Significant Proportion Of Parents Research Articles

Early childhood caries: parents’ knowledge, attitude and practice towards its prevention in refugee camps in Erbil, Iraq

BackgroundEarly childhood caries is a significant oral health issue in socially deprived communities, including refugees, where prevention plays a crucial role in minimizing the challenges and costs associated with treating early childhood caries. To improve oral health outcomes, it is important to understand parents’ knowledge, attitudes, and practices. This study aims to assess the oral health knowledge, practices, and attitudes of refugee parents.MethodsThis cross-sectional study included 503 parents/caregivers residing in Erbil’s refugee camps in Iraq, with healthy preschool children aged one to six years. Structured questionnaire was utilized in conducting individual interviews with parents to evaluate their knowledge, attitudes, and practices. The questionnaire collected demographic information and data on access to oral health services.ResultsA total of 503 out of 505 households actively participated in the study, resulting in a high response rate of 99.6%. Demographic analysis revealed that the majority of respondents were female parents, constituting 92.05% of the sample. Within the participant pool, the primary age groups were 26–35 years (55.3%) and 18–25 years (26.2%). Educational background analysis revealed that a significant proportion of parents had attained a secondary school education (29.6%) or primary school education (27.4%). Statistical analysis further established a noteworthy association between educational background and knowledge level. The investigation of participants’ knowledge uncovered notable gaps and misconceptions pertaining to early childhood caries, with an overall mean score of 5.1. Assessing the overall attitude of parents, a mean score of 3.87 (SD = 1.29) suggested a generally unfavorable attitude towards oral hygiene practices and prevention of early childhood caries. In terms of actual practices, parents demonstrated a mean practice score of 5.7.ConclusionsThis study emphasizes knowledge gaps and misconceptions among parents in refugee camps regarding early childhood caries in preschool children. Findings revealed low knowledge scores, limited understanding of hidden sugars, delayed oral hygiene practices, and limited knowledge about fluoride.

The roles of health literacy in parents’ honey use and the use of complementary alternative medicine in a Turkish population

BackgroundAs a biologically based therapy, honey is used by parents in many parts of the world as a home remedy for their children. While information exists regarding the traditional use of honey for health issues in children, data regarding its relationship with health literacy is lacking. The aims of this study were to determine the use of honey to address children’s health issues among parents of children aged 0–72 months and to explore the relationship between the use of complementary and alternative medicine (CAM) and health literacy.MethodsThe data for this descriptive, cross-sectional study were collected between October and November 2022 via an online survey of 907 parents of children aged 0–72 months. A sociodemographic data collection form, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and the Turkey Health Literacy Scale-32 (THLS-32) were used to collect the data. A t-test, one-way analysis of variance, and Pearson correlation analysis were used to analyze the data.ResultsThe majority (86.5%) of the parents used honey for their children’s health problems. Among the parents, 83.1% utilized honey as a remedy for alleviating cough symptoms, 10.4% employed it as a treatment for diarrhea, and 14% administered it for the management of oral mucositis. The mean THLS-32 and HCAMQ scores of the parents were 29.39 and 21.31, respectively, and there was a moderate correlation between the parents’ THLS-32 and HCAMQ mean scores (r = 0.662, p < 0.001).ConclusionThis study revealed that a significant proportion of parents who used honey to alleviate their children’s health issues displayed positive attitudes toward complementary and alternative medicine (CAM) while concurrently exhibiting insufficient or limited health literacy levels. Therefore, it is advisable to enhance health literacy regarding the proper and safe utilization of honey, which functions as a biologically based CAM therapy.

Psychological Distress Among Parents of Children With Chronic Health Conditions and Its Association With Unmet Supportive Care Needs and Children's Quality of Life.

To assess parent psychological distress in families of children with common chronic health conditions (CHC) and to explore relationships between parent psychological distress, unmet supportive care needs and children's quality of life (QoL). Cross-sectional study involving parents of children diagnosed with a common CHC between 0 and 12 years of age and who had received treatment within the last 5 years. Eligible parents completed an online survey, that included the Depression Anxiety Stress Scale (DASS-21) assessing distress in parents and a 34-item assessment of unmet supportive care needs across 6 domains. Parents completed ratings of their child's current functioning (QoL) using the 23-item PedsQL. Multivariable regression models examined the relative association between unmet needs, children's QoL and parents' depression, anxiety, and stress. The sample consisted of 194 parents of children with congenital heart disease (n=97; 50%), diabetes (n=50; 26%), cancer (n=39; 20%), and asthma (n=8; 4%). A significant proportion of parents had moderate-severe symptoms of depression (26%), anxiety (38%), and stress (40%). Of the PedsQL scales, the poorest outcomes were found for emotional and school functioning. Multivariable analyses showed that both higher unmet needs and poorer child emotional functioning were associated with parent depression, anxiety, and stress symptoms. Evidence linking parent distress symptoms to higher unmet needs and poorer child emotional functioning suggests these factors may be targets for interventions to alleviate parent distress. Longitudinal research using larger samples is required to replicate findings, and clarify the magnitude and direction of associations.

Factors predicting caregivers' readiness for vaccination of 5-11 years old children against SARS-CoV-2 - Saudi Arabia, 2022.

A significant proportion of parents are still reluctant to have their children vaccinated against COVID-19. This study aimed to determine what factors influence parents' decision to get COVID-19 vaccine for the children of age group 5-11 years. A cross-sectional study was conducted in the region Qassim of Saudi Arabia, by using a self-administered, pre-tested questionnaire to assess the predicting factors of caregivers' readiness to get their children vaccinated against COVID-19. Two-thirds of the caregivers surveyed were unwilling to get their children vaccinated against COVID-19. The factors that influence the parents' decision to get their young children (5-11 years old) vaccinated against COVID-19 were: having secondary school education (p = 0.019), family members infected with SARS-CoV-2 (p = 0.016), caregivers completed the three doses of vaccination (p = 0.003) and those who received additional flu vaccine (p = 0.014), and not experiencing the side effects of COVID-19 vaccine (p = 0.0001). Additionally, no history of COVID-19 vaccine adverse events in older 12-18 year old children (p = 0.011) and no chronic diseases in the 5-11 year old children (p = 0.001) were predictors. Caregivers' preferences about the children's vaccination were influenced by multiple factors, including educational level, having family members infected with SARS-CoV-2, caregivers completing three doses of COVID-19 vaccine, receiving additional flu vaccine with no or mild adverse events, and history of chronic diseases in the child. Understanding these factors can help determine the likelihood of the caregivers getting their child vaccinated.

Parental Willingness to Vaccinate Their Children Against SARS-CoV-2 in Jordan: An Explanatory Cross-Sectional Study.

BackgroundSuccessful control of the COVID-19 pandemic is largely dependent on vaccine administration to epidemiologically influential groups, including children. Considering that pediatric population comprises a significant portion on the population in developing countries, and their risk of infection and spreading the disease has been underestimated, it is crucial to investigate parental willingness to administer SARS-CoV-2 vaccine to their children between 5 and 11 years old. This study investigates the prevalence and determinants of parental willingness towards vaccinating their children (5–12 years old) against COVID-19 in a developing country setting, Jordan.MethodsA cross-sectional study, conducted between October and November 2021, utilized online Google Forms to collect data on parents’ background characteristics, willingness to vaccinate their children, SARS-CoV-2, infection and vaccine, risk perception, and factors affecting decision to vaccinate.ResultsA total of 564 parents completed the questionnaire; 82.8% were mothers, 85.3% were 30 years of age or older, and 75.9% had bachelor’s degrees or higher. Only 25.4% of parents reported willingness to vaccinate their 5–12 years old children against SARS-CoV-2. Lower parental age, higher income, and having health insurance coverage increased parental willingness. Among participants vaccinated against COVID-19, only 29.0% were willing to vaccinate their children. Healthcare providers’ trust and vaccine recommendations by pediatricians increased parental willingness. COVID-19 risk perception seems to have negative effects on parental willingness.ConclusionA significant proportion of parents in Jordan indicated hesitancy towards administering COVID-19 vaccine for their children. Concerns about vaccine safety and trust in the healthcare system appear to be the most important predictors of parents’ hesitancy. Effective vaccine campaigns should focus on risk perception and communication and should consider parental socio-demographic characteristics.

'Sometimes they're gammin, playing tricks, but sometimes it's ears.' The perspectives of urban parents and carers of young Aboriginal and Torres Strait Islander children on their journey to diagnosis of persistent ear health and hearing problems.

Data presented in this paper were gathered during the Urban Hearing Pathways study. The objective of the study was to investigate how access to, and availability of, ear health and hearing services contributes to the burden of avoidable hearing loss experienced by young, urban Aboriginal and Torres Strait Islander children and their families. The objective of this paper is to present the perspectives of parents and carers about awareness and concern in their community, detection and diagnosis of children's ear health and hearing problems in primary care, and impacts of delays in diagnosis on children and families. These perspectives are complemented by those of health professionals. Importance of study: The study findings address an evidence gap relating to factors that prompt an ear health and hearing check for young, urban Aboriginal and Torres Strait Islander children. They reveal the difficulties families experience in establishing a diagnosis of chronic ear disease and receiving the care they perceive will effectively addresses their child's needs. Qualitative study with surveys. The project team consisted of six Aboriginal researchers and 10 non-Indigenous researchers. Data collection tools and methods were designed by the project team. A total of 33 parents and carers completed surveys, and most also took part in interviews (n = 16) or focus groups (n = 16); 23 described their child's ear health journey. Fifty-eight service providers from the health, early childhood and community service sectors completed anonymous surveys and 26 were interviewed. Descriptive statistics were generated from survey data and thematic analysis was conducted for interview and focus group data. Five main themes emerged from the analysis of parent and carer interviews: community knowledge and parent/carer recognition of signs of ear health and hearing problems; parent and carer action-taking; getting ear health and hearing checks; recognition of persistent problems; and impacts of delays on children and families. Reiterating previous findings, there is no evidence of a systematic approach to ear checks for this at-risk population. A significant proportion of parents and carers are noticing problems by watching their child's listening behaviours: early and reliable indicators of hearing status that can be harnessed. Some persistent ear health problems are being managed in primary care as acute episodes, thus delaying specialist referral and increasing developmental impacts on the child. Parents' and carers' practical recommendations for improving hearing health services are presented.

Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey.

Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines.Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia.Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels.Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.

Parents' experiences of early discharge after a planned caesarean section: A qualitative interpretive study

ObjectiveThe birth rate in Denmark is increasing, and the rate of births by caesarean section has increased to more than 20%. Thus, the obstetric departments have been put under pressure to identify new solutions to optimize the maternity care system, in which early discharge might be considered. The aim of this study was to explore parents' experiences of the postnatal care after planned caesarean section with focus on factors that support or hinder early discharge. DesignAn interpretive, hermeneutic approach was chosen, using qualitative interviews with multiparous women and their partners. Data analysis was performed using thematic analysis. Participants and settingTwelve women and partners were recruited from two hospital-based maternity units in Denmark. The inclusion criteria were low-risk Danish-speaking multiparous women having a planned caesarean section with a singleton pregnancy (gestational age between 37+0 and 41+6 weeks). Seven sets of parents were discharged before 28 h and five were discharged after 48 h. FindingsThree main themes were identified as important for timing of discharge: (1) Setting for recovery (2) Views on length of stay, and (3) Preparation and individual planning. All parents valued the safe and supportive environment at the hospital, but several preferred early discharge as they felt more comfortable in their home environment and wanted to be together as a family with all siblings. When considering appropriate time of discharge, the main issues were that pain was manageable, that breastfeeding was initiated successfully and that professional support was available after discharge. Finally, early discharge required preparation and planning and the parents stressed the importance of knowing that they would not be discharged unless they felt ready. Conclusion and implication for practiceA clear link was observed between the care package the parents received and their views on the optimal time of discharge. Based on our findings it seems likely that a significant proportion of parents will accept and feel confident about early discharge if individual circumstances are taken into account in the antenatal planning of a caesarean section.

Parental perception on the effects of early exposure to anaesthesia on neurodevelopment.

Several studies have investigated the effects of general anaesthesia on neurodevelopment in children, with conflicting results. The potential for early general anaesthesia exposure to impact neurodevelopment in children may cause significant concern for parents. Administering a questionnaire in 200 parents, we aimed to explore their knowledge, concerns and perceptions, and determine factors which influence parents' willingness for their children to participate in relevant research studies. A significant proportion of parents (40%) were concerned that general anaesthesia may affect their child's neurodevelopment. Generally these concerns arose from the parents' own beliefs or preconceived ideas and only 25.5% had encountered prior information in this domain. Parents with children aged 2years or younger, those whose children had previous general anaesthesia exposure, and those who had encountered information about potential neurodevelopmental effects were most likely to be concerned. The majority of parents (68%) would agree to participate in research studies, especially if they were able to receive the test results. Anaesthetists should pre-emptively initiate discussions to address any potential misconceptions regarding the effects of general anaesthesia on neurodevelopment in children.

Continuous Flash Glucose Monitoring in children with Congenital Hyperinsulinism; first report on accuracy and patient experience

BackgroundThe factory calibrated FreeStyle Libre (FSL) flash glucose monitoring system has been recently introduced for use in patients with diabetes mellitus. There are no reports available regarding its use in patients with congenital hyperinsulinism (CHI). We have assessed the accuracy of FSL compared to the finger prick capillary blood glucose (CBG) over 2 weeks period in patients with CHI and evaluated the parents’ experience of using FSL.MethodsFour hundred sixty-seven episodes of CBG along with corresponding swipe FSL readings were available from 11 children with CHI (0.5–5 years). A detailed questionnaire was completed by the parents.ResultsThe mean variation between the two methods was 0.29 mmol/l (SD ±1.07), higher readings by FSL compared to CBG. The FSL sensors stayed in-situ for an average period of 11.5 days. There was a positive correlation between the two methods (r = 0.7). The FSL tended to overestimate compared to CBG (bias = 0.29 mmol/l; 95% CI: 0.19 to 0.38). Only 70% of values were within the reference standard (±0.83 mmol/l) at glucose concentrations less than 5.6 mmol/l. The overall Mean Absolute Relative Difference (MARD) was 17.9%. Forty two episodes of hypoglycaemia (CBG < 3.5 mmol/l) were noted but FSL identified only 52% of these episodes. The Bland Altman analysis showed the 95% limits of agreement between the two methods ranging from − 1.8 (95% CI: -1.97 to − 1.64) to 2.37 (95% CI: 2.21 to 2.54). Majority of the parents found the glucose trend on FSL to be useful to detect and prevent hypoglycaemic episodes. All parents felt that FSL is a very easy and convenient method to measure the glucose especially during sleep. A significant proportion of parents felt that FSL readings were not accurate and 56% of parents expressed interest to continue using FSL after the trial period.ConclusionNoticeable variability between the two methods of measuring the glucose was noted. Despite the ease of using the FSL system, concerns related to accuracy, especially at low glucose values do remain although parents find the glucose trend to be very useful. Further larger trials are needed in CHI patients before FSL is recommended as a routine alternative method for measuring glucose levels.

High‐conflict parents in mediation: An analysis of dialogues and sources to conflict

A significant proportion of parents in mediation present destructive and escalating conflicts. In a naturalistic study of sessions with high‐conflict couples, we observed dialogues with frequent interruptions, rapidly shifting subjects, and emotional attacks. A systematic search revealed eight distinct sources of conflict that interfered with the mediation process: Two related to the breakup, four regarding differing concerns of care for the child, and two mainly about the contextual conditions for childcare arrangements. The article describes these sources of conflicts in a format that could increase the capacity of mediators to recognize and address them during the process of mediation.

Myths and beliefs of long-term care providers towards starting inhaled medications in children with bronchial asthma

Introduction: Management of persistent forms of asthma needs long term use of inhalers. Myths and beliefs of long term care providers influence compliance with inhaled medications. Objective: To assess the presence of myths and beliefs of long term care providers towards starting inhaled medications in children with bronchial asthma and the influence of socio-demographic factors on them. Method: A prospective cross-sectional descriptive study was carried out in clinics and in-ward patients of paediatric units at 3 Base Hospitals using a self-administered questionnaire. The patients selected were those who were newly planned to start or those already on inhaled medications for bronchial asthma. Care providers who were educated by our team and short term care givers were excluded. Results: The study included 242 long term caregivers of children with bronchial asthma. Of them, 98% had education beyond Grade 5 and 75% had a family income greater than Rs.30, 000/- per month. Majority (59.4%) were already informed regarding the use of inhalers and of them, more than 95% received it from a health care worker. The most prevalent myth among them was that ‘the cost of inhalers is very high’ (n=99, 41%). Among the other myths, a significant percentage of parents believed that ‘inhalers may damage the lungs’ (n=92, 38%) and in ‘inhaler dependency’ (n=86, 35.5%). The proportions of parents having myths were more with the more educated and higher income groups. Previous use of inhalers by the patient or a family member did not significantly influence the presence of myths. Conclusions: A significant proportion of parents / long term care-givers of children with bronchial asthma had myths and false beliefs towards starting inhaled medications. The most prevalent myth was that ‘the cost of inhalers is very high’. Sri Lanka Journal of Child Health , 2015; 44 (4): 202-208

Knowledge Of Child Abuse Among Parents Of Under 5 Years Children In Kathmandu, Nepal

Child abuse and neglect is a significant global problem with a serious impact on the victims’ physical and mental health, well-being and development throughout their lives. Out of the many parental causes of child abuse, the important reason is lack of knowledge regarding it among them. We explored the knowledge of child abuse among the parent of under 5 children in urban setting of Kathmandu district of Nepal. This is descriptive cross sectional study which involved the parents of children under 5 years of age residing in Kalanki area of Kathmandu in order to identify their existing knowledge on child abuse and to explore the relationships between their knowledge scores and some selected variables by interviewing using a semi-structured questionnaire. Out of the total 95 participants, 50.53% had good knowledge and 48.4% had average knowledge on overall child abuse. None of the parents had poor knowledge in terms of child physical abuse, child neglect and child emotional abuse. However, 20% and 10.5% of the parents had poor knowledge on child sexual abuse and general child abuse respectively. The level of knowledge and the variables viz. age group and exposure to different source of information were significantly associated while no significant association was found with their educational status. The parents do have a satisfactory level of knowledge regarding child abuse. However, a significant proportion of parents still had poor knowledge in context of general child abuse and child sexual abuse. A nationwide study of such kind using qualitative tools as well as conducting awareness raising activities especially focusing on the general abuse and abuse of sexual nature is recommended.DOI: http://dx.doi.org/10.3126/jmmihs.v1i4.11995Journal of Manmohan Memorial Institute of Health SciencesVol. 1, Issue 4, 2015Page : 9-13

Outpatient penicillin use after negative skin testing and drug challenge in a pediatric population

The practice of elective penicillin skin testing could be compromised by the fact that patients, their parents, or their physicians remain reluctant to reuse penicillin-class antibiotics (PCAs) despite a negative evaluation by an allergist. This study addresses reuse of PCAs in a pediatric population after negative penicillin skin testing and drug challenge and factors associated with its reluctance. All children evaluated for a history of penicillin allergy at the CHU Sainte-Justine Allergy Clinic between January 1998 and June 2000 with negative skin testing and drug challenge were included in the study. A telephone survey was conducted between May and October 2002 to assess the perception of the initial reaction by the parents, subsequent use of antibiotics, and antibiotic-related adverse reactions. Among the 200 children selected, parents of 170 (85%) children completed the survey. Since the allergist evaluation, 130 (76%) children had received antibiotics. PCA was used in 59 (45%) children. Parents of 24 (18%) children refused PCAs because they still feared an adverse reaction. They were more likely to have been very frightened by their child's allergic reaction than other parents whose children had used PCAs (p = 0.008). Although elective penicillin skin testing is useful and safe in the pediatric population, a significant proportion of parents still refuse PCAs even though they are needed. Identification of parents that were very frightened by their children's allergic reactions and additional reassurance could improve this situation.

Parental Awareness of Substance Use Among Youths in Public Service Sectors

When asked about substance use, youths typically endorse higher levels of use than parents, suggesting that parents are often unaware of their child's drug and alcohol use. This study sought to examine the level of concordance between reports of youths enrolled in public sectors of care and their parents, and identify potential predictors of parental awareness of substance use and related problems. Youths receiving services in one or more public sectors of care (N = 985; 67% male) and their parents were interviewed about the youths' substance use and substance use problems, as well as associated demographic, parental, and youth factors. As has been found in other studies, youths generally reported higher rates of substance use and substance use problems compared with parents. Rates of agreement ranged from κ = .24 (sedatives) to κ = .67 (marijuana) and were higher for drug problems (κ = .47) than for alcohol problems (κ = .34). Predictors of parental awareness of drug problems included youth gender (male), race (White compared with Hispanic), and higher ratings of youth's functional impairment. Predictors of parental awareness of alcohol problems included race (White compared with Hispanic), lower levels of youth-reported parental monitoring, lower levels of parental depression, and higher ratings of youth functional impairment. In this high-risk population, a significant proportion of parents are unaware of their child's alcohol (30%) and substance use (50%) problems. Services geared toward enhancing parental awareness, especially for parents of Hispanic and female youths, may increase communication and treatment seeking.

Hilfebedarfe von Eltern mit psychischen Erkrankungen - eine Literaturübersicht

Approximately 10 % of women and 6 % of men who become parents will experience mental health problems and a significant proportion of these have a severe psychiatric illness. This paper provides a literature review of the needs of parents with severe mental illness. Literature review. Mothers with severe mental illness have a wide range of complex health and social care needs in addition to their parenting needs, which must be addressed by services in pregnancy and postpartum to optimise outcomes. There is limited evidence on the needs of fathers with severe mental illness but they may have a greater number of needs than women, and a greater need for training in parenting skills than women suffering from severe mental illness. Parents with severe mental illness may experience stigma and discrimination, and fear accessing services due to fears of losing custody of their child. Although a significant proportion of parents with severe mental illness do lose custody, many can successfully parent if adequate support is available and needs are assessed and managed by a multi-disciplinary team.

Neonatal research: the parental perspective

Objectives: To investigate the recollections of parents consenting for their infants to be research subjects and determine their views about the need for consent. Subjects: Parents of 154 sick newborn...

Use of the internet by parents of paediatric outpatients

Aims: (1) To establish how many parents of children seen in paediatric outpatient departments use the internet to find information about their child’s medical condition. (2) To ascertain what information...

Impact of extreme prematurity on families of adolescent children

Objectives: To compare the impact of burden of illness on families of teenaged children who were extremely low birth weight (ELBW) with that of members of a term control group (C) and to determine whether the attitudes toward active treatment of very immature infants differ between the 2 cohorts. Design: In a cross-sectional survey, parents of 145 (86%) of 169 members of an ELBW cohort and 123 (85%) of 145 members of a control cohort completed a 23-item self-completed questionnaire encompassing occupational, marital, and family-related issues and attitudes toward treatment of infants of borderline viability. Results: Both positive (P =.0003) and negative (P <.005) effects on marriage were higher in parents of the ELBW group; although more parents in the ELBW group felt that their child had brought their families closer together (P =.0001), their child’s health had adversely affected their emotional health (P =.02) and that of other children in the family (P =.003). Despite this result, a significant proportion of parents from both cohorts supported saving all infants (ELBW 68%; C 58%) and favored the role of parents in decision making (ELBW 98%; C 97%). Conclusions: In the long term, it appears that parents of ELBW children have adjusted fairly well to their work and family life. Although some negative effects were identified, there was still considerable support for active treatment of infants of borderline viability. (J Pediatr 2000;137:701-6)

Parental concern towards the use of inhaled therapy in children with chronic asthma.

Parental attitudes towards the use of inhaled therapy in children with chronic asthma influence treatment adherence and outcome. In the present study, we evaluated the perceptions and concerns of parents of children with chronic asthma towards inhaled therapy. A self-administered standard questionnaire was distributed to parents of children attending the Paediatric Asthma Clinic. All these children required inhaled steroids for treatment. One-hundred and twelve of 170 parents (66%) surveyed were concerned with inhaled therapy. The most common concern with its use was medication side effects (91%), followed by 'inhaler dependency' (86%), cost of the inhaler (34%) and difficulty in using the inhaler (15%). Parental perception that the oral route was superior to the inhaled route, preference for the oral route for asthma prophylaxis and a higher steroid dose required for prophylaxis were more likely to be associated with concerns towards inhaled therapy. More importantly, these children were also more likely to miss > 25% of their prescribed doses of inhaled steroids (46 vs 22% in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P = 0.007) and had a higher mean number of nebulization treatments in the last year (3.2 +/- 2.9 vs 1.8 +/- 1.3 in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P = 0.01). A significant proportion of parents whose children were on inhaled prophylaxis had concerns towards the use of inhaled therapy. Parental concern towards inhaled therapy appeared to increase the problem of non-adherence to treatment. Education for these parents will need to be addressed to improve asthma management in our patient population.