Psychological Care Of Children Research Articles

Psychological Care for Children and Adolescents with Diabetes and Patient Outcomes: Results from the International Pediatric Registry SWEET

Background. Easy accessibility of psychosocial care is recommended for children and adolescents with type 1 diabetes (T1D) and their families. Objective. The study aimed to evaluate the availability of psychological care and its associations with glycemic control in centers from the multinational SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) registry. Subjects. Centers participating in SWEET (n = 112) were invited to complete a structured online survey, designed for the study, regarding their psychology service. Methods. Linear/logistic regression models adjusted for several confounders were used to determine the patient’s HbA1c (mmol/mol) and odds ratios (ORs) for diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) related to survey responses. Results. 76 (68%) centers with relevant data in the SWEET database responded to the survey. Psychological services were provided in 89% of the centers. The availability of psychological service in centers was associated with a slightly lower HbA1c of the patients (72 (62–82) vs. 67 (57–78) mmol/mol, p = 0.004 ) and significantly lower odds for DKA (1.8 (1.1–2.9), p = 0.027 ). Conclusions. Most centers from the SWEET registry offered some form of structured psychological care, consistent with the recommendations of easy access to psychosocial care for children and adolescents with T1D and their families. The main benefit of this psychological care appears to be in the incidence of DKA between centers. The study data also continues to emphasize the importance of treatment targets in shaping the outcomes of pediatric diabetes care. These findings should inform health-service planners and the diabetes community of the importance of mental healthcare in multidisciplinary diabetes teams.

Entrustable Professional Activities in Psychological Care for Children with Cancer: A Case Study

<p>本案例報告為試用可信賴專業活動(Entrustable Professional Activities, EPAs)於兒童癌症心理照護臨床教學的經驗分享。對象為1位臨床心理PGY(Post-graduate year)學員在1位臨床教師督導下，於某醫學中心癌童病房執行心理照護，從2020年8月至11月探視16人，計34人次；每次照會，學員及教師分別填寫EPAs即時評量，內涵可對應ACGME(Accreditation Council for Graduate Medical Education)六大核心能力，針對當次照會做即時信賴等級的評量及需加強項目之量化與質性雙向回饋討論。EPAs量化結果呈現教師評核學員專業任務表現之進步，質性討論反映出教學效能增進，可作為總評及勝任能力授權依據。EPAs的推廣需要更多臨床教師的修正討論並試用，以確認其信、效度，優化臨床心理教學效能及照護品質。</p> <p> </p><p>This study describes the experience of a postgraduate clinical psychology student working with children with cancer and their families as part of a training program that incorporated entrustable professional activities (EPAs) into its framework. The student was supervised by a clinical supervisor. The training program involved providing psychological care for 16 children with cancer in the pediatric ward of a medical center from August to November 2020. The student and supervisor both assessed EPAs corresponding to the six general competencies defined by the Accreditation Council for Graduate Medical Education and used quantitative and qualitative two-way feedback to explore the relationship between EPAs and the core competencies. The quantitative results revealed progressive improvement over the different training phases, and qualitative feedback indicated increased comprehension by and self-modification from the student. This information can be used to assess the student’s performance and authorization for managing EPAs. Programs that adopt EPAs would benefit from increased participation by clinical supervisors, who are best positioned to discuss, revise, and support the implementation of EPAs to ensure their reliability and validity, thereby optimizing educational effectiveness and the quality of health-care services.</p> <p> </p>

ISPAD Clinical Practice Consensus Guidelines 2022: Glycemic targets and glucose monitoring for children, adolescents, and young people with diabetes.

ISPAD Clinical Practice Consensus Guidelines 2022: Glycemic targets and glucose monitoring for children, adolescents, and young people with diabetes.

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes.

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes.

Psychological care for children with autism: bioethical problems in the conditions of the pandemic

Comparison of the opinions working with the children of psychologists of Volgograd region concerning the provision of psychological assistance to children with early childhood autism in the 10-year interval (2009-2019) showed the ongoing institutionalization of this social practice, although not intensive enough. However, the COVID-19 pandemic, which began in early 2020, made it virtually impossible to provide psychological support to children with the disorder, due to numerous factual and subjective factors. It was concluded that regional medical and social services needed to be particularly proactive in providing support to vulnerable categories of persons (in particular, with regard to psychological support for children with early childhood autism).

Psychological care in children and adolescents with type 1 diabetes in a real-world setting and associations with metabolic control.

International guidelines recommend psychosocial care for children and adolescents with type 1 diabetes. To assess psychological care in children and adolescents with type 1 diabetes in a real-world setting and to evaluate associations with metabolic outcome. Delivery of psychological care, HbA1c, and rates of severe hypoglycemia and diabetic ketoacidosis (DKA) in children and adolescents with type 1 diabetes from 199 diabetes care centers participating in the German diabetes survey (DPV) were analyzed. Overall, 12 326 out of 31 861 children with type 1 diabetes were supported by short-term or continued psychological care (CPC). Children with psychological care had higher HbA1c (8.0% vs 7.7%, P<.001) and higher rates of DKA (0.032 vs 0.021 per patient-year, P<.001) compared with children without psychological care. In age-, sex-, diabetes duration-, and migratory background-matched children, HbA1c stayed stable in children supported by CPC during follow-up (HbA1c 8.5% one year before psychological care started vs 8.4% after two years, P = 1.0), whereas HbA1c was lower but increased significantly by 0.3% in children without psychological care (HbA1c 7.5% vs 7.8% after two years, P <.001). Additional HbA1c-matching showed that the change in HbA1c during follow-up was not different between the groups, but the percentage of children with severe hypoglycemia decreased from 16.3% to 10.7% in children receiving CPC compared with children without psychological care (5.5% to 5.8%, P =.009). In this real-world setting, psychological care was provided to children with higher HbA1c levels. CPC was associated with stable glycemic control and less frequent severe hypoglycemia during follow-up.

The Role of Psychological Care in Children and Adolescents with Type-1 Diabetes

Diabetes is a major health-care problem all over the world with a high prevalence and incidence [1,2]. The approach and the management of the disease are challenging, especially in the early stages after diagnosis and in children.

Helena Antipoff

Helena Antipoff was one of the pioneers in the constitution of the fields of knowledge of educational psychology and special education in Brazil. Born in Russia, Antipoff received her education in Paris and Geneva. Researches in the history of education and of psychology have revealed the innovative character of Antipoff’s work as a researcher, as a professor and as a founder of different educational institutions in Brazil, with a focus on educational and psychological care for children with disabilities or at social risk. Her career is characterized by a sound scientific approach combined with a deep commitment to the right of children and youth to education and care. These directions can be associated with her scientific training in the sciences of education in a time of social turbulence and school reform, when many women became professionals in the field of education, trying to combine family, work and militant activity.

ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes.

ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes.

Medically Related Post-traumatic Stress in Children and Adolescents with Congenital Heart Defects.

Children and adolescents with a congenital heart defect (ConHD) frequently undergo painful or frightening medical procedures and hospitalizations. They often need multiple invasive procedures at a very young age and require regular checkups during their entire life. From other pediatric populations, it is known that these kinds of experiences can result in acute stress reactions and even in post-traumatic stress disorder (PTSD) in the long-term. PTSD and also subthreshold PTSD can lead to serious (psychosocial) impairment. However, limited information is available about PTSD in children with ConHD. Therefore, the aim of this review is to provide a summary of the current literature on post-traumatic stress (PTS) in children and adolescents with ConHD describing the prevalence of PTSD and its predictors/correlates. This review indicates that a range of 12–31% of children undergoing cardiac surgery develop PTSD. A range of 12–14% shows elevated post-traumatic stress symptoms (PTSS). These findings are comparable to those of hospitalized children without ConHD. Noteworthy, most studies used varying self-report questionnaires to measure PTSD and only one study used a semistructured interview. Although all studies point in the same direction of elevated PTSD and PTSS, systematic research is necessary to be able to draw firm conclusions. At present, as far as we know, in most clinics treating patients with ConHD, there is no regular screening for PTS in children with ConHD. In the reviewed literature, there is strong consensus that screening for PTSS and (preventive) psychological care for children and adolescents with ConHD is urgently needed.

Intérêt et limites de l’Intégration du Cycle de la Vie (Lifespan Integration) auprès d’adultes victimes du Syndrome de Munchausen Par Procuration pendant leur enfance

AimsWhile the scientific literature has so far shown interest in all clinical variants of Munchausen Syndrome By Proxy (MSBP), in diagnostic criteria and in theoretical hypotheses to explain its onset, there are few studies on the psychological care of children, or especially adults who experienced MSBP as children. In addition to our literature review of MSBP, this article seeks to present the psychotherapeutic treatment of adult patients who, during their childhood, were victims of this abuse, using Lifespan Integration therapy. MethodA precise phenomenological description of the conduct of Lifespan Integration sessions will provide an opportunity to understand its different forms. Reiterations of patient life stories, using a timeline, in visual and sensory form, can be effectively used in different ways for early traumas. ResultsThis detailed and commented description enables identification of dissociative processes as sequelae of invasive care and emotional deprivation, especially when this was experienced during childhood. DiscussionIn this process of co-construction of patient biographies, we consider it important to achieve emotional stabilization before addressing the trauma. This phase of tuning that is both containing and soothing is a key component of Lifespan Integration therapy, as it enables integration of previously insurmountable mental suffering and the lifting of the paradox whereby, as a child, being cared for was dangerous. ConclusionIt then becomes possible for these adults to be freed from the unchanging conviction that they are sick, incurably so, and to reorient the repetitive process initially organized by their parents.

Psychological care of children and adolescents with type 1 diabetes

Psychological care of children and adolescents with type 1 diabetes

1319 – Psychiatric legacy of chernobyl: fukushima projections

Psychiatric legacy of the Chernobyl disaster (April 26, 1986, Ukraine) remains global burden for the society till now, however its causes are at issue. The Great East Japan Earthquake with trio impact (earthquake, tsunami and radiation accident at the Fukushima Daiichi Nuclear Power Plant, March 11, 2011) provides the new challenges to emergency psychiatry. Implementation of the Chernobyl disaster psychiatric lessons into the mental health care in Fukushima. Analysis of own studies in interaction with current evidences on cerebral radiation effects. Stress-related (somatoform, anxiety, PTSD) disorders, depression and suicides, cognitive impairment, cerebrovascular pathology, and alcohol abuse are the main neuropsychiatric aftermath in exposed adults. Chernobyl survivors exposed at the brain development period (in utero and 0-1 years at the accident) have somatoform disorders, emotional and behavioural disorders, including attention deficit and hyperactive disorder (ADHD), cognitive impairments, paroxysmal disorders, and congenital abnormalities. Is there an increased risk of epilepsy, schizophrenia, neurodegenerative diseases, and multiply sclerosis among exposed individuals should be explored in further international studies. Psychiatric aftermath of Fukushima will be similar to the Chernobyl disaster one. Recommendations include: annual general medical and neuropsychiatric examinations, early diagnostic and treatment of physical and mental problems, mother’s mental health care, psychological care for children and their parents, individual relevant educational programs, never separate children from parents and relatives, radiation risk perception management. There is a strong necessity to develop and implement the international mental health care system for the survivors of radiation accidents.

Approaches to Standard School Education Balanced with Psychological Care for Children during Disaster Recovery : From the Point of View of Class Management

Approaches to Standard School Education Balanced with Psychological Care for Children during Disaster Recovery : From the Point of View of Class Management

Psychological care of children and adolescents with diabetes

Psychological care of children and adolescents with diabetes

Psychological care of children and adolescents with diabetes

Psychological care of children and adolescents with diabetes

Family Connections: A Program for Preventing Child Neglect

Family Connections was a demonstration program specifically designed to prevent child neglect. This article describes the development of prevention strategies and the assessment of outcomes for families who received two versions of the intervention. The sample included 154 families (473 children) in a poor, urban neighborhood who met risk criteria for child neglect and who were randomly assigned to receive either a 3- or 9-month intervention. Self-report and observational data were analyzed using analyses of variance (ANOVA) with repeated measures. Results for the entire sample indicated positive changes in protective factors (parenting attitudes, parenting competence, social support); diminished risk factors (parental depressive symptoms, parenting stress, life stress); and improved child safety (physical and psychological care of children) and behavior (decreased externalizing and internalizing behavior). Results further reflected no advantage of the 9-month intervention for improving parenting adequacy. Further testing of the intervention with other target populations is being conducted.

Analysis of the circumstances at the end of life in children with cancer: symptoms, suffering and acceptance.

In an effort to improve the quality of life of children with cancer, this study analyzes the signs and symptoms at the end of life in such children. It is hoped that these data will contribute to the development of appropriate programs to address the challenges faced by these children. Between 1994 and 2000, 28 children died after treatment for cancer at Hamamatsu University Hospital, Japan. The circumstances, signs and symptoms at the end of life of these children were analyzed through their medical records. Of the 28 children, the underlying diseases were leukemia/lymphoma (LL group; n=11), brain tumors (BT group; n=7), and other solid tumors (OST group; n=10). Records showed poor appetite (100%), dyspnea (82.1%), pain (75.0%), fatigue (71.4%), nausea/vomiting (57.1%), constipation (46.4%) and diarrhea (21.4%) among these children. Anxiety was reported in 53.6% of the entire group of 28 children; however, no child in the BT group manifested anxiety. However, disturbance of consciousness was reported in all children in the BT group, which was significantly greater than in the other groups. Awareness, fear or acceptance of the imminence of his/her own death as indicated by verbal expression was reported in nine children (32.1%). Using the data obtained in the present study, we describe situations faced in the terminal care of children. It is important to address the problems revealed by this analysis in order to achieve improvements in both the physical and psychological care of children with terminal cancer.

Liaison child and adolescent psychiatry

Liaison child and adolescent psychiatry has been described as the “partnership of child psychiatrists, paediatricians and other specialities concerned with children to provide integrated medical and psychological care for children” (Blacket al, 1990). Although liaison work conjures up visions of the psychiatrist on the paediatric ward, it may also involve collaboration with community paediatric and primary care services. Indeed, the number of different professionals that may be involved with even quite mildly ill children is large (see Box 1). Much of the work is indirect (e.g. consultation with other professionals), but this and direct therapeutic work with children and families may continue long after discharge from the paediatric wards and clinics.

Psychological aspects of cancer in children, adolescents, and their families

With improving medical management and survival of children and adolescents with cancer, increasing attention is being focused on the quality of life for the patient and family. This review will discuss the psychological aspects of various phases in the illness process and highlight major issues in intervention. It is concluded that the psychological care of children and adolescents with cancer can serve as a model for comprehensive care in other pediatric disorders as well.