Search Results (202)

Family self-care emphasizes a family’s role in health promotion and protection, reflecting society’s views on health, illness, and human relationships. In families with children with an intellectual disability, where the child may lack self-care abilities, family self-care becomes crucial, highlighting that self-care needs exceed individual capacity and require family cooperation. Background/Objectives: This pilot study aims to explore the factors influencing family self-care and define attributes of its cognitive, psychosocial, physical, and behavioral domains in families with children with intellectual disabilities. Methods: A descriptive and correlational study with forty-four families was conducted. Exploratory analysis and linear regression analysis were estimated through the assumptions of the Gauss–Markov theorem (specifically homoscedasticity, normality, and model specification adequacy). Multicollinearity was also evaluated. Results: The significant family conditioning factors identified were family income, education level, degree of physical and functional dependence of the child, family household size, and social support. Socioeconomic, demographic, and health-related factors shaped self-care experiences. Conclusions: Family empowerment and the impact of disability are key elements in enabling self-care. Families reporting a greater impact of their child’s condition tended to feel less empowered, directly affecting their ability to perform daily self-care activities. The evidence suggests a pattern in which self-care activities might be reactive rather than proactive and focused on managing immediate challenges rather than long-term well-being. These insights can guide healthcare professionals, especially family nurses, toward a holistic, family-centered approach to supporting families with children with intellectual disabilities. Full article

Background/Objective: This retrospective observational study describes the social, health, and psychological conditions of children living in a disadvantaged and degraded suburb of Rome Metropolitan City during the COVID-19 pandemic as registered by the primary healthcare service of the Solidarity Medicine Institute, with the aim of fighting social exclusion and health disparities during lockdown and offering free health care to vulnerable families. Methods: The access to pediatric interventions was assessed from April 2020 to December 2022. For each child, biometric parameters were recorded, and the physical and psychological states of health were assessed. Furthermore, data regarding family socio-economic variables were collected. Results: From April 2020 to December 2022, 638 children, aged 0 to 18 years, had access to the healthcare system, which was provided by the Solidarity Medicine Institute, with a total of 2300 pediatric visits. Moreover, food supplements, drugs, and hygiene kits that were necessary for the containment of the COVID-19 infection were freely distributed at the center. The highest proportion of children included in this study were from African and Eastern European families (46% and 35.8%, respectively), and 41% of these children did not have a pediatrician from the public health service. Children aged 0 to 5 years comprised 50.81% of the entire population of this study. Nutritional status assessment indicated that among the 117 infants aged 0–12 months, 5.7% were below the 3rd weight percentile, while 28.9% exceeded the 85th weight percentile. BMI assessment for children aged 2 years and older (i.e., 521 children) indicated that 21.7% of these children were overweight, and 9.5% were obese. Sixty-nine cases of psychiatric disorders were also detected among these children, with a high frequency of cases of Specific Language Disorder (31.8%), Attention Deficit Hyperactivity Disorder (21.7%), and Specific Learning Disorder (14.5%). Psychiatric and rehabilitative interventions were also offered. Conclusions: The Solidarity Medicine Institute responded to the request of the municipality of Rome to remain open and offer social and health assistance to the most vulnerable people during the pandemic. The Solidarity Medicine Institute has efficaciously served a fragile pediatric population, intercepting social, health, and psychological needs and overcoming social exclusion, health disparity, and the fragmentation of welfare services exacerbated by the COVID-19 pandemic. Full article

Children with non- or minimally verbal autism (nmvASD) commonly display sensory and emotional dysregulations leading to extremely stressful situations that trigger challenging behaviors which are often difficult to treat. Nonetheless, this population remains rarely studied in clinical research. Recent methods use electrophysiological biomarkers as diagnostic tools to detect stress signals, which may be useful in anticipating situations or conditions leading to challenging behaviors in nmvASD. A specific questionnaire was created in order to identify the characteristics of nmvASD children and gather the opinions of future users (parents and caregivers) on the design of a wearable device able to collect stress-related electrophysiological data. The results indicate that approximately 67.5% of respondents (n = 40) would be interested in such a device, both in outpatient and inpatient settings. In 70% of cases, prolonged contact with an object on the trunk is always well accepted by the child. This location was also preferentially chosen by 57.5% of respondents for such a wearable device. The presence of wires could be problematic in 82.5% of cases. About 65% of respondents find it far better to integrate these wearable devices directly into the clothing. These results will help in the development of devices specifically developed for the nmvASD population to enhance their care for behavioral disorders and based on user-center design. Full article

Background: This study aims to analyze the vaccination status and factors influencing delayed vaccination among toddlers born to hepatitis B surface antigen (HBsAg)-positive mothers. Methods: Data of HBsAg-positive mothers between 1 January 2021 and 31 December 2022 were provided by the Suzhou Maternal and Child Health Care and Family Planning Service Center. The vaccination records were obtained from the Jiangsu Province Immunization Service Management Information System. Logistic regression analysis was used to analyze influencing factors of delayed vaccination. Results: A total of 4250 toddlers born to HBsAg-positive mothers were documented. The data revealed that the first dose of the hepatitis B vaccine was administered to 100% of the toddlers. In addition, the coverage of the National Immunization Program (NIP) vaccines among these toddlers ranged from 92.9% to 99.4%. The proportion of delayed NIP vaccination varied between 0% and 12.2%. The proportion of delayed Bacillus Calmette–Guérin (BCG) vaccination was 11.3%, with the delay predominantly observed between 4 and 6 months. Notably, the proportion of delayed BCG vaccination among the toddlers born to HBsAg-positive mothers was significantly higher than that in the general population. Additionally, the proportion of the first dose of non-NIP vaccines was 3.3–36.4%, and the proportion of DTaP-IPV/Hib was 27.0%. Logistic regression analysis revealed that the regional level, the mother’s human papillomavirus (HPV) vaccination status, and the infant’s birth weight were significant factors influencing the timeliness of vaccination. Conclusions: Although the vaccination status of toddlers born to HBsAg-positive mothers in Suzhou city remains stable, the issue of delayed vaccination requires attention. It is essential to continue strengthening targeted vaccine education to reduce vaccine hesitancy and improve the rate of timely vaccination. Full article

Background: Children in pediatric oncology report unmet needs related to communication and information about the illness, care involvement, and psychosocial support. Supporting the whole family involves challenges, with a risk that children’s voices are not heard above those of the adults. Article 12 of the UNCRC has been a catalyst in supporting children’s voices and their right to participate in processes that affect them. The aim of this study was to explore how children with cancer and their siblings experienced participation in a family-centered psychosocial support intervention, the Family Talk Intervention (FTI). Methods: Interviews were held with 35 children (ill and siblings) from 26 families in pediatric oncology after having completed the FTI. A combined deductive and inductive qualitative content analysis was undertaken, guided by the Lundy model of child participation. Results: Children’s experiences of being able to express their views, being listened to, and being involved during FTI were mainly positive. This was related to their participation in individual meetings where they could raise their concerns and views, undertake small activities while talking, and have their voices and needs mediated to relevant adults, such as parents and professionals. Conclusions: The findings of this study showed that the FTI for families in pediatric oncology created opportunities to promote child participation. These findings indicate that, by offering children an individual space where they can express themselves freely and supporting them in various ways to do so, the children’s voices and involvement are strengthened. Full article

Background: Evidence indicates that pediatric burns are a significant form of trauma. They affect not only children but also their parents, who often experience short- and long-term psychopathological symptoms. The body of knowledge on the impact of hospitalization on parents has expanded; however, there is a dearth of evidence on the dynamics of parental relationships, parental experiences, and how these experiences affect their parenting. Objectives: This study aims to map and summarize the available literature on the repercussions of trauma associated with pediatric burns and hospitalization on parental and family dynamics. Methods: A scoping review will be carried out in accordance with the JBI methodology, based on the PCC. Studies involving hospitalized children (up to the age of 18) who have suffered accidental burns and their parents or caregivers will be included. The literature study will examine the effects of pediatric burn-related trauma on family and parental dynamics, emphasizing interventions and adjustment strategies that support children and families affected by this injury. Studies related to hospital settings and returning home will be included and analyzed by two independent reviewers using a standardized form developed for this study. The databases consulted will be Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, Collection of Psychology and Behavioral Sciences (via EB-SCO), PsycInfo, Cochrane Library, Embase, and Web of Science (Clarivate). Results: The results will be summarized narratively, presented in tables or diagrams, to highlight key findings related to parental experiences with burned children, the trauma associated with this episode, and its impact on parenting. In addition, strategies developed within the framework of the care partnership will be highlighted. Conclusions: Understanding how family dynamics change after a child suffers a burn injury and goes through the hospitalization process is crucial for nurses to improve their practice. We hope that this review will promote partnership-oriented, family-centered nursing practice in the care of child burn victims and their families, as well as assist in the identification of knowledge gaps in the literature and potential areas for future research and development. Full article

Background/Objectives: Refugee children are vulnerable in many respects. Determining their nutritional characteristics can guide the interventions that need to be developed. We aimed to determine the infant feeding characteristics of Syrian refugee mothers. Methods: Syrian health care workers administered a survey file to Syrian mothers (n = 210) having a child under two years of age in 39 refugee health centers from five provinces. Analysis for association was conducted using the Chi-square test and logistic regression. Results: The mean (±SD) age was 27.1 ± 6.3 years for mothers and 11.0 ± 6.2 months for infants. Thirty percent of the children had prelacteal feeding, most frequently sugary water, formula, and anise. Of all, 69% continued to be breastfed; 86% in 0–5-month-old babies and 36% in 16–23-month-old infants. Of 16–23-month-old children, 40% had not eaten any fruit and vegetables rich in vitamin A before. Multivariate analysis revealed that prelacteal feeding was associated with bottle feeding and not having lactation counseling support in the prenatal and postnatal periods (AOR: 2.61, 95% CI: 1.35–5.10; AOR: 2.79, 95% CI: 1.33–5.84). Being still-breastfed was associated with younger age (0–5 months old) and not using feeding bottles (AOR: 3.85, 95% CI: 1.47–10.10; AOR: 2.66, 95% CI: 1.35–5.21, respectively). Conclusion: Prelacteal feeding, sugary water consumption, bottle feeding, and limited dietary diversity were identified as significant nutritional issues among Syrian infants. In addition to lactation counseling, there is a need for culturally appropriate education on complementary feeding and healthy child nutrition for pregnant mothers and those with children under two years of age. Full article

Background: The death of a child due to complex congenital heart disease (CCHD) in pediatric intensive care units profoundly affects families, often resulting in lasting grief and emotional distress. Despite advancements in pediatric palliative care (PPC), significant gaps persist in communication and end-of-life (EoL) planning. This study explores the experiences and perceptions of bereaved parents to identify areas for improvement in PPC delivery. Methods: A qualitative phenomenological design was used to analyze the lived experiences of 18 bereaved parents whose children died from CCHD at a tertiary cardiac center. Semi-structured telephone interviews were conducted, incorporating five open-ended questions. Data were analyzed inductively using Colaizzi’s method to identify recurring themes and subthemes. Results: Four key thematic areas emerged: communication issues, the parental role, child care, and bereavement support. Parents highlighted inconsistent communication, lack of preparedness for EoL decisions, and emotional isolation as major challenges. Positive experiences often involved compassionate healthcare providers and structured psychological support. A significant proportion of parents identified family support and faith as key coping mechanisms, while others expressed dissatisfaction with post-mortem follow-up and the absence of long-term bereavement care. Conclusions: Bereaved parents’ experiences underscore the need for improved communication strategies, greater parental involvement in care, and enhanced bereavement support. Integrating structured decision-making pathways early in the care trajectory may help mitigate parental distress and improve the quality of EoL experiences for children with CCHD. Full article

Background: The Child Amputee Prosthetics Project—Prosthesis Satisfaction Inventory (CAPP-PSI) is a comprehensive instrument designed to measure satisfaction across functionality, aesthetic, and service domains. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the CAPP-PSI in an Italian pediatric population. Methods: Following international guidelines, the CAPP-PSI was translated and culturally adapted. Internal consistency was evaluated using Cronbach’s alpha, while test–retest reliability was assessed with intraclass correlation coefficients (ICCs). Construct validity was measured by analyzing correlations among subscales. Results: A total of 113 children with congenital or acquired upper limb amputation, accompanied by their parents, were recruited from the Bambino Gesù Children’s Hospital in Rome. The Italian CAPP-PSI demonstrated excellent internal consistency (Cronbach’s alpha = 0.913) and strong test–retest reliability (ICC = 0.966). Subscale correlations showed strong relationships between child and parent satisfaction (r = 0.724, p < 0.01) and parent satisfaction with service (r = 0.612, p < 0.01), while moderate correlations were observed between child satisfaction and service (r = 0.434, p < 0.01). Conclusions: The Italian version of the CAPP-PSI is a reliable and valid tool for assessing prosthetic satisfaction in pediatric populations. It provides valuable insights for clinicians and researchers, supporting patient-centered care and targeted improvements in prosthetic design and services. Future studies should explore longitudinal outcomes and the role of psychosocial factors in prosthetic acceptance. Full article

Background: Parents of children with life-limiting or life-threatening illnesses and/or medical complexity experience intense stress and pain soon after the birth and lifelong. Understanding parents’ experiences and coping strategies is the prerequisite to provide tailored support to families. Aim: To explore the experiences of parents of children with medical complexity (CMCs) during hospitalization in a Family-Centered Care (FCC) neonatal unit and after discharge. Design: Qualitative study. Methods: Semi-structured interviews were administered to the parents of children with medical complexity admitted to the Neonatal Intensive Care Unit (NICU) of Modena between October 2016 and January 2024. The interview was developed based on three time points: birth, hospitalization, and discharge, focusing on parents’ experiences, emotions, and communication with healthcare professionals. The interviews were analyzed using the template analysis. Results: A total of 10 parents were interviewed. Four domains were identified, encompassing eight significant themes in the parents’ experiences and their communication with healthcare professionals. The relevant emotions included anxiety and fear for survival, fatigue, and guilt over the child’s suffering, alongside hope and trust that parents felt entitled to nurture. Relationships with professionals were characterized by expectations and frustrations; mothers and fathers had different perceptions and reactions to the situation they were facing. Conclusions: This qualitative study explores the experiences of parents of CMCs in a neonatal intensive care unit adopting FCC. From admission to discharge, parents’ emotions were influenced by the child’s unique clinical history. Active listening and the humane attitude of healthcare professionals were the aspects most appreciated by parents. Full article

Background: While multimodal analgesia is the standard of care for postoperative pain relief, opioid medications continue to be a part of the treatment regimen, especially for more invasive surgeries such as spinal fusion, craniofacial reconstruction, laparotomy, and others. In pediatric patients, safe usage, storage, and dosing are especially important, along with clear instructions to caregivers on how to manage their child’s pain. Combination opioids such as hydrocodone with acetaminophen and acetaminophen with codeine are the most commonly prescribed opioid medications for postoperative pain control. However, these combination products can lead to acetaminophen toxicity, limit the ability to prescribe acetaminophen or ibuprofen, and add to caregiver confusion. Administering acetaminophen and ibuprofen individually rather than in combination products allows the maximal dosing of these nonopioid medications. The primary aim of this quality improvement (QI) project was to increase the utilization of single-agent opioids for postoperative pain control, primarily oxycodone, by the various surgical groups here at Cook Children’s Medical Center (CCMC). Methods: The project setting was a tertiary-level children’s hospital with a level 2 trauma center, performing over 20,000 surgeries annually. The opioid stewardship committee (OSC) mapped the steps and overlapping activities in the intervention that led to changes in providers’ prescription practices. A Plan–Do–Study–Act continuous improvement cycle allowed for an assessment and modification of implementation strategies. Statistical control process charts were used to detect the average percentage change in surgical specialties using single-agent opioid therapy. Data were monitored for three periods: one-year pre-intervention, one-year post-intervention, and one-year sustainment periods. Results: There were 4885 (41%) pre-intervention procedures, 3973 (33%) post-intervention procedures, and 3180 (26%) sustainment period procedures that received opioids. During the pre-intervention period, the average proportion of single-agent opioids prescribed was 8%. This average shifted to 89% for the first five months of the post-intervention period, then to 91% for the remainder of the study. Conclusions: The methodical application of process improvement strategies can result in a sustained change from outpatient post-surgical combination opioid prescriptions to single-agent opioid prescriptions in multiple surgical departments. Full article

Background/Objectives: Caregivers of children with chronic illnesses, including chronic pain, experience high levels of distress, which impacts their own mental and physical health as well as child outcomes. Virtual care solutions offer opportunities to provide accessible support, yet most overlook caregivers’ needs. We conducted a scoping review to create an interactive Evidence and Gap Map (EGM) of virtual care solutions across a stepped care continuum (i.e., from self-directed to specialized care) for caregivers of youth with chronic illnesses. Methods: The review methodology was co-designed with four caregivers. Data sources were the peer-reviewed scientific literature and a call for innovations. Records were independently coded and assessed for quality. Results: Overall, 73 studies were included. Most virtual care solutions targeted caregivers of children with cancer, neurological disorders, and complex chronic illnesses. Over half were noted at lower levels of stepped care (i.e., self-guided apps and websites), with psychological strategies being predominant (84%). However, very few addressed caregivers’ physical health (15%) or provided family counseling (19%) or practical support (1%). Significant gaps were noted in interventions for managing caregiver chronic pain, despite its high prevalence and impact on child outcomes. Conclusions: Evidence and Gap Maps are innovative visual tools for knowledge synthesis, facilitating rapid, evidence-informed decision-making for patients, families, health professionals, and policymakers. This EGM highlighted high-quality virtual care solutions ready for immediate scaling and identified critical evidence gaps requiring prioritization. To address the complexities of pediatric chronic illnesses, including chronic pain, virtual care initiatives must prioritize family-centered, accessible, and equitable approaches. Engaging caregivers as partners is critical to ensure interventions align with their needs and priorities. Full article

During pregnancy, reproductive hormonal changes could affect the mental health of women, such as depression and anxiety. Previous studies have shown that exposure to endocrine disrupting chemicals (EDCs) is significantly associated with mental health symptoms; however, the results were inconsistent. We aimed to examine the association between 24 endocrine-disrupting chemicals (EDCs) in maternal urine and perinatal depression and their association with dietary and lifestyle factors. Participants were recruited from the “No Environmental Hazards for Mother–Child” cohort in Korea. Structured questionnaires asking dietary and lifestyle factors and evaluation of depressive symptoms were administered during antepartum (14 weeks of gestation) and postpartum (within four weeks after birth) periods. Urine samples were collected from 242 and 119 women during antepartum and postpartum periods, respectively. To assess perinatal depression, we used the Center for Epidemiological Studies-Depression Scale and the Edinburgh Postnatal Depression Scale. Antepartum depression and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) (1.50, 1.01–2.23) and 1-hydroxypyrene (1-OHP) (0.05, 0–0.89) showed significant positive association. Additionally, postpartum depression showed significant associations with mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) (2.78, 1.00–7.70), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (2.79, 1.04–7.46), 2-hydroxynaphthalene (2-NAP) (7.22, 1.43–36.59), and 2-hydroxyfluorene (2-FLU) (<0.01, 0–0.004). Some dietary factors (consumption of fish, fermented foods, cup noodles, and popcorn) and consumer product factors (use of skin care, makeup, perfume, antibiotics, sunscreen, nail polish, new furniture, plastic tableware, detergent, polish, paint, and pesticide) were associated with the concentration level of chemicals. We found that exposure to several EDCs during pregnancy and the postpartum period was associated with perinatal depression and dietary–lifestyle factors. Women in childbirth need to actively seek out information about exposure to EDCs and make efforts to avoid them for their own and fetal health. Full article

This review critically evaluates the existing literature on youth punishment system (YPS)-involved Black girls and their intersections of with trauma and post-traumatic stress disorder (PTSD). It synthesizes findings from previous studies, identifying key research trends, gaps, and controversies, while also highlighting areas in need of further investigation. Black girls, particularly those involved in systems such as juvenile justice, child welfare, and education, often face disproportionate exposure to violence, abuse and neglect, trauma, and systemic racism. For Black girls with histories of trauma and PTSD, these intersecting challenges are compounded by the added vulnerabilities of race, gender, and YPS involvement. This article argues that addressing the complex needs of this population requires recognition that Black girls’ harm is criminalized and, therefore, inextricably linked to their YPS-involvement, so a comprehensive, culturally responsive approach that includes trauma-informed care, healing-centered engagement, and holistic support systems are needed. Equitable access to tailored mental health services, educational resources, and culturally relevant interventions is essential to mitigate the long-term effects of trauma, promote resilience, and foster healing. Additionally, advocacy efforts to dismantle systemic harm and address racial and gender disparities are critical for creating inclusive environments that empower and support Black girls in these systems. By centering their lived experiences, this review emphasizes the importance of fostering environments of healing, justice, and equity for this vulnerable population. Full article

Introduction: Pregnant women’s experiences and concerns regarding childbirth are complex, necessitating a multidimensional and personalized approach in maternal care. This study explores the psychological and emotional factors influencing pregnant women’s decisions regarding their mode of delivery. The results will provide valuable insights for the development of educational and counseling strategies designed to support pregnant women in making informed and conscious decisions about their childbirth. Material and method: This cross-sectional study aimed to develop and validate a questionnaire exploring the psychological dimensions of childbirth. Factor analysis was employed to assess emotional perceptions, perceived medical risks, and the impact of cesarean section on pregnant women. The questionnaire was distributed online via Google Forms, using social networks like Facebook and Instagram to ensure rapid and broad accessibility. The questionnaire was available for seven months, from January to July 2023. Results: McDonald’s ω, Cronbach’s α, average inter-item correlation, and total item correlations were calculated to assess the consistency of the questionnaire items in measuring the same construct. The three-factor model emerged as the primary structure based on exploratory and confirmatory factor analyses (EFA and CFA). The first profile, centered on the psychological and emotional benefits of vaginal birth, highlights the importance of the natural birth experience for the mother’s psychological well-being. The second profile addresses concerns about medical risks and the need for interventions. The third profile focuses on perceptions and concerns related to the intelligence and adaptability of children born by cesarean section and the effects of anesthesia. Conclusions: Each profile reflects different strategies for seeking control and security amid childbirth uncertainties. These include emphasizing the psychological benefits of vaginal birth, addressing medical risks, and focusing on the impact of interventions on child development. Understanding these variables is essential for providing appropriate counseling and psychosocial support, thereby optimizing the birth experience and promoting the health of both mother and child. The integration of multi-factor and single-factor models in the questionnaire analysis serves complementary purposes, providing distinct yet interrelated insights into the instrument’s structure and validity. Full article