Protecting Family Interests: An Interview Study with Foreign-Born Parents Struggling On in Childhood Cancer Care

Sweden's population is gradually changing to become more multiethnic and diverse and that applies also for recipients of health care, including childhood cancer care. A holistic view on the sick child in the context of its family has always been a cornerstone in childhood cancer care in Sweden. The purpose of this study was to gain knowledge about the experiences and main concern of foreign-born parents in the context of paediatric cancer care. Interviews were performed with eleven foreign-born parents and data were analysed using a classic grounded theory approach. Foreign-born parents often feel in a position of powerless dependence, but family interests are protected in their approaches to interaction with healthcare staff, through cooperation, contesting, and reluctant resigning. Healthcare staff need to listen to foreign-born parents and deal with their concerns seriously to prevent powerless-dependence and work for trustful cooperation in the common fight against childhood cancer

Influence of nurse performance on children’s anxiety and pain during venipuncture procedures: An observational study

Introduction: Venipuncture has been practiced for centuries and is still one of the most common invasive procedures in health care. However, practice varies considerably between countries and between institutions and individuals within the same country. The purpose of this study was to examine the association between nurses’ clinical performance and the level of pain and anxiety experienced by children during venipuncture procedures.Methods: Participants were conveniently enrolled in this prospective cross-sectional study, the pain and anxiety levels of 400 children aged 6-12 years old were measured and correlated with measurements of clinical performance by 20 nurses during the venipuncture procedure. A major pediatric hospital in Iraqi Kurdistan recruited patients for 3 months between September 2019 and August 2020.Results: The study found that there was no statistically significant difference in the overall clinical performance of male and female nurses or between those who worked in different departments. However, nurses with a higher level of education, whether working in the public or private sector, had higher levels of clinical performance. The level of pain and anxiety of children during venipuncture decreased significantly in relation to increased levels of nurse performance (r-values: −0.137 and −0.137), which included both their pain-related performance (r-values: −0.224 and −0.229) and their anxiety-related performance (r-values: −0.177 and −0.204; p < 0.0001). The factors contributing to higher levels of clinical performance by the nurses during venipuncture procedures were a higher level of education, sufficient sleep and working in the medical department, being older in age, and having longer clinical experience.Conclusions: This study highlights that children’s pain and anxiety decreased when nurses’ clinical performance levels increased. The levels of pain and anxiety in the children were significantly decreased in those patients who received better clinical treatment from nurses during the venipuncture procedure

Exclusive breastfeeding of Swedish children and its possible influence on the development of obesity: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Overweight and obesity are increasing among children all over the world. Socio-economic factors may influence the development of overweight and obesity in childhood, and it has been proposed that breastfeeding may protect against obesity. The aim of our study was to examine the relationship between exclusive breastfeeding and obesity when potential confounders, such as socioeconomic factors, are considered.</p> <p>Methods</p> <p>The data analyzed was from ABIS (All Babies in Southeast Sweden), a prospective cohort study. All parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden (n = 21,700) were asked to participate. Parents were asked to answer periodic questionnaires from the time of the child's birth (n = 16,058) until he/she was five years of age (n = 7,356). Cutoffs for overweight and obesity were defined according to Cole et al, age and gender adjusted. Short-term exclusive breastfeeding was defined as < 4 months of exclusive breastfeeding. Multiple logistic regressions were used to identify variables that predict the child's BMI (Body Mass Index) at five years of age.</p> <p>Results</p> <p>At five years of age, 12.9% of the children in the study wereoverweight and 4.3% were obese. At the age of three months, 78.4% of the children were being breastfed exclusively. The median exclusive breastfeeding duration was four months. High maternal BMI > 30 (AOR = 1.07; CI = 1.05–1.09; P < 0.001), maternal smoking (AOR = 1.43; CI = 1.05–1.95; P = 0.023) and being a single parent (AOR = 2.10; CI = 1.43–3.09; P < 0.001) were associated with short-term exclusive breastfeeding (less than 4 months). Short-term exclusive breastfeeding was less common if one of the parents had a university degree (Mother: AOR = 0.74; CI = 0.61–0.90; P = 0.003 Father: AOR = 0.73; CI = 0.58–0.92; P = 0.008) or if the father was more than 37 years old (AOR = 0.74; CI = 0.55–0.99; P = 0.045). Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00–2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance.</p> <p>Conclusion</p> <p>We cannot exclude the possibility that exclusive breastfeeding influences weight development, but it does not seem to protect against obesity at five years of age.</p

The experience of mothers caring for a child with a brain tumour

Background: Brain tumours are the second most common form of childhood cancer, accounting for over 20% of all cases in European children. Understanding the impact of diagnosis and treatment of a brain tumour on the family is an essential pre-requisite to identifying ways to provide effective support. Aim: (1) To explore the impact of having a child with a brain tumour on the main caregiver in the family; (2) to describe mothers' experiences of coping with their child's illness, including personal barriers and strengths; and (3) to identify causes of stress and sources of support to inform improvements in care delivery. Method: Participants were drawn from a group of caregivers enrolled in a longitudinal study of outcome following diagnosis of a childhood brain tumour. Six caregivers took part, two from each of the high-, medium- and low-impact groups based on their Impact on Families Scale scores. Semi-structured interviews were used, with questions covering: (1) impact of the diagnosis on main caregiver and family; (2) personal barriers and strengths; and (3) causes of stress and sources of support. Interviews were transcribed verbatim and coded manually into five themes, which comprised 19 subthemes. Findings: Coping methods and provision of help and support were major preoccupations for main caregivers from all impact groups. Caregivers in the high-impact group reported less conflict. High- and medium-impact group caregivers had experienced less 'hindrance and heartache', than those with low impact scores, suggesting that the stress associated with diagnosis and treatment of the tumour may have increased cohesion and acceptance within these families. Conclusion: Families of children diagnosed with a brain tumour experience considerable negative impact and may perceive themselves as struggling to cope. Provision of help and support, within and outside the extended family, including from health, education and other services, is perceived as helpful. © 2012 John Wiley & Sons Ltd

Children's voices-differentiating a child perspective from a child's perspective

OBJECTIVE : The aim of this paper was to discuss differences between having a child perspective and taking the child's perspective based on the problem being investigated. METHODS : Conceptual paper based on narrative review. RESULTS : The child's perspective in research concerning children that need additional support are important. The difference between having a child perspective and taking the child's perspective in conjunction with the need to know children's opinions has been discussed in the literature. From an ideological perspective the difference between the two perspectives seems self-evident, but the perspectives might be better seen as different ends on a continuum solely from an adult's view of children to solely the perspective of children themselves. Depending on the research question, the design of the study may benefit from taking either perspective. In this article, we discuss the difference between the perspectives based on the problem being investigated, children's capacity to express opinions, environmental adaptations and the degree of interpretation needed to understand children's opinions. CONCLUSION : The examples provided indicate that children's opinions can be regarded in most research, although to different degrees.http://informahealthcare.com/journal/pdr2016-06-30hb201

Family participation in childhood cancer care

Background: Child cancer care is becoming increasingly successful, the treatment brought more success through intensified therapy, but this development has not been easy to achieve due to the pain and anxiety that the treatment often causes. It is not possible to eliminate the chaos the family experiences, but it can be reduced through a deepened understanding of the situation. Purpose: The aim of the study is to highlight families views on participation in childhood cancer care. Method: A qualitative design, appropriate to gain a holistic view, has been chosen. Eight families with children diagnosed with cancer, of various ages and gender and from various backgrounds, participated in five interviews each during the first year of the child´s illness. Findings: The families constitute a cornerstone in paediatric oncology care today, but the results indicate that all the various tasks and commitments for the families, sometimes entail too heavy a burden. They are in need of better support and clearer instructions to be able to cope with the situation including rules and measures concerning the child. Therefore, it is urgent to clarify who has the formal responsibility for medical consequences that might occur in connection with delegated responsibility. The study shows that there is a lack of pedagogical thought and a need to create a pedagogical model. Conclusion: There is a need for guiding principles and education for the parents, which would contribute to their increased confidence

Barriers in the School-Based Pan-Gender HPV Vaccination Program in Sweden : Healthcare Providers' Perspective

Background: Human papillomavirus (HPV) vaccines effectively prevent, and can even eliminate, HPV-related cancers. Currently, vaccination rates are suboptimal in the national Swedish school-based vaccination program. School nurses play a key role in all aspects of the vaccination process. Therefore, this study aims to explore school nurses' perceived HPV vaccination challenges. Methods: Seven focus group interviews were conducted with school nurses (n = 35) working in nine socio-demographically diverse municipalities in mid-Sweden. Data were analyzed using qualitative content analysis. Results: Participants described difficulties in encountering and handling the diversity of reasons for vaccine hesitancy. Parents known to be skeptical of vaccines in general were seen as most difficult to reach. Uncertainty was expressed concerning the extent of professional responsibility for vaccine promotion. The informants expressed a lack of guidelines for vaccine promotion and described challenges in supporting the child's own wishes. Creating a safe space for the individual child was seen as crucial. Other problems described were the challenges of overcoming children's fear of needles, supporting unvaccinated children, and being confronted with the remaining gender inequities of the pan-gender vaccination program. Conclusions: Our results suggest that school nurses, especially those new to their profession, may benefit from training and guidance22 material on how to address vaccine hesitancy

The meaning of being a visiting child of a seriously ill parent receiving care at the ICU

Purpose: Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU. Method: A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach. Findings: Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding. Conclusions: The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way

Contributing to making the school a safe place for the child : School nurses’ perceptions of their assignment when caring for children having parents with serious physical illness

Aim: To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness. Design: An explorative inductive qualitative design. Method: The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis. Results: The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignmen