Model Of Care For Children Research Articles

Exploring Allied Health Models of Care for Children with Developmental Health Concerns, Delays, and Disabilities in Rural and Remote Areas: A Systematic Scoping Review.

Access to appropriate healthcare is essential for children's healthy development. This is lacking in rural and remote areas, impacting health outcomes. Despite efforts to improve access for these communities, to date, no review has systematically mapped the literature on allied health models of care for children with developmental needs. This scoping review seeks to address this knowledge gap. Adhering to the PRISMA-ScR and Joanna Briggs Institute guidelines, a systematic search was conducted. A total of 8 databases (from inception to May 2023) and 106 grey literature sources were searched. Two reviewers independently undertook a two-stage screening process. Data were extracted using customised tools and narratively synthesised utilising the Institute of Medicine's quality domains. This review is registered a priori via Open Science Framework. Twenty-five citations were identified within the literature. Varied models of care were reported from five mostly Western countries. Models of care identified in these areas were classified as screening services, role substitution, consultative services, or online-based services. Positive impacts on quality of healthcare were reported across all quality domains (apart from safety) with the domain of effectiveness being the most commonly reported. Multiple models of care are currently in operation for children with developmental needs in rural and remote areas and appear to improve the quality of care. Due to complexities within, and limitations of, the evidence base, it is unclear if one model of care is superior to another. This review provides a basis for further research to explore why some models may be more effective than others.

Comparison of 2 Models of Care for Children With Medical Complexity Following Spinal Fusion.

We conducted a retrospective chart review of patients with neuromuscular scoliosis following spinal fusion surgery who were cared for post-operatively by either a hospitalist/orthopedics co-management team or a complex care clinic (CCC). Assignment to either treatment group was not random. To account for baseline differences between groups, we calculated propensity scores and used these as probability weights in generalized linear models. After matching, the CCC had a shorter length of stay (LOS, coefficient = -2.60; P = .04) without a significant difference in 30-day readmission rate (P = .62). For secondary outcomes, there were some significant resource utilization benefits favoring the complex care group without significant difference in complication outcomes between groups. In managing patients after spinal fusion surgery, both groups had similar LOS compared with prior studies of children after spinal fusion surgery. Management by the CCC may confer some outcome benefits for their patients.

Attachment Theory: Its Absence and Role in Deinstitutionalisation Strategies

Institutional care for children without families is still widely used globally as a child protection intervention, despite concerns that it violates child rights, separates children from their families, puts children at risk of abuse and neglect and is harmful for child development. This article applied attachment theory to analyse the use and risks of institutional care. It also discusses the challenges and consequences of implementing deinstitutionalisation strategies, a series of policy-driven activities aimed at transitioning a child protection system from an institutional to family-based model of childcare. A secondary data analysis found the progressive elimination of institutions can be effective where deinstitutionalisation strategies implement an attachment approach to improve institutions alongside building permanency planning capacity for children. This article proposes that institutional care may have a role as a child protection intervention where it is temporary, recognises a child’s need for secure attachment and facilitates safe permanency in a family setting.

Intersectoral collaboration in home-based end-of-life pediatric cancer care: A qualitative multiple-case study integrating families’ and professionals’ experiences

Background: Many children and adolescents with incurable cancer and their families prefer to receive end-of-life care and to die at home. This implies a transition of care from hospital to home and presupposes the establishment of a well-functioning collaboration between the family and professionals across health care sectors. Aim: To identify and explore key elements of home-based end-of-life care collaboration for children with cancer, as experienced by their parents and grandparents and the hospital- and community-based professionals involved. Design: Descriptive qualitative multiple-case study. Data were collected by semi-structured interviews and written responses to open-ended questions, and analyzed inductively across cases using qualitative content analysis. Setting/participants: Cases comprised a criterion sample of five children (aged <18 years), who died of cancer at home. Cases were represented by the children’s bereaved parents (n = 8) and grandparents (n = 7), and community-based professionals (n = 16). Also, hospital-based professionals (n = 10) were interviewed about the children’s end-of-life care through group interviews. Results: We identified five main themes, describing key elements of the end-of-life collaboration: Establishing the collaboration, Bolstering family life, Elucidating organization and integration, Managing challenges, and Closing the collaboration. These themes all came under the overarching theme: A mutual trust-based collaboration. On this basis, we developed the “Home-Based Pediatric End-of-Life Care Model for Children with Cancer.” Conclusions: By highlighting key elements in the family-centered, intersectoral and interprofessional end-of-life care collaboration, our “Home-Based Pediatric End-of-Life Care Model for Children with Cancer” offers a framework for further optimization of home-based end-of-life care services for children with cancer and their families.

Options for Africa’s Child Welfare Systems from Nigeria’s Unsustainable Multicultural Models

The sustainability of Africa’s existing child welfare systems remains uncertain, potentially owing to the maltreatment of children amid the competing worldviews of the continent’s indigenous and non-indigenous practices and international childcare models. This article focuses on Nigeria’s unsustainable multicultural child welfare system in order to highlight the inherent challenges of child welfare systems in Africa and proffer remedies. Seven discernible trends derived from available indigenous sources of information and scholarly literature on Nigeria are used as mind maps to describe and discuss Nigeria’s multicultural characteristics and childcare practices. From the discussion, the country’s child welfare challenges manifest in the following forms: ethnocultural, or more specifically, ethnoreligious diversity; the infiltration of Nigeria by non-native worldviews; colonial legacies; vacillating post-colonial social policies; conceptual ambiguities in non-indigenous welfare terminologies; and persistent unnecessary professional rivalries, which are also present in other African countries. As remedies, three transformative response options for the sustainability of the Nigerian child welfare system and those of other African countries are recommended: embracing cultural relativity regarding child maltreatment, leveraging the transformative and expanded mandates of the social work profession for the development of effective and sustainable child welfare systems, and using research and systems thinking as a driver for transforming professional rivalries into multidisciplinary approaches.

Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh

BackgroundCentre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care.MethodsWe used sequential mixed methods including a household survey (n = 222) and qualitative interviews with care-givers (n = 16), community leaders (n = 5) and policy-makers (n = 5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n = 5), non-users (n = 3), ex-users (n = 3) and staff (2) were used to refine the model and identify implementation issues.ResultsWe found 24% (95% CI: 16,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.ConclusionSustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

Development of two instruments for assessing maternity health needs: protocol of a clinimetric study

BackgroundThere is an unquestionable need to adapt health care to the needs of each woman, to foster her self-confidence and provide her with the autonomy to manage her own maternity. This involves empowering her to choose and face her model of childbirth and childcare responsibly. The range of self-management health needs tests offered by the scientific community at this stage of life is practically non-existent. In this project, we intend to develop and evaluate the validity, reliability and ease of use of two self-administered analysis instruments for: 1.- Needs of women preparing for childbirth and 2.- Identification of alarm symptoms in the puerperium.MethodsThis is a descriptive study of the clinimetric characteristics and usability of two developed self-applied digital instruments for measuring needs in childbirth and postpartum based on the recommendations made in the consensus-based standards for the selection of health measurement instruments (COSMIN) and by the International Test Commission (ITC). The study consists of two phases: 1 - Evaluation of the clinimetric properties of the two instruments, which were developed and then altered, based on their comprehensibility and global usability estimated from a pilot study and 2 - Pre-implementation study.DiscussionThe final product will be two valid, reliable, usable instruments for self-assessment of health needs that are highly acceptable to young couples and the professionals who serve them. They will be a valuable resource for meeting the needs of the population more efficiently and guiding decision-making, and they will contribute to the greater sustainability of the health system.

An Overview of Continuity of Care Model for Children With Juvenile Diabetes in West Java Region, Indonesia

INTRODUCTION: The absence of insulin in people with Juvenile Diabetes (JD) requires that they get daily injections of insulin in addition to daily lifestyle that must be managed.Children with JD requires routine care and check-ups from doctors and nurses in hospitals so that the quality of life of children can be optimal. This researchaimed to obtain an overview of JD continuityof care model. &#x0D; &#x0D; METHOD: The design implementedwas descriptive phenomenology. The number of participantswas 18 people, consisting of6 JD patients:3 parents, 2 guidance and counseling teachers, 2 doctors, 1 midwife and 3 nurses. The data were analyzed using Collaizi method. &#x0D; &#x0D; RESULTS: This research identified 8 themesi.e1)health education from doctors and nurses is needed regularly;2) the treating doctor does not change frequently because it will be confusing; 3)looking for treatment because of responsibility and feeling sad for children;4) insulin medicine is obtained according to what the doctor programmed; 5) simplified registration system; 6) fast service;7) the teacher knows how to supervise children in school and 8) the parents need a community as means of sharing information.&#x0D; &#x0D; CONCLUSIONS: Continuity of care model for JD is related to 3 aspectsof service, i.e.continuity of information; communicationcontinuity and continuity of management to becontained in the INKOLA Model (Informasi, Komunikasi and Tata Kelola).The result of research are expected to give information about the need of care so that a proper continuity of care model can be develop.

Актуални нормативни промени и икономически аспекти на деинституционализацията на социални услуги за деца в България

The process of the deinstitutionalisation of social services for children is examined. Some of its economic features are highlighted based on an analysis of key economic elements and existing staff issues. A regulatory review of the changes in this area is made. The aim is to rationalize deinstitutionalisation as an adequate model for childcare and child rearing. The role of the state in the understanding of childcare is examined and the economic conditions under which it is carried out are presented.

Empowering Residential Carers of Looked After Young People: The Impact of the Emotional Warmth Model of Professional Childcare

Empowering Residential Carers of Looked After Young People: The Impact of the Emotional Warmth Model of Professional Childcare

Empowering Residential Carers of Looked After Young People: The Impact of the Emotional Warmth Model of Professional Childcare

Summary: Children and young people in public care have long been recognised as a particularly vulnerable group in our society. Many have complex personal, interpersonal and educational needs as a result of pre-care maltreatment. Despite a number of initiatives to change the often-negative outcomes for these children, results have remained stubbornly disappointing. The model of professional childcare, rooted in psychological research and theory, was designed to enable and empower foster and adoptive parents and residential carers to acquire a deeper understanding of their children's needs and to provide these young people with the informed support required to help them to lead more fulfilling lives. In this study, we examined the impact of the model in a three-year project involving fifty-three children and young people and their carers in local authority children's homes on two UK sites (northern and southern England). Significant improvements in both behavioural and affective measures were observed following implementation of the model with these young people (Z(N=53) = 3.978, p < .001). These results demonstrate that this model of professional childcare can achieve positive outcomes for previously maltreated young people in children's homes. Methodological constraints on implementation of the model are discussed.

10.1 A Multidisciplinary Model of Care for Children With Neurogenetic Disorders

The goal of this session is to describe our experience with the multidisciplinary Developmental Neurogenetics (DNG) Clinic that offers psychiatry, neurology, and medical genetics services to children with complex neurogenetic syndromes.

Illnesses and Injuries at Nature Preschools

Nature preschools, where children spend the entire school day outdoors, are increasingly popular, but their health consequences have not been well researched. This study tested the hypothesis that nature preschools and conventional preschools differ in their illness and injury incidence, by comparing observed illness and injury occurrence in the two types of schools. For 14 weeks, teachers at five nature preschools and four conventional preschools in Seattle, Washington logged absences due to illness. Two nature preschools and three conventional preschools also logged injuries that occurred during the school day. There was no difference in illness incidence by preschool type, and no serious injuries were reported in either setting. Overall, the study found that nature preschools are a healthy and safe child-care model.

Gender Matters: Rethinking the Childcare Model in Hong Kong

This study aims to reveal the gendered practices in childcare under the family care model and the effects of these practices on carers in Hong Kong. Familial ideology remains a dominant welfare principle in childcare policy in Hong Kong, which assumes that family care is the best form of care provision. However, this policy assumption fails to respond to the needs in childcare arising from the social changes and development. The suggested possible solution for this issue is the shifting of the family care model to the social care model, in which childcare responsibilities are shared between the family and the state.

L’assistenza all’infanzia a Reggio Emilia: origini e trasformazioni tra Otto e Novecento

The aim of this article is to reconstruct the evolution in the type of interventions and childcare models adopted by the institutions charged with caring for orphans in 18th- and 19th-century Reggio Emilia, Italy. Through analysis of the documents – some previously unseen – preserved at the archives of ASP Reggio Emilia Città delle Persone and Polo Archivistico Comunale, it is possible to understand how the city of Reggio Emilia adapted itself to the developing needs of its wards, and social, legislative and especially educational changes, seeking to go beyond the isolatory and custodial spirit that characterised life within orphanages until the end of the 19th century. The history of the local institutions intertwines with that of the national processes and changes which revolutionised the traditional concept of «institute». The monolithic, centuries-old and obsolete «orphanage» gave way to care within the community (1962), founded on the principles of protection, promotion and education of individuals. The stories of these individuals that emerge from the personal records and material analysed enable us to broaden our gaze on the reconstruction of institutional history, starting from a more internal perspective and focusing on the «subjectivity» of those in need of basic care. Such personal histories enable us to not only to understand the peculiarities of the various «cases», but also their living conditions, and the ways in which care, and at the same time education, was provided.

Early Socialization of the Child: Cultural Aspects of Childcare in Twenty-First-Century Lithuania

Drawing on cultural perspectives of childcare, the aim of this paper is to explorethe childcare culture in twenty-first-century Lithuania. The main objectives are as follows: to discuss childcare models in the society of contemporary Lithuania, to reveal early socialisation goals, to analyze how childcare models can be shaped by the cultural context. My descriptions of the childcare in contemporary Lithuania are based on ethnographic fieldwork conducted from 2013 to 2016. Two main childcare models can be observed in twenty-first-century Lithuania. According to the sociologist Petra Büskens, one of them can be called the romantic childcare model (childcare practices: one-to-three years of unregulated breastfeeding, “in arms” or “baby-wearing” practice, the family bed with emphasis on the child’s needs). Proponents of the rational childcare model have a more critical opinion on breastfeeding and “baby-wearing”, and their babies sleep in a separate bed. Proponents of rational childcare tend to emphasize the parents’ and not the baby’s interests. Proponents of different childcare models pose different goals of child socialisation. The landmarks of child socialisation for the adherents of the romantic childcare model are the child’s psychological security and strong family ties. Proponents of the rational childcare model advocate the child’s adjustment to other people’s interests as the main aim of early socialisation of the child. The material of ethnographic fieldwork in contemporary Lithuania supports the researchers’ view that the character of childcare is associated with a broad cultural context that is expressed through parents’ worldview. In contemporary Lithuania, the proponents of the romantic model associate childcare with social power or acquisition of the socially relevant qualities. For them, “natural” is “what is close to nature”. They reject the more structured childcare practices, equating them with human constraints which for them are a symbolic representation of the Soviet times. Meanwhile, the proponents of the rational childcare model do not tend to impart much meaning of social power to childcare. “Natural” or “normal” practices for them are those which do not create problems for adults. Proponents of rational childcare equate the more structured childcare practices not with the Soviet times, but with the tradition of their grandparents and parents. The study supports the researchers’ assumption that taking care of an infant is associated with a much broader circle of issues than health and feeding. The meanings of childcare practices are influenced by the fundamental cultural contexts such as those which define the concept of the person, the relation of the man and the woman to nature, social priorities, and the socially accepted concept of time.

Moving Towards a More Aggressive and Comprehensive Model of Care for Children with Ebola

bola is a devastating illness for children, particularly those under 5 years of age. Although children are proportionally less affected than adults during outbreaks of Ebola, including in the current West Africa outbreak, it remains a major threat to child health in the affected nations and a neglected area of investigation and discussion. The threat is not only for those infected with Ebola, but for all children in the affected region because of the tremendous impact of this outbreak on national health care systems. In addition to what appears to be a different immunologic response to Ebola in children, the uniquely challenging bedside care of suspect and infected children plays a significant role in the increased morbidity and mortality in this age group. Little information has been published on efforts to care for children in Ebola treatment units (ETUs). We present a report of our experience caring for children at what was the largest ETU in Port Loko, Sierra Leone, and a discussion of our protocols for caring for children with Ebola, with the hope of stimulating an international dialogue regarding the care of children with this disease. These protocols represent the culmination of the accumulated experience and knowledge of our ETU health care staff. Although, admittedly, they reflect some shared insights from staff at other ETUs, themajority stem from the published literature with adaptations of standard pediatric therapy. The protocols represent the care we aspired to provide to each child at the time our ETU closed inMarch 2015 and serve as a starting point for future ETU providers and policymakers for the next Ebola epidemic. Because of resource limitations, a rigorous evidence-based demonstration of efficacy for all of these recommended interventions remains to be done. Thus, the protocols are well rooted in solid, biological rationale and clinical experience but as yet lack ideal empirical support.

施設養護家庭論の検討

近年, 子どもの権利への関心が高まるなか, 社会的養護における支援の個別性の保障が課題となっている. とりわけ強調されるのが「施設の家庭化」である. 本稿の目的は, 児童自立支援施設での質的調査データにもとづき, 施設の家庭化論を検討するとともに, 今後に向けた示唆を得ることにある.

Construction of an evaluation structure model for childcare in authorized nursery schools: A case study on Saga City in Japan

Construction of an evaluation structure model for childcare in authorized nursery schools: A case study on Saga City in Japan

Early supplementary feeding among central African foragers and farmers: A biocultural approach

The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for six months, yet this recommendation has proven difficult to implement. Here, we examine the nature of and influences on early supplementation (ES) in light of current evidence regarding evolved human caregiving patterns (cooperative breeding). We utilize a biocultural approach, which takes into consideration that infant feeding is influenced by an array of evolutionary, physiological, structural, ecological, and cultural factors. The research is cross-cultural, conducted among the Aka foragers and Ngandu farmers in the Central African Republic. We explore emic perspectives of ES as well as infant characteristics and socioecological factors that, when combined with evidence of human care patterns, offers a more holistic understanding of early infant feeding. We employ a mixed-methods approach, utilizing qualitative interview and quantitative focal-follow behavioral observation data, collected from 2009 to 2012. Results indicate that foragers introduce ES earlier than farmers; nevertheless, only a small proportion of Ngandu mothers EBF. Maternal and non-maternal caregiver ES patterns are predicted by different factors. Maternal ES is associated with infant age, while non-maternal ES is associated with maternal labor activities and the infant's caregiving network. Non-maternal ES, but not maternal ES, reduces breastfeeding. Results suggest that neither subsistence ecology nor maternal labor patterns fully explain the timing of ES. However, cooperative caregiving, infant mortality risk, and cultural models of caregiving offer insights into why foragers commence ES so early. We discuss the implications of ES on weaning age, inter-birth intervals, and fertility. Throughout our evolutionary history and today, non-maternal caregivers were and are essential participants in childcare and provisioning, yet are rarely viewed as active participants in early infant feeding. Consideration of evolved caregiving patterns and the role of others in feeding practice will enhance public health outreach.