Daily Functioning Of Children Research Articles

Teaching in Hospitals and Healthcare Resorts: A Qualitative Study of Teachers’ Needs

The daily functioning of children who suffer from chronic conditions may be limited by the disease and by hospitalization. Hospital schools have an important role in counterbalancing those negative effects. The aim of the study was to define hospital schools’ teachers’ needs. The data from qualitative research conducted on 21 Polish hospital school teachers was included in the analysis. A semi-structured interview method was chosen. Researchers played an active role as moderators. Thirty-four descriptive codes were assigned to the main five areas of needs related to: work conditions, the character of work, psychological support, self-fulfillment, and social relations. The results showed that the teachers were concerned about hospital school marginalization, they received no mental health support, and felt that the extent of their role was underestimated by medical staff. The lack of recognition is likely to make teachers feel frustrated, and demotivated. By learning more about what hospital teachers think of their work, it is possible to create recommendations for changes. There seems to be a need to raise awareness of the importance of schools in health care institutions.

Rumination, Catastrophizing, and Other-Blame: The Cognitive-Emotional Regulation Strategies Involved in Anxiety-Related Life Interference in Anxious Children.

Childhood anxiety problems have a great impact on the daily functioning of children and their families. The first objective of this study was to compare whether the use of cognitive-emotional regulation strategies differs in children with and without anxious symptomatology. A second objective was to analyze the possible mediating role of regulation strategies in the relationship between the presence of anxious symptomatology and its subsequent interference in children's lives. In total, 315 children (53.7% boys) between 8 and 12years old participated. Mann-Whitney-Wilcoxon U-test was used to analyze differences in the use of cognitive-emotional regulation strategies between children with and without anxious symptomatology. In order to identify the cognitive-emotional regulation strategies which mediate the relation between anxiety and the consequent interference in children's lives, mediation analyses were carried out. As expected, children with anxious symptomatology used more maladaptive regulatory strategies than those without such symptomatology. Multiple mediation models in parallel showed that catastrophizing, rumination, and other-blame mediated the relationship between anxiety problems and their consequent interference. The identification of functional or dysfunctional patterns of cognitive-emotion regulation may favor the inclusion of new components in the evidence-based interventions currently available, in an attempt to increase rates of remission of anxiety.

Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy

BackgroundCerebral palsy (CP) is frequently associated with specific cognitive impairments, such as executive dysfunction which are related to participation and quality of life (QOL). The proposed study will examine whether a computerized executive function (EF) training programme could provide superior benefits for executive functioning, participation, QOL and brain plasticity, as compared to usual care.MethodsA single-blind randomized controlled trial (RCT) design will be performed. Thirty children with CP aged 8 to 12 years will participate in a home-based computerized multi-modal executive training programme (12 weeks, 5 days a week, 30 min a day training, total dose = 30 h). Thirty children with CP matched by age, sex, motor and intelligence quotient (IQ) will compose the waitlist group. Cognitive, behavioural, emotional, participation and QOL measures will be obtained at three time points: before, immediately after and 9 months after completing the training. Additionally, structural and functional (resting state) magnetic resonance images (MRI) will be obtained in a subsample of 15 children from each group. Outcomes between groups will be compared following standard principles for RCTs.DiscussionThe study will test whether the cognitive training programme exerts a positive effect not only on neuropsychological and daily functioning of children with CP but also on other measures such as participation and QOL. We will also use brain MRI to test brain functional and structural changes after the intervention.If this on-line and home-based training programme proves effective, it could be a cost-effective intervention with short- and long-term effects on EF, participation or QOL in CP.Trial registrationClinicalTrials.gov: NCT04025749. Registered 19 July 2019. Retrospectively registered.

Marfan syndrome in childhood: parents\u2019 perspectives of the impact on daily functioning of children, parents and family; a qualitative study

BackgroundMarfan syndrome (MFS) is a heritable connective tissue disease caused by a defect in FBN1. The diagnosis is based on the revised Ghent criteria. The main features involve the cardiovascular, musculoskeletal, ophthalmic, pulmonary systems and facial features. Although the clinical manifestations of MFS in children are thoroughly addressed in several studies, literature on the impact of MFS on daily functioning is restricted to pediatric advice on sports and leisure participation. Therefore, the full impact of MFS on daily functioning remains unclear. The aim of this qualitative study was to explore parents’ perspectives on the impact of MFS on daily functioning of children with MFS aged 4–12 years, themselves and family regarding functional performance, activities, participation, personal and environmental factors, and disease burden.MethodsIn this qualitative study parents participated in individual semi-structured interviews (n = 10) and 3 focus groups (n = 5, n = 5 and n = 6). Meetings were transcribed, and data were analyzed using thematic analysis. Meaningful concepts were coded, and concepts concerning children with MFS were linked to the International Classification of Functioning, Disability and Health for Children and Youth. Thereafter themes were identified and interpreted.ResultsParents reported their children could not keep up with peers because of fatigue, pain and physical impairments. Children experienced participation restrictions in school, sports, play and other leisure activities. Parents reported their child as being different due to physical appearance, which provoked unsupportive attitudes. Parental burden was caused by high care needs, lack of support, a limited social life, and concerns about the child’s development. Family burden was caused by adjusted and complex family schedules, other family members with MFS, and reproductive planning decision-making, whereas family cohesiveness and caring were positively perceived factors.ConclusionsParents perceived a large impact of MFS on daily functioning of their children with MFS, themselves and their family. More awareness among all professionals involved in the care of children with MFS and their families is needed so that professionals can address their support needs and provide tailored interventions, rehabilitation and/or educational programs to empower and improve daily functioning of the children, parents and family.

Comparison of Efficacy and Tolerability of Modified Release Methylphenidate, Osmotic-Release Methylphenidate and Atomoxetine in Children with Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder (ADHD) is a common psychiatric condition that affects the daily functioning of children, adolescents, and adults. In this study, we aim to determine the efficacy and tolerability of medications that frequently use in the treatment of ADHD. Materials and Methods: 204 primary school-age children with documented DSM-5 ADHD diagnosis were included. Clinical characteristics of the sample were obtained from the medical records and structured psychiatric interviews. Improvement and side effects were assessed with the Clinical Global Impression-Improvement Scale (CGI-I) and the adverse effect scale developed by the authors, respectively. Results: Mean age of the patients was 8.32±1.15 and 67.1% of the patients were male. 33.3% of the patients were using modified-release methylphenidate, 35.3% were using osmotic-release methylphenidate, and 31.4% were using Atomoxetine. The CGI-I was significantly different between the three groups (p=0.012). There was no significance in terms of treatment compliance. Sleep disturbances, appetite, and sadness were different between the groups. Conclusion: Atomoxetine seems to be less effective and has fewer side effects than modified-release methylphenidate and osmotic-release methylphenidate. Modified release methylphenidate and osmotic-release methylphenidate appear to show similar effectiveness. Osmotic release methylphenidate may be associated with more and severe side effects.

Making sense of it all: The impact of sensory processing sensitivity on daily functioning of children

Previous research on sensory processing sensitivity and related concepts showed an association with internalizing problems. The current explorative study investigated the underlying factor structure of the parent-report Highly Sensitive Person Scale (HSPS) and its association with problems in daily functioning. Caregivers of 235 children (3–16years) completed the HSPS as well as questions on daily functioning. First, the factor structure of the HSPS was explored and evaluated. Second, both differences in reported problems between a high SPS and a control group, and in SPS factors between children with few versus many problems, were examined. Results suggested that the scores of the HSPS have good internal consistency and supported a two-factor structure which distinguishes Overreaction to Stimuli (OS) and Depth of Processing (DP). Children with high SPS were reported to have more internalizing problems. High OS was more common in children who cried excessively as a baby, children with medically unexplained physical symptoms (MUPS), sleeping, eating and drinking problems while high DP was more common in children with MUPS and sleeping problems. This study provides the first empirical evidence that the parent-report HSPS may add valuable information to the assessment of children with problems in daily functioning.

Concerns expressed by parents of children with pervasive developmental disorders for different time periods of the day: a case-control study.

Background/AimThe Questionnaire: Children with Difficulties (QCD) is a parent-assessed questionnaire designed to evaluate child’s difficulties in functioning during specific periods of the day. This study aimed to evaluate difficulties in daily functioning of children and adolescents with pervasive developmental disorder (PDD) using the QCD. Results were compared with those for a community sample.MethodsA case–control design was used. The cases comprised elementary school students (182 males, 51 females) and junior high school students (100 males, 39 females) with PDD, whereas a community sample of elementary school students (568 males, 579 females) and junior high school students (180 males, 183 females) was enrolled as controls. Their behavior was assessed using the QCD, the Tokyo Autistic Behavior Scale (TABS), the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI) for elementary and junior high school students, respectively. Effects of gender and diagnosis on the QCD scores were analyzed. Correlation coefficients between QCD and TABS, ADHD-RS, and ODBI scores were analyzed.ResultsThe QCD scores for the children with PDD were significantly lower compared with those from the community sample (P < 0.001). Significantly strong correlations were observed in more areas of the ADHD-RS and ODBI scores compared with the TABS scores.ConclusionsChildren with PDD experienced greater difficulties in completing basic daily activities; moreover, their QCD scores revealed stronger associations with their ADHD-RS and ODBI scores in comparison with their TABS scores. The difficulties of PDD, ADHD and OBDI symptoms combined in children makes it necessary to assess all diagnoses before any therapy for PDD is initiated in order to be able to evaluate its results properly.

Daily Functioning Problems in Children with Cerebral Palsy (CP) Aged 5 and More

Introduction. Children with CP struggle with various problems in daily living due to diverse symptomatology which accompanies the central nervous system (CNS) damage. The problems concern both basic self-care activities like dressing, grooming or bathing as well as more complicated activities like reading or social interactions — starting and maintaining relationships.Aim. This study aims to identify and present daily living problems experienced by the children with CP aged 5 or more.Material and Methods. The study was conducted among a group of 130 randomly selected participants, 50 participants were children with CP aged 5–19 and 80 participants were their parents. The author’s self-designed questionnaire was used to collect data in the study. Results. Analysis of the collected data shows that:— according to surveyed parents the most common disorders characteristic for their children are: visual disturbance (75%), speech disorder (65%) and intellectual disability (65%),— one fourth of children with CP are non-ambulant, wheelchair provides independent mobility for the children or they require personal assistance from another person,— problems with balance in vertical position are the most problematic limitation in daily living for the group of surveyed children (68%).Conclusions.1. Children with CP struggle with various problems concerning daily living functioning.2. Small percentage of children with CP are able to move independently.3. Majority of children with CP are not able to function independently due to the disorders resulting from the brain damage.4. Management of associated conditions through motor rehabilitation has improved mobility and motor skills in daily functioning of children with CP. (JNNN 2014;3(2):52–57)

Children receiving treatment for cancer and their caregivers: A mixed methods study of their sleep characteristics

Sleep has a significant impact on the daily functioning of children and their parents. The purpose of this study was to describe and gain an understanding of the sleep characteristics of children receiving treatment for cancer and their caregivers using a mixed methods concurrent triangulation design. Data were collected from questionnaires completed by 35 caregivers of children receiving treatment for cancer and compared to similar data from 64 caregivers of healthy children. There was considerable variability in the sleep characteristics of the children receiving treatment for cancer as reported by their caregivers. However, as a group, the magnitude of their sleep problems, particularly among the adolescents, was significantly greater than that of the comparison group and had the potential to impact negatively on their participation in everyday life. They had poorer sleep efficiency. Many impairments, particularly pain, nightmares, and symptoms associated with steroid administration, impacted their sleep. Their caregivers also experienced an increased prevalence of sleep issues, which impacted their daytime functioning. Suggestions to prevent and treat the sleep issues of children receiving treatment for cancer focused on practicing good sleep habits, ensuring a safe, secure, and comfortable sleep environment, and using non-pharmaceutical and pharmaceutical interventions to address impairments interfering with sleep. Caregivers noted that it was important to take care of themselves by getting sufficient sleep and accepting help from others. Sleep issues are prevalent in families of children receiving treatment for cancer and should be assessed routinely and addressed.

Psychometric qualities of questionnaires for the assessment of otitis media impact

The assessment of impact and evaluation of treatment effects in chronic otitis media (OM) calls for a much broader approach than just examining the presence of middle ear effusion or hearing loss. It is increasingly recognised that this condition may result in a comprised quality of life. Several studies have used proxy completed questionnaires to objectify the illness experience associated with chronic OM. To review questionnaires which have been developed to describe the effects of chronic OM on the daily functioning of children. Psychometric properties have been evaluated, in addition to discriminative and evaluative qualities. A systematic review of publications pertaining to developed questionnaires related with chronic OM. Systematic literature searches of PubMed (1966-January 2007) and EMBASE (1989-January 2007) were conducted, supplemented by using free text words to identify publications after January 2005. The included 15 questionnaires were developed for children with recurrent or persistent OM, describing functional health status (FHS), while two questionnaires also evaluate the effect of tympanostomy tubes insertion. The questionnaires generally cover six impact areas (physical symptoms, child development, educational performance, emotional/practical burden and general health status) with physical symptoms being the most prominant. The OM8-30, OMO-22 and OM-6 adequately reflect the multidimensional aspects of FHS in chronic OM. The OMO-22 and OM8-30 show the best psychometric properties for the discrimination of impact severity between children, while the OM-6 was found to have the best qualities for the evaluation of clinical change. Clinical applicability is crucial for the assessment of FHS in chronic OM, but requires a trade-off with necessary psychometric properties.

Sleep Issues in Children with Physical Disabilities and Their Families

Sleep has a significant impact on the daily functioning of children and their parents. The purpose of this study was to describe the sleep patterns, issues, and strategies used to facilitate sleep in children with and without physical disabilities and their families. Data were collected from questionnaires completed by caregivers and siblings. Caregivers of children with physical disabilities reported significantly greater concerns regarding general sleep problems, safety, and discomfort at night, night wakening, daytime irritability, interference with daytime activities and sleep-related health concerns in children with physical disabilities than in their counterparts. Caregivers, but not siblings, in families of children with physical disabilities experienced an increased prevalence of sleep issues. The most frequently cited strategies to alleviate problems were the establishment of consistent routines and provision of calming, supportive sleep environments. Pediatric therapists need to assess and address sleep issues to promote the well-being of children and their families.