Journal of Child Health Care

The relationship between certain lifestyle habits and schoolchildren’s health has previously been reported on, but the exact pathway of the effects lifestyle habits have on physical/psychosocial health (PPH) has not been investigated nor has the relative influence of different habits on schoolchildren’s health. In this study, schoolchildren were recruited from a primary school in Toyama Prefecture, Japan (n = 576), and the relevant data were collected in June/July 2017. Path analysis was used to examine the relationships of lifestyle habits and physical fitness with PPH among schoolchildren in grades 1–4 and 5–6. Body weight and total fitness scores were found to be not related to the children’s PPH. The pathway via which lifestyle habits influenced PPH was determined successfully. Among children in grades 1–4, sex (p < .05), age (p < .01), and breakfast intake (p < .05) were related to PPH. Among schoolchildren in grades 5–6, the duration of sleep (p < .05) was related to PPH. Thus, factors related to schoolchildren’s PPH vary by school grade. The identification of the predictors of the PPH of schoolchildren should inform the design of tailored, grade-specific health promotion interventions in Japanese elementary schools.

Previous studies have shown beneficial effects of physical exercise (PE) in adults submitted to hematopoietic stem cell transplantation (HSCT). Conduct a systematic review about the effects of PE on the functional capacity of children and adolescents submitted to HSCT. The studies were searched in the databases MEDLINE (via PubMed), Central Register of Controlled Trials (Cochrane CENTRAL), EMBASE, LILACS, and Evidence Database in Physical Therapy (PEDro) (CRD42018080093). Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. Randomized and nonrandomized clinical trials comparing PE with usual treatment in children and adolescents aged 3–18 years were included. The risk of bias was assessed using the Cochrane Collaboration tool and ROBINS-I tool, and the overall quality of the evidence was determined by the GRADE system. We included three studies with 91 patients. PE improved the functional capacity assessed by the timed up and down stairs test (MD −1.23 [95% CI, 2.27 to −.20, I2 = 0%]), but there was no significant effect in the six-minute walk test (MD 44.63 [95% CI, −20.86 to 110.13, I2 = 83%]). The benefits regarding quality of life and peripheral muscle strength of these individuals were not clearly demonstrated, but positive responses were observed in relation to the analyzed data. None of the studies evaluated the fatigue. The limitations found were the high heterogeneity between studies, as well as the sample size and the low methodological rigor. PE might be favorable to improve the functional capacity of children and adolescents treated with HSCT. However, further studies are needed to clarify the best PE program.

According to the United Nation’s Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children’s perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6–13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children’s voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children’s needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice.

A systematic review examined the association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity in adolescents, since it represents an alert to adolescent’s health and well-being. Six electronic databases and gray literature were systematically searched from January 1980 to December 2018. A total of 11 articles met the inclusion criteria. Included studies assessed body weight dissatisfaction using different dimensions/components: satisfaction component of the attitudinal dimension was assessed in five studies, behavior component of the attitudinal dimension was assessed in two studies, perceptual dimension was assessed in two studies, and two studies were unclear about dimension. Behaviors: two assessed only unhealthy eating behaviors, six assessed lack of physical activity, and three assessed both behaviors. Only three studies found an association between body weight dissatisfaction with unhealthy eating behaviors, three with lack of physical activity, and one did not perform a statistical test for an association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity. Few studies have reported an association between body weight dissatisfaction with one of these unhealthy behaviors. There was substantial heterogeneity related to unit of measures, both for body weight dissatisfaction and for behaviors studied.

Paediatric feeding disorders (PFDs) are common. Earlier studies have shown an association between PFD and caregiver stress, but these studies have been hampered by insufficient power. This study reports stress for caregivers of children diagnosed with PFD. These caregivers were then compared to community norms of the Parental Stress Index–Short Form. Caregivers also completed the Mealtime Behaviour Questionnaire, Child Behaviour Checklist and Child Development Inventory. Linear regression and hierarchical regression analyses assessed the relationship among the variables. Caregivers of 840 children with PFD responded. Negative child behaviours and lower child developmental function predicted higher levels of total parenting stress, parental distress, parent–child dysfunctional interaction and caregiver perceptions of their child as difficult. Higher rates of child internalizing and externalizing problems and child mealtime aggression were associated with parent perceptions of their child as difficult and contributed to total parental stress. Parents of older children reported higher levels of stress, whereas parents of younger children were more likely to be defensive responders. Overall, parents of children with PFD have more caregiver-related stress. These caregivers may benefit from consultations with mental health professionals to provide the most appropriate care to affected families.

This study aimed to explore the levels of participation in a UK sample of children and young people (CYP) with an acquired brain injury (ABI) at home, school and in the community through a cross-sectional study. The Child and Family Follow-Up Survey was distributed to parents/carers of 134 CYP with ABI (CYP-ABI) who received neuro-rehabilitation from 2014 to 2016. Access and recruitment were problematic resulting in a low response rate (4%). Widespread restrictions in participation were reported by four of the five respondents with community-structured events/activities and educational activities being the most restricted. Factors impacting on participation were cognitive-based and movement skills, family stress and lack of support/encouragement in the community. Study results provide information pertaining to the feasibility of undertaking research with this population while also highlighting the restrictions to participation experienced by CYP-ABI more than two years after injury.

This study investigates the influence of household socioeconomic status and maternal risk factors and health-care service availability on changes in the under-five mortality rate (U5MR) in Bangladesh. Potential risk factors that influence U5MRs were investigated using multilevel logistic regression analysis and 29,697 data points from the Bangladesh Demographic and Health Surveys, 2004–2014. Maternal and child health parameters such as childhood morbidity, low vaccination coverage, poor utilization of perinatal care, and malnutrition were found to be more concentrated in poorer households. Pooled estimates indicated that the aggregate odds of U5MR risk declined by 18% to 2007 to 38% to 2014 compared to 2004. However, inadequate antenatal care, short birth interval, primiparity, illiteracy, delayed conception, and low socioeconomic status were significantly associated with a higher risk of under-five mortality. The magnitude of inequality using these measures were significantly associated with large variations in U5MR changes. Although a significant reduction in U5MR in Bangladesh was found in this study, substantial socioeconomic variations still persist. The analysis suggests that decreasing inequality in society is required for further reductions in child mortality. This will help to achieve a more equitable distribution of child and neonatal outcomes and assist the achievement of Sustainable Development Goals 3.2 by 2030.

The purpose of this article is to offer an improved understanding of how parents of children with long-term disabilities are empowered to successfully take up their role as decision-making partners in the design and delivery of the care of their child. The intention is to stimulate dialogue, encourage reflection and provide practical suggestions for health professionals working with children and their families. The reported findings are from a study which was guided by a constructivist grounded theory methodology. This involved an iterative process of repeated cycles of data collection and analysis, which comprised 12 semi-structured, in-depth interviews with 14 parents of children accessing paediatric services within a single National Health Service Trust. A novel model, explaining how the power im/balance and the perceived state of the therapeutic relationship influence how successfully a parent takes up their position in the collaborative partnership, is presented and discussed. It is suggested that by thoughtfully addressing the traditional hierarchy that exists within healthcare, health professionals might facilitate the development of a ‘truly’ therapeutic relationship, which can help promote parental empowerment.

Children with cancer experience pain throughout their cancer trajectory. Pain has short- and long-term negative consequences for children physically and psychologically. Children with cancer spend more time at home with their families and less time in hospital. While this has benefits for quality of life, it shifts responsibility for pain management from healthcare professionals to parents. Little is known about parents’ pain management abilities in this setting. This study aimed to understand how parents of children with cancer manage their child’s pain at home. A convergent, parallel, mixed methods design including pain diaries, surveys and interviews was used. Participants were parents of children with cancer on active treatment recruited from one tertiary cancer centre. Each data collection method was analysed separately and then integrated. Parents frequently under-medicate their child’s pain at home. Practical barriers including the analgesic context and children finding medications unpalatable led parents to prefer non-pharmacological interventions. Attitudinal and practical barriers result in parents having an “empty toolbox” of pharmacological interventions. Consequently non-pharmacological interventions are essential to parents managing their child’s cancer pain at home.

This study aimed to develop an instrument to assess the perception of hospital safety among hospitalized children for preschool age children. An initial 30 items of the preliminary Hospital Safety Scale for Kids (HSS-Kids) were generated based on literature reviews and focus-group interviews. The 30 items were developed as different types of hospital-based incidents, situation scenarios, and pictorial animation cards for describing them. The evaluation process was conducted with a sample of 150 hospitalized children and their caregivers. Construct, convergent, and discriminant validities were tested by exploratory and confirmatory factor analyses. For criterion validity, concurrent validity was confirmed, and reliability was established through Cronbach’s α coefficients. The final 15 HSS-Kids hospital scenario picture cards were categorized into four subdomains, falls, general injuries, burns, and medical devices, which explained 62.92% of the total variance. The HSS-Kids demonstrated construct, convergent, discriminant, and concurrent validity, with Cronbach’s αs ranging from .649 to .792. The HSS-Kids is a promising instrument to screen children at high risk of incidents by capturing their perception on hospital safety.

Children’s hospices are key players in the provision of palliative care services for families with children with life-limiting conditions (LLCs). However, evidence suggests that some of the negative terminology/language which surrounds the notions of palliative and hospice care may contribute to the lack of uptake of hospice services by families. This article reports two elements of place bonding: parents’ experiences of place identity and place belongingness at a children’s hospice in a region in England. Underpinned by a constructivist grounded theory methodology, focus groups were undertaken with 24 parents of children with LLCs accessing a children’s hospice. Despite initial reservations associated with the identity of the hospice, parents described how and why their view changed and therefore consequently how they were able to experience the hospice differently. This article demonstrates how parents’ views of the identity of the hospice change and how the hospice becomes a place where parents experience a sense of belongingness.