middle school. The results show that children's anxiety is positively related to their worries about the transition to middle school, whereas children's academic self-efficacy is negatively related to their worries. Parents' worries regarding their children's school transition are positively related to their children's worries regarding the transition. Furthermore, academic self-efficacy moderates the relation between children's anxiety and their worries about school transition. Children with lower levels of anxiety reported lower worries for the transition when their academic self-efficacy was higher, whereas children with higher anxiety reported higher worries for school transition at every level of self-efficacy. Theoretical and practical implications of these findings for successful school transition are discussed.

Maternal Worry Socialization and Toddler Inhibited Temperament: Transactional Associations and Stability across Time.

Caregiver socialization of child emotions has consequences for both typical development and anxiety risk, with caregivers’ non-supportive responses to worry perhaps especially salient to children’s anxiety development. Children, in turn, impact the caregiving environment they receive through their temperament. We investigated transactional relations between maternal non-supportive responses to child worry (mother-reported) and two differently-measured child inhibited temperament indices (i.e., mother-perceived child inhibition to novelty, laboratory-observed child dysregulated fear) in a sample of 136 predominantly non-Hispanic, White mother-toddler dyads. Worry socialization and mother-reported inhibition to novelty were measured at each of three time points (toddler age 2, 3, 4 years), and dysregulated fear was measured at ages 2 and 3. Constructs showed stability across time, with effect sizes ranging from medium to large. Child inhibited temperament measures positively correlated within time point at ages 2 and 3, and laboratory-observed child dysregulated fear predicted mothers’ later perceptions of their children’s inhibition to novelty. At toddler age 2, mothers of children showing more dysregulated fear reported responding more non-supportively to worry. However, when controlling for one another, more mother-perceived child inhibition to novelty and less laboratory-observed child dysregulated fear at age 3 predicted mothers’ greater non-supportive worry responses at child age 4. There was an indirect effect across time, such that children’s greater laboratory-observed dysregulated fear predicted their mothers’ heightened perceptions of inhibited temperament, which in turn predicted mothers’ greater non-supportive worry responses. Findings lend support to anxiety-relevant construct stability in toddlerhood, as well as child-elicited, rather than parent-elicited, associations across time.Supplementary informationThe online version contains supplementary material available at 10.1007/s10802-022-00938-w.

Early Evidence of the Interplay between Separation Anxiety Symptoms and COVID-19-Related Worries in a Group of Children Diagnosed with Cancer and Their Mothers.

Having cancer in childhood is a risk factor for separation anxiety symptoms, with negative effects on the disease and psychological wellbeing. The Covid-19-pandemic-related concerns could have a negative effect. The present study explores the interplay between separation anxiety symptoms and COVID-19-related worries in pediatric cancer patients and their mothers, compared to a group of healthy children and their mothers, during the pandemic. Thirty-three subjects with cancer, aged 7–15 years, and their mothers were compared to a control sample of 36 healthy children and caregivers. They were administered a pandemic-related psychological experience survey and standardized questionnaires assessing psychological wellbeing, anxiety, and separation anxiety symptoms. Children with cancer reported significantly higher prosocial behaviors, fear of being alone, and fear of abandonment. Their mothers had worse psychological wellbeing, higher COVID-19 concerns, anxiety, and separation anxiety symptoms. The multiple linear regression model showed that an increase in children’s separation anxiety symptoms was associated with younger age, more recent diagnosis, more mother-child time, lower mothers’ worry for children’s contagion, and higher mothers’ and children’s anxiety. COVID-19-related worries of clinical children’s mothers seem to be protective for children’s psychological wellbeing. Early psychosocial support interventions for mothers are essential in health services for cancer.

The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak.

The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.

Perfectionism and worry in children: The moderating role of mothers’ parenting styles

Perfectionism and worry in children: The moderating role of mothers’ parenting styles

Excess Baggage: Exploring Triggers of Worry and Stress in Young Students

Throughout their primary school years, children are likely to experience feelings of stress or worry, triggered by elements within the school setting. While these terminologies indicate negative connotations, such feelings can differ in consistency and are known to occur when young children respond negatively to situations that are considered problematic. The research study presented in this paper is analysed from a sociological perspective and it examines the triggers of worry and stress in young school children and what form of action is taken by parents in such instances. The insights and opinions of parents regarding how schools can contribute and support such students are also critically examined. Data was gathered from parents with children between the ages of 3 and 8 years through online questionnaires that were analysed qualitatively employing a thematic approach, while quantitative data was used in order to quantify the responses and present demographic information. The findings indicate that the most common causes of worry and stress in young children are linked to social, academic, logistical, and situational factors including, but not limited to, attachment, bullying, changing of teachers, academic load, and online exclusion. Data also suggests that most parents took action when their children expressed feelings of worry or stress; this included the elements of discussions, guidance and reassurance. The findings further revealed that the school staff were rarely informed about such situations, which raises a concern in terms of communication practices between stakeholders.

A Qualitative Investigation of Parent and Child Perceptions of School Food Allergy Policies in the United States.

Many schools implement well-intentioned food allergy policies; however, may not ease parents'/children's worry and concern. The purpose of this study was to (1) explore children's and parents' perceptions their school's food allergy policy and (2) compare these perceptions to the documented school policy. Children ages 8 to 18 with a food allergy and their parents (N=18 pairs) across the US completed one-on-one semi-structured, audio-recorded phone interviews. School food allergy policies were collected from school websites. Content analysis was applied to the transcriptions by two investigators to identify themes among parents and children. Parents and children described policies may impact the child's social and/or emotional well-being. Many opportunities for improvement were provided by parents and children. There is a wide variation in food allergy policies across the schools in this study, and overall, parents and children thought that policy enforcement needs to be improved. With so much variation in food allergy policies in schools coupled with inconsistent enforcement, parents and children may feel unsafe or unsupported by the school. Schools should adopt a team- or whole-school approach to develop and enforce policies that help protect children with food allergies.

Ambulatory assessment of rumination and worry: Capturing perseverative cognitions in children's daily life.

Rumination and worry are common forms of perseverative cognition in children. Research has started to target perseverative cognitions in the everyday life of children, however, valid measurement instruments reliably capturing rumination and worry in children's daily life are still missing. We conducted two ambulatory assessment studies validating short scales suitable for the measurement of rumination and worry in children's daily life. Results of the first study (N = 110, 8-11 year-olds, 31 days, up to 4 daily measurements) supported a unidimensional structure of the rumination scale. Rumination was associated with negative affect (but not positive affect) on the within- and on the between-person level. On the between-person level, children who ruminated more showed poorer working memory performance. In the second study (N = 84, 8-10 year-olds, 21 days, up to 3 daily measurements), findings of Study 1 were largely replicated. Moreover, we established a unidimensional worry scale in Study 2 reliably capturing worry in children's daily life. Importantly, Study 2 showed that worry and rumination share common variance but can be differentiated in children. On the within-person level, higher levels of worry were associated with higher levels of negative affect and lower levels of positive affect. On the between-person level, worry was associated with higher levels of negative affect and lower working memory performance. Altogether, findings of both studies demonstrated that the short scales had excellent psychometric properties suggesting that they are helpful tools for the assessment of rumination and worry in children's daily life.person level, worry was associated with higher levels of negative affect and lower working memory performance. Altogether, findings of both studies demonstrated that the short scales had excellent psychometric properties suggesting that they are helpful tools for the assessment of rumination and worry in children's daily life (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Memahami Lebih Dalam Mengenai Pentingnya Pencegahan Penularan Covid-19 Sejak Usia Dini di TPQ Al-Mubarok

It takes an intensive understanding of the corona virus and how to deal with it so that the spread rate does not increase. Especially early childhood, including those who are vulnerable to the Covid-19 virus because they do not understand how fast this virus spreads and still have an immune system that is vulnerable to the virus. With the Covid-19 virus, it has resulted in children being unable to study at school, so learning activities must also be supported by parents at home and teachers are also responsible for monitoring children's learning activities. This Covid-19 virus also brings fear and worry to children, this is because children do not understand how they understand the virus and how to prevent it. Therefore, it is very important to carry out socialization or education about the prevention of Covid-19 for children -child. Covid-19 prevention education contains the introduction of the Covid-19 virus, how to deal with worry, and how to prevent the Covid-19 virus through short animated videos that are interesting and easy for children to understand, so that children's worries can be reduced and parents will also understand how to teach children to prevent the virus.

Navigating the terrain of moral distress: Experiences of pediatric end-of-life care and bereavement during COVID-19.

Parents of seriously ill children worry about their vulnerable child contracting COVID-19, whether their child's palliative care providers will be able to continue to provide the same quality of care to their child, and who can be with the child to provide comfort. For providers, shifts in healthcare provision, communication formats, and support offerings for families facing distress or loss during the pandemic may promote providers' moral distress. This study aimed to define the ways that the COVID-19 pandemic has impacted end-of-life care and approach to bereavement care in pediatric palliative care (PPC). The Palliative Assessment of Needed DEvelopments and Modifications In the Era of Coronavirus (PANDEMIC) survey was developed to learn about the PPC experience during COVID-19 in the United States. The survey was posted with permission on seven nationally focused Listservs. A total of 207 PPC team members from 80 cities within 39 states and the District of Columbia participated. In the majority of hospitals, admitted pediatric patients were only allowed one parent as a visitor with the exception of both parents or nuclear family at end of life. Creative alternatives to grief support and traditional funeral services were described. The high incidence of respondents' depicted moral distress was often focused on an inability to provide a desired level of care due to existing rules and policies and bearing witness to patient and family suffering enhanced by the pandemic. The COVID-19 pandemic has had a profound impact on the provision of end-of-life care and bereavement for children, family caregivers, and PPC providers. Our results identify tangible limitations of restricted personal contact and the pain of watching families stumble through a stunted grieving process. It is imperative that we find solutions for future global challenges and to foster solidarity in PPC.

The Effectiveness of Nerve Activation for Special Needs Children Who are Addictive to Gadget During Pandemic

The Covid-19 pandemic that occurred has resulted in changes in several aspects of human life, including education and therapy. The closure of therapy and school is enough to make parents who have special needs children worry about their child's development. As a result, many special need children developments are slowing down or even stooped. Even a lot of them are addicted to gadget because they cannot be asked to do other activities and they also feeling bored at home. So eventually, many parents give gadget to their children so that they can be controlled. Their children also expressing tantrum if they are not given gadget to play. Parents are hoping that during the pandemic, in which they have to stay home long enough, they can also help their children and see the significant development of their children. A natural way that can aid the brain become actively re-integrated is by activation of the nerves. Nerve activation is a consolidation of an assortment of simple movements and light massage integrated into the head and inside the mouth. This movement and massage can be executed passively or actively. Some of this nerve activation movement is simple and can be consummated at home. Massage at home can only be done to patients that had been nerve activated before in the clinic before the pandemic occur. The categories of patients in this case are aged 3 to 5 years, experiencing speech delays and concentration disorders, have never tried any therapy. Parents can see significant progress in their children as long as they perform routine massage every day with duration of 30 minutes. Significant developments are seen in several areas: self-controls, concentration, language, academic understanding and socialization.

Sleep in Hospitalized Children With Cancer: A Cross-Sectional Study.

Many children with cancer have repeated and prolonged hospitalizations, and in-hospital sleep disruption may negatively affect outcomes. Our objective for this study was to characterize sleep quality and quantity in hospitalized children with cancer by using parental surveys and actigraphy, to evaluate the association between subjective and objective sleep measures, and to describe hospital-associated risk factors related to poor sleep. Cross-sectional study of children aged 0 to 18 years old admitted to a pediatric oncology ward. Parents completed a baseline sleep questionnaire describing their child's sleep at home before hospitalization, followed by daily questionnaires describing their child's sleep for up to 3 nights while in the hospital. A subgroup of children aged 5 to 18 years wore actigraphs during the same time period. Demographic and clinical data were extracted from the electronic medical record. The primary outcome was inadequate sleep, defined by the total sleep duration adjusted for age. Among 56 participants over 135 hospital nights, 66% (n = 37) reported inadequate sleep. Actigraphy was completed on 39 nights (29%), with a median total sleep time of 477 (interquartile range 407-557) minutes. There was a strong correlation between subjective questionnaire measures and actigraphic measures (r = 0.76). No patient-specific demographic factors were related to inadequate sleep. A multivariable model indicated the following hospital-related factors were associated with inadequate sleep: noise (adjusted odds ratio [aOR] 3.0; confidence interval [CI] 1.2-7.7), alarms (aOR 3.1; CI 1.2-8.3), child's worries (aOR 2.8; CI 1.1-7.2), and receipt of benzodiazepines (aOR 2.9; CI 1.2-7.5). A majority of children experienced inadequate sleep during hospitalization. Subjective report of sleep duration correlated well with objective measures of sleep by actigraphy. Several potentially modifiable factors were independently associated with poor sleep. Further interventional studies are required to test approaches to optimize sleep in hospitalized children with cancer.