Family Presence During Resuscitation (FPDR) remains controversial and is not consistently implemented during resuscitation events or invasive procedures. Evidence has demonstrated positive outcomes produced by implementation of FPDR; such as, decreased rates of post-traumatic stress symptoms, decreased symptoms of anxiety, and depressive symptoms were not significantly different. Unfortunately, use of FPDR in the acute care setting is not widely accepted or readily implemented. The primary purpose of this integrative literature review is to evaluate the use of FPDR in the acute care setting. The secondary purpose is to evaluate the health care professional's level of perceived value associated with the outcome of having family present during resuscitation. A systematic literature search was conducted using multiple databases for relevant articles in the English language between 2006 to 2017, including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Elton B. Stephens Co. Host (Ebsco Host), Medical Literature On-line (Medline), Psychological Information Database (PsychINFO), and PubMed. Search terms included 'family presence during resuscitation', 'family presence', 'pediatrics', 'nurse perceptions', and 'perceptions'. Ten of the nineteen articles suggest the use of FPDR leads to positive outcomes such as decreased post-traumatic symptoms, and decreased anxiety for family members. The use of FPDR can enhance family members' understanding of resuscitation efforts and involves them in their loved one's care. This integrative review indicates the implementation of FPDR can provide benefits for family members of those undergoing CPR and invasive procedures; although the perceptions of the healthcare team remain the barrier to its use.

Bakgrund: Enligt familjemedlemmars erfarenheter upplevs det som en svårare situation när ett barn i familjen är i behov av palliativ vård jämfört med en vuxen person. Ett barn som är i ett livshotande tillstånd kan medföra stora förändringar i relationerna i familjen, då rollerna i familjen ändras och konflikter i familjen kan uppstå.  Syfte: Syftet var att beskriva familjers erfarenheter av att ett barn i familjen får palliativ vård.  Metod: En litteraturstudie där kvalitativ metod använts och åtta artiklar har analyserats. Resultat: Analysen av de åtta artiklarna resulterade i tre huvudkategorier och nio underkategorier. Huvudkategorierna var: Att hantera liv och död, familjens upplevelse av utsatthet och förändringar i familjens dynamik.  Konklusion: Resultatet i denna litteraturstudie visar att när ett barn i familjen får palliativ vård påverkas hela familjen. Familjen utsätts för många negativa situationer och känslor som sorg och rädsla över att förlora barnet. Resultatet visar också att familjemedlemmarna använder sig av olika strategier för att orka med och klara av den svåra situationen de befinner sig i. / Background: According to family members experience it is harder when a child inthe family is in need of palliative care compared to an adult. A child with a lifethreateningcondition can bring big changes within the family relationships since theroles in the family changes and conflicts appear. Aim: The aim of the study was to describe families’ experience of having a child inthe family who is in need of palliative care. Methods: A qualitative literature study was used, and eight qualitative articles werereviewed and analysed. Results: The analysis of the eight articles resulted in three main categories and ninesubcategories. The main categories were: To handle life and death, the family'sexperience of exposure and changes in the family dynamics. Conclusion: The results in this literature study shows that when a child in thefamily is in need of palliative care the entire family is affected. The families areexposed to many difficult situations and feelings like grief and fear of losing the child.The result also shows that the family members use different kinds of strategies tocope with the difficult situation they are living in.Keywords: Families

The Rural Expansion Program for At-risk Communities to Promote Health Outcomes through the Integration of Mental health and Enabling services in an Existing Primary Care School-Based Setting (REACH ME) program was established to increase access to mental health services at two existing school-based health centers (SBHC) in rural Hancock County, TN. These SBHCs are among the most unique in the nation, holding designations as federally funded qualified health centers - proving primary care services in a geographically isolated, rural, and medically underserved area. The aim of the project is increasing the number of patients receiving mental health and enabling services for not only the children and adolescents of Hancock County, but also adults who use the clinic for primary care services. This project employs a secondary data analysis to determine if there is an increase in the use of mental health services by patients using a school-based health center for care. Variables include number of visits, screening employed, and mental health diagnosis. Data gathered by health center staff and input into Excel will be used. Data collection is ongoing and is expected to be completed in February 2024. Early results indicate an increase in mental health and enabling services from initiation of the project. There were identified facilitators and barriers that impacted the project. Significance for this project is two-fold, identified facilitators and barriers to initiating integrated mental health services in the SBHC setting and increasing early screening, identification, referral and treatment of rural populations with mental health problems.

Bakgrund: Preoperativ oro förekommer hos över hälften av alla barn som ska genomgå kirurgiska ingrepp. Oron inför den kommande operationen orsakar ett stort lidande för barnet. Detta kan orsaka både fysiologiska och psykologiska symtom till följd av oron. Dessutom får dessa barn en ökad risk för postoperativa komplikationer, vilket innebär fortsatt lidande för barnen men även en ökad belastning för sjukvården. Lekterapi har visat ha en lindrande effekt på känslor hos barn och därför syftar denna studie på att undersöka om lekterapin även kan lindra den preoperativa oron.  Syfte: Detta arbetets syfte var att undersöka om lekterapi har effekt på preoperativ oro hos barn i åldrarna 0-18 som ska genomgå kirurgiska ingrepp.  Metod: En litteraturstudie gjordes med en deskriptiv design med en kvantitativ ansats. Denna studie baserades på 11 experimentella kvantitativa studier som undersökte lekterapins effekt på preoperativ oro. Artiklarna kvalitetsgranskades utifrån Fribergs granskningsmall.  Resultat: Studien använde Popenoe et al.s guide för dataanalys och resultatet delades in i tre kategorier: terapeutisk lek, teknologisk lek och strukturerad lek. Gemensamt för alla tre kategorier var att de visade på en reducerande effekt på preoperativ oro hos barn.  Slutsats: Lekterapi verkar ha en reducerande effekt på den preoperativa oron hos barn. Vilken typ av lek som lekterapin baseras på tycks inte påverka effekten av interventionen. Lekterapi bör därmed kunna användas som preoperativ förberedelse av barn i kombination med den rutinmässiga förberedelsen. / Background: Preoperative anxiety is prevalent in over half of all children undergoing invasive procedures. This may cause great suffering for the child which can lead to both physiological and psychological symptoms. Additionally these children face an increased risk of postoperative complications, which only leads to more suffering for the children but also an additional burden on the healthcare system. Studies have shown that play therapy has an alleviating effect on emotions in children, therefore this study aims to explore if play therapy also could have an alleviating effect on preoperative anxiety. Aim: To examine play therapy’s effect on preoperative anxiety in children undergoing invasive procedures.  Method: A literature review using a descriptive design with a quantitative approach. This study was based on 11 experimental quantitative studies examining the effect of play therapy on preoperative anxiety. The articles were reviewed based on Friberg’s quality review template. Results: This study used Popenoe et al.’s guide for data analysis and the results were categorized into three groups: therapeutic play, technological play and structured play. Common across all three categories was that they showed a reduction in preoperative anxiety in children.  Conclusion: Play therapy appears to have an alleviating effect on preoperative anxiety in children. What type of play that was carried out in play therapy does not seem to matter. Therefore, play therapy should be considered as part of the preoperative preparation for children, in conjunction with general surgery preparation.

Sammanfattning Bakgrund: Omvårdnadens ansvarsområden är att främja hälsa och förebygga sjukdom. Trots att barn med intellektuella funktionsnedsättningar har likvärdiga rättigheter till vård visar internationella studier på brister i anpassad vård. Sjuksköterskor tycker ofta att det är svårt, utmanande och tidskrävande att ta hand om dessa barn. God omvårdnad bygger på att främja goda relationer mellan barnen, deras föräldrar och vårdpersonal. Syfte: Att beskriva specialistsjuksköterskors erfarenheter av att möta barn med intellektuell funktionsnedsättning på barnklinik.  Metod: En kvalitativ intervjustudie med induktiv ansats genomfördes med 14 specialistsjuksköterskor från två barnkliniker omfattande både slutenvårdsavdelningar och öppenvårdsmottagningar. Analysen genomfördes utifrån kvalitativ manifest innehållsanalys enligt Graneheim & Lundman. Resultat: Datainsamlingen resulterade i två kategorier, med tillhörande underkategorier. Den första kategorin beskriver att det krävs en individanpassning för att mötet ska bli bra, där relationsskapande och anpassning av kommunikation har stor betydelse. Den andra kategorin beskriver att omgivningsfaktorer har betydelse för mötet, där förberedelser och föräldramedverkan är viktiga komponenter för barnets trygghet. Även kunskap och erfarenhet hos specialistsjuksköterskan är av betydelse.  Slutsats: Studien visar vikten av att specialistsjuksköterskan individanpassar mötet med barn med intellektuell funktionsnedsättning. Med hjälp av en personcentrerad omvårdnad kan barnets individuella behov tillgodoses. Nyckelord: Intellektuell funktionsnedsättning, pediatrisk omvårdnad, personcentrerad omvårdnad, specialistsjuksköterska. / Summary Background: Nursing's responsibilities encompass promoting health and preventing disease. Despite children with intellectual disabilities having equivalent rights to care, international studies reveal care adaptation shortcomings. Nurses often find providing care for these children difficult, challenging, and time-consuming. Effective nursing relies on fostering good relationships between the children, their parents, and nursing staff. Purpose: To describe specialist nurses experiences of meeting children with intellectual disabilities at a child´s clinic.  Method: A qualitative interview study with an inductive approach was conducted, with 14 specialist nurses from two children´s clinics covering both inpatient and outpatient care. The analysis was conducted using qualitative manifest content analysis, according to Graneheim & Lundman.  Results: The data collection resulted in two categories, with associated subcategories. The first category describes that individual adaption is required for the meeting to be good, where relationship building, and adaption of communication are of great importance. The second category describes that environmental factors are important for the meeting, where preparations and parental involvement are important components for the child´s safety. The specialist nurse´s knowledge and experience are also important.  Conclusion: The study shows the importance of the specialist nurse individually adapting the meeting with children with intellectual disabilities. With the help of person-centred care, the child's individual needs can be met.    Key words: Intellectual disability, pediatric nursing, person-centered care, specialist nurse

Background: Pediatric cancer patients are susceptible to emotional distress, depression, anxiety, and physical symptoms impacting their quality of life. Dance movement therapy is a non-pharmacological method that has been shown to improve feelings of depression, anxiety, emotional, somatic symptoms, and overall quality of life. While much of cancer research is dedicated to finding cures, it is also important to focus on identifying methods for improving the symptoms and quality of life for pediatric cancer patients. Aim: The purpose of the literature review is to examine studies that show the effects of dance movement therapy on pediatric oncology patients’ cancer-treatment related symptoms and identify any gaps in the literature. Methods: An electronic multi-database literature review CINAHL, MEDLINE, and APA PsycInfo databases using terms such as “dance movement therapy (DMT)”, “pediatrics (paediatric)”, “child (children)”, “cancer”, “oncology”, “anxiety”, “depression”, “symptoms”, “mood”, “family”, and “quality of life”. Results: The search resulted in 122 articles, and 3 were eligible to be included in the literature review. The studies used methods such as randomized controlled trials, non-randomized descriptive studies, and retrospective studies. The studies found that based on patient, family, and clinician reports, DMT sessions were associated with decreased pain, improved emotions, and improved coping studies. Younger patients were more likely to be referred to DMT and when compared to other forms of integrative medicine, such as music, mind-body, massage, and acupuncture, DMT had the most referrals. Conclusion: The studies identified in this review demonstrate overall positive benefits of dance movement therapy for pediatric patients with cancer. Measurements taken from both patient and parent reports of symptoms found improvements in pain, emotions, and psychological stress. Future research would benefit from utilizing a randomized controlled trial, replication of past study methods to confirm validity, larger sample sizes, and utilizing both subjective and objective measurement tools.

Malaria is endemic in Uganda. The study attempted to determine how Ugandan caregivers managed home-based care of fever. Structured interviews were conducted with sixty caregivers of children under five. In 15 (25.0%) out of the 60 interviewed households, at least one child had reportedly died from malaria. Caregivers’ decisions were influenced by health education, family members, community leaders and other caregivers. Most caregivers knew about malaria, but lacked knowledge about its danger signs, and about the services of village drug distributors. Most caregivers initiated treatment for fever at home before taking the children to health units. Mosquito nets, indoor residual spraying and other malaria preventive measures were rarely used due to lack of funds. The recommendations include that anti-malaria drugs should always be available and accessible, the services of village drug distributors should be improved, health education should be enhanced, malaria preventive measures should be implemented and sustained. / Health Studies / M.A. (Public Health)

Atualmente, os índices de morbi-mortalidade na população pediátrica têm sido controlados por meio de diversas estratégias nos diferentes níveis de atenção, mas esta clientela ainda é vulnerável a diversas enfermidades de etiologia ambiental, social ou econômica. Os serviços de saúde de urgência e emergência para pediatria, integrantes da rede de serviços da saúde, também devem estar preparados, na sua organização estrutural e funcional, para responder as diferentes necessidades da população infanto-juvenil. Quando uma criança ou adolescente necessita de atendimento de urgência ou emergência as unidades não-hospitalares deverão estar preparados para seu acolhimento com avaliação e classificação de risco. Este estudo tem por objetivo avaliar a assistência à criança e ao adolescente nas unidades não-hospitalares de urgência e emergência, em um município do interior do Estado de São Paulo, nos componentes de estrutura, processo e resultados. A coleta de dados foi realizada em cinco unidades não-hospitalares de atenção a crianças e adolescentes em urgência ou emergência. A coleta de dados foi realizada por meio da observação e entrevista, complementadas com dados das fichas de atendimento. Os resultados do presente estudo evidenciaram no que diz respeita a estrutura planta física inadequada e materiais e equipamentos em quantidade e qualidade insuficiente. Na avaliação do processo observou-se que o atendimento prestado pela equipe de saúde é dirigido a queixa, não avaliando outros aspectos que podem prevenir riscos nesta clientela. A avaliação de resultado foi realizada a partir da percepção de satisfação dos acompanhantes e trabalhadores de saúde. Os acompanhantes assinalam aspectos de satisfação como a escuta, a orientação e o fornecimento de medicamentos; como aspectos não satisfatórios são declarados o atendimento por diferentes médicos e o gasto com medicamentos quando não disponíveis na unidade. Os trabalhadores de saúde são predominantemente receptivos para o trabalho com crianças, sendo que existe dificuldade no cuidado aos adolescentes, em decorrência das particulares deste grupo. No que se refere à satisfação, aspectos assinalados foram estímulos em decorrência do bom desempenho de seu trabalho e motivações intrínsecas relacionadas a sua profissão. A insatisfação é manifestada pela baixa remuneração e falta da capacitação na área da urgência e emergência. / Nowadays the indexes of mortality and morbity among child have been controlled by several strategies in different levels of assistance. This population is still vulnerable for many different diseases (economical, social and environmental). Urgency and emergency pediatric services must be well structured in order to answer all the needs of this group. When a child or a teenager goes to these services, the specific units must be prepared to receive and classify the risk of each case. This study aimed at study the child and teenager assistance in units (not hospitals) of urgency and emergency in an inner city of São Paulo State by checking structure, process and results of assistance. The data collection was made in five different units by using interview and observation; the records of patients were also checked. The results reveal that the physical structure was unsatisfied, material and equipment also were, the same observation was revealed to quality of assistance. Analyzing the consultation we observed that the attitudes was founded on the patient\'s claim, not consider other facts that may help on prevention other pathologies. The evaluation of results was realized by understanding the satisfaction perceptions of health workers and companies. As good points companies declared the orientation, possibility of been listened and medicine supply; and as bad points we found that the problem of been assisted by different doctors and the need of buying medicine out of the unit. The health workers like to work with children, and the assistance to teenagers has been difficult due to specified characteristics of this group. As good points to this group they are stimulated for doing a good job. The insatisfacion is noted when related to low remuneration and not continuing training on urgency and emergency.

Promover saúde à criança é garantir cuidados de qualidade que proporcionem seu desenvolvimento integral. A creche é um dos locais onde muitas crianças vivem grande parte da infância, o que justifica buscar compreender como são os cuidados oferecidos a elas nesse serviço. A presente investigação teve como objetivo geral caracterizar aspectos relacionados à implementação de cuidados de saúde infantil em creche e como objetivos específicos identificar percepções de educadoras e proposta institucional acerca dos cuidados de saúde às crianças. Foram realizadas entrevistas com quatro professoras e a coordenadora pedagógica de uma creche pública municipal, na cidade de São Paulo, e análise de documentos institucionais. Nos discursos das educadoras, a integração das funções de educar e cuidar aparece como própria do trabalho na creche, mas vários fatores dificultam seu exercício, tais como a precária formação para as questões de cuidado, particularmente os de saúde, e a sobrecarga de atividades. Face às dificuldades, surgem questionamentos acerca da possibilidade de efetivar amplamente essa integração. A educação ainda aparece como o foco principal do trabalho das professoras, ficando o cuidado como algo inevitável, dada a situação de dependência das crianças. As ações de cuidado ficam restritas ao corpo e são valorizadas somente enquanto atividades a serem ensinadas, visando à independência da criança. As propostas institucionais identificadas nos documentos ainda apresentam lacunas no que diz respeito à inclusão efetiva do cuidado como categoria independente e inerente à função profissional do educador em creche. Em conclusão, reafirma-se a necessidade de persistir na construção de propostas apropriadas a esse nível de atendimento infantil, com apoio das diferentes disciplinas que atuam na área de atenção à criança. / To promote children health is to guarantee care quality to provide their integral development. The child day-care center is a place where children live great part of their days, justifying the attempt to understand how this care is offered to them. The aim of the present study, as a general objective, was to characterize the aspects related to the implementation of health care in day-care center and as specific objectives to identify the caregivers‘ perceptions and institutional proposal concerning the child health care. Interviews had been carried out with four teachers and the pedagogical coordinator of a municipal public day-care center, in the city of São Paulo, as well as the analysis of institutional documents. Based on caregivers speeches, the integration of education and care seems to be as a characteristic of the work itself in the day-care center, but many factors made this implementation difficult, such as the deficient personnel formation in relation to care, particularly those in the health area, and the burden of activities. In view of these difficulties, questions concerning the possibility to extensively accomplish this integration arouse. Education still appears as the main focus of the teachers’ work, and care seems to be something inevitable since the child is very dependent. Therefore, care actions remain restricted to the body itself and are only emphasized when they are considered as activities to be taught, aiming the independence of the child. The institutional proposal identified in documents presents gaps concerned to the effective inclusion of the care as an independent and inherent category that is a characteristic of caregivers in day-care centers. In conclusion, it is pointed out the need to continue improving the construction of appropriate proposals to this level of childhood attendance, with support of other knowledge areas that perform childcare.

A hospitalização pode desencadear na vida da criança adversidades e estresse no curso do seu desenvolvimento natural. Diante da preocupação com a saúde mental da criança hospitalizada e na busca de atendimento às suas necessidades vitais, vê-se a possibilidade da inserção da Arteterapia, com suas atividades lúdicas, no ambiente hospitalar pediátrico, tendo em vista que favorece o desenvolvimento da expressão e criação infantil, bem como o crescimento global da criança, motivo pelo qual deve fazer parte da vida delas, especialmente daquelas hospitalizadas. Este estudo objetivou realizar uma análise compreensiva das produções plásticas de uma criança hospitalizada, a partir da Psicologia Analítica, buscando apreender as transformações das representações plásticas que ocorreram ao longo do processo arteterapêutico. Escolheu-se como percurso metodológico a pesquisa qualitativa, que privilegiou analisar o conteúdo e a evolução das produções plásticas da criança hospitalizada. Compôs o estudo o corpus das produções plásticas de uma criança de oito anos de idade, com diagnóstico de meningite, internada em um hospital público de Goiânia/GO, a qual passou por intervenções breves de Arteterapia. A análise de dados evidenciou que, ao projetar suas imagens nas produções plásticas, no decorrer da avaliação inicial à final, a criança expôs sua história de vida e seu momento existencial, e também mostrou como estavam organizados seus conteúdos internos, como essa organização foi se modificando ao longo do processo arteterapêutico em favor de seu fortalecimento, crescimento e desenvolvimento psíquico. A realização deste trabalho mostrou que a criação de espaços para as intervenções de Arteterapia muito contribuirá para facilitar a expressão das crianças de forma mais produtiva, bem como para transformar o ambiente hospitalar em local propício ao desenvolvimento saudável da criança. / hildhood Hospitalization can be an stressor event in the course of her development.. Considering the hospitalized child\'s mental health Art Therapy activities can create in pediatric units a healthy environment that will favor self expression. This study aimed to accomplish a comprehensive analysis of a hospitalized child\'s plastic arts, from the Analytic Psychology perspective. This study has a qualitative design that approaches a content analysis of child\'s artistic works and its evolution during the hospitalization period. An eight year old child, with meningitis, in an inpatient pediatric unit of a public hospital of Goiania/GO participated of the study. The corpus of her works provided a set of data for analysis. It was showed that child\'s works expressed her life story, worries and fears as well as positive feelings and ways of coping the adversities. The accomplishment of this work showed that the creative setting of art therapeutics interventions will contribute to facilitate children\'s more productive forms of expression, as well as to transform the hospital environment in propitious location to children\'s healthy growth.