High Parental Satisfaction Research Articles

Feasibility of Implementing a Modified SENSE Program to Increase Positive Sensory Experiences for Preterm Infants in the Neonatal Intensive Care Unit (NICU): A Pilot Study

Aims To evaluate the feasibility of implementing the Supporting and Enhancing NICU Sensory Experiences (SENSE) program with adaptations to increase positive sensory exposure for infants born preterm, support neonatal neurodevelopment, and decrease parent stress. Methods Eight infants born between 28 and 33 weeks were recruited within one week of birth. Parents, trained in the program, delivered the SENSE protocol. The first author provided up to 1 h of sensory input on weekdays when a parent could not be present. Results Recruitment and retention rates were 87.5% and 100%, respectively. Recruitment and initial parent education and training averaged 37.5 min. On average, parents were present in the NICU 85.1% of days; they participated in SENSE for an average of 515.5 min. SENSE dose recommendations were not consistently met. Weekly infant assessments and regular parent check ins averaged 22.5 and 13.8 min, respectively. Post-assessments revealed normal scores on a neurodevelopmental assessment, low parent stress, and high parent satisfaction. Conclusions The recruitment and retention rates suggest high demand to participate. Outcomes for parent stress and neonatal neurodevelopment support continuation of SENSE. Time commitment for implementation, coupled with supporting families in meeting dose recommendations, suggest a need for a neonatal therapist to promote sustainability.

QS67. Non-surgical Correction of Congenital Ear Deformities: The Relationship Between Age of Presentation and Regression

Purpose: After 3 weeks of age, studies show ear molding to be unsuccessful due to increased regression rates. Studies have not differentiated success rates based on regression severity; partial regressions may be deemed successful and satisfactory by parents. We examined successful ear molding at different ages of presentation by measuring regression severity and parental satisfaction. Methods: Patients who presented to clinic for ear molding from January 2017 to October 2018 were eligible for inclusion. Molds were applied on the initial visit and monitored biweekly. Treatment length was based on age, deformity type and severity. One month after treatment completion, parents completed a satisfaction survey where they assessed regression on a three-point severity scale. Results: 165 patients were included in this study. 67 were less than three weeks of age and had an overall correction rate of 95%. The complete correction rate was 80% and only 5% saw complete regression. In the remaining 98, the overall correction rate was 94%, with a 63% complete correction rate. Only 6% percent saw complete regression. There was no statistical significance in parental satisfaction, perceived improvement, or likelihood to recommend ear molding between age groups. Conclusion: Regression rates are higher in children older than three weeks although not statistically significant. Most regressions were partial and ear molding still significantly corrected most deformities. We suggest that ear molding be offered past three weeks of age, with maximum age being dependent on deformity type, as it still leads to high parental satisfaction.

Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision.

Objective To assess the efficacy of dexmedetomidine anesthesia plus dorsal penile nerve block in pediatric circumcision. Methods In this retrospective study, 80 children receiving circumcision in our hospital from February 2020 to February 2021 were recruited and assigned via different anesthesia methods at a ratio of 1 : 1 to receive dorsal penile nerve block plus dexmedetomidine anesthesia (combined anesthesia group) or only sevoflurane for total inhalational anesthesia (total anesthesia group). Traditional Chinese medicine (TCM) care was introduced to both groups of patients. Outcome measures included vital signs, operative indices, anesthesia effect, adverse reactions, parent satisfaction, and nursing satisfaction. Results There were no significant differences in the heart rate, oxygen saturation, and mean arterial pressure between the two groups of children before anesthesia, after anesthesia, and during the awakening period (P > 0.05). Patients receiving combined anesthesia showed a shorter time lapse before the disappearance of eyelash reflex, longer time lapse before postoperative analgesic use, faster awakening, and shorter operation time and hospital stay versus those receiving total inhalational anesthesia alone (P > 0.05). The combined anesthesia resulted in a lower Induction Compliance Checklist (ICC) score, McGill score, and Richmond Agitation-Sedation Scale (RASS) score and a higher Ramsay score versus total anesthesia (P > 0.05). Patients receiving combined anesthesia showed a significantly lower incidence of adverse events (5.00% (2/40)) versus total inhalational anesthesia (62.50% (25/40)) (X2 = 29.574, P > 0.05). The combined anesthesia group had a higher parent satisfaction (92.50% (37/40)) versus the total anesthesia group (75.00% (30/40)) (X2 = 4.501, P > 0.05). A total of 80 questionnaires were distributed, with a 100% return rate and a 100% validity rate, and all 80 questionnaires scored 90 points or above. The families of children in both groups were satisfied with the quality of TCM care. Conclusion The efficacy of dorsal penile nerve block plus dexmedetomidine anesthesia in pediatric circumcision is better than total inhalational anesthesia with sevoflurane.

61 Use of Ketamine Sedation for the Treatment of Minor Plastic Surgery Procedures in the Paediatric Emergency Department

Abstract Aim To determine if ketamine sedation is a safe and cost-effective way of treating paediatric patients presenting with minor injuries, requiring plastic surgery procedures, in the emergency department. Method A retrospective cohort study was carried out over a 9-month period in children between ages 18 months and 16 years old, presenting to the paediatric emergency department at Chelsea and Westminster Hospital with minor injuries requiring plastic surgery input. The data collected included previously validated co-primary outcome measures of surgical site infection at 7 days and cosmetic appearance summary score at a minimum of 4 months. Parental satisfaction surveys were completed at 4 months to assess perceived quality of treatment. A cost analysis comparison against procedures completed under general anaesthetic was also undertaken. Results During the 9-month period of study, 24 minor procedures were performed under ketamine in the paediatric emergency department. There were no serious adverse events recorded. Three cases exceeded the recommended 20-minute maximum procedure duration, but there was no associated adverse outcome. No cases required further procedures under general anaesthesia and there were no cases of surgical site infections at 7 days. Parents reported extremely favourable outcomes using this technique, with an average overall satisfaction score of 9.2 (assessed over a number of parameters, where 10 is complete satisfaction). Conclusions Ketamine procedural sedation in the paediatric population is a safe and cost-effective method for the treatment of minor plastic surgery procedures, with low risk for surgical site infection post-operatively, and high parent satisfaction rates

An Objective Assessment and Comparison of the Cosmetic Outcome: Parental Perspective after Tubularized Incised Plate Urethroplasty with Foreskin Reconstruction and Circumcision.

We aimed to evaluate the parents' view of the cosmetic outcome after hypospadias surgery. Between January 2017 and December 2020, 70 patients aged between 2 and 7 years underwent surgical correction of hypospadias. Group 1 had 35 patients (coronal: 6, distal: 19, and mid-penile: 10) assigned for tubularized incised plate urethroplasty (TIPU) with modified foreskin reconstruction. Group 2 had 35 patients (coronal: 4, distal: 22, and mid-penile: 9) assigned for TIPU and circumcision. Parents were assessed with the Pediatric Penile Perception Score (PPPS). Parent satisfaction for the position and shape of the urethral opening, shape of the glans, penile skin, and length exhibited no statistically relevant difference between the group. Parent satisfaction with the appearance of the genitals in Group 1 was relatively high 2.60 ± 0.55, as compared to Group 2 1.77 ± 0.49 which is statistically significant (P < 0.00028). Our experience shows good early cosmetic results of foreskin reconstruction and high parental satisfaction. Foreskin reconstruction should constitute a key element of the final result to restore a penis with an appearance as normal as possible.

Developing a standardized approach to prenatal counseling following the diagnosis of a complex congenital heart abnormality

• Pediatric cardiologist provides couples with information, guidance and support. • Standardized counseling leads to high parental satisfaction with the counseling process. • Standardized counseling is associated with high cardiologists ability to predict parental decision.

A Nonrandomized Pilot of a Group, Video-Based Telehealth Intervention to Reduce Diabetes Distress in Parents of Youth With Type 1 Diabetes Mellitus

ObjectivesOur aim in this study was to refine and pilot a video-based telehealth intervention to reduce diabetes distress, depressive symptoms and hypoglycemia fear in parents of school-age children with type 1 diabetes and to assess for changes in child glycated hemoglobin (A1C). MethodsWe recruited 41 parents of children (5 to 12 years) to participate in a manualized, video-based telehealth intervention (Cognitive Adaptions to Reduce Emotional Stress [CARES]). Of these, 29 parents completed either a 12-week (n=13) or 8-week (n=16) version of CARES based on the timing of their recruitment. We assessed feasibility (i.e. attrition, attendance) and parent satisfaction with CARES. We used repeated-measures analysis of variance with parent group (8 vs 12 sessions) as a between-subject variable and time as a within-subject variable to measure change in our dependent variables. ResultsMostly mothers participated (97.3%). Parents’ mean age was 39.65±6.84 years and children’s mean age was 9.86±1.57 years at pretreatment. CARES had low attrition (20% to 25%) and good attendance (96% to 98%). Parents also reported high levels of treatment satisfaction (>85%). There were significant main effects for time for parent-reported diabetes distress and depressive symptoms at posttreatment and 3-month follow-up. There was a statistical trend suggesting a time × group interaction for parent depressive symptoms at posttreatment. There was a significant main effect for time for hypoglycemia fear at the 3-month follow-up but no change at posttreatment. There was no change in child A1C at posttreatment. ConclusionCARES showed high parent satisfaction, good feasibility and promising results for reducing diabetes distress in parents of school-age children with type 1 diabetes.

Commentary: Getting kids what they need, where they are, when they need it: home-based services in a continuum of care - a commentary on Boege etal. (2021).

In this edition of CAMH, Boege and colleague's 4-year follow-up study supports intensive home-based treatment as a viable alternative to inpatient hospitalization. Youth receiving home-based multimodal treatment fared just as well as those who remained hospitalized longer, with higher parental satisfaction. This study contributes to a sparse evidence base regarding longitudinal outcomes of psychiatric inpatient and intensive outpatient treatments for children and adolescents. Although mental illness is prevalent and increasing among youth, existing systems of care are often inadequate to provide flexible, effective, interdisciplinary team-based treatments, and supports for children and their families. Innovative approaches to providing evidence-based care and tracking outcomes are needed to strengthen the continuum of care.

Development and psychometric evaluation of the CO-PARTNER tool for collaboration and parent participation in neonatal care.

Active parent participation in neonatal care and collaboration between parents and professionals during infant hospitalization in the neonatal intensive care unit (NICU) is beneficial for infants and their parents. A tool is needed to support parents and to study the effects and implementation of parent-partnered models of neonatal care. We developed and psychometrically evaluated a tool measuring active parent participation and collaboration in neonatal care within six domains: Daily Care, Medical Care, Acquiring Information, Parent Advocacy, Time Spent with Infant and Closeness and Comforting the Infant. Items were generated in focus group discussions and in-depth interviews with professionals and parents. The tool was completed at NICU-discharge by 306 parents (174 mothers and 132 fathers) of preterm infants. Subsequently, we studied structural validity with confirmatory factor analysis (CFA), construct validity, using the Average Variance Extracted and Heterotrait-Monotrait ratio of correlations, and hypothesis testing with correlations and univariate linear regression. For internal consistency we calculated composite reliability (CR). We performed multiple imputations by chained equations for missing data. A 31 item tool for parent participation and collaboration in neonatal care was developed. CFA revealed high factor loadings of items within each domain. Internal consistency was 0.558 to 0.938. Convergent validity and discriminant validity were strong. Higher scores correlated with less parent depressive symptoms (r = -0.141, 95%CI -0.240; -0.029, p = 0.0141), less impaired parent-infant bonding (r = -0.196, 95%CI -0.302; -0.056, p<0.0001), higher parent self-efficacy (r = 0.228, 95%CI 0.117; 0.332, p<0.0001), and higher parent satisfaction (r = 0.197, 95%CI 0.090; 0.308, p = 0.001). Parents in a family integrated care model had higher scores than in standard care (beta 6.020, 95%CI 4.144; 7.895, p<0.0001) and mothers scored higher than fathers (beta 2.103,95%CI 0.084; 4.121, p = 0.041). The CO-PARTNER tool explicitly measures parents' participation and collaboration with professionals in neonatal care incorporating their unique roles in care provision, leadership, and connection to their infant. The tool consists of 31 items within six domains with good face, content, construct and structural validity.

Quality improvement by introduction of 72-hour admission pathway in Forest House Adolescent Unit (FHAU) for young people in crisis

AimsShort admissions for crisis management among young people suffering with Emotionally Unstable Personality Disorder (EUPD) as recommended in National Institute for Health and Care Excellence (NICE) 2009 guidelines are not routinely offered in the United Kingdom (UK). Our aim was to introduce crisis admissions lasting for 72 hours. During this brief admission the families of young people presenting with suicidal behaviour are offered an assessment and diagnosis of young person's difficulties, psychoeducation, and safety plan for future risky behaviour, in addition to respite.BackgroundThree-day Crisis admission was set up with the aim of reducing inappropriate long admissions in people who may have more negative effects from admission than positive ones. A need was felt for a brief admission pathway in order to be able to provide treatment for patients suffering from EUPD traits in keeping with NICE guidelines. NICE guidelines suggest that people with borderline personality disorder should be considered for acute psychiatric inpatient admission only for the management of crises involving significant risk to self or others that cannot be managed by other services. The guidelines also recommend ensuring that the decision is based on an explicit and joint understanding of the potential benefits and likely harm that may result from admission and agreeing to the length and purpose of the admission in advance.MethodA retrospective study comparing length of hospital stay in the 2018 (when this model was introduced) with previous years, the number of serious incidents was carried out to assess the impact of this new admission model. The rate of readmissions in the same year was also assessed. For qualitative feedback regarding the effectiveness of the crisis admission as an intervention, a survey was carried out to assess parent satisfaction and the nursing staff was asked for their views.ResultThere was a marked reduction in the number of serious incidents linked to suicide and length of hospital stay was reduced to half in the year when the crisis admissions were introduced as compared to the previous year. Only about 10-15% of patients required re-admission in the same year. About 90% of parents gave a positive feedback confirming the effectiveness of this intervention.Conclusion72-hour crisis admissions for adolescents are effective, appropriate, clinically indicated alternative to routine admissions with a high parent satisfaction.

Understanding key worker experiences at an Australian Early Childhood Intervention Service.

The delivery of family-centred practice (FCP) within Early Childhood Intervention Services (ECISs) for young children with a disability or development delay conceptualises that children's learning environments, parenting, family and community supports intersect to have the greatest impact on the developing child. The transdisciplinary key worker model is considered a best-practice approach within ECISs whereby staff work collaboratively across disciplinary boundaries to plan and implement services for children and their families. Research suggests families who have a key worker have better relationships with services, fewer unmet needs, better morale, more information about services, higher parental satisfaction and more parental involvement than those not receiving this service. Using a phenomenological qualitative design this study sought to understand transdisciplinary key workers' perspectives regarding the strengths and challenges to undertaking their role in providing services to children and families accessing an ECIS at a major disability service organisation, in light of the changing policy reform during the roll out of the National Disability Insurance Scheme in Australia. Purposive sampling was used to recruit key workers (n=13) to participate in semi-structured interviews during 2015. Data were analysed using an inductive, thematic approach. Results revealed four main themes that impact on the effectiveness of key workers' service provision. These are broadly categorised as (a) Engagement with the workplace, (b) Engagement with clients, (c) Professional capacity and (d) Staff Wellbeing. The findings aligned with previous studies identifying sources of support and stress for disability services staff. They also provided new insights into key workers' lack of confidence in addressing parental mental health issues, despite operating under a family-centred approach. These findings informed the development of an intervention trial and evaluation to improve support for parent and staff wellbeing within a Victorian Disability Service with the aim of building their capacity to support children with a disability.

An Analysis of Safety and Efficacy of Day-care Surgery in Children in a Tertiary Care Hospital in India.

Background:Advances in surgery and anesthesia have paved the way for the establishment of day-care surgery (DCS). Observations that children achieve better convalescence in the home environment along with significant economic advantages have led to this paradigm shift in clinical practice.Aims and Objectives:This study is aimed to evaluate the feasibility of performing various surgical procedures on day-care basis and assess parental satisfaction with DCS in children.Materials and Methods:In this prospective observational study, all children >3 months of age undergoing various elective surgical procedures as day-care cases in our institution were enrolled. Types of operations, complications, including any unplanned admissions and parental satisfaction, were recorded.Results:Between December 2015 and December 2018, a total of 654 day-care surgeries were performed in our institution by pediatric surgeons. The mean age was 5.5 years with M: F 5.5:1. Thirty different surgical procedures were successfully performed as DCS, the common procedures being inguinal herniotomy (31.5%), and orchidopexy (14.3%). Unplanned admissions were recorded in 2.29% (15/654) patients (scrotal edema-5, postoperative pain-8, and a long recovery from anesthesia-2). No major complications occurred; two minor complications during follow-up were superficial wound infection and drug reaction. Overall parental satisfaction was very high (100%)-preoperative prolonged fasting period and long waiting time in the preoperative room of afternoon shift patients (7.95% and 8.3%) were the reasons for their discontent.Conclusions:DCS in children is safe and effective with high parental satisfaction. It can substantially reduce the waiting list for several surgical procedures in children.

Do Parents Expect Too Much or is it All About Grades? The Discrepancy between Parents' Aspirations and Child's Academic Performance, and Parental Satisfaction with the School

Schooling is related to health and future labor market outcomes. The school parents choose for their children often depends on feedback received from other parents. Therefore it is important to understand whether parental satisfaction with the school depends only on objective measures of the quality of the school. We examine the association between children's academic performance, parents' aspirations, the mismatch between the two, and parents' satisfaction with different aspects of children's schooling. The findings suggest that excellent academic performance of the child is associated with higher parental satisfaction, regardless of parents' aspirations. High expectations accompanied by low performance are negatively related to parental satisfaction with all aspects of children's schooling. The results have implications related to school rankings and the significance of parental school reviews.

Paediatric dental-oral medicine clinic: management during COVID 19

Introduction: Minimising spread of the COVID-19 infection through reducing face-to-face consults is essential. In doing so, alternative assessment and communication methods for management of patients with oral conditions should be considered. Material and methods: Patients on the waiting list for the joint oral medicine-paediatric dental clinic between March and June 2020 were prioritised based on a criteria including relevant medical history, diagnosis and clinical need and current management − monitoring, topical therapy or systemic therapy. A telephone consult method was chosen to assess and follow up patients and a parental satisfaction questionnaire was conducted following telephone consult. Results: Recurrent aphthous stomatitis (RAS) was the most common diagnosis of patients reviewed on the telephone clinic. Overall, the patient satisfaction questionnaire revealed that 100% of respondents would prefer a telephone consult during COVID-19 rather than face-to-face appointments. 74% opted for a video consult in preference to a telephone consult. Conclusion: This service evaluation has found telephone consults to be a valuable alternative to face-to-face consults in the management of patients with chronic oral mucosal diseases. Telephone consultations have high parental satisfaction and are an effective, convenient method to assess and follow up patients whilst maintaining their safety during the COVID-19 pandemic.

Evaluating Ceftriaxone 80 mg/kg Administration by Rapid Intravenous Infusion-A Clinical Service Evaluation.

In pediatric ambulatory care, the speed of medication infusion can have major impact on healthcare staff workload and the number of children able to be treated by services designed to reduce inpatient length of stay. In many regions of the world, local and supraregional guidelines allow ceftriaxone infusions of ≥50 mg/kg in infants and children up to 12 years of age to be given over 10 minutes. The generic European summary of product characteristics for ceftriaxone does not state a specific infusion time for this dose range, although 1 manufacturers' summary of product characteristics in the United Kingdom states a 30-minute minimum infusion time. We conducted a formal service evaluation of a change in practice at a large UK pediatric children's hospital and demonstrated the clinical feasibility, safety, and high parent satisfaction of 10-minute ceftriaxone infusions for prescribed doses ≥50 mg/kg. This approach can improve patient flow within hospital-based ambulatory services as well as by community nursing teams administering antibiotics at home.

Cluster randomized controlled trial (RCT) to support parental contact for children in out-of-home care

BackgroundThere is an identified need to improve the evidence-base in relation to contact visits for children in the out-of-home-care (OOHC) system, to ensure optimal outcomes. ObjectiveThe aim of this cluster randomized controlled trial (RCT) was to test the effectiveness of a contact intervention for parents having supervised contact with children in long-term OOHC. Participants183 study children in 15 clusters (OOHC services) and their parent(s) were randomized to the intervention (8 clusters, 100 children) and control groups (7 clusters, 83 children) in three Australian jurisdictions. SettingThe manualized intervention consisted of increasing the preparation and support provided by caseworkers to parents before and after their contact visits. MethodInterviews were conducted with carers, parents and caseworkers of the study children at baseline and nine months post-randomization. Interviews included standardized assessment tools measuring child and adult wellbeing and relationships, carer and caseworker ability to support contact, and contact visit cancellations by the parent. ResultsCompared with controls, the intention-to-treat (ITT) analyses showed that fewer visits were cancelled by parents in the intervention group at follow-up (−10.27; 95 % CI: −17.04 to −3.50, p = .006). In addition, per-protocol (PP) analyses showed higher caseworker receptivity to contact (6.03; 95 % CI: 0.04–12.03, p = .04), and higher parent satisfaction with contact (7.41; 95 % CI: 0.70–14.11, p = .03) in the intervention group at follow-up. ConclusionsWhile the intervention did not have an effect on child wellbeing, as measured by the SDQ, the trial reports significant positive findings and demonstrates the benefits of the kC kContact intervention in providing support to parents to attend contact visits. The findings of the current study provide an important contribution to knowledge in an area where few RCTs have been completed, notwithstanding the null findings.

Clinical and functional outcome of elastic stable intramedullary nailing in pediatric femoral fractures in the age group of 5-16 years

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Fractures of the femur are the most incapacitating fractures. The best treatment for children between five to sixteen years of age is still debated. The ESIN has the benefits of early immediate stability to the involved bone segment, permitting early mobilization and return to the normal activities of the patients, respect for the physes, minimal scarring with lower complications. The purpose of this study was to present this study results following fixation of femoral shaft fractures with titanium elastic nails between the age 5-16 years of age.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total 52 patients in the age group of 5-16 years with femoral shaft fractures were stabilized using flexible nailing. Clinical and radiological follow-up was for a minimum period of 24 months. The final results were analysed using Flynn’s criteria.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean age at surgery was 7.4 years (range 5.6-14.3 years). The average duration of surgery was 65.3 (45-95) minutes and the mean duration of hospital stay was 8 (5-14) days. Skin irritation due to nail ends was the most common complication followed by significant lengthening (n=6), infection (n=2), significant shortening (n=2), varus angulation (n=2) and delayed union (n=2). The final outcome was excellent in 65.4% cases, satisfactory in 30.8% cases and three patients had poor outcomes as per Flynn's scoring criteria.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; In this study, ESIN showed good clinical and radiographic results in the age group 5 to 16 years, with minimal complications and high parent satisfaction consistent with previous studies but lesser number of mid adolescent age groups in the present study is a limitation.&lt;/p&gt;

A PILOT STUDY ON EFFECTIVENESS OF SELECTED INTERVENTIONS ON PAIN PERCEPTION AND PARENTAL SATISFACTION AMONG INFANTS RECEIVING IMMUNIZATIONS AT PUBLIC HEALTH CENTRE, CHENNAI.

An experimental post test only control design was used to assess the effectiveness of selected interventions on pain perception and parental satisfaction among infants receiving immunizations at Public Health Centre, Chennai. Using simple random sampling method, the total of 40 infants were allocated in four groups where each group had 10 infants. The interventions provided are oral sucrose for Experimental group I, 4 S’s technique for experimental group II, oral sucrose with 4 S’s technique for Experimental group III and routine care for Control group. The data collection tool consists of demographic profile, modified riley pain scale and parental satisfaction likert scale were used to collect data. The result of the study revealed that mean pain perception of experimental group III (3.21) was less than the experimental group I (4.08), experimental group II (3.40) and control group (4.22). There was no statistical difference between experimental group II and experimental group III at the level of 0.693 and also between experimental group I and control group at the level of 1.000 when other groups had statistically significant difference in pain perception. In mean parental satisfaction, the experimental group III (43.20) had high parental satisfaction than the experimental group I (39.80), experimental group II (41.90) and control group (38.60).Hence the pilot study concluded that 4S’s technique was the effective intervention for infant immunizations.

Diagnostics and treatment of adenotonsillar hyperplasia in children

Adenoidectomy, paracentesis, and tonsillar interventions are the most common operations in childhood. Hypertrophy of the lymphatic tissue of Waldeyer's ring can lead to individually distinct, acute, and chronic symptoms as well as anatomical and functional changes. When presented with affected children in otolaryngologic practice, the combination of parental interview, questionnaire-based screening for obstructive sleep apnea syndrome, and physical examination including ear microscopy, inspection of the oropharynx and, if necessary, the nasopharynx, has proven its worth. Audiometric diagnosis for detection of tympanic effusion should be mandatory. The treatment of choice is adenoidectomy, if necessary plus tonsillotomy and paracentesis with atympanic tube insert. However, the indication remains controversial, as the effectiveness of the interventions seems to depend on the preoperative severity of symptoms. With a correct indication, effective symptom reduction, improvement in quality of life, and high parent satisfaction can be expected.

Ağrıyı Azaltan Girişimi Tercih Edelim, Buzzy veya ShotBlocker: Bir Randomize Kontrollü Araştırma

INTRODUCTION: The aim of this study was to detect and compare the effects of ShotBlocker and Buzzy methods on pain, fear, and parental satisfaction during intramuscular injection. METHODS: This study was an experimental randomized controlled trial. The sample included 90 children at the ages of 6 and 12 to whom intramuscular injection was administered in the pediatric emergency department of a university hospital. The participants were randomly assigned to ShotBlocker (n=30), Buzzy (n=30), and control (n=30) groups. Child Information Form, Wong-Baker FACES Pain Rating Scale, Children’s Fear Scale, and Parental Satisfaction Questionnaire were used to collect the data. RESULTS: ShotBlocker and Buzzy groups had significantly lower pain and fear scores and higher parental satisfaction than control group after the procedure (p=0.0001). The lowest pain and fear score and the highest parental satisfaction score were observed in Buzzy group (p=0.0001). DISCUSSION AND CONCLUSION: Both ShotBlocker and Buzzy methods reduce pain and fear of children during intramuscular injection and increasing satisfaction of their parents. However, when compared to ShotBlocker, Buzzy method is more effective in reducing intramuscular injection-related pain and fear and should be preferred primarily.