Families, systems & health : the journal of collaborative family healthcare
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Munchausen Syndrome by Proxy (MSP) is a disturbing diagnosis that should be considered when persistent signs and symptoms defy adequate explanation despite extensive testing. Insistence by a parent (often mother) that more, and particularly invasive investigations be pursued, should serve as a warning sign that MSP might be present. ⋯ This easily occurs in cases of MSP both because frequent hospitalizations offer ample opportunity for the articulate and inquisitive parent to pick up the ways of "medical-speak," and because the World Wide Web provides countless and effortlessly accessible sources of disease related information (albeit not always accurate or relevant to the diagnostic dilemma in question). An additional complicating factor in posing a risk for MSP is the child with a chronic illness, or one whose neonatal course has served to label the child as vulnerable.
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Families navigate loss of loved ones in a number of ways, including the creation of narratives of family experiences during the patient's illness and death. Robinson (2004) suggests that grieving family members create poetry together. Using a version of this method, the author processes losses by responding to the poems her husband wrote about the illnesses and deaths of a friend and several family members. Each poem is followed by a letter in which the author addresses the main character of the poem in order to provide new perspectives on her identity and her memories.
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Parents of young children with Type 1 diabetes describe daily management as relentless. Nighttime caregiving, including nocturnal blood glucose monitoring (NBGM), occurs and may increase parents' anxiety and stress. The goal of this study was to examine the frequency of NBGM among parents of young children with Type 1 diabetes, and to identify children's illness characteristics and parents' fear of hypoglycemia, anxiety, and parenting stress associated with nighttime monitoring. ⋯ Frequency of NBGM was positively associated with basal-bolus regimen, longer illness duration, and increased parent-reported anxiety and parenting stress (p < .05). NBGM is prevalent among parents of young children with Type 1 diabetes, suggesting that parents' nighttime caregiving practices and resulting sleep disruption should be routinely addressed in clinical practice. Further investigations of NBGM, child health outcomes, and parent quality of life are warranted.