A stress inoculation program for parents whose children are undergoing painful medical procedures.

The efficacy of a stress inoculation intervention program was compared with that of a child-focused intervention program in helping parents cope with their children's painful medical procedures. Ss included 72 parents (79% mothers) of pediatric leukemia patients (aged 3–12 yrs) who were undergoing either bone marrow aspirations (n?=?28) or lumbar punctures (n?=?44). Parents were assessed during a baseline procedure and then were randomly assigned to either a stress inoculation group or a child-focused intervention group. In the child-focused intervention, parents merely observed their child's participation in a cognitive behavior therapy program. Assessment of parents included an observation measure of parent behavior, self-reported measures of anxiety and coping, and physiological measures. Results indicate that parents in the stress inoculation program reported lower anxiety scores and higher positive self-statement scores than did parents in the child-focused intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family group cognitive–behavioral preventive intervention for families of depressed parents: 18- and 24-month outcomes.

Objective: In a long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group cognitive–behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder (MDD). Method: Parents with a history of MDD and their 9- to 15-year-old children were randomly assigned to a FGCB intervention or a written information comparison condition. Children's internalizing, externalizing, anxiety/depression, and depressive symptoms; episodes of MDD and other psychiatric diagnoses; and parents' depressive symptoms and episodes of MDD were assessed at 18 and 24 months after randomization. Results: Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18 months and were significantly lower in self-reports of externalizing symptoms at 18 and 24 months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). Marginal effects were found for parents' symptoms of depression at 18 and 24 months but not for episodes of MDD. Conclusions: Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children's episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

An analysis of a behavioral intervention for children undergoing venipuncture.

An examination of factors was conducted to determine the effectiveness of the distraction component of a behavioral intervention (use of a party blower). In one condition, parents were instructed to coach children in the use of a party blower and to praise child cooperation. In a second condition, nurses were instructed to assist parents in coaching the child. Parents used the coaching skills they learned and got their children to use the distraction technique. Use of the distraction technique was associated with less crying. Encouragement from a health care professional and intervention early in the procedure did not enhance the intervention's effectiveness. Older children and children who were less distressed during the initial phase of the procedure were less likely to reject the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and parent reports of childhood anxiety: differences in coping styles

This study compares children anxious only on parent report (PR) with those anxious on self-report (SR) and self- and parent report (SPR) to examine the reasons for the reporting differences. Sixty-five children aged 7-12 years who met criteria for one or more Axis I anxiety disorders (25% with comorbid nonanxiety diagnoses) completed standardized measures of anxiety, depression, and coping style. Parents completed measures of child psychopathology and adult coping style. Assessing clinicians completed the Global Assessment of Functioning. All parents endorsed anxiety in their children. Based on their responses on standardized self-report measures of anxiety, children were classified as endorsing anxiety (SPR group) or not endorsing anxiety (PR group). Multivariate analysis of variance revealed that children in the SPR group endorsed more depression and employed a greater variety of coping strategies than children in the PR group. The two groups did not differ on parent or clinician measures. These findings suggest that reporting differences may be related to differences in coping styles in anxious children. SPR children may over report anxiety symptoms due to feelings of decreased self-worth associated with depressive thinking, whereas PR children may be able to distract themselves from their anxieties. The lack of difference in functioning between the two groups suggests that self-report anxiety questionnaire scores are not necessarily indicative of severity.     

Comparison of hypnosis and distraction in severely ill children undergoing painful medical procedures.

An ethnically diverse sample of high and low hypnotizable children (N?=?27) suffering from cancer or blood disorders and their parents were trained to use both distraction and hypnosis to reduce pain and anxiety. Measures of pain and anxiety were obtained from the children and their parents. Independent raters also judged participants' video-taped distress responses. Data were collected during painful medical procedures, for baseline, distraction, and hypnosis conditions. Supporting E. R. Hilgard's (1977, 1992) neodissociation theory, hypnotizable children showed significantly lower pain, anxiety, and distress scores in response to hypnosis in contrast to low hypnotizable children. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain metastasis model in athymic nude mice using a novel MUC1-secreting human breast-cancer cell line, MA11

OBJECTIVES: This study explored parental attitudes about their interactions with their children's providers when decision making involved critical life situations. We evaluated parents' attitudes regarding the following questions: What was the parents' understanding of their children's health care issues, and what was the parental perception of the professionals' understanding of their children and of themselves? Who should be the principal decision makers for the children? What was the parents' knowledge about advance directives? Did parents want to participate in a process of advance planning to assist with critical life decision making for their children? METHODS: We surveyed all parents attending a conference sponsored by the Massachusetts Department of Public Health for parents of children with special needs. The questionnaire was provided to all parents attending the conference. An announcement was made at the conference requesting parental participation. The 76 respondents constitute a convenience sample of parents of children with special needs sufficient for this preliminary stage of investigation. RESULTS: Of 177 parents attending the conference, 76 (43%) completed the questionnaire. Eighty-eight percent of the participants strongly agreed that they understood their children's conditions. Twenty-one percent stated that they had sufficient understanding of their children's future medical needs, and 21% thought that they had a sufficient understanding of their children's developmental potential. Ninety-nine percent of parents strongly agreed that physicians should share information with parents no matter how serious or potentially upsetting. Ninety-four percent of those parents who thought that their children's physicians understood their own needs also thought that the physicians understood their children's needs. In contrast, only half (55%) of those parents who thought the physicians did not understand their needs thought the physicians understood their children's needs. Ninety-two percent of parents who thought that the physicians understood their needs agreed that the physicians would make the best decisions in crises versus 60% of those who did not think the physicians understood their needs. Seventy-four percent stated that they would consider written guidelines for their children that dealt with critical life situations. All parents who thought their children's conditions were not understood wanted written guidelines. Of those parents who had thought their children would not survive (15 parents), 94% wanted written guidelines. All seven parents who had been told their children would not survive wanted written guidelines. CONCLUSIONS: Parents in this study were generally satisfied with care being provided to their children. Nevertheless, the results clearly suggest goals that could lead to improved capacity for parents and providers to make critical life decisions for and with children. First, physicians must understand the needs of parents to be able to make decisions that would be in the children's best interests. Second, parents should participate fully in critical life decisions for their children and should use written guidelines to assist with the process of these critical life decisions. Our findings strongly support the development of a longitudinal process, initiated early after the onset or discovery of illness and maintained longitudinally throughout the course of a child's illness, to help parents and providers work together in this vital area of health care to children.     

Coping skills training for children: Effects on distress before, during, and after hospitalization for surgery.

Tested the hypothesis that coping skills (COS) intervention would help children adapt to hospitalization better than anxiety reduction (AR) or information interventions, using 33 parent–child dyads (children's mean age 7.2 yrs). All groups received the information procedure that described hospitalization and surgery experiences via a puppetry film. In the AR group, parents also learned procedures to help them reduce their own distress. Parents in the COS group learned how to help children use coping self-talk and related techniques. Results show that the AR and COS groups, compared to the information group, reduced children's self-reported fearfulness and parents' reported distress. The COS group, compared to the information group, exhibited fewer maladaptive behaviors during hospitalization and less problematic behavior in the preadmission week and 2nd postdischarge week. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of 24-hour oesophageal pH-metry for the detection of gastro-oesophageal reflux in infants: what is the ideal score and the optimal threshold? A receiver-operating-characteristic analysis

Day care is currently a common way of providing treatment for minor and average paediatric surgical procedures. The purpose of this study was to assess possible benefits of increasing parental involvement in the care of operated children in a day-care surgery unit. By giving parents information and education about post-operative care, the goal was to facilitate recovery and minimize time spent in hospital. Results show that parents in the intervention group were well prepared to assume a greater part of the care of their children. Children in the intervention group appeared to have less pain and fewer children vomited post-operatively than children in the control group.     

Using videotape modeling to prepare children psychologically for surgery: Influence of parents and costs versus benefits of providing preparation services.

60 patients (aged 2–12 yrs) having 1st-time elective surgery participated in surgery preparation using videotape procedures. The research design included 2 viewing conditions (parent present or absent) and 3 treatment procedures (adult or peer-narrated videotape and control/no-videotape condition). Anxiety measures included a palmar sweat index, a hospital fears rating scale, an observer rating scale of anxiety, and a recovery index. Results suggest that Ss who viewed the videotape with their parent present exhibited less preoperative arousal compared to Ss who did not. The Ss using the videotape exhibited less arousal, less self-reported anxiety, and less behaviorally rated anxiety. In addition, parents who saw the tape or whose children viewed the videotape without them exhibited less arousal prior to the operation than parents who did not and whose children did not view the videotape preparation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do parents reinforce somatic complaints in their children?

Objective: To examine the influence of parental solicitousness on self-reported somatic complaints in school-age children. Design and Main Outcome Measures: Participants were 564 children (mean age 10 years) and their parents. Children completed self-report measures of somatic complaints, parental solicitousness, depressiveness, fear, and sense of coherence. Somatic complaints were assessed again 6 months later. Parents also completed a questionnaire about solicitousness. Results: Parental solicitousness as reported by children or parents was unrelated to the frequency of self-reported somatic complaints. Symptoms of depression, fear, and lower sense of coherence were associated with more somatic complaints, but did not interact with parental solicitousness. Conclusion: Parental solicitousness seems unrelated to more frequent somatic complaints in schoolchildren. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accelerating language development through picture book reading.

We experimentally assessed a 1-month, home-based intervention, designed to optimize parental reading of picture books to young children. Parents in the experimental group received instructions to increase their rates of open-ended questions, function/attribute questions, and expansions; to respond appropriately to children's attempts to answer these questions; and to decrease their frequency of straight reading and questions that could be answered by pointing. Control-group parents were instructed to read in their customary fashion. All families audiotaped their reading sessions at home. Analysis of these tapes demonstrated that the experimental group scored significantly higher than children in the control group on standardized posttests of expressive language ability. On the basis of analysis of audiotapes, children in the experimental group also had a higher mean length of utterance (MLU), a higher frequency of phrases, and a lower frequency of single words. Follow-up 9 months after the completion of treatment disclosed continued, although statistically diminished, differences between the two groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Involvement of adenosine in vanadate-stimulated release of lipoprotein lipase activity

BACKGROUND: Optimal bottle weaning should occur between 12 and 15 months of age. We hypothesized that high-risk populations have different parental attitudes, learned behaviors, and knowledge of weaning practices. OBJECTIVE: To determine whether high-risk populations are less likely to wean their children by 15 months of age than low-risk populations. METHODS: A cross-sectional survey using a convenience sample of parents was conducted at 3 community-based pediatric clinics. Spanish- and English-speaking parents with weaned and unweaned children 12 to 36 months of age were included in the study. A self-administered questionnaire was completed at a clinic visit. The questionnaire addressed aspects of parents' sociodemographic characteristics and included feeding history; weaning practices; sources of information about weaning; and parental behaviors, attitudes, and knowledge of age at which the child should be weaned. RESULTS: One hundred eighty questionnaires were completed. Marital status was related to weaning behavior. Seventy-six percent of single mothers had weaned their children in a timely manner, whereas 48% of married mothers had done so (chi2 = 7.70; P = .008). Parental education, race, and income were not significantly related to the timeliness of weaning. When respondents rated the helpfulness of multiple sources, only the health clinic was found to be significantly more important for the timely weaning group (t = -2.13; P = .04). Parents with timely weaned children stated that the mean +/- SD optimal age for weaning is 13.6 +/- 3.2 months. Parents with unweaned and late-weaned children stated that the mean +/- SD optimal age is 19.9 +/- 6.6 months. Bedtime bottle feedings were reported in more than 87% of the unweaned group. Sixty-nine percent reported poor dental development associated with delayed weaning. CONCLUSIONS: Married parents are at risk of late weaning. Parents continue to allow their children to sleep with milk bottles in their mouths in bed at night. Parents are not aware of the medical problems associated with late weaning. Late-weaning parents are not knowledgeable about current weaning recommendations. Current approaches are not effective in altering set patterns of inappropriate weaning habits. Additional interventions and innovative parental education methods are needed to improve age-appropriate weaning practices.     

Evaluation of an intensive psychosocial intervention for children of parents with multiple sclerosis.

Objective: To evaluate an intervention for children of parents with multiple sclerosis (MS). It was hypothesized that the intervention would increase knowledge of MS, approach coping, and social support and decrease avoidant coping and stress appraisals. It was expected that these changes would reduce the adverse impacts of caregiving and produce better adjustment. Method: Twenty children (9-14 years) who had a parent with MS attended a 6-day camp intervention. These children completed questionnaires at pre- and postintervention and at 3-month follow-up; their parents with MS (N = 14) completed questionnaires at preintervention and at follow-up. Results: After the intervention, children reported significant decreases in distress, stress appraisals, caregiving compulsion, and activity restrictions and increases in social support and knowledge of MS. Parental data confirmed the increase in the children's knowledge of MS, and overall, qualitative data supported the quantitative findings. Qualitative data showed that the intervention had indirect effects on some parents and families. Conclusions: Findings offer preliminary support for the use of a stress- and coping-based intervention for supporting children and their families with parental MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing parental instructions to schizophrenic and normal children: A pilot study.

Hypothesized that parents communicate to their schizophrenic children in conflicting ways. An experiment was designed where parents instructed their children in a task. Instructions were given from a separate room and were tape recorded so they could be played to matched samples of children. Parents of schizophrenics, of nonschizophrenic abnormal children, and of normal children were contrasted. The achievement of the children in the task was measured, and matched samples of children listened to the instructions of a group of parents of schizophrenics and a group of parents of normal children. Indications were that parents of schizophrenics do not communicate in more conflicting ways than parents of normal children when the measurement is the success of a child in following their instructions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy: An intervention for parents of children with chronic illness.

Describes the use of filial therapy as an intervention with families of chronically ill children. Filial therapy is an extension of play therapy which uses the behaviors of the client-centered play therapist in a family skills training program. Ss were 5 29–36 yr old mothers of 4.5–8.0 yr old children with chronic illnesses. Parents completed the State–Trait Anxiety Inventory and Parental Acceptance Scale (B. R. Porter, 1952) before and after participating in filial therapy sessions. Children completed the Child Anxiety Scale. Results show that filial therapy can have a positive impact on parents of children with chronic illness. Parents were better able to accurately judge their child's level of anxiety and reported differentiation between themselves and their children. Qualitative reports of outcomes indicate that the parents believed that the course had a positive impact on their relationships with their children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental anxiety before elective surgery in children. A British perspective

This study measures the anxiety levels in 100 parents of children scheduled for elective surgery at the Royal Aberdeen Children's Hospital. Anxiety levels were quantified using the Leeds scale for self-assessment of anxiety. Forty-two per cent of parents were significantly anxious. Mothers were identified as being more pathologically anxious than fathers. The 'anxious' parents were specifically more anxious about the surgery, anaesthesia, postoperative pain and treatment, and hospitalisation in general. All parents, whether identified as anxious or not, agreed on factors likely to reduce anxiety: pre-operative information from staff, being able to accompany their child to the operating theatre and being present at induction of anaesthesia.     

Sibling relationships for deaf children: The impact of child and family characteristics.

Objective: To examine factors that affect relationships between deaf children who use cochlear implants or hearing aids and their hearing siblings. Study Design: Qualitative analysis of interview data from parents of deaf children. Participants: Parents of 29 deaf children with at least 1 sibling; 20 children used cochlear implants and 9 used hearing aids. Main Outcome Measure: Quality of deaf-hearing sibling relationships as assessed by an ordinal scale developed by the authors. Results: Birth order, family size, parents' anxiety about deafness, and negative comparisons by parents of hearing and deaf siblings were key factors in sibling relationships. Conclusions: Family context is important in understanding experiences of deaf children and their hearing siblings. The model replaces assumptions of hearing loss as individual disability with an emphasis on the social determinants of managing differences in siblings' hearing status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Informing subjects of epidemiologic study results. Children's Cancer Group

OBJECTIVE: To assess the feasibility and process of providing feedback to parents regarding the results of epidemiologic research, in particular to look at the importance and clarity of the information provided, parental reactions to the results, and utilization of the data provided. METHODOLOGY: Parents who participated in an epidemiologic study of pediatric brain tumors (patient and control mothers) were sent a letter summarizing the results of the study and the Parent Study Results Survey to complete and return. The final sample used for analyses was 109 (patient) and 90 (control) mothers. Analyses were conducted to determine differences between patient and control mothers and differences among subsets defined by educational level and vital status of the patient. RESULTS: Mothers rated the importance and clarity of the information very highly, although patient mothers were more likely than control mothers to want more information and a telephone contact. Patient and control mothers were similar in reported sadness, anxiety, and being overwhelmed, but patient mothers felt less satisfied and relieved. Patient mothers expressed feeling more guilt nad anger than control mothers, although even the levels among the patient mothers were only moderate. Close to half of all mothers commented on the inconclusiveness of the study results. Nearly all mothers indicated they would suggest that other parents participate in epidemiologic research. CONCLUSIONS: It is valuable to many parents that they receive information about results of research in which they have participated. We found little evidence of strong negative effects to a detailed feedback letter. We recommend that evaluative data be used to guide the process of informing research participants about study results and that investigators consider making feedback letters a standard part of research protocols.