Remembering the Chaos - But Life Went on and the Wound Healed. A Four Year Follow Up with Parents having had a Baby with Infantile Colic

OBJECTIVE: To elucidate parent´s experience of having had a baby with colic four years previously and of how the colic and care influenced the family in a long-term perspective. METHODOLOGY AND PARTICIPANTS: A qualitative inductive follow-up study with 13 individual and one focus group interview including four parents. Altogether ten mothers and seven fathers representing 12 families, who had been interviewed when they were in the midst of the colicky period four years ago, were in the present study interviewed between December 2010 and May 2011. Parents' narratives were analysed using content analysis. RESULTS: Parent´s memories of the exhausting colic period were vivid, but when the colic had healed the family relationships also healed. Although it had taken longer time for some parents to attach to their child they now experienced a close relationship with their four year old child and felt confident in their role as parent. The colic scream was still unbearable and evoked negative feelings in the parents. Parents had decreased confidence in Child Health services and made suggestions for improvements in the health care approach. Most of all they wished for an effective treatment of infantile colic. CONCLUSION: The family relationships were healed and the colic left only few residual symptoms but parents still had decreased confidence in the Child Health Center. Consequently, there is a need to raise awareness to parents' situation when having a child with infantile colic

A Methodological Description of a Randomised Controlled Trial Comparing Hospital-Based Care and Hospital-Based Home Care when a Child is Newly Diagnosed with Type 1 Diabetes

AIM AND OBJECTIVE: To describe the study design of a randomised controlled trial with the aim of comparing two different regimes for children with newly diagnosed type 1 diabetes; hospital-based care and hospital-based home care. BACKGROUND: Procedures for hospital admission and sojourn in connection with diagnose vary greatly worldwide and the existing evidence is insufficient to allow for any conclusive determination of whether hospital-based or home-based care is the best alternative for most families. Comparative studies with adequate power and outcome measurements, as well as measurements of cost-effectiveness are needed. DESIGN: The study design was based on the Medical Research Council framework for complex interventions. After two to three days with hospital-based care, children between the ages of 3 and 16 were randomised to receive either continued hospital-based care for a total of 1-2 weeks or hospital-based home care, which refers to specialist care in a home-based setting. The trial started in March 2008 at a University Hospital in Sweden and was closed in September 2011 when a sufficient number of children according to power calculation, were included. The primary outcome was the child's metabolic control during the following two years. Secondary outcomes were set to evaluate the family and child situation as well as the organisation of care. DISCUSSION: Childhood diabetes requires families and children to learn to perform multiple daily tasks. Even though intervention in health care is complex with several interacting components entailing practical and methodological difficulties, there is nonetheless, a need for randomised controlled trials in order to evaluate and develop better systems for the learning processes of families that can lead to long-term improvement in adherence and outcome

Reorganizing Life: A Qualitative Study of Fathers' Lived Experience in the 3Years Subsequent to the Very Preterm Birth of Their Child.

This is the second part of a study that is following eight Swedish fathers of very preterm children using qualitative interviews. The aim was to illuminate fathers' lived experience of the 3years since the birth of their very preterm child using a hermeneutic phenomenological method. The fathers described their lived experience as a process of reorganizing life, which constituted the overarching theme. They described a journey from the past to the present in which they adapted ordinary family life. The sub-themes identified were: struggling to endure, experiencing empowerment, and building a secure base. The results may serve as a basis for neonatal staff to optimize care for both fathers and mothers during the child's hospitalisation, as well as subsequent to their discharge

Like being covered in a wet and dark blanket – Parents' lived experiences of losing a child to cancer

Purpose The aim of this study was to illuminate parents' lived experiences of losing a child to cancer. Method Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach. Results One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life. Conclusion There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process

Living an Everyday Life Through a Child's Cancer Trajectory: Families' Lived Experiences 7 Years After Diagnosis

The aim of this study was to illuminate the lived experiences of families where a child had survived 7 years from a diagnosis of childhood cancer. This article describes one part of an inductive and longitudinal research project that included 17 families. Four families whose child was diagnosed with cancer 7 years previously were interviewed using a hermeneutical phenomenological approach. The families lived experience was described in one essential theme, Living an everyday life through the child's cancer trajectory, further illuminated in 3 related themes: Leaving the disease behind yet feeling its presence, Being the same yet always different, and Feeling stronger yet vulnerable. The results suggest that family members feel vulnerable even if a long period of time has passed since completion of treatment. To varied degrees they still may need support. When moving forward in life, the family members are helped if they can reconcile their memories and experiences derived from the childhood cancer trajectory

Surviving Overwhelming Challenges: Family Caregivers' Lived Experience of Caring for a Child Diagnosed with HIV and Enrolled in Antiretroviral Treatment in Ethiopia.

Family caregivers play a critical role in caring for children living with HIV, however, there is little knowledge about their experiences. The aim of this study was to illuminate the family caregivers' lived experiences of caring for a child when he or she has been diagnosed with HIV and enrolled to antiretroviral treatment. Qualitative interviews with 21 family caregivers of 21 children diagnosed with HIV were analyzed using an inductive design with a hermeneutic phenomenological approach. The caregivers' experience were articulated in 5 subthemes under the main theme of "Surviving overwhelming challenges": "Committed care-giving," "Breaking the family life," "Caring burdens," "Confronting conflicts," and "Living with worry." Despite the difficult situation the family caregivers experienced with extensive worry, caring burdens, and disrupted family and social networks, they were committed caregivers. They were empowered by their belief in God but also by their strong belief in the child's treatment and support from healthcare workers. The healthcare system needs to consider possible ways to support the family caregivers during child's HIV diagnosis and treatment initiation as part of a continuum of care

PENGARUH DISIPLIN KERJA TERHADAP KINERJA GURU DI SMA NEGERI SE-KECAMATAN COBLONG KOTA BANDUNG

Penelitian ini berjudul “Pengaruh Disiplin Kerja Terhadap Kinerja Guru di SMA Negeri se-Kecamatan Coblong Kota Bandung”. Masalah yang dikaji dalam penelitian ini adalah seberapa besar pengaruh disiplin kerja terhadap kinerja guru. Secara umum penelitian ini bertujuan untuk mengetahui gambaran yang jelas terkait pengaruh disiplin kerja terhadap kinerja guru di SMA Negeri se-Kecamatan Coblong Kota Bandung. Metode yang digunakan dalam penelitian ini yaitu metode deskriptif dengan pendekatan kuantitatif. Teknik pengumpulan data menggunakan angket tertutup dengan lima skala penilaian (Likert) yang disebar pada 56 guru yang berada di SMA Negeri Kecamatan Coblong sebagai sampel penelitian. Hasil perhitungan kecenderungan umum dengan menggunakan Weighted Means Scored (WMS), menunjukkan bahwa rata-rata kecenderungan variabel X (Disiplin Kerja) berada dalam kategori sangat baik, dan rata-rata kecenderungan variabel Y (Kinerja Guru) berada dalam kategori sangat baik. Hasil pengujian normalitas distribusi data bahwa variabel X dan variabel Y berdistribusi normal. Hasil perhitungan koefisien korelasi menunjukkan bahwa terdapat hubungan yang kuat antara variabel X dan variabel Y, serta nilai uji signifikansi yang terbukti signifikan. Perolehan analisis determinasi sebesar 40,5%, hal ini menunjukan bahwa besarnya pengaruh disiplin kerja terhadap kinerja guru adalah sebesar 40,5% dan sisanya dipengaruhi oleh faktor lain. Kesimpuln dari penelitian ini yaitu adanya pengaruh yang positif dan signifikan antara disiplin kerja terhadap kinerja guru di SMA Negeri se-Kecamatan Coblong Kota Bandung, hal telah tersebut dibuktikan secara perhitungan statistik. ;---This research “The effect of labor discipline on the performance of teachers in the District small hole SMA in Bandung”. Problem in this research is how much influence the discipline of work on teacher performance. In general, this study aims to determine a clear picture of work-related discipline influence the performance of teacher the District small hole SMA in Bandung. The method used in this research is descriptive method with quantitative approach. Data collection techniques using closed questionnaire with 5 rating scale (Likert) distributed in 56 high school teachers in the country districts as a small hole sample. The calculation results by using Weighted Means Scored (WMS),general trend shows that the average propensity variable X (Work Discipline) is the excellent category, and the average tendency of variable Y (Teacher Performance) is the excellent category. Results of testing the normality of the data distribution that the variables X and Y variables with normal distribution. Correlation coefficient there are shows that a strong relationship between the variables X and Y variables, as well as the significance test which proved significant. Acquition analysis of determination of 40,5%, this suggests that the influence of labor discipline on teacher performance was 40,5% and the rest influenced by other factors. Conclusions of this analysis, the influence of positive and significant correlation between discipline of work on teacher performance in SMA Bandung District of small hole it can be proven statistical calculations

Caregiver-reported antiretroviral therapy non-adherence during the first week and after a month of treatment initiation among children diagnosed with HIV in Ethiopia

To achieve optimal virologic suppression for children undergoing antiretroviral therapy (ART), adherence must be excellent. This is defined as taking more than 95% of their prescribed doses. To our knowledge, no study in Ethiopia has evaluated the level of treatment adherence at the beginning of the child's treatment. Our aim was therefore to evaluate caregiver-reported ART non-adherence among children and any predictors for this during the early course of treatment. We conducted a prospective cohort study of 306 children with HIV in eight health facilities in Ethiopia who were registered at ART clinics between 20 December 2014 and 20 April 2015. The adherence rate reported by caregivers during the first week and after a month of treatment initiation was 92.8% and 93.8%, respectively. Our findings highlight important predictors of non-adherence. Children whose caregivers were not undergoing HIV treatment and care themselves were less likely to be non-adherent during the first week of treatment (aOR = 0.17, 95% CI: 0.04, 0.71) and the children whose caregivers did not use a medication reminder after one month of treatment initiation (aOR = 5.21, 95% CI: 2.23, 12.16) were more likely to miss the prescribed dose. Moreover, after one month of the treatment initiation, those receiving protease inhibitor (LPV/r) or ABC-based treatment regimens were more likely to be non-adherent (aOR = 12.32, 95% CI: 3.25, 46.67). To promote treatment adherence during ART initiation in children, particular emphasis needs to be placed on a baseline treatment regimen and ways to issue reminders about the child's medication to both the health care system and caregivers. Further, large scale studies using a combination of adherence measuring methods upon treatment initiation are needed to better define the magnitude and predictors of ART non-adherence in resource-limited settings