Le regroupement en flexion: un traitement antalgique non pharmacologique pour le prématuré : revue de la littérature

Depuis 1980, la douleur du nouveau-né prématuré n’est plus remise en question. Cependant, celui-ci subit de nombreux soins invasifs lors de son hospitalisation en néonatologie. La prise de sang représente notamment le quart des procédures administrées au prématuré. Dans un souci de confort et de sécurité de leur patient, les infirmières en néonatologie tentent de soulager le nouveau-né prématuré à l’aide d’interventions non pharmacologiques en combinaison avec les traitements médicamenteux

The process of institutionalization-deinstitutionalization and children’s psychological adjustment in Rwanda:: Parents matter

Negative effects of institutionalization and positive effects of deinstitutionalization on children’s wellbeing have been well documented. However, the majority of reports on institutional care rely on adult interviews and there is a wide disparity of results and methodologies in few result-oriented studies of deinstitutionalization outcome. In addition, though all over the world, especially in developed countries, many children in orphanage have parents; little is known about on the effect of having or not living biological parents and be institutionalized. The present thesis aims generally to investigate whether institutionalization negatively impacts the psychological adjustment of children. Specifically, this thesis aims at (1) exploring children’s perceptions on institutionalization process; (2) investigating the influence of biological parental living status on institutionalized children’s psychological adjustment; and (3) evaluating the effectiveness of deinstitutionalization as well as conditions for better psychological adjustment once children are deinstitutionalized. With a prospective longitudinal comparative design, focus group discussions and self-report questionnaires were used by the present thesis to collect respectively qualitative and quantitative data from 177 children aged 9 to 16 and their parents/primary caregivers divided in 6 registered orphanages and 5 primary schools in Rwanda. Grounded theory was used to analyze qualitative data whilst analysis of variance and multiple regression were used to analyze quantitative data. Outcome variables included externalizing and internalizing behavior, attachment and self-esteem. Taken together, our results show that institutionalization has a negative impact on children’s psychological adjustment. The most remarkable and unexpected finding is that Rwandan children living in institution have more impairment in psychopathological symptoms when they have living parents. They considered institutionalization as an orphanization process. Another remarkable finding is that the present thesis failed to prove the improvement of psychological adjustment due to de-institutionalization in all domains as expected. The improvement was reported in attachment while no change was observed in externalizing behavior or self-esteem after deinstitutionalization and worse, internalizing behavior worsened among de-institutionalized children. Family relationships and parenting involvement were reported to be the strongest predictors of children’s psychological adjustment in most of measured outcome variables. Unexpectedly, socioeconomic status, didn’t gain as much importance in that prediction. Contrariwise, adult’s perceived quality of life was a significant mediated predictor in children’s externalizing behavior and had a moderating effect in children’s internalizing behavior. This should be considered to develop and improve supportive specific interventions for children and considered when making the decision of placing or not a child with parents in an institution. Results suggest the intensification of identifying and addressing the behavioral problems as part of deinstitutionalization process focusing also on family characteristics to improve children’s psychological adjustment. Moreover, understanding the development of psychopathological problems during the process of institutionalization and de-institutionalization may be key to preventing high costs associated with these disorders across the life course

Engaging in spaces: How mature distance students fit study into their homes and lives

In order to fit study around family and work, a third of mature aged tertiary students in New Zealand study by distance. By enabling students to study when and where they want, distance study is said to overcome the barriers of space and time. But space and time must still be found and the blurring of the physical boundaries between study and home creates new challenges. While much has been written about how distance students juggle time, little has considered how they manage space; yet it is often the availability of an appropriate learning space that determines not just when and where they study, but the quality of their engagement. This qualitative study, following 19 mature aged distance students and their families through their first semester, examines how the students carved learning spaces from their busy lives, the nature of those spaces, and the impact this had on their engagement. For some, a space without other people was the essential characteristic and they achieved this through either a physical separation strategy such as studying at work, or a temporal separation strategy such as studying only when children were at school. For others, isolation was a barrier to their engagement and they gravitated to shared living spaces. Individual lifeload, context, and personal preference mean there are no right or wrong choices, but family support is a critical influence on the success of different strategies