Search

This paper represents a personal reflection on what is needed worldwide to prevent child injuries. It repeats messages that have been frequently delivered in the past. The main points are: first, the need for everyone to accept the view that, ultimately, injuries are a health problem and health departments must view them as such. Second, although increased and improved research is undoubtedly important, it is futile and frustrating if the results of existing research are not acted upon. Third, governments must play a central role by creating a national focus for the coordination and implementation of programmes whose value has been established. These points require widespread support if we hope to make genuine progress towards the goals reflected in this issue of the Bulletin. Le present article est une reflexion personnelle sur ce qu'il est necessaire de faire dans le monde pour prevenir les traumatismes chez l'enfant. II reitere des messages deja frequemment emis dans le passe et enonce trois points importants. Premierement, chacun dolt reconnaitre qu'en fin de compte, les traumatismes sont un probleme sanitaire et les services de sante doivent les considerer en tant que tel. Deuxiemement, bien qu'il soit indubitablement important de multiplier et d'ameliorer les recherches a ce sujet, ces travaux paraftront inutiles et frustrants si les resultats de la recherche existante ne sont pas suivis d'action. Troisiemement, les Etats doivent jouer un role central en creant un point focal national pour la coordination et la mise en oeuvre des programmes dont la valeur est etablie. L'application de ces points doit beneficier d'un large soutien si l'on veut que des progres veritables s'effectuent en direction des objectifs formules dans ce numero du Bulletin. Este articulo es una reflexion personal sobre Io que hace falta para prevenir las lesiones infantiles en todo el mundo, y repite mensajes que se han difundido con frecuencia en el pasado. Los puntos principales son: primero, la necesidad de que todos aceptemos que las lesiones son, en ultima instancia, un problema de salud, y que los departamentos de salud las consideren como tal. Segundo, que a pesar de la indudable importancia de aumentar y mejorar la investigacion, esta sera inutil y frustrante si no se actua teniendo en cuenta los resultados de las investigaciones existentes. Tercero, que los gobiernos deben tener un papel central, creando un foco de coordinacion y aplicacion de programas cuyo valor este demostrado. Estos puntos necesitan un amplio apoyo si queremos hacer verdaderos progresos hacia la consecuci6n de los objetivos expuestos en el presente numero del Boletin., Introduction I am sure others have written more profoundly about repetition but I like this quote attributed to Collier: "Constant repetition carries conviction". (1) It seems especially important to write [...]

A nursing intervention that focuses on health rather than illness and that involves the family as well as the patient appears effective in preventing psychosocial maladjustment in children with chronic illnesses. A total of 332 children and their families were studied. Tests measuring the parent's evaluation of the child's behavior and the child's self-perception were administered before and after the intervention. Improvements were noted on tests of anxiety and depression as well as on tests of self-perception. Analysis of the parent-completed questionnaires indicated there were significant improvements in child behavior and adjustment. Surprisingly, children between four and seven years old rated themselves lower in peer acceptance after the intervention. This was not the case for the children between eight and 16 years old., Objective. This study was conducted to determine whether a specialized form of nursing could help prevent or reduce psychosocial maladjustment among children, aged 4 to 16 years, with chronic physical disorders. In contrast to other studies, nurses were chosen to provide the intervention based on their central role in health care and the appropriateness of their training for this task. Methodology. A clinical trial was concluded in which 332 children and their families were randomly assigned either to receive this specialized nursing for a 1-year period, or to remain in the control condition. The children were all active outpatients in nine clinics at the Montreal Children's Hospital. Three measures of psychosocial functioning administered before and after the intervention were the basis for assessing its efficacy. The measures included the behavior problems profile of the Achenbach Child Behavior Checklist, the Personal Adjustment and Role Skills, completed by the parents, and two versions of the Self-Perception Profile (Harter) for children aged 4 to 7 years and 8 to 16 years. Results. Differences between groups were examined both categorically and quantitatively. In the former, the percent of children with clinical scores (those above or below a cut-off indicative of maladjustment) at baseline and postintervention were compared. In the latter, the mean scores at the end of the trial were analyzed using analysis of covariance with the baseline scores as covariates. Statistically significant positive differences were found in the domain of anxiety/depression on the Personal Adjustment and Role Skills, and in the areas of scholastic competence, behavior, and global self-worth on the Harter. Conclusion. The results indicate that this intervention helps children with chronic disorders by preventing or reducing maladjustment. Most university-prepared nurses already have the basic skills required to achieve these results; only a modest investment in reorientation may be needed. Thus, other pediatric centers should be able to replicate these findings and thereby take a major step toward improving the lives of children with chronic disorders. Pediatrics 1994,94:70-75, chronic physical disorders, randomized clinical trial, nursing intervention, psychosocial adjustment.

Rosenberg E E (Department of Pediatrics, and Department of Family Medicine, McGill University, 2100 Marlowe Avenue, Montreal, Quebec H4A 3L6, Canada) and Pless I B. Clinicians' knowledge about the families of their patients. 1985; 2: 23–29. This study was designed to determine what doctors and nurses in family medicine actually know about the families of their patients; to assess the accuracy of the professed knowledge; and to relate this knowledge to the patient's level of satisfaction and compliance. Clinicians completed questionnaires dealing with their knowledge of personal and family information about patients. These patients completed a mirror-image questionnaire-to assess the accuracy of the clinician's responses-and a questionnaire about their satisfaction with the consultation. At a follow-up visit by the patients, clinicians completed questionnaires which assessed patients' compliance. Clinicians thought they knew the patient's occupation in 86% of cases and were correct in 73% of the total. The respective percentages for the spouse's level of education were 49% and 35%. Clinicians and patients agreed on whether there was a marital or a financial problem 66% and 47% of the time respectively. High clinician knowledge scores were not associated with either high satisfaction or good compliance on the patient's side. [ABSTRACT FROM PUBLISHER]

In 1946 a random sample (N = 5,362) of all children born in England, Wales, and Scotland during 1 week in March were selected for a longitudinal study of health and development. Educational, clinical, and psychological information were obtained from this national cohort at repeated intervals. At age 15, all children who had experienced a chronic physical disorder were identified. Their clinical profiles were defined and the social, psychological, and educational data on this group (N = 528) were compared with the remaining physically healthy children (N = 4,196). A total prevalence rate of 111 chronically ill children per thousand under age 16 was found. This figure is of the same order as those reported for other studies of a similar kind. Most of the children (58%) suffered from a condition which primarily affected motor activities; 2070 involved vision, speech or hearing and 20% affected appearance. Most disorders were mildly disabling and over 60% were still present at age 15. The composition of this population was compared with that of the remaining healthy children with respect to sex, social class, family size, and parents' health. These comparisons provide a background for subsequent reports describing the psychological, educational, and social consequences of chronic illness during childhood. [ABSTRACT FROM AUTHOR]

Discusses a case study on secretory otitis media in children. Evaluation of the complaint of recurrent acute otitis media and hearing loss; Possibility of an allergy following tonsillectomy and adenoidectomy; Result of physical examination of the ears, nose and throat without movement on examination with the pneumatic otoscope.