Guest editorial: Evidence based developmental care for optimal babies’ brain development
Joy Browne
Achieving family-centred care: working on or working with stakeholders?
Margaret Kelly
Family-centred care has been described as a process in which the child and family are professionally supported in their journey through hospitalisation 1. This paper presents the experience of trialling a model of care that advocates partnership between health professionals and families in planning and delivering care to a hospitalised child to assist them in their journey. The development of the model and the pre-planning for implementation are described. The paper also highlights the challenges faced in implementing the model with nurses in one large children’s hospital. Introduction of the model was perceived as being imposed on nurses and the strategies developed to work with, rather than work on, stakeholders are outlined.
Knowledge and attitudes of secondary school students to breastfeeding
Dianne Juliff, Jill Downie, Pat Rapley
Research has indicated that adolescents hold both negative and positive attitudes and have common misconceptions regarding breastfeeding that appear to result from their limited knowledge and reduced exposure to breastfeeding. The purpose of this study was to determine the knowledge and attitudes toward breastfeeding of adolescent rural and metropolitan secondary school students. A survey of a purposeful sample of 1845 male and female students was carried out.
The study results indicated that, overall, Western Australian adolescent secondary school students have less than ideal knowledge of breastfeeding that is consistent with findings from other studies. Female students were found to be more positive towards breastfeeding than male students. The comparison of rural to metropolitan students found that metropolitan students had higher breastfeeding knowledge and were more positive towards breastfeeding than rural students. This study suggests that breastfeeding and lactation information needs to be addressed earlier than adolescence in order to increase breastfeeding knowledge and promote positive attitudes.
Parents’ perception of nursing support in the neonatal intensive care unit (NICU)
Joanne Lam, Kaye Spence and Robert Halliday
Parents of sick infants who require neonatal surgery or who have a cardiac condition which may require surgery often face a very stressful and difficult time. Meeting their needs may be difficult in a neonatal care unit (NICU) where the average length of stay is short (approx 12 days). This high patient turnover rate may impact on neonatal nurses’ ability to provide the level of support needed by these parents. The aim of the study was to explore the level of stress perceived and experienced by parents related to nursing staff behaviour and communication during their infant’s hospitalisation and to also assess their perception of the support they received from nursing staff. This pilot study was undertaken in a children’s hospital in Australia with families of English, Chinese and Arabic speaking backgrounds whose infants were admitted primarily for a cardiac or surgical problem. The study utilised a self-report questionnaire consisting of a sub-scale of the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU), a subscale of nursing staff behaviour and communication, and the Nurse Parent Support Tool (NPST).
Sixty-six parents were approached; 62 completed and returned the questionnaires, giving a response rate of 94%. The majority (76%) of respondents were mothers. Insufficient information regarding tests and treatment and uncertainty as to whether nurses would call them about changes in their baby’s condition caused parents the most stress. The overall mean score for ‘nursing support’ was 4.2, indicating a high perception of support. A moderate correlation was found between the level of stress experienced/reported and perceived support (R2=0.35), with increasing support associated with decreasing stress. Generally, parents of infants admitted to the NICU had a low level of stress and perceived a high level of support. To provide a high level of support, there is a need for ongoing education for nurses in the use of support strategies.
Parents’ and school-aged children’s views on managing treatment adherence in asthma or diabetes
Sandra Wales, Kidest Nadew and Jackie Crisp
Expectations that children with chronic illness will take over management of their treatment as they mature, and the factors that enable this shift in responsibility from parents to children, remain relatively unexplored within the treatment adherence literature. There is, however, an implicit assumption that establishing effective and efficient self-management skills in childhood improves the adherence behaviours of adolescents. The purpose of this study was to explore the views of children with asthma or diabetes and their parents on treatment adherence, and to suggest potential strategies to assist in the development of positive adherence behaviours. Fourteen children with diabetes, six children with asthma and 14 parents were interviewed or participated in focus groups to discuss treatment adherence. Data were analysed using a thematic approach.
This paper discusses the challenging issues identified by parents and children attempting to adhere to treatment regimes. The most important of these challenges includes family dynamics regarding roles, the potential for conflict regarding who is in control of the treatment and difference in the expectations within each family concerning the child’s management of their illness and associated treatments. Nurses working with school-aged children with chronic illness, and their families, are well placed to develop approaches for assisting this transfer of responsibility. These findings support the need for nurses to explicitly address the issue of self-management, and assist families to develop individualised plans to facilitate the transfer process as the child matures.
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