Journal of child health care : for professionals working with children in the hospital and community
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J Child Health Care · Sep 2006
Obesity and physical fitness of pre-adolescent children during the academic year and the summer period: effects of organized physical activity.
This study examined obesity and parameters of physical fitness in 178 elementary schoolchildren during an academic year as well as after the summer holidays. Results showed significant physical fitness improvements during the school year, with little or no changes in the summer holidays. ⋯ Longitudinal modelling using generalized estimating equations demonstrated that physical activity is a major contributing factor for obesity over time, masking the singular effect of various fitness parameters. It is concluded that pre-adolescent children advance in physical fitness mainly during the school year, with physical activity being a beneficial countermeasure for the development of obesity.
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J Child Health Care · Mar 2006
The moral experience of parents regarding life-support decisions for their critically-ill children: a preliminary study in France.
The common paediatric critical care practice in France is for physicians (rather than parents) to maintain the ultimate responsibility for lifesupport decisions in children. Some French literature asserts that it is inappropriate for parents to bear such responsibilities because they do not have the required knowledge and should be protected from feeling culpable for such decisions. ⋯ Five principal themes emerged as significant from these interviews: (1) a need for more information; (2) physicians should be responsible for life-support decisions; (3) the child's concerns and wishes need to be better heard; (4) maternal guilt; and (5) physicians require better training in parent communication. These findings raise important issues for clinical practice and further research in France.
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J Child Health Care · Sep 2005
Pain experiences and non-pharmacological strategies for pain management after tonsillectomy: a qualitative interview study of children and parents.
Tonsillectomy is one of the most common paediatric surgical procedures. This study aimed to investigate children's experience of pain and the nonpharmacological strategies that they used to manage pain after tonsillectomy. A further aim was to investigate parental views on these same phenomena. ⋯ Children rated their 'worst pain' during the past 24 hours between 6 and 10 (visual analogue scale, 0-10). The non-pharmacological strategies used most frequently to manage pain were thermal regulation (physical method) and distraction (cognitive-behavioural method) according to the framework used. Specific non-pharmacological strategies for pain management relative to different surgical procedures need to be considered.
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J Child Health Care · Mar 2005
Validating the Derbyshire Children's Hospital Pain Tool in children aged 6-12 years.
The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is the current pain assessment tool used at the Derbyshire Children's Hospital. It was originally devised as a simple pain tool for use in the post-operative clinical area. It is applicable across the spectrum of age groups that present for paediatric surgery. ⋯ Assessments were performed preoperatively and for four hours post-operatively. Any analgesia administered post-operatively was recorded, and its effects noted. This study supports construct validity and inter-rater reliability of the DPC pain assessment tool for children aged 6-12 undergoing minor and intermediate surgery.
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The development of research with children highlights a number of ethical issues for the research process concerning consent, confidentiality and protection from harm. This article aims to analyse the extent to which these issues have been considered within the published guidance for research involving children. Several key principles emerged: there is consensus that it is unethical not to conduct research with children; consent should be obtained from both the child and the parent or guardian; where the child does not have sufficient understanding of what is involved and the implications of such involvement, the assent of the child should be sought; children involved in research should be made aware that, where information concerning risks to themselves or others emerges, confidentiality cannot be guaranteed; and finally researchers must consider the potential impact of research participation on the child, building methods of providing support to children into the research proposal.