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Commentary on: Carlton E, Kohne J, Shankar-Hari, et al. Readmission diagnoses after paediatric severe sepsis hospitalisation. Crit Care Med 2019;47:583–90.
Children with coexisting comorbidities when discharged following severe sepsis have a higher rate of readmission as compared with matched hospitalisations for other acute medical conditions. There is a need for internationally agreed evidence-based guidelines/consensus paper to minimise post-sepsis readmissions through identification of potentially preventable factors, appropriate discharge criteria and parental education. More research is required into strategies towards prevention of readmissions following discharge after an episode of severe sepsis in children.
Sepsis is a leading cause of avoidable death across all age groups.
Commentary on: Hanna JR, McCaughan E, Semple CJ. Challenges and support needs of parents and children when a parent is at end of life: a systematic review. Palliat Med 2019;338:1017–1044. doi: 10.1177/0269216319857622.
When a parent is dying, an honest discussion should be made with the children to prepare them for an imminent bereavement. Community awareness is important for better support networks for grieving families. Further research is needed to explore ways of supporting dying parents to have conversations with children of different ages, family settings and cultural backgrounds.
Dying parents of dependent children are faced with accepting their own impending death as well as supporting their children to understand what is happening and prepare them for when death occurs. Such a challenge needs support from healthcare professionals to facilitate a positive approach that prepares the children for loss...
Commentary on: Stephens S, Shams S, Lee J, et al. Benefits of physical activity for depression and fatigue in multiple sclerosis: a longitudinal analysis. J Pediatr 2019;209:226–32. https://doi.org/10.1016/j.jpeds.2019.01.040
Young people with paediatric-onset multiple sclerosis (POMS) experience increased depression and fatigue across illness duration; healthcare professionals should be cognisant of the need to address these symptoms to ensure improved well-being and trajectory of these psychosocial aspects over time. Additional longitudinal research among young people with MS is required to address symptomology and improve well-being among this grouping; and also to inform trends, potential interventions and treatment for the adult population.
Paediatric-onset multiple sclerosis presents in childhood or adolescence with fatigue and depression common among those living with POMS.
Commentary on: McGill DE, Volkening DA, Wasserman RM, et al. Text-message responsiveness is associated with HbA1c benefit in teenagers with type 1 diabetes. Diabet Med 2019;36:600–5.
Teenagers with type 1 diabetes (T1D) are at a transition phase in becoming independent for their blood glucose monitoring. Digital interventions may be a key component of behaviour change and management strategies for glycaemic control. Involving the user at the centre of the technology design is critical for research that aims to support adherence with self-management for long-term conditions such as T1D.
There is a growing body of evidence associating the use and functions of mobile devices such as text-message services for people with T1D to promote glycaemic control.
Commentary on: Canbulat Sahiner N, Turkmen AS, Acikgoz A, et al. Effectiveness of two different methods for pain reduction during insulin injection in children with Type 1 Diabetes: Buzzy and ShotBlocker. Worldviews Evid Based Nurs [EPub ahead of print 11 Oct 2018].
Use of ShotBlocker or Buzzy during insulin administration was effective in reducing self-reported, parental and observer assessments of pain in comparison with no intervention. ShotBlocker or Buzzy was effective in lowering self-reported, parental and observer assessments of fear and anxiety prior to and during insulin administration in comparison with no intervention. Further research is needed to examine the effectiveness of the devices over a longer time period for children who need regular injections.
The negative impact of needle-related procedures has been widely reported with evidence of distress, anxiety and non-compliant behaviours.
Commentary on: McMahon GE, Spencer-Smith MM, Pace CC, et al. Influence of fathers’ early parenting and development of children born very preterm and full term. Journal of Pediatrics 2019:205; 195–201.
Fathers’ parenting behaviours are important to subsequent child development. Further research is needed to review parental interactions and child development for infants born prematurely.
Parenting behaviours impact on child development.
There are many ways to measure behaviours associated with ‘positive and negative’ parenting.
Commentary on: Harding L, Davison-Fischer J, Bekaert S, Appleton JV. The role of the school nurse in protecting children and young people from maltreatment: An integrative review of the literature. Int J Nurs Stud. 2019 Jan 2;92:60–72.
Interagency communication can be problematic; adopting an interagency approach to education and training in this area may be beneficial. There is a need for research exploring the impact of school nurse interventions in relation to child maltreatment from the perspective of children and young people.
Child maltreatment is a global public health issue with one in four adults experiencing physical violence in their childhood.
Commentary on: Marshall C, Forgeron P, Harrison D, et al. Exploration of nurses’ pediatric pain management experience in rural hospitals: a qualitative descriptive study. Appl Nurs Res 2018;42: 89–97.
Considering the context within which nurses deliver paediatric pain management provides implication for practice via ensuring that there are systematic procedures rather than pain care based on individual beliefs. Further research is required to consider rural contextual specific pain management interventions that could enable long-term improvements to care.
Poor pain management for children can have long-term negative impact.
Commentary on: Linder LA, Bratton H, Nguyen A, et al. Symptoms and self-management strategies identified by children with cancer using draw-and-tell interviews. Oncol Nurs Forum 2018;45:290–300.
Nurses should consider using arts-based approaches when assessing symptoms experienced by children with cancer and identifying and exploring the self-management strategies employed. Further research exploring the use of draw-and-tell methods to inform clinical nursing assessments could inform practice.
The importance and complexity of effective communication in informing children’s knowledge and understanding of their cancer and care, is recognised
Commentary on: Lang JE, Bunnell HT, Hossain MJ, et al. Being overweight or obese and the development of asthma. Pediatrics 2018;142. pii: e20182119. doi: 10.1542/peds.2018-2119.
The findings of this study further support the importance of reducing childhood obesity levels to reduce the risk for comorbidities, including asthma. This study also found a more modest increase in the risk of childhood asthma in overweight children, highlighting the importance of interventions focusing on preventing further weight gain for overweight children. Future research can focus on understanding causal pathways and developing effective interventions to manage and prevent childhood obesity and associated comorbidities.
There is clear evidence that obesity and asthma both place a significant burden on children, their families and healthcare systems.
Commentary on: Jibb LA, Croal L, Wang J, et al. Children’s experiences of cancer care: A systematic review and thematic synthesis of qualitative studies. Oncology Nursing Forum 2018;45:527–44.
Developmentally appropriate conversations with children receiving cancer treatment can ensure timely referrals to the wider team through early identification and understanding of impact and needs. The benefits of ongoing social support during cancer treatment while wide ranging may not be optimally facilitated or utilised in care settings and therefore is an area for future research.
As the overall long-term survival rate for children’s cancer increases,
Commentary on: Skarstein S, Lagerløv P, Kvarme LG, et al. Pain and development of identity in adolescents who frequently use over-the-counter analgesics: a qualitative study. J Clin Nurs 2018;27:3583–91. doi:10.1111/jocn.14513
A mother’s pain beliefs are influential in shaping an adolescents beliefs, behaviours and coping strategies. There is a historical pattern of pain beliefs and behaviour within families. Further qualitative exploration is needed using co-design, a more diverse group and involvement of fathers.
Chronic pain affects more than 15% of able-bodied adolescents and 27% of those with disabilities.
Commentary on: Morrison-Beedy D, Grove L. Adolescent girls’ experiences with sexual pressure, coercion, and victimization: #MeToo. Worldviews Evid Based Nurs 2018;15:225–229.
The power imbalance within sexual relationships needs to be addressed; sex and relationship education should focus around consent, issues of respect and gender harassment. Research exploring the attitudes of young males towards sexual relationships, including sexual pressure and coercion, may provide valuable insight in order to develop appropriate sexual health promotion programmes.
The #MeToo campaign and the use of social media have highlighted and brought to the forefront of society the sexual pressure, coercion and victimisation of women that has been an experience of women across time.
Commentary on: Arıkan D, Gürarslan Bas N, Kurudirek F, Bastopcu A, Uslu H. The effect of therapeutic clowning on handwashing technique and microbial colonization in preschool children. J Nurs Scholarsh; article in press.
Further interventions targeting preschool children can consider delivery methods involving clowns and other entertaining methods. The effectiveness of the therapeutic clowning approach should be compared with existing teaching methods.
Handwashing is an effective and convenient practice to prevent many infectious diseases.
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