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This study was an outcome oriented experiment considering the effects of Preadmission Preparation on 110 children between the ages of 5 and 12 years entering B.C.'s Children's Hospital for Day Care Surgery. Preadmission Preparation has been shown to reduce negative reactions to hospitalization on children having inpatient surgery. To date, no one has found Preadmission Preparation to be of benefit to children having Day Care Surgery. The study considered effects of attention only; general Preparation; Hospital Tours; Instructional Approaches (Modeling and Rehearsal-Instruction); and Modes of Preparation (Print and Audio-Visual). Additionally, the interaction of experimental factors of preparation programmes with individual characteristics of the children (age, gender, position in sibling structure, socio-economic status, verbal ability, health locus of control, trait anxiety, previous hospitalizations, chronic conditions, and stressful life events) were examined. Measures used as outcomes were: Hospital Behaviour Questionnaire, Observation Rating Scale, and Children's State Anxiety Inventory (Spielberger, et al., 1973). These instruments gave 8 different variables. For the repeated measures aspect of the design, data were collected one week and immediately prior to preparation and immediately prior to and six weeks following surgery. Children who received attention only (the experimental control group) were found to react differently than children who received no attention on only one variable. Although Tours alone were found to reduce negative reactions to day care surgery, Preparation in general (regardless of Approach or Mode) was not found to be effective, and in some cases increased negative reactions. Children receiving Rehearsal-Instruction approach programmes had lower verbal and overall observed anxiety prior to surgery than those receiving Modeling programmes. However, they also had higher dependent anxiety following discharge. The Audio-Visual programme reduced negative behaviours on more dependent variables than the Print programme. Rehearsal-Instruclion/Print and Rehearsal-Instruction/Audio-Visual each reduced different negative reactions. Of the 10 individual characteristics of children considered in this study, 5 did not interact with the Programme variables on more than 2 dependent variables or had insufficient cell sizes and were not interpreted. Girls appeared to both benefit from and be more negatively affected by preparation than boys, whose reactions to day care surgery were less affected by preparation. Preparation programmes were particularly effective in reducing negative reactions in children from lower socio-economic families and tours were particularly effective for children with chronic conditions. Children with more external health locus of control benefited most from Modeling or Rehearsal-Instruction programmes with no Tour. Children with high and low trait anxiety reacted differently to preparation, with different effects observed on different measures and for different programme conditions. It was noted that dependent measures did not react in similar ways, nor consistently throughout the study. Limitations of a clinical study with extensive analyses is discussed. Further investigations of measures used to evaluate reactions to day care surgery is warranted. Clinical discussion and further research of programme facets and individual characteristics of children is recommended. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

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The purpose of the study was to assess psycho-social differences between two groups. A review of the literature suggested psychological and social factors may affect the onset and progression of malignant disease. Comparisons were made between a group of 23 experimental families with a leukemic child, and a group of control families with a normal child matched for child's sex, age, and number of siblings. Data. was gathered on three quantifiable measures; Coddington's Social Readjustment Rating Questionnaire; a specially constructed Child's Questionnaire, and The Minnesota Multiphasic Personality Inventory. The leukemic children and their matched normal controls had approximately equal numbers, and similar types, of social events that had occurred within their present life span. This suggests that the occurrence of a specific stressful life event is not, in itself, a major precipitating factor in onset of leukemia. The leukemic children and their normal controls were likewise similar in their responses concerning self-reported aggressive behavior and attitudes toward expression of aggressive feelings. This implies that, other than the presence of disease, the leukemic children respond to specific stimuli in a manner typical of normal children. The parents of the leukemic children however, were differentiated from the parents of normal children, through the statistical method of stepwise discriminant analysis of MMPI responses. A combination of five variables, for each pair of parents, father's Sc 0 (Si) score, mother's Sc I (Hs) score, and father's Sc 9 (Ma), F scale, and Sc 3 (Hy) scores, had a level of significance. This finding presents evidence that parents of leukemic children differ from parents of normal children on personality characteristics assessed by the MMPI. Some possible interpretations of these results, and suggestions for treatment and additional research, were offered.

Objective The goal of this study is to report on the linguistic validation and reliability of the Hong Kong Chinese version of the Pediatric Quality of Life Inventory™ (PedsQL™) End-stage Renal Disease Module for Children with end-stage renal disease (ESRD) in Hong Kong, and its use to assess health-related quality of life (HRQOL) in end-stage renal disease children receiving different treatment modalities: peritoneal dialysis, haemodialysis and renal transplantation. Methods In part 1, forward and backward translations following a stringent validation protocol produced the Chinese translation version. Content validity of the translated instrument was assessed. In part 2, internal consistency and reliability of the questionnaire was evaluated by 38 pairs of parents and children with end-stage renal disease aged 5 to 18. The data was further analysed according to different treatment modalities. Results The translated Hong Kong Chinese version of the Pediatric Quality of Life Inventory ™ (PedsQL™) End-stage Renal Disease Module (PedsQL™ 3.0 ESRD Module-HKC) was found to have good content validity and was acceptable to most patients and parents. Internal consistency was excellent (Cronbach’s α = 0.91 in Patient version and = 0.94 in Parent version). Test-retest reliability, determined with the intraclass correlation coefficients, was excellent (0.89 in Patient version and 0.93 in Parent version). It was found that there was significant better HRQOL in patient received renal transplantation compared with Dialysis (peritoneal dialysis or haemodialysis, p=0.006.) Conclusions This study suggested good content validity, internal consistency, and reliability of the Chinese version of the Pediatric Quality of Life Inventory ™ (PedsQL™) End-stage Renal Disease Module (PedsQL™ 3.0 ESRD Module-HKC). It opened a new dimension of health care assessment for end-stage renal disease children in Hong Kong. Transplantation was reported to have a significant better quality of life score. Further studies with larger samples should be performed to confirm the psychometric properties of this translated instrument. / published_or_final_version / Public Health / Master / Master of Public Health

Bibliography: pages 47-49. / This dissertation is based largely on an original study performed by myself and Dr EB Hoffman on 34 neonates with bone and joint sepsis. Our experience of 19 septic hips is the largest in the literature. The study was performed at the Red Cross Children's Hospital in 1987 and 1988. The paper has been accepted for publication in the Journal of Bone and Joint Surgery (September 1990). The literature has been reviewed in depth and compared with our findings. In order to avoid repetition, I have not included a separate literature review in my dissertation. I have however incorporated the literature review in the introduction and especially in the discussion.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008. 149 p. / Objectives: To investigate the knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, and to determine if any correlation exists between the two. Methods: A posted quantitative questionnaire was used to collect data from Paediatricians in South Africa. Follow up telephonic calls were made to encourage response from participants. After a 12-week period, returned questionnaires were collected and data analysed. Results: The results obtained (25% response rate), indicated that there are relatively low levels of knowledge and poor perceptions amongst Paediatricians, which was supported by the low referral rate from Paediatricians for Chiropractic treatment. With regard to perception, Paediatricians seem to have a better perception of Chiropractic for the general compared to the paediatric population. Paediatricians felt that they do not have enough knowledge to discuss Chiropractic with their patients and would like to be further informed. This was reflected in the statistically significant correlation between knowledge and perception, and it would seem that better knowledge allowed for more positive perceptions. The study also found that Paediatricians agreed that they would like to receive treatment feedback after referring a patient for Chiropractic treatment and they were more likely to refer to a Chiropractor if they had a post-registration paediatric specialisation. Conclusions: A correlation exists between knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, with both being relatively, although better perceptions of Chiropractic for the general than for the paediatric population exist.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008. 149 p. / Objectives: To investigate the knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, and to determine if any correlation exists between the two. Methods: A posted quantitative questionnaire was used to collect data from Paediatricians in South Africa. Follow up telephonic calls were made to encourage response from participants. After a 12-week period, returned questionnaires were collected and data analysed. Results: The results obtained (25% response rate), indicated that there are relatively low levels of knowledge and poor perceptions amongst Paediatricians, which was supported by the low referral rate from Paediatricians for Chiropractic treatment. With regard to perception, Paediatricians seem to have a better perception of Chiropractic for the general compared to the paediatric population. Paediatricians felt that they do not have enough knowledge to discuss Chiropractic with their patients and would like to be further informed. This was reflected in the statistically significant correlation between knowledge and perception, and it would seem that better knowledge allowed for more positive perceptions. The study also found that Paediatricians agreed that they would like to receive treatment feedback after referring a patient for Chiropractic treatment and they were more likely to refer to a Chiropractor if they had a post-registration paediatric specialisation. Conclusions: A correlation exists between knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, with both being relatively, although better perceptions of Chiropractic for the general than for the paediatric population exist.

D.Ed. / The goal of this research was to generate and describe an acquiescent approach for the educational psychologist to utilise with a family with a terminally ill child. It appears that family units with a terminally ill child have a tendency to withdraw and this isolation leads to problems in mental health. Their mental health is, amongst others, characterised by anger, frustration, unrest and depression. A tendency with psychologists, clergy and helpers from other professions is to act as ideal experts on the lives of saddened people. From painful personal experience this does not seem to enable acquiescence. In their efforts to provide consultation to the grief stricken families, these professionals often overlook the family's real needs and forge their own views upon them. In this way they only further damage their mental condition. This led me to ask the following questions: • What does the world of the family with a terminally ill child comprise of? • Which approach could be described in order to lead the family with a terminally ill child to acquiescence? A qualitative, explorative, descriptive and contextual research design was followed. v The research was conducted in two phases as follows : The experiences of four families with terminally ill children were explored and described in phase one. This was done using phenomenological, unstructured, in-depth interviews. In phase two, a description for educational psychologists for families with a terminally ill child was done, which is based on the results from phase one. After data was gathered in phase one, I came to the conclusion that the family with a terminally ill child goes through a painful process which could last for years. As they go through the process they gain insight into certain life-skills. The aim of the support was then to facilitate a context for the family with a terminally ill child in order for them to internalise these lifeskills. The central statement of this research was thus supported and can be read as follows: An understanding of the world of the family with a terminally ill child will provide the educational psychologist with the data to describe a acquiescent approach.