Millions of children are affected by acute medical events annually, creating a need for resources to promote recovery. Although web-based interventions promise wide reach and low cost for users, ...development can be time- and cost-intensive. A systematic approach to intervention development can help to minimize costs and increase the likelihood of effectiveness. Using a systematic approach, our team integrated evidence on the etiology of traumatic stress, an explicit program theory, and a user-centered design process to intervention development. This study describes evidence and the program theory model applied to the Coping Coach intervention and presents pilot data evaluating intervention feasibility and acceptability. Informed by empirical evidence on traumatic stress prevention, an overarching program theory model was articulated to delineate pathways from specific intervention content to program targets and proximal outcomes to key longer-term health outcomes. Systematic user-testing with children ages 8-12 years (N = 42) exposed to an acute medical event and their parents was conducted throughout intervention development. Functionality challenges in early prototypes necessitated revisions. Child engagement was positive throughout revisions to the Coping Coach intervention. Final pilot-testing demonstrated promising feasibility and high user-engagement and satisfaction. In conclusion, applying a systematic approach to the development of Coping Coach led to the creation of a functional intervention that is accepted by children and parents. Development of new e-health interventions may benefit from a similar approach. Future research should evaluate the efficacy of Coping Coach in achieving targeted outcomes of reduced trauma symptoms and improved health-related quality of life.
This study examined after-hospital medical and psychosocial care parents sought for their child following an injury and how this was affected by parent and child traumatic stress symptoms. Whereas ...the majority of parents (> 70%) reported seeking after-hospital pediatric medical services, less than one-third sought psychosocial assistance. More severe child or parent acute traumatic stress within the first month post injury was associated with a greater number of subsequent outpatient medical visits. Level of child or parent acute stress was also related to the type of psychosocial help sought. Results support trauma-informed care and symptom screening in children and parents post injury.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
For children with sickle cell disease (SCD), pain is associated with significant current and future morbidity and mortality. Unfortunately, few evidence-based guidelines exist for the management of ...pain episodes in children with SCD. To inform empirically based treatment strategies for pain management in pediatric SCD, this review integrates and evaluates the extant literature on psychosocial and pharmacological approaches to the management of pain. Findings reveal a paucity of rigorous investigations of psychosocial and pharmacological pain management interventions in children with SCD. Psychosocial interventions included were primarily cognitive-behavioral in nature, whereas pharmacological approaches targeted non-opioid analgesics (ie, nonsteroidal anti-inflammatory drugs and corticosteroids) and opioid medications (ie, morphine and oxycodone). However, to date there is not a "gold standard" for pain management among children with SCD. Because psychosocial and physiological processes each play a role in the etiology and experience of pain, effective pain management requires multidimensional, comprehensive treatment approaches. Considering the significant impact of pain on functional outcomes and quality of life among children with SCD, additional clinical trials are warranted to ensure that interventions are safe and efficacious.
Millions of children and adolescents each year are exposed to potentially traumatic events (PTEs), placing them at risk for posttraumatic stress (PTS) disorder symptoms. Medical providers play an ...important role in the identification and treatment of PTS, as they are typically the initial point of contact for families in the wake of a PTE or during a PTE if it is medically related (eg, injury/illness). This paper offers a review of the literature focused on clinical characteristics of PTS, the assessment and diagnosis of PTS, and current effective treatments for PTS in school-age children and adolescents. The clinical presentation of PTS is often complex as symptoms may closely resemble other internalizing and externalizing disorders. A number of screening and evaluation tools are available for medical providers to assist them in the accurate diagnosis of PTS. Treatment options are available for youth at minimal risk of PTS as well as for those with more intensive needs. Additional training regarding trauma-informed medical care may benefit medical providers. By taking a trauma-informed approach, rooted in a solid understanding of the clinical presentation of PTS in children and adolescents, medical providers can ensure PTS does not go undetected, minimize the traumatic aspects of medical care, and better promote health and well-being.
Pediatric physical injury is a very common, potentially traumatic medical event that many families face each year. The role that child or parent coping behavior plays in emotional recovery from ...injury is not well understood. This study described coping used by children and coping assistance implemented by parents in the early aftermath of a child's injury. Ten child-parent dyads participated in individual semistructured interviews that were audiorecorded, transcribed, and coded using hierarchical coding schemes. Study findings highlight reliance on a broad range of coping strategies. Although children and parents report some similarities in their perceptions of child coping, parents do not recognize all the coping strategies that children report. This suggests potential for improvement in parent-child communication concerning coping techniques. Parents report a limited number of coping assistance strategies, indicating a niche for preventive programs. Further research should examine coping during the peritrauma period as it relates to physical and emotional outcomes to inform secondary prevention programs.
This study's purpose was to examine relationships among dental anxiety, psychological functioning, coping, and pain perception in child and adolescent dental patients and their parents. Participants ...were recruited from private dental offices and included 129 9- to 15-year-old patients
and 84 parents. The children completed self-report measures of dental anxiety, dental coping, and pain perception, while parents completed self-report measures of dental anxiety, dental coping, and child's psychological functioning. The intraclass correlation coefficient method was used to
examine each hypothesis. For child-ren, correlational analyses indicated positive relationships between dental anxiety and total psychological symptoms, and dental anxiety and pain perception. Both child and parent coping measures were examined using principal axis factor analysis. Clear 2-factor
structures (ie, approach and avoidant-based coping factors) emerged. The children's approach-based coping was negatively related to both dental anxiety and pain perception; their use of avoidant-based coping was also negatively related to dental anxiety. Psychological functioning emerged as
a mediating variable between dental anxiety and pain perception. The findings suggest that dental professionals and clinicians should consider dental anxiety and general psychological functioning to reduce pain perception in the office. Additionally, the child's coping type and approach should
be considered in treatment planning.
Background Following a physical injury, many children exhibit long‐term psychological reactions such as post‐traumatic stress symptoms (PTSS). Children's coping strategies, and the ways that others ...help them cope with injury (i.e. coping assistance), are understudied, potentially malleable variables that could be targeted in preventive interventions. The objectives of the current research were to describe child coping behaviour and parent coping assistance following a child's injury, and to investigate the relationships among coping, coping assistance and child PTSS.
Method Participants included 82 children with injuries and one parent of each child. Children completed measures of coping and coping assistance 2 weeks after their injury (T1). Children also completed measures of coping and PTSS at a 3‐month follow‐up (T2). Parents reported on the coping assistance they provided to their child at T1.
Results Children reported using an average of six coping strategies (out of 10) with wishful thinking, social support, distraction, and cognitive restructuring endorsed most frequently. Child‐reported social withdrawal and resignation 2 weeks after his or her injury (T1) were related to subsequent PTSS (T2). Social withdrawal at T2 was related to concurrent child PTSS (T2). Children were more likely to seek social support when their parents reported helping their child cope. No relationships were identified between active coping behaviours or parent coping assistance and PTSS outcomes.
Conclusions Findings suggest that children's coping strategies (particularly social withdrawal and resignation) play a possibly important, complex role in the development of traumatic stress symptoms. When parents help their child cope, children are more likely to seek out social support, suggesting that they will be more able to ask their parents for help as needed. Future research should identify effective strategies to prevent PTSS including how parents can best support their child following paediatric injury.
Sickle cell disease (SCD) and its treatment can place physical and psychosocial strain on children and their families, underlining the need for behavioral and emotional support. Much of SCD is often ...managed at home, which may prevent children from obtaining supportive services from medical and psychosocial teams. Children with SCD report a restricted number of coping strategies specific to managing SCD, and they may benefit from education on adaptive coping. To address this unmet need, a coping tool for children with cancer (Cellie Cancer Coping Kit) was adapted for children with SCD. The Cellie Coping Kit for SCD (Cellie Coping Kit) includes a stuffed "Cellie" toy, coping cards for children, and a book for caregivers. This study sought to assess the acceptability and feasibility of an intervention using the Cellie Coping Kit. Fifteen children with SCD (ages 6-14) and their caregivers participated in a baseline assessment including semistructured interviews to examine SCD-related stressors and coping strategies. Next, families received a brief introduction to the Cellie Coping Kit and were provided with a kit to use independently over the next 4 weeks before completing a follow-up assessment. Results indicated strong intervention acceptability overall. Although families reported using and learning information and skills from the Cellie Coping Kit, several challenges were identified (e.g., child's living situation, busy schedules). The Cellie Coping Kit is a promising tool to support children with SCD and their families. Future research should examine whether use of the Cellie Coping Kit affects behavioral change and improved health outcomes.
Coping With Pediatric Cancer Hildenbrand, Aimee K.; Clawson, Kathleen J.; Alderfer, Melissa A. ...
Journal of pediatric oncology nursing,
11/2011, Letnik:
28, Številka:
6
Journal Article
Pediatric cancer patients and their families face significant physical, emotional, and psychosocial challenges. Few studies have investigated how children manage these challenges and how parents may ...help in the process. This qualitative study aimed to explore common cancer-related stressors for children and to examine child coping and parental assistance in coping with these stressors during treatment. Fifteen children undergoing cancer treatment and their parents participated in semistructured interviews. Four themes emerged capturing cancer-related stressors: cancer treatment/side effects, distressing emotions, disruption in daily routines, and social challenges. Six themes emerged regarding child coping strategies that were classified within an approach/avoidance coping framework. Approach coping strategies included the following: cognitive restructuring, relaxation, practical strategies, seeking social support, and emotional expression. Distraction was the only avoidant coping strategy. Parents tended to encourage approach coping strategies (eg, cognitive restructuring, social support). Within families, few coping strategies were reported (child: M = 1.47, SD = 0.99; parent: M = 3.33, SD = 1.18), suggesting that early family-based interventions teaching coping techniques for cancer-related stressors may be beneficial.
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