Mise en contexte : Les chémoréflexes laryngés (CRI) sont déclenchés suite au contact entre un liquide et la muqueuse laryngée. Chez un organisme mature, ces CRL sont responsables de mécanismes de protection des voies aériennes inférieures (VAI) tels que déglutitions, toux et réaction d'éveil afin d'éviter l'aspiration. Par contre, chez un organisme immature comme c'est le cas chez les nouveau-nés, ces CRL associent apnée, bradycardie, laryngospasme, hypertension et redistribution du débit sanguin. En période néonatale, ces CRL, déclenchés en réponse à un reflux gastro-oesophagien acide, sont tenus responsables d'apnées du prématuré, de malaises graves du nourrisson (ALTE) et probablement de quelques cas de mort subite du nourrisson (MSN). Malgré leur pertinence clinique évidente, la revue de la littérature permet de constater que de nombreuses questions persistent concernant les CRL, principalement parce que les conditions expérimentales des études antérieures ne reflètent pas ce qui est vu en clinique. Ainsi, les CRL ont été étudiés le plus souvent en utilisant des modèles anesthésiés, en utilisant l'eau distillée, en se servant d'une trachéotomie pour l'injection des solutions et finalement en ne prenant pas en compte les stades de conscience. Une meilleure compréhension des CRL, en particulier déclenchés par des solutions acides, est donc nécessaire. But du projet : Le but de ce travail est d'étudier les CRL chez l'agneau nouveau-né sans sédation en réponse à l'acide, en comparaison à l'eau distillée et au salin durant le sommeil calme.

It has been suggested that mental health professionals are insufficiently trained to assess and manage suicide risk (U.S. Department of Veterans Affairs and Defense [USDVA/DOD], 2013; Goldsmith, Pellmar, Kleinman, & Burney, 2002; Jobes, Rudd, Overholser, & Joiner, 2008; Mirick, McCauley, Bridger, & Berkowitz, 2015; Silverman & Berman, 2014) and this problem may originate during graduate training (Feldman & Freedenthal, 2006; Mackelprang, Karle, Reighl, & Cash, 2014; Rudd, Cukrowicz, & Bryan, 2008; Schmitz et al., 2012). Unfortunately, however, this area has been inadequately studied (Battista, 2007; Cramer, Johnson, McLaughlin, Rausch, & Conroy, 2013; Department of Health and Human Services, 2012; Stuber & Quinnett, 2013), precluding a full understanding of this problem. The present study surveyed clinical psychology doctoral students’ behavioral competency in responding to suicidal clients, attitudes toward suicide prevention, perceived ability to engage in appropriate practices, subjective norms surrounding SRA behaviors, intentions to engage in these behaviors, and the relationship of amount of graduate training in suicide risk assessment (SRA) core competencies to the aforementioned constructs. It was hypothesized that amount of training in SRA competencies would be significantly related to participants’ attitudes, perceived behavioral control, and subjective norms related to SRA behaviors. Further, it was hypothesized that the aforementioned variables would be significantly related to participant intentions to engage in these behaviors. Finally, it was hypothesized that intentions to engage in SRA behaviors would be positively related to participants’ behavioral competency in SRA. Study participants were 167 students from 46 clinical psychology doctoral programs. Hypotheses were tested using path analysis. Results provided partial support for significant relationships between attitudes, PBC, subjective norms, and intentions (Hypothesis 1a). Implications of this research include advancing the training practices of clinical psychology doctoral programs so as to help increase the number of mental health practitioners competent in suicide risk assessment and management practices.

Incidence of incurable disease and disability has been increasing in the Western world in recent years. Parallel to this increase, survival rates for adolescents and young adults with life threatening illness, specifically cancer, have not improved relative to younger and older age groups. Palliative care is a total care for patients, regardless the type and status of the illness, and aims to improve quality of life by controlling symptoms and alleviating physical social, psychological and spiritual suffering. The varying level of physical, emotional and psychological maturity makes palliative and supportive care needs of adolescents distinct and challenging.  In this systematic review, the aim was to describe the experiences of palliative and supportive care for adolescents with life threatening illness, from the perspectives of adolescents, family and nurses as providers of palliative and supportive care.  A systematic review of descriptive meta-synthesis was the appropriate method of choice concerning the aims focus on subjective experiences of palliative and supportive care for adolescents. PubMed and CINAHL were the two databases used for data sources of qualitative published articles between the years of 2006-2016.  A total of 1066 qualitative published articles were identified, but only 16 articles have met the inclusion criteria. Nine articles were focusing on adolescents’ experiences, whereas five articles were focusing on families’ experiences and the remaining two were on the nurses’ experiences in providing palliative and supportive care to adolescents. A total of eleven themes have emerged. Four themes were from adolescent’s perspective: preserving self or identity, social support, acceptance and feeling positive and care setting. Another four themes were on family’s perspective: social support, information and decision making, care setting and perception of self-image. Whereas the remaining three themes were on nurse’s perspective: importance of family dynamics, reaching out to adolescents, balancing professional and personal involvement.  In conclusion this systematic review meta-synthesis showed that social support, specifically peer’s support had an impact in enhancing coping with the altered body image and ordinary daily social activities of adolescents due to life threatening illnesses and their treatment. Nurses have a key professional role in facilitating the social network of social support to promote quality of life by maintaining the need for normality.

Spiritual health is one of the essential components of health, where patients search for meaning and purpose in life. Patients with life threatening illnesses experience distress, both physically and spiritually. There are studies which found that nurses did not regularly integrate spiritual care into their daily routine, due to lack of time and lack of education. It is important to discover existing evidences of spiritual interventions which help the nurses promote spiritual health as regards to patients’ need in hospital settings. The aim of this study was to describe nursing interventions applied in promoting spiritual health for patients with life threatening illnesses in hospital settings. A literature review of sixteen articles was carried out. Articles were retrieved from CINAHL and MEDLINE databases to answer the study’s objective. Eleven articles were retrieved from the databases and five articles were found using an ancestry search. A process of re-reading and finding the similar categories from articles was being used to develop themes in analyzing the data. Results were categorized into three themes: person-centred communication, adapting a team approach, and modifying the physical environment. It was found that the nurses conducted a deeper level of communication which covered topics about patients’ wishes and hopes, and being there for patients as major interventions. The nurses also assessed patients’ spiritual needs prior to interventions, and were promoting patients and family belief and value in a respectful way. Family and referrals were also included in the intervention given by the palliative care team, moreover the nurses were providing privacy with regards to supporting a healing environment. In conclusion acknowledgement of dying is essential in providing appropriate care. It is essential for the nurses to be prepared adequately through education, to conduct spiritual care interventions within a person-centred care approach. The information from this study may improve the quality of delivering spiritual care in hospital settings for patients with life threatening illnesses. Further recommendation for future research is to explore deeper about various spiritual nursing interventions from various cultures.

No description available.

Bakgrund: Palliativ vård syftar till att lindra symtom och öka livskvalitén i livets slutskede hos den som har en livshotande sjukdom. Att stödja närstående är en viktig del inom palliativ vård. Närstående definieras som en person med nära relation till den enskilde. Individer upptill 18 år definieras som barn och har lagstadgade rättigheter, bland annat inom vården. Barn som är närstående till en förälder med livshotande sjukdom är sårbara och påverkas både fysiskt och psykiskt. Forskning visar att sjuksköterskor saknar tillräckliga kunskaper för att bemöta och stödja barn som närstående. Syfte: Att utforska barns erfarenheter av att leva med en förälder som har en livshotande sjukdom. Metod: En litteraturöversikt med induktiv ansats bestående av 13 vetenskapliga kvalitativa och kvantitativa artiklar som publicerades mellan år 2004–2023. Resultat: I resultatet framkom fyra stycken teman. Information om sjukdom och vård, Barns känslomässiga reaktioner relaterat till förälderns livshotande sjukdom, Barns upplevelser av hemsituationen” och Barns behov av stöd och strategier för att hantera vardagen. Barnen önskade kontinuerlig information om förälderns sjukdomsförlopp från vårdpersonalen och föräldrarna. Barnen påverkades psykiskt och fysiskt vid brist på information. Förälderns sjukdom fick barnen att uppskatta tiden tillsammans med familjen och ledde till ökad mognad och nya perspektiv på livet. Slutsats: Barn som närstående till föräldrar som har en livshotande sjukdom önskar vara mer delaktiga för att hantera situationen lättare. Sjuksköterskorna önskade utökade insatser såsom utbildning för att främja kommunikationen mellan familjemedlemmarna. Att involvera barnen och delge information om sjukdomsförloppet skapar goda förutsättningar och anses vara till nytta för barnets mående på lång sikt. / Background: Palliative care aims to relieve symptoms and increase the quality of life in the final stages of life for those who have a life-threatening illness. Supporting relatives is an important part of palliative care. A relative is defined as a person with a close relationship to the individual. Individuals up to the age of 18 are defined as children and have statutory rights, including in healthcare. Children who are close to a parent with a life-threatening illness are vulnerable and are affected both physically and psychologically. Research shows that nurses lack sufficient knowledge to respond to and support children as relatives. Aim: To explore children's experiences of living with a parent who has a life-threatening illness. Method: A literature review with an inductive approach consisting of 13 scientific qualitative and quantitative articles that were published between the years 2004–2023. Results: The results revealed four themes. Information about illness and care, Children's emotional reactions related to the parent's life-threatening illness, Children's experiences of the home situation" and Children's need for support and strategies to manage everyday life. The children wanted continuous information about the course of the parent's illness from the care staff and the parents. The children were affected psychologically and physically when there was a lack of information. The parent's illness made the children appreciate the time together with the family and led to increased maturity and new perspectives on life. Conclusion: Children who are relatives to parents who have a life-threatening illness wish to be more involved in order to handle the situation more easily. Nurses wanted increased stakes such as education to promote communication between family members. Involving the children and sharing information about the course of the illness creates good conditions and is considered beneficial for the child's well-being in the long term.

Bakgrund: Palliativ vård syftar till att lindra symtom och öka livskvalitén i livets slutskede hos den som har en livshotande sjukdom. Att stödja närstående är en viktig del inom palliativ vård. Närstående definieras som en person med nära relation till den enskilde. Individer upptill 18 år definieras som barn och har lagstadgade rättigheter, bland annat inom vården. Barn som är närstående till en förälder med livshotande sjukdom är sårbara och påverkas både fysiskt och psykiskt. Forskning visar att sjuksköterskor saknar tillräckliga kunskaper för att bemöta och stödja barn som närstående. Syfte: Att utforska barns erfarenheter av att leva med en förälder som har en livshotande sjukdom. Metod: En litteraturöversikt med induktiv ansats bestående av 13 vetenskapliga kvalitativa och kvantitativa artiklar som publicerades mellan år 2004–2023. Resultat: I resultatet framkom fyra stycken teman. Information om sjukdom och vård, Barns känslomässiga reaktioner relaterat till förälderns livshotande sjukdom, Barns upplevelser av hemsituationen” och Barns behov av stöd och strategier för att hantera vardagen. Barnen önskade kontinuerlig information om förälderns sjukdomsförlopp från vårdpersonalen och föräldrarna. Barnen påverkades psykiskt och fysiskt vid brist på information. Förälderns sjukdom fick barnen att uppskatta tiden tillsammans med familjen och ledde till ökad mognad och nya perspektiv på livet. Slutsats: Barn som närstående till föräldrar som har en livshotande sjukdom önskar vara mer delaktiga för att hantera situationen lättare. Sjuksköterskorna önskade utökade insatser såsom utbildning för att främja kommunikationen mellan familjemedlemmarna. Att involvera barnen och delge information om sjukdomsförloppet skapar goda förutsättningar och anses vara till nytta för barnets mående på lång sikt / Background: Palliative care aims to relieve symptoms and increase the quality of life in the final stages of life for those who have a life-threatening illness. Supporting relatives is an important part of palliative care. A relative is defined as a person with a close relationship to the individual. Individuals up to the age of 18 are defined as children and have statutory rights, including in healthcare. Children who are close to a parent with a life-threatening illness are vulnerable and are affected both physically and psychologically. Research shows that nurses lack sufficient knowledge to respond to and support children as relatives. Aim: To explore children's experiences of living with a parent who has a life-threatening illness. Method: A literature review with an inductive approach consisting of 13 scientific qualitative and quantitative articles that were published between the years 2004–2023. Results: The results revealed four themes. Information about illness and care, Children's emotional reactions related to the parent's life-threatening illness, Children's experiences of the home situation" and Children's need for support and strategies to manage everyday life. The children wanted continuous information about the course of the parent's illness from the care staff and the parents. The children were affected psychologically and physically when there was a lack of information. The parent's illness made the children appreciate the time together with the family and led to increased maturity and new perspectives on life. Conclusion: Children who are relatives to parents who have a life-threatening illness wish to be more involved in order to handle the situation more easily. Nurses wanted increased stakes such as education to promote communication between family members. Involving the children and sharing information about the course of the illness creates good conditions and is considered beneficial for the child's well-being in the long term

In children, life-threatening illnesses (LTIs) present with both physical and psychosocial side effects, which seem to contribute to the perpetuation of hopelessness and fear among the children and their families. Children with LTIs often experience regular and painful treatment routines. A LTI not only impacts on the child but also on the family. LTIs put families in a critical and vulnerable situation, evoking emotions such as shock, disbelief and fear. Hope and coping strategies appear to be crucial for both children and their families when facing the effects of a LTI on a child. While medical intervention strategies are used to alleviate physical side effects, psychosocial intervention strategies (as referred to in this research study) that are focused on improving the well-being of the child and family, appear to be limited. Psychosocial interventions are defined as any intervention that emphasizes psychological or social factors, rather than biological factors. Psychosocial intervention strategies, such as „dream-come-true‟ projects, appear to ameliorate distress, offer respite, decrease isolation, empower individuals, increase self-confidence and give the children unique opportunities to connect with their families in a positive, normal way. Such a psychosocial intervention strategy is offered by the Reach For A Dream Foundation (RFAD) in South Africa. The experiences of the recipients of RFAD „dream-come-true‟ projects were the focus of this study. The goal of this research study was to study the „dream-come-true‟ psychosocial experiences of children/adolescents and their families, by means of a narrative enquiry design. This design allowed participants to tell their stories truthfully, giving the researcher the opportunity to immerse herself in the personal experience of each participant. Participants were purposively, and then randomly, selected from an RFAD client list. A total of six children/adolescents, between the ages of 8 and 18 years, were randomly selected from Johannesburg and the surrounding areas. The children/adolescents and both parents were interviewed, except for one father who was not present (17 participants in total). Child/adolescent interviews included the use of fun, tactile emotive cushions to assist the participants to recognize emotions they had felt „pre-dream‟, during the „dream‟, and „postdream‟. Semi-structured, individual in-depth interviews were used to interview parent participants. The parent‟s story was not interrupted, thereby providing the opportunity for a fluid narrative. In addition to interviews, the researcher made field notes of the participant‟s reactions, body language and emotions after each interview. All interviews were recorded and transcribed. Tesch‟s (1990) approach was used to identify, analyse and report patterns within the data. The findings of this study suggest that intervention strategies improve emotional health and overall wellness in participants. „Pre-dream‟ feelings of fear, sadness, loneliness and a lack of normality in everyday life, were prominent themes. Participating parents expressed anger, helplessness and guilt about being unable to help their children. During the „dream-come-true‟ experience, the predominant themes that emerged were excitement, amazement and gratitude. The theme of disbelief in the reality and experience of the „dream‟ was also prominent. „Post-dream‟, the participants reported a more positive, confident and hopeful outlook. This research appeared to yield some important information on the possible benefits of psychosocial intervention strategies, as they seemed helpful in addressing the challenges presented by LTIs in children/adolescents. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

In children, life-threatening illnesses (LTIs) present with both physical and psychosocial side effects, which seem to contribute to the perpetuation of hopelessness and fear among the children and their families. Children with LTIs often experience regular and painful treatment routines. A LTI not only impacts on the child but also on the family. LTIs put families in a critical and vulnerable situation, evoking emotions such as shock, disbelief and fear. Hope and coping strategies appear to be crucial for both children and their families when facing the effects of a LTI on a child. While medical intervention strategies are used to alleviate physical side effects, psychosocial intervention strategies (as referred to in this research study) that are focused on improving the well-being of the child and family, appear to be limited. Psychosocial interventions are defined as any intervention that emphasizes psychological or social factors, rather than biological factors. Psychosocial intervention strategies, such as „dream-come-true‟ projects, appear to ameliorate distress, offer respite, decrease isolation, empower individuals, increase self-confidence and give the children unique opportunities to connect with their families in a positive, normal way. Such a psychosocial intervention strategy is offered by the Reach For A Dream Foundation (RFAD) in South Africa. The experiences of the recipients of RFAD „dream-come-true‟ projects were the focus of this study. The goal of this research study was to study the „dream-come-true‟ psychosocial experiences of children/adolescents and their families, by means of a narrative enquiry design. This design allowed participants to tell their stories truthfully, giving the researcher the opportunity to immerse herself in the personal experience of each participant. Participants were purposively, and then randomly, selected from an RFAD client list. A total of six children/adolescents, between the ages of 8 and 18 years, were randomly selected from Johannesburg and the surrounding areas. The children/adolescents and both parents were interviewed, except for one father who was not present (17 participants in total). Child/adolescent interviews included the use of fun, tactile emotive cushions to assist the participants to recognize emotions they had felt „pre-dream‟, during the „dream‟, and „postdream‟. Semi-structured, individual in-depth interviews were used to interview parent participants. The parent‟s story was not interrupted, thereby providing the opportunity for a fluid narrative. In addition to interviews, the researcher made field notes of the participant‟s reactions, body language and emotions after each interview. All interviews were recorded and transcribed. Tesch‟s (1990) approach was used to identify, analyse and report patterns within the data. The findings of this study suggest that intervention strategies improve emotional health and overall wellness in participants. „Pre-dream‟ feelings of fear, sadness, loneliness and a lack of normality in everyday life, were prominent themes. Participating parents expressed anger, helplessness and guilt about being unable to help their children. During the „dream-come-true‟ experience, the predominant themes that emerged were excitement, amazement and gratitude. The theme of disbelief in the reality and experience of the „dream‟ was also prominent. „Post-dream‟, the participants reported a more positive, confident and hopeful outlook. This research appeared to yield some important information on the possible benefits of psychosocial intervention strategies, as they seemed helpful in addressing the challenges presented by LTIs in children/adolescents. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

<p>Syftet med denna litteraturstudie var att beskriva hur sjuksköterskor kan samtala om döden och döendet med barn som har livshotande sjukdomar. Litteratursökningen genomfördes i databaserna Medline (via PubMed) och Cinahl samt via manuell sökning. Tio artiklar som mötte inklusionskriterierna granskades. Resultatet bearbetades och presenterades utifrån de nio grundelementen i professionell, omvårdnadsorienterad kommunikation. Resultatet visade att en förutsättning för att sjuksköterskor ska kunna samtala om döden och döendet med barn är att de visar <em>empati</em>, har <em>yrkeskunskap</em> samt <em>ett mål</em> för samtalet. Relationen mellan sjuksköterskor och barnet måste bygga på <em>känslor</em>, <em>förnuftigt tänkande</em> samt en <em>etiskt reflekterande </em>vård. Sjuksköterskor måste se på <em>nuet</em> samtidigt som de har barnets <em>förflutna</em> i åtanke och föreställer sig hur barnets <em>framtid</em> kan gestalta sig. Genom att använda teckningar som kommunikationshjälpmedel kan sjuksköterskor åskådliggöra barnets känslor, tankar, drömmar och frågor samt förstå barnets livsupplevelser. Slutsatsen är att det finns stöd för att samtalet om döden och döendet med barn som har livshotande sjukdomar kan bygga på de nio grundelementen i professionell, omvårdnadsorienterad kommunikation.</p> / <p>The aim of the present literature review was to describe how nurses can talk about death and dying with children who have life-threatening diseases. A literature search was conducted in the databases Medline (through PubMed) and Cinahl, and through manual search. Ten articles that met the inclusion criteria were reviewed. The results were processed and presented on the basis of the nine basic elements of professional, caring-oriented communications. The result showed that a condition for nurses to be able to talk about death and dying with children is that they show <em>empathy</em>, have <em>professional knowledge</em> and <em>a target</em> for the conversation. The relationship between nurses and the child must be based on <em>emotions</em>, <em>rational thinking</em> and an <em>ethically reflective</em> care. Nurses must look at the <em>present moment</em>, while they have the child's <em>past</em> in mind and imagine how the child's <em>future</em> can turn out. To use drawings as a communication tool can help nurses to visualize the child's feelings, thoughts, dreams and questions, as well as understand the child's life experiences. The conclusion is that there is evidence for that conversation about death and dying with children who have life-threatening diseases could be based on the nine basic elements of professional, caring-oriented communications.</p>