Sleep Problems in Relation to Autism Severity, Problematic Behaviour and Parental Distress in Children with Low Functioning Autism

One of the most burdensome and profound complaint among parents of children with autism is disrupted sleep, with more than 40-80% of the children experiencing sleep problems compared with 25-40% in typically developing children. Consequence of disrupted sleep is potentially serious; it may exacerbate core ASD symptoms. Research is limited on sleep and its relation with behavioural problems and parental distress in low functioning autism. The main aim of the study is to assess the sleep problems and its relation with severity of autism, day time problem behavior and parental distress in children with low functioning autism. A descriptive cross sectional design was adopted for the study among 40 children aged between 6-16 years of age, recruited from selected special schools and autism centres in Kerala. Sleep problems, autism severity, problematic behavior and parental distress were assessed using Children’s sleep habit questionnaire (CSHQ), Social responsive scale (SRS), The Disruptive Behaviour Disorder Rating Scale, Parenting stress index respectively. Prevalence of sleep problems were more among children with low functioning autism. All the children in the study met the cut off score of sleep problems in CSHQ .But sleep problem was not correlated with severity of autism, problematic behaviours and parental distress. Findings showed that autism severity is related with parental stress (p=0.046) and problem behaviour (p<0.01) in children with autism. It was also observed that problematic behaviours in children is correlated with parental stress (p=0.019) .Study results emphasize the need for implementing interventions to reduce sleep problems, problematic behaviours and parental distress

Changing dimensions in human–animal relationships: Animal Assisted Therapy for children with Cerebral Palsy

Animal Assisted Therapy (AAT) or Pet Therapy is an emerging trend in the management and rehabilitation of many conditions. It has become an area of dedicated research recently, even though tradition has always affirmed the significance of animals in promoting the health and well-being of people. In AAT, animals are involved in the therapy as a Co-Therapist. Main goal, the health professionals are not really convinced about the usefulness of this kind of therapy and the evidenced based practice in this area is extremely minimal. Hence we felt it would be beneficial to discuss various researches conducted on Animal Assisted Therapy in children with cerebral palsy (CP) and the issues and challenges associated with it. We focused on original research conducted among children with cerebral palsy. Horses (Hippo Therapy or Equine Assisted Therapy) are the most widely used animals among children with CP. Most of the studies were aimed to assess the effect of AAT in neuro rehabilitation of children with CP. Results indicated improvement in motor areas such as Gross Motor Functioning, re-establishing muscle symmetry, improving trunk stability, postural control, balance, gait, range of motion, functional skills, ADL, strength, co-ordination, and muscle tone. It also revealed significant improvement in psychological variables such as cognition, attention, concentration, memory, self-esteem, emotional well-being and social interaction, but we noticed a scarcity of literature in the paediatric population and most of the articles are anecdotal in nature. Nevertheless, in the United States and Northern Europe, this kind of therapy has begun to be implemented in a regulated and systematic way to deliver concrete results

A systematic review:Unfinished nursing care and the impact on the nurse outcomes of job satisfaction, burnout, intention-to-leave and turnover

Aim: To investigate the association of unfinished nursing care on nurse outcomes. Design: Systematic review in line with National Institute for Health and Care Excellence guideline. Data sources: CINAHL, the Cochrane Library, Embase, Medline, ProQuest and Scopus databases were searched up until April 2020. Review methods: Two independent reviewers conducted each stage of the review process: screening eligibility, quality appraisal using Mixed Methods Appraisal Tool; and data extraction. Narrative synthesis compared measurements and outcomes. Results: Nine hospital studies were included, and all but one were cross-sectional multicentre studies with a variety of sampling sizes (136-4169 nurses). Studies had low internal validity implying a high risk of bias. There was also a high potential for bias due to non-response. Only one study explicitly sought to examine nurse outcomes as a primary dependent variable, as most included nurse outcomes as mediating variables. Of the available data, unfinished nursing care was associated with: reduced job satisfaction (5/7 studies); burnout (1/3); and intention-to-leave (2/2). No association was found with turnover (2/2). Conclusion: Unfinished nursing care remains a plausible mediator of negative nurse outcomes, but research is limited to single-country studies and self-reported outcome measures. Given challenges in the sector for nurse satisfaction, recruitment and retention, future research needs to focus on nurse outcomes as a specific aim of inquiry in relation to unfinished nursing care. Impact: Unfinished nursing care has previously been demonstrated to be associated with staffing, education and work environments, with negative associations with patient outcomes (patient satisfaction, medication errors, infections, incidents and readmissions). This study offers new evidence that the impact of unfinished nursing care on nurses is under investigated. Policymakers can prioritize the funding of robust observational studies and quasi-experimental studies with a primary aim to understand the impact of unfinished nursing care on nurse outcomes to better inform health workforce sustainability