Journal of pediatric psychology
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Comparative Study
Emotional distress of mothers of hospitalized children.
Compared 20 mothers of children hospitalized on a pediatric intensive care unit (PICU), 20 mothers of children hospitalized on a general pediatric medical surgical unit, and 20 mothers of nonhospitalized ill children on standardized measures of anxiety and negative moods. The mothers of children admitted to the PICU experienced greater state anxiety, depression, confusion, and anger than the other mothers. ⋯ Maternal age, family stress, number of prior hospitalizations of the ill child, and the mother's rating of the severity of her child's illness were predictive of emotional distress. Results indicate that hospitalization of a mildly or moderately ill child per se may not necessarily increase maternal emotional distress.
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Managing psychological distress is a central treatment goal in Pediatric Intensive Care Units (PICUs), with medical and psychological implications. However, there is no objective measure for assessing efficacy of pharmacologic and psychological interventions used to reduce distress. Development of the COMFORT scale is described, a nonintrusive measure for assessing distress in PICU patients. ⋯ Criterion validity, assessed by comparison with concurrent global ratings of PICU nurses, was also high. Principal components analysis revealed 2 correlated factors, behavioral and physiologic, accounting for 84% of variance. An ecological-developmental model is presented for further study of children's distress and coping in the PICU.
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Coded behaviors of pediatric oncology patients undergoing bone marrow aspirations and lumbar punctures, parents, and medical staff using the Child-Adult Medical Procedure Interaction Scale. Children were grouped into high and low coping groups for three analyses. Results indicated that adults with the high coping children engaged in more coping-promoting behaviors than adults with the low coping children. ⋯ Both groups were more likely to respond with distress following distress-promoting antecedents. When interacting with children, staff engaged in a higher proportions of giving control to the child and apologies than did parents. Also, children were more likely to display coping than distress following staff's and parents' nonprocedural talk (distraction).
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Investigated postoperative PRN analgesic medication decisions regarding children in 113 hospital nurses, using analog stimuli. Nurses with greater narcotics knowledge and comfort indicated they would provide significantly more medication. Nurses provided more analgesics to children showing higher pain, and on the first than on the third postoperative day. ⋯ These findings were consistent across high and low pain conditions. Nurses' ratings of children's pain were also affected by seriousness and time since surgery. Findings are discussed with reference to problems of undermanagement of children's pain.
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Comparative Study
Development and evaluation of a presurgical preparation program.
Three presurgical preparation programs were developed and evaluated in an Australian hospital utilizing an additive component design. The component basic to all three preparation programs was modeling. This technique was compared with the additional components of teaching child coping skills and parent coping skills via videotape. ⋯ Results indicated that there was no further anxiety reduction by the addition of child and parent coping skills. Results are discussed in terms of the viability of teaching coping skills via videotape particularly to parents. Methodological difficulties associated with research in this area are examined.