Complications of Hickman-Broviac catheters in children with malignancies

The aim of this study was to explore the complications related to Hickman-Broviac central venous catheters (Hickman-Broviac CVCs) in children with cancer, their incidence, and possible associations of complications and premature removal of CVCs with a number of risk factors. During the study period (1 Jan 2000-31 Dec 2003), 223 CVCs were inserted in 198 children (117 boys, 81 girls) at a mean age of 5.73 years (95% CI 5.19-6.27, SE 0.275). In total, 76 (38.4%) children suffered from solid tumors and 122 (61.6%) from leukemia. The mean follow-up after CVC insertion was 232.5 days (95% CI 214.9-250.2, SE 8.94) for a total of 51,839 catheter-days. A complication occurred in 20.8% of them and in 9.6% the complication led to the removal of the catheter. The most frequent complications were infection (63.9%), obstruction (26.2%), accidental failure (8.2%), and rupture (1.6%). An overall incidence of 1.17 (0.38 and 0.79 for mechanical complication and infection, respectively) per 1000 catheter days for the development of a complication was recorded. Additionally, the study revealed more nonelective removals in cases of leukemia compared to those of solid tumors. Systemic use of CVC does not appear to increase significantly the number of complications, and thus CVC remains an effective and safe tool for the management of childhood malignancies. Copyright © Informa Healthcare USA, Inc

Assessment of self-reported self-esteem in healthy and diabetic children and adolescents in Greece

Background: The aim of the present study was to evaluate any possible negative effect of diabetes on the self-esteem of children and adolescents with diabetes. Methods: Self-esteem was evaluated using the Culture-Free Self-Esteem Inventory (CFSEI-2) in 144 patients with Type 1 diabetes mellitus (T1DM; 7-18 years of age) treated in a diabetes center and compared against that of 136 healthy children and adolescents. Results: Self-esteem was correlated with age (P = 0.017), but not with diabetes (P = 0.886). The median CFSEI-2 score for both healthy and diabetic children was 22. There was no significant correlation between self-esteem and sex, body mass index (BMI), physical exercise, HbA1c or parental educational level. According to Spearman's rank correlation coefficient (rs), there was a significant association between age and self-esteem (rs = -0.15). Conversely, although BMI (rs = -0.09) and treatment duration (rs = -0.107) had a slight negative effect on self-esteem and the duration of physical exercise (rs = 0.11) and parental education (rs = 0.07) seemed to have a positive effect, the associations did not reach statistical significance. Conclusions: Self-esteem in diabetic children is mainly affected by their age, level of physical activity and level of family support. These findings emphasize the need to discriminate between glycemic control and diabetic adjustment. © 2010 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd

Greek students' knowledge and sources of information regarding sex education

Background: Human sexuality is a complex part of life and is considered a multidimensional phenomenon. Therefore there is an increased need for adequate and comprehensive sex education, especially for teenagers and young adults. Aim: The main aim of the study was to evaluate the level of students' sexual knowledge, as well as to identify their sources of information regarding sexual life and reproduction. Population and Method: A cross-sectional study using a designed self-report questionnaire was performed. The study population consisted of 936 students who were attending 10 high schools and four medical schools in Attica. Data were collected after obtaining permission from the Pedagogic Institute of the Greek Ministry of Education. Findings: The main sources of students' sexual information about reproduction were friends (29.1%) and parents (24.0%), whereas school was reported by 14.3% of them. The preferred sources of information, according to students' perceptions, were sex education specialists (65.6%), followed by school (39.1%), parents (32.2%) and friends (27.7%). Conclusions: The importance of school, peer and parent support upon adolescents' sexual life was revealed by the results of the study. Students' knowledge level on sex topics is not satisfactory and therefore there is a need for sex education specialists and special courses regarding sex education in Greek schools. © 2009 International Council of Nurses

Factors influencing the quality of life of young patients with diabetes

Background: Diabetes is a significant challenge for pediatric health care professionals because it affects youths' psychoemotional functioning and, consequently, the quality of life (QOL). The aim of the present study was to evaluate the QOL in young patients with diabetes, as well as the factors affecting it. Methods: The study was conducted from April to September 2008 in 98 young patients, 11-18years of age, who were under the supervision of Diabetological Center, General Pediatric Hospital (Athens, Greece). The Diabetes Quality of Life for Youths Questionnaire was used to evaluate the QOL of youths with diabetes. Results: The mean QOL score was 97.5. There was a negative correlation between the QOL and age (P=0.02), the duration of diabetes (P=0.05), body mass index (BMI; P=0.04), and comorbidities (P=0.03). In contrast, there was a positive correlation between QOL and increased metabolic control (P=0.03), participating in sports activities (P=0.007), and a greater number of insulin infusions (P=0.04). Conclusions: The QOL of young diabetics was influenced by demographic, somatometric, and other characteristics of diabetes. Increased metabolic control, participating in sports activities, and a greater number of insulin infusions resulted in better QOL. Increased patient age, duration of diabetes, HbA1c values, BMI, and the coexistence of various health problems, as well as the use of an insulin pump, decreased QOL. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd

Parents' satisfaction concerning their child's hospital care

Aim: To explore parents' satisfaction concerning their child's care during hospitalization and its determinants. Methods: A descriptive, non-experimental correlational design was used. The data collection was based on interviews using a 63 item questionnaire, the Swedish Pyramid Questionnaire. The parents of 206 children (hospitalized in two pediatric and two surgical units) participated in the study. Results: The independent t-test results demonstrated that the parents showed greater satisfaction with staff attitudes and medical treatment, whereas they were less satisfied with the information concerning routines and the staff work environment. The stepwise multiple regression analysis revealed that adequacy of care, adequate pain management, parents' involvement in care, a trusting relationship, and staff attitudes were the most important determinants of parental satisfaction. Conclusion: Interventions in pediatric care should include measurements of parental and child satisfaction as a tool to assess the quality of care. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science

Physician and nursing perceptions concerning interprofessional communication and collaboration

The aim of the study was to investigate the physician and nursing perceptions regarding communication and collaboration as well as the factors that may influence these activities. A self-administered questionnaire survey was sent to a random sample of 93 physicians and 197 nurses based in two large public hospitals in Athens, Greece. Descriptive statistics, t-test and chi square test were performed with the SPSS 19.0 statistical package. Years of experience, the size of the clinic, the university degree and the postgraduate studies were found to be significant factors according to nurses' view (p<0.05). For the physicians, age, sex, years of experience and the size of clinic affected the communication and collaboration with the nursing staff significantly (p<0.05). In summary, these findings suggest that nurses and physicians do not share the same views concerning the effectiveness of their communication and nurses' role in the decision-making process of the patients' care. The most important barrier for the establishment of good relations between these professions, according to the physicians, was that they did not recognize the nurses' professional role. The study also indicated that the absence of interprofessional collaboration may result in a higher possibility of errors and omissions in patients' care. Therefore, in everyday practice, both nurses and physicians should acknowledge the importance of their effective communication and they should develop and implement interprofessional teamwork interventions to improve collaboration. Moreover, nurses have to constantly consolidate their role in the decision process and patients' care, especially in countries with limited interprofessional collaboration culture. In addition, factors that improve physicians' attitudes toward collaboration and effective communication should be further explored. © 2014 Informa UK Ltd