Parental Comfort Research Articles

Early enteral nutrition (EEN) following intestinal anastomosis in pediatric patients – what’s new?

Abstract Introduction Abdominal surgery in children may disrupt normal gut function, necessitating prolonged fasting, which can lead to complications such as dehydration and nutritional deficits. Early enteral nutrition (EEN) after surgical procedures can enhance wound healing, prevent malnutrition, and expedite recovery. Although concerns exist regarding the risk of complications associated with EEN, current evidence suggests that it is not linked to increased perioperative complications. Content This scoping review provides an overview of the role of EEN in pediatric abdominal surgery, exploring its benefits and risks within the context of recent literature from 2021 to 2024. A systematic literature search was conducted using the PubMed database in April 2024 and the identified studies were compared. The search revealed 586 results, wherefrom eight studies (three systematic reviews and five clinical studies) fulfilled the inclusion criteria. Five studies were added since 2021. Overall, EEN may reduce the length of hospital stay, time to full oral intake, and return of bowel function. It does not seem to increase the rate of anastomotic leakage. EEN is associated with lower rates of surgical site infections and wound dehiscence as well as fewer septic complications. One study showed an increase in nausea/vomiting and abdominal distension in the EEN group, which did not lead to further complications. Summary and Outlook Current evidence suggests that EEN after abdominal surgery in pediatric patients is not associated with a higher rate of complications. In fact, EEN seems to be beneficial and lead to improved patient outcomes and shorter hospital stays. Emphasis on patient and parent comfort, individualized feeding initiation based on clinical factors, and standardized postoperative feeding protocols are recommended to optimize outcomes in pediatric abdominal surgery.

Facilitators and barriers to contraception access and use for Hispanic American adolescent women: An integrative literature review.

Hispanic American adolescents experience high rates of pregnancy with profound consequences. Compared with White teens, Hispanic teens use contraception less frequently and often choose less effective forms of contraception. Access to contraception is a primary barrier to use which contributes to relatively high and disparate rates of pregnancy in Hispanic teens. This integrative review identifies facilitators and barriers of contraception access and use for Hispanic women, 13-17 years of age, living in the U.S. Following the Whittemore and Knafl (2005) methodology and PRISMA guidelines, peer reviewed studies were retrieved from PUBMED, CINAHL and EMBASE. The Mixed Methods Appraisal Tool was used to assess the study quality and thematic analysis was used to categorize barriers and facilitators. Of 131 studies retrieved, 16 met inclusion criteria. Individual, interpersonal and healthcare provider factors were identified as primary categories of barriers and facilitators with structural issues comprising an additional barrier category. Individual level barriers were disproportionately represented and further categorized into themes: beliefs/misconceptions, dislike of contraception, pregnancy risk perception, lack of knowledge, and lack of control. Barriers related to cultural and religious influences were identified in individual, interpersonal and structural levels. The most frequently reported facilitators were perceived parent comfort discussing sexual health and past experience of pregnancy. Limitations in this review may stem from heterogeneity in the acculturation and geography of participants and analysis by a single reviewer. Implications include considering the range of information sources and the influence they have on risk perception and risk mitigation for this population. Adolescents describe many modifiable influences on contraception access and use. Misperceptions related to contraception, stemming from beliefs and perceptions, can be corrected through increased access to reliable sources of sex education, parental support, and direct access to nurses and healthcare providers. Awareness of these influences can inform further research and intervention development to address these health disparities.

Sexually explicit media literacy education: a scoping review of parental perspectives and relevant resources

ABSTRACT Viewing sexually explicit media (SEM) can influence young people’s sexual attitudes and behaviours. Media literacy education can help young people navigate this, yet parental opposition is sometimes cited as a barrier to the implementation of comprehensive school programmes. A scoping review explored parent perspectives towards and comfort with SEM literacy education, parent-focused resources, and the level of parental engagement in resource development. An expansive view of SEM included pornography alongside sexually explicit content in movies, television shows, video games, or other online spaces. Collectively, a focused search of five academic databases, an online search for grey literature and resources from non-governmental and government organisations, and interviews (n = 7) with key stakeholders were undertaken. Screening reduced 4,745 peer-reviewed records to seven. The online search located 35 resources from 28 organisations. While parents support SEM literacy education for their children, other sexuality education topics (e.g. contraception and the prevention of sexually transmitted infections) were more widely endorsed. Parental comfort in providing such education was variable. Online resources vary in type and content, with limited information available about development processes or evaluation. Further research and co-design are needed to ascertain parent needs to support their children’s SEM literacy knowledge and understanding.

Receptivity of providing firearm safety storage devices to parents along with firearms safety education.

In the United States, 33% of households with children contain firearms, however only one-third reportedly store firearms securely. It's estimated that 31% of unintentional firearm injury deaths can be prevented with safety devices. Our objective was to distribute safe storage devices, provide safe storage education, evaluate receptivity, and assess impact of intervention at follow-up. At five independent, community safety events, parents received a safe storage device after completing a survey that assessed firearms storage methods and parental comfort with discussions regarding firearm safety. Follow-up surveys collected 4 weeks later. Data were evaluated using descriptive analysis. 320 participants completed the surveys, and 288 participants were gunowners living with children. Most participants were comfortable discussing safe storage with healthcare providers and were willing to talk with friends about firearm safety. 54% reported inquiring about firearm storage in homes their children visit, 39% stored all their firearms locked-up and unloaded, 32% stored firearms/ammunition separately. 121 (37%0.8) of participants completed the follow-up survey, 84% reported using the distributed safety device and 23% had purchased additional locks for other firearms. Participants were receptive to firearm safe storage education by a healthcare provider and distribution of a safe storage device. Our follow up survey results showed that pairing firearm safety education with device distribution increased overall use of safe storage devices which in turn has the potential to reduce the incidence of unintentional and intentional self-inflicted firearm injuries. Providing messaging to promote utilization of safe storage will impact a firearm safety culture change.

Parental Comfort with School Food Allergy Policies

Parental Comfort with School Food Allergy Policies

School Attendance Among Pediatric Oncology Patients During the COVID-19 Pandemic in Ontario, Canada.

Supporting schooling for current and past pediatric oncology patients is vital to their quality of life and psychosocial recovery. However, no study has examined the perspectives toward in-person schooling among pediatric oncology families during the COVID-19 pandemic. In this online survey study, we determined the rate of and attitudes toward in-person school attendance among current and past pediatric oncology patients living in Ontario, Canada during the 2020-2021 school year. Of our 31-family cohort, 23 children (74%) did attend and 8 (26%) did not attend any in-person school during this time. Fewer children within 2 years of treatment completion attended in-person school (5/8; 62%) than those more than 2 years from treatment completion (13/15; 87%). Notably, 22 of 29 parents (76%) felt that speaking to their care team had the greatest impact compared to other potential information sources when deciding about school participation, yet 13 (45%) were unaware of their physician's specific recommendation regarding whether their child should attend. This study highlights the range in parental comfort regarding permitting in-person schooling during the COVID-19 pandemic. Pediatric oncologists should continue to address parental concerns around in-person school during times of high transmission of COVID-19 and potentially other communicable diseases in the future.

Development of a storytelling communication facilitation tool (SCFT) to facilitate discussion of complex genetic diagnoses between parents and their children: A pilot study using 22q11.2 deletion syndrome as a model condition.

To develop and evaluate a storytelling communication facilitation tool designed to help parents overcome barriers to discussing a complex multisystem genetic diagnosis with their affected children, using 22q11.2 deletion syndrome (22q11DS) as an exemplar condition. A story telling communication facilitation tool (SCFT), entitled 22q and Me, was developed for a target audience of children with 22q11DS aged 9 to 12. The SCFT was evaluated by 14 parents to assess usability and utility by comparing responses to survey questions before and after viewing the SCFT, using a Likert scale. After viewing 22q and Me, parents reported that barriers to discussion were mitigated. Participants indicated they felt more comfortable and better prepared to talk to their children about 22q11DS and worried less that the diagnosis would affect their children's self-esteem. Parents described 22q and Me as engaging and able to address parental concerns. 22q and Me was found to be an effective tool for increasing parental comfort and ability to talk to their children about their diagnosis of 22q11DS. This novel storytelling communication facilitation tool can serve as a model for the development of other educational tools geared at facilitating disclosure and discussion of other genetic conditions.

Assessing Barriers to Human Papillomavirus (HPV) Vaccination in At-Risk Rural Communities of Western North Carolina, United States.

Human papillomavirus (HPV) vaccination among adolescents in rural, western North Carolina (NC) remains suboptimal. Data are needed to understand the barriers to HPV vaccination in these communities. We conducted a cross-sectional pilot study of parental attitudes and provider practices regarding HPV vaccination in rural western NC counties with lower HPV vaccination rates. Eight health department clinics were enrolled in the study. Further, 29 provider and 32 parent surveys were analyzed along with environmental scans. Median provider comfort regarding knowledge of HPV-associated diseases was 85% (IQR = 75-95), on a scale of 0-100% (100% representing complete comfort). Median parental comfort level regarding knowledge of HPV-associated diseases and the HPV vaccine was 75% (IQR = 50-89) and 75% (IQR = 49-96), respectively. Less than 25% of parents rated the HPV vaccine as 'extremely effective' against genital (16.7%) and anal cancers (17.9%). Parents were more likely to rate the vaccine as 'extremely effective' to 'very effective' if their child was female. There was no significant difference between parental- and provider-reported comfort with knowledge about HPV-associated diseases (p = 0.0725) and the HPV vaccine (p = 0.167). This study identified multiple opportunities to increase HPV vaccine coverage among unvaccinated adolescents at parental, provider, and clinic levels. Health education of rural NC residents and providers in public health settings may identify future interventions to increase HPV vaccine uptake.

“We’re stronger as a family”: Family experiences and relationships in an adapted physical activity camp

Adapted recreation programs involving the entire family may offer ways to enhance relationships in families with a child living with a disability because they enable participating together in new and potentially empowering experiences. This study examined family members’ perspectives on their lived experiences with their relationships within their family and how they perceived they were affected by their participation in an adapted summer camp for families with a child living with a disability. We conducted a collective case study with five families who participated in a week-long camp. A focus group was conducted with each family and analyzed using reflexive thematic analysis. Participation in the camp impacted family relationships by reducing isolation for mothers; alleviating stress and anxiety which helped families bond; providing shared experience which led to mutual understanding, communication, and support; improving independence and confidence of the child living with a disability; facilitating sibling bonding and parent comfort with giving siblings more responsibility; and enhancing families’ confidence to participate in family activities beyond the camp. These findings elucidate how participation in this type of program can impact relationships in families that include a child living with a disability and inform future program design.

Lived Experiences in Family Business Among Business Graduates of a Private Higher Educational Institution in Iloilo City, Philippines

There has been no academic work dedicated to the discovery of the lived experiences of business graduates from a private higher educational institution in Iloilo City, Philippines in their respective family businesses in terms of their daily lives. This phenomenological study was conducted to explore the lived experiences of business graduates of a private higher educational institution in Iloilo City, Philippines who joined their respective family businesses. Moreover, this study intended to describe the profile of the business graduate participants, family business involvement, family relationships, personal and work-related conflicts, and (4) contributions to their family firms. The qualitative research design was employed for this study, specifically phenomenology. Seven participants through purposive sampling voluntarily joined in this phenomenological study after signing the informed consent form. They came from the class of 2017 to 2019 business graduates. The result showed that the seven (7) participants of this study were all business graduates, who were majority males, aged 23-27 years old from a private educational institution in Iloilo City. They had never enrolled in any graduate school programs. The majority graduated last 2019 with three (3) years of working experience. The majority are into retail and hardware supplies. The operational years of their businesses ranged from nine (9) to 55. Almost all were classified as having medium businesses and only one was classified as small. For their family business involvement, they have experienced early involvement in their businesses, they were trusted to manage, and they feel valued. Strong family relationships also emerged among business graduates. They have experienced parental comfort and advice as well as close relationships with their parents. As to the personal and work-related conflicts, they experienced careless operational mistakes, interpersonal work conflicts, emotional challenges, and limited freedom. When it comes to their contributions to the family businesses, they have contributed to the vision and internal control strategies, social media marketing, sales increase, financial clarity, and lessening the workloads of parents. This study can serve as a basis for involving business graduates early in the family business. Employing them can enable them to contribute success factors earlier. Maintaining strong relationships among family members employed in the family firm must be done to avoid personal and work-related conflicts.

Parental Preferences for Mental Health Screening of Youths From a Multinational Survey

Screening youths for mental disorders may assist in prevention, promote early identification, and be associated with reduced related lifetime impairment and distress. To assess parents' and caregivers' comfort with and preferences for pediatric mental health screening and factors associated with these preferences. This survey study used an online survey available from July 11 to 14, 2021, through Prolific Academic. Analyses were conducted from November 2021 to November 2022. The survey was administered to English-speaking parents and caregivers in the US, UK, Canada, and 16 other countries who were aged 21 years or older and had at least 1 child aged 5 to 21 years living at home. The main outcomes were parental preferences regarding content, implementation, and review of the findings of pediatric mental health screening. Parental comfort with screening topics was reported on a 6-point Likert scale with 6 indicating highest comfort. Mixed-effects logistic regression models were used to evaluate factors associated with parental comfort levels. Of 1200 survey responses requested, data were collected from 1136 participants (94.7%). The final sample meeting the inclusion criteria comprised 972 parents and caregivers aged 21 to 65 years (mean [SD] age, 39.4 [6.9] years; 606 [62.3%] female). A total of 631 participants (64.9%) supported annual mental health screening for their child, and 872 (89.7%) preferred reviewing the screening results with professional staff (eg, physicians). Participants reported significantly decreased comfort with child self-report compared with parent-report screening assessments (b = -0.278; SE = 0.009; P < .001), although they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child's age, participants were generally comfortable discussing all 21 screening topics on the survey. The greatest comfort was with sleep problems (mean [SE] score, 5.30 [0.03]); the least comfort was with firearms (mean [SE] score, 4.71 [0.05]), gender identity (mean [SE] score, 4.68 [0.05]), suicidality (mean [SE] score, 4.62 [0.05]), and substance use or abuse (mean [SE] score, 4.78 [0.05]). In this survey study of parents and caregivers, parent-reported and child self-reported mental health screening in primary care settings was supported by the majority of the sample, although comfort levels differed according to various factors (eg, screening topic). Participants preferred to discuss screening results with professional health care staff. In addition to parental need for expert guidance, the study findings highlight the growing awareness of child mental health needs and the importance of addressing mental health concerns early via regular mental health screenings.

American Parents’ Perceptions of Child Explicit Image Sharing

Parents and other adult caregivers of biologically or sociolegally related children (hereafter, “parents”) can play an important role in the online behavior of children in their care. In this study, we examined parental correlates of three outcomes— talking to their child about image sharing (66% yes); expecting their child had shared sexually explicit images (39% yes); and preparedness if their child’s sexually explicit images were leaked (38% yes)—in a survey of a nationally representative sample of 402 parents in the United States. Regression analyses revealed that talking to one’s child about sexually explicit image sharing was significantly associated with the parent being a mother, having a child in high school, enforcing a higher number of technology rules, knowing about secondary social media accounts, and expecting that their child’s friends share sexually explicit images of themselves. Expecting their child had sent sexually explicit images was significantly predicted by parents having fewer technology rules in place for their child, more permissive parental attitudes about resharing sexually explicit images, and the expectation that their child’s friends or schoolmates had sent sexually explicit images. Unexpectedly, perceived parental preparedness if their child’s sexually explicit images were leaked was significantly predicted by less—rather than more—parental comfort in talking to children about their child’s online activities.

Prefabricated Trays Stock for Impression of Cleft lip and Palate Orthopedic Appliances: A Three-Dimensional Computational Analysis of Maxillary Jaws.

This study aimed to propose digitally designed impression trays, for newborns with cleft lip and palate (CLP) defects, using the computer-assisted design and manufacturing (CAD/CAM) technique, based on measurements of width, length, and height made on processed and scanned plaster models. Thus, we will describe the different software and concepts that can be used for the design of these impression trays. A total of 59 plaster casts of newborn patients with CLP were collected and then scanned. After that, digital dental casts were three-dimensional (3D) evaluated, using precise anatomical landmarks. The Maxillofacial Prosthodontics Team at the Dental consultation and treatment center in Rabat, Morocco. The study involved plaster casts of newborns with CLP, who had undergone presurgical neonatal treatment in the Maxillofacial Prosthodontics service in Rabat, Morocco. None. 3D evaluation of 59 scanned plaster casts of newborn patients with CLP. This work allowed us to obtain digital impression trays for each anatomical variation of orofacial clefts. These trays will limit the problems linked to conventional techniques for making neonatal orthopedic plates. We also emphasized the importance of a multidisciplinary approach involving several professionals in Morocco from various fields and specialties. This original technique is advantageous for the practitioner as well as for the patients and their parents. It allows for precise recording, better adaptation, time-saving, and parental comfort.

Mino-Pimaatisiwin Beginning the Journey towards Decolonisation and Reconciliation

Mino-Pimaatisiwin is an Ojibwe term for life in the fullest, healthiest sense. Grounded in anti-colonial theory, this case study explores the impact of infusing Indigenous perspectives into an elementary school curriculum on students, school staff, parents, and community. With a focus on building self-esteem and cultural connectedness among Indigenous students, it uses the cultural frameworks of Mino-Pimaatisiwin and the Ojibwe seven sacred teachings of a good life. Findings indicate high levels of cultural connectedness and a reduced gap in self-esteem levels between Indigenous and non-Indigenous students, an increased awareness among staff of Indigenous history and culture, a greater parent comfort level with visiting the school, and increased involvement from the community.

Treatment of centered developmental dysplasia of the hip under the age of 1 year: an evidence-based clinical practice guideline - Part 1.

Despite the high incidence of developmental dysplasia of the hip (DDH), treatment is very diverse. Therefore, the Dutch Orthopedic Society developed a clinical practice guideline with recommendations for optimal and uniform treatment of DDH. This article summarizes the guideline on centered DDH (i.e. Graf types 2A–C).The guideline development followed the criteria of Appraisal of Guidelines for Research and Evaluation II. A systematic literature review was performed to identify randomized controlled trials and comparative cohort studies including children <1 year with centered DDH. Articles were included that compared (1) treatment with observation, (2) different abduction devices, (3) follow-up frequencies, and (4) discontinuation methods. Recommendations were based on Grading Recommendations Assessment, Development, and Evaluation, which included the literature, clinical experience and consensus, patient and parent comfort, and costs.Out of 430 potentially relevant articles, 5 comparative studies were included. Final guideline recommendations were (1) initially observe 3-month-old patients with centered DDH, start abduction treatment if the hip does not normalize after 6–12 weeks; (2) prescribe a Pavlik harness to children <6 months with persisting DDH on repeated ultrasonography, consider alternative abduction devices for children >6 months; (3) assess patients every 6 weeks; and (4) discontinue the abduction device when the hip has normalized or when the child is 12 months.This paper presents a summary of part 1 of the first evidence-based guideline for treatment of centered DDH in children <1 year. Part 2 presents the guideline on decentered DDH in a separate article.

Belonging on Rounds: Translating Research Into Inclusive Practices for Families With Limited English Proficiency to Promote Safety, Equity, and Quality.

Belonging on Rounds: Translating Research Into Inclusive Practices for Families With Limited English Proficiency to Promote Safety, Equity, and Quality.

Parenting under pressure: Parental transmission and buffering of child fear during the COVID‐19 pandemic

The current study investigated the impacts of parental behaviors (threat communication and comforting) on children's COVID-19 fears and whether effects differed by age. Caregivers of 283 children (5.5-17 years, M=10.17, SD=3.25) from 186 families completed online measures assessing children's and parents' COVID-19-related fears, children's sources of COVID-19 threat information, and parents' engagement in behaviors to reduce child distress (i.e., comfort behaviors). Higher COVID-19 fear in parents was associated with greater communication of COVID-19 threat information, which was associated with higher COVID-19 fear in younger, but not older, children. Over and above parental fear and threat communication, greater exposure to COVID-19 threat information from community sources (e.g., media, school, friends) was associated with greater COVID-19 fear in children, regardless of age. Greater engagement of parental comfort behaviors buffered the association between community sources of COVID-19 threat information and COVID-19 fears in older, but not younger, children. These findings suggest that younger children might be more vulnerable to developing heightened COVID-19 fears as a result of increasing sources of COVID-19 threat information in their lives. This study highlights the importance of supporting the socioemotional well-being of children and families through the COVID-19 pandemic and beyond.

Parental perceptions of the impact of COVID-19 and returning to play based on level of sport

This study examined the impact of COVID-19 on youth sport parents based on competition level to understand how the pandemic affected youth sport and factors associated with youth returning to sport. Survey data were collected from samples of US sport parents in two waves - early in the pandemic (N = 751) and as programs began to resume (N = 707). Data showed elite sport parents were more willing to return. Although most participants returned to play, significant numbers had not resumed participation. Parent comfort was the most important factor associated with resuming. However, parents allowed children to resume play due to perceived external pressure, potentially creating stress among parents regarding sport participation decisions. Attending school in person and household income were associated with the ability to resume sport suggesting the need to provide school sport environments and consider the financial impacts of COVID-19 on sport families.

The Impact of Formal School Entry on Children's Social Relationships with Parents, Siblings, and Friends.

The normative transition to formal schooling confronts children with social challenges but also opportunities. Longitudinal research on how school entry impacts children’s family and friend-ship relationships is scarce. This study investigated social relationship qualities with parents, siblings, and friends among 1110 children (49.9% female) from the prospective, population-based Bavarian Longitudinal Study at 6 years (before school entry) and 8 years using a forced-choice card-sorting task. Multivariate analyses of variance revealed significant effects of age (i.e., school entry) on social relationship qualities with mothers (Pillai’s Trace (PT) = 0.28, F(9, 1101) = 47.73, p < 0.001), fathers (PT = 0.14, F(9, 1101) = 19.47, p < 0.001), siblings (PT = 0.27, F(9, 1101) = 46.14, p < 0.001), and friends (PT = 0.21, F(9, 1101) = 32.57, p < 0.001). On average, children reported higher levels of parental comfort after school entry. Companionable qualities increased in relationships with friends, whereas sibling relationships became more conflictual from preschool to early school age. Findings provide unique insights into how social relationships develop from preschool to early school age, supporting evidence of the growing importance of friends. Conflict was predominant and increasing in sibling relationships and should be considered more in future research.

The interplay between children, their parents and anaesthesia staff during the child's anaesthesia - An observational study.

To interpret and understand the interplay between children, their parents, and anaesthetic staff to gain a greater understanding of children being anaesthetised. Anaesthesia induction is a stressful procedure for the child and parents in the technologically advanced environment in the operating room (OR). Anaesthesia staff are a key resource for ensuring safety and interplays, but the meeting is often short, intensive, and can affect the child and the parent. A qualitative observational design with a hermeneutic approach. Twenty-seven non-participant observations were conducted and videotaped when children were being anaesthetised. The SRQR checklist was used. The result is presented as a theatre play with three headings; the scene, the actors, and the plot. The scene was not designed for the child or the parent's comfort and could lead to anxiety and insecurity. Four themes described the interplays: The need to be inviting and to be invited, The need for varying compliance, The need for mutual dependence, and The need to give and to receive emotional support. The plot could lead to uncertainty, and the interplay could change between being caring and uncaring depending on the actors. The technologically advanced environment in the OR constituted an emotional obstacle, but the anaesthesia staff themselves can be a powerful resource creating a caring environment. The outcome of the plot may depend on the anaesthesia staff's bearing. A caring approach in the OR requires a willingness from the anaesthesia staff to invite the child to participate and find a balance between helping the parents to find their place in the OR and support them in supporting their child. The findings can start reflections in the unit on how to create a more caring environment.