Purpose: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. Methods: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, $x^2$ test, t-test, and logistic regression analyses. Results: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age ($x^2=14.10$, p=.007), admission type ($x^2=7.40$, p=.007), use of physical restraints ($x^2=26.11$, p<.001), RASS score ($x^2=14.80$, p=.001), need for oxygen ($x^2=5.31$, p=.021), use of a mechanical device ($x^2=9.97$, p=.041), feeding ($x^2=7.85$, p=.005), and the presence of familiar objects ($x^2=29.21$, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). Conclusion: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.
Purpose: The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM). Methods: A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM. Results: From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technology-based interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parent-child teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression. Conclusion: Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.
Purpose: This study was conducted to identify the role and role burden of caregivers with hospitalized children. Methods: The participants included 149 main caregivers from two pediatric hospitals whose children have been hospitalized for at least 2 days at children's hospital. The data were collected from August 1 to september 30, 2013 using self-report questionnaires of checklist type for caregivers' role and Likert scale for role burden. Results: Role for hospitalized children showed that personal hygiene was the highest, and consultation with nurses and doctors was the lowest in total frequency per day. Of the role for the caregivers themselves and family, personal hygiene was the highest, and home management was the lowest. The degree of role burden perceived by hospitalized children's caregivers was the slightly high. Of the categories, emotional burden was the highest and dependent burden was the lowest. There were differences by caregivers' age, children's age, and children's health status. Conclusion: The caregivers performed various roles, especially more frequently on personal hygiene and nutrition for their hospitalized children and themselves and family, and had slightly high role burden. These results may contribute to develop nursing interventions that can help adapt on hospitalization of children and their caregivers.
Purpose: The aim of this study was to investigate applicability of the GMFM-88 in planning intervention for CP children. Specifically, this study assessed functional improvement after a four-week GMFM-88 item-based training in CP children divided into three age groups (${\leq}24$ months, 25-48 months, and >48 months) and five levels of the gross motor function classification system (GMFCS). Methods: Subjects were 264 children with CP (mean age 32.90 months) recruited from one CP clinic. The GMFM-88 item-based training was planned for each child, after an interview with its caregiver. To investigate functional improvement after the intervention, minimum important difference (MID) and MID proportion for the change in scores of GMFM-88 were calculated. Results: The GMFM-88 scores increased after the interventions in all three age groups (p<0.05). In particular, children with CP aged ${\leq}24$ months and at the GMFCS level II showed greater functional improvement after training. Conclusion: This study found that the GMFM-88 item-based training would be used to plan activity-oriented intervention both in clinic and home in each CP child.
The purpose of this study was to investigate infants' development, parenting characteristics, and the infants' daily routines by monthly family income, and examine variables related to infants' development. The 2010 data of the panel study on Koreans were used. The sample for this analysis was 1,802 children aged 21-23 months and their parents. The data were analyzed with ANOVA, Pearson's correlation analysis, and multiple regression analysis with SPSS version 18.0. The results were as follows: First, the development of infants differed by the family income. Infants' communication and problem solving skills in families with an income at the 25th percentile or below was lower than those above the 25th percentile. Second, parenting characteristics differed by family income. In the lower income group, the mother's parenting stress was highest, but the father's parenting time on weekends was lowest. Third, the most frequent activity of infants differed by family income. Playing with friends or caregivers was lowest, but watching TV and videos was highest in the lower income family group. Fourth, there was a relation among infants' development (communication and fine motor skills) and parenting characteristics (mother's parenting style, stress, and father's parenting time on weekends), and the infants' daily routines (playing with friends or caregivers). Fine motor development was affected by playing with a caregiver.
Background: Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods: An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work-family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results: All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion: This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.
Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient's individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.
The present study was to investigate the teacher's and the mother's beliefs about literacy acquisition and to analyse differences between them The subjects for this study were 134 teachers and 174 mothers of the kindergarten and daycare centers. The 25-item questionnaire constructed by Westwood, Knight and Redden(1997) was used in this study with a slight modification. Collected data were analyzed by one-way ANOVA to verify the differences of the teacher's beliefs according to an academic background and a career, and mother's according to an academic background and an occupation, and compared by t-test to verify the differences of the teacher's and mother's beliefs. The major findings were the most teachers and mothers showed balanced approach: more skill-based about reading than writing. The university graduated teachers took more meaning-based, child-centered approach than finisher of caregiver training center. According to career, more the experienced kept more skilled-based approach. In case of the mother, the university and graduated school graduates took more meaning-based, child-centered approach than finisher of college and High school. According to occupation, more the professional kept more meaning-based approach. Finally there were no meaningful difference in an income and mothers' age. And teachers took more meaning-based, child-centered approach than mothers. Especially about writing, teachers kept much more meaning-based approach than mothers.
Objectives: The purpose of this study is to identify the factors affecting job satisfaction, job stress, turnover intention, work-family and family-work relationship of married dental hygienists with young children. Methods: 242 copies of self-reported questionnaires were analyzed. Statistical analysis of collected data was conducted using the statistical program of Stata 13.0 (StataCorp., College Station, TX, USA). Results: Turnover intention was higher when the child age was lower and the child support and parenting stress were higher. But when working hours were adjustable, the turnover intention was low. Job stress was higher as the position, monthly income and night working hours were higher. Job satisfaction was higher as night work was fewer, work time was adjustable and family life satisfaction was higher. When parenting stress was high, job satisfaction was low and job stress and turnover intention were high. Work-family relationships were more affected by lower monthly income and parents-first child caregivers. Workplace factors affecting the family life were monthly income, caregiver and number of night work. The higher the parenting stress, the greater the mutual influence between family and work life. Age, family life, parenting stress and turnover intention were identified to affect family-work relationship. Parenting stress and job stress were identified to be influential on work-family relationship. Conclusions: Married dental hygienists are leaving the clinical setting due to their marriage and childbirth, or showing the effects on family-work and work-family relationships due to parenting. Efforts should be made to efficiently utilize professional manpower and to improve the psychological and physical working environment surrounding the married dental hygienists.
This study examines the effects of coping resources on life satisfaction of middle and older caregivers looking after family members with activities of daily living disabilities. Personal resources and socio-relational resources were included as predictors after controlling for demographic characteristics. We studied 154 middle and 132 older adults drawn from the Korean Longitudinal Study of Ageing (KLoSA). The multiple regression results of this study were as follows. First, subjective health and family satisfaction had significant effects on middle-aged caregivers' life satisfaction. Specifically higher levels of subjective health and better relationships with their family predicted higher levels of life satisfaction. Second, cognitive function, household income, and family satisfaction had significant effects on middle-aged caregivers' life satisfaction. Higher household incomes, higher levels of cognitive function, and better relationships with family predicted higher levels of life satisfaction. For both middle and older adults, the effect size of family satisfaction was the largest out of all coping resources. The results revealed discrepancies regarding the importance of coping resources between middle and older caregivers, implying that developing interventions for middle and older caregivers (in accordance with their need for coping resources) is necessary. The results also indicated that having good relationships with one's family was the most important factor for both middle aged and older caregivers' life satisfaction. The results suggest that policies or services focused on endorsing healthy family relationships should be developed to improve the life satisfaction of caregivers.
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