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A growing body of conceptual evidence over the last decade has increased our understanding of parents' experiences of having an infant with complex congenital heart disease. These concepts include parents' feelings of uncertainty, fear, excitement, and mastery. However, little is known about parents' experiences, confidence, and knowledge acquisition during transition from hospital to home with their infant after the first stage of complex cardiac surgery. A theoretical framework to assess, plan and implement child and family centered care would assist children's cardiac nurses responsible for parental education, discharge planning and coordination. To explore parents' experiences of the transition from hospital to home with their infant, following the first stage of cardiac surgery. A prospective mixed methods longitudinal design. Semi-structured interviews were undertaken, including administration of the Maternal Confidence Questionnaire at four timepoints: before discharge following stage one cardiac surgery (T0), 2 weeks' post discharge (T1), 8 weeks' post discharge (T2) and after stage two surgery (T3). Qualitative data were thematically analyzed. Descriptive statistics were used to characterize the sample and non-parametric repeated measures analysis of variance was used to analyze changes over time in maternal confidence scores. Sixteen parents of 12 infants participated. Four "patterns of transition experience" emerged, the fourth "Mastery", is discussed in this paper. Mastery can be contextualized in terms of the parents' journeys of knowledge construction, gaining confidence and reflection. Learning was dynamic and transformational, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. Confidence at T0 was significantly lower than at T1 (p =.011), T2 (p =.018) and T3 (p =.012). There were no significant differences between scores at T1, T2 and T3. Liminality, as a concept, described the between and betwixt time that parents experienced as they were preparing for discharge from hospital; excitement to be going home balanced with the fear of being alone and confidence in looking after their fragile infant. Parents of infants with complex congenital heart disease obtain knowledge, confidence, and mastery dependent upon their transition experience and their personal journey through pre-liminal, liminal, and post-liminal phases of discharge from hospital to home. A conceptual framework "Parenting through Transitions – hospital to home" emerged that could assist in structuring assessment of parents' knowledge and support needs within a coordinated discharge process. Identifying individualized support would promote adaptation and adjustment during transition from the pre to post liminal phase, following their infant's first stage of complex cardiac surgery. Parents learning was dynamic and transformational, learning opportunities overlapped transitional phases of their infant's journey, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. The transition from hospital to home and traversing the physical boundary of leaving the hospital for the first time with their infant (liminal phase), was loaded with emotionally traumatic experiences that could not be separated from the transition that was being explored within this study. Adjusting to the new situation, developing confidence over time, and becoming comfortable as they mastered new skills, demonstrated that some of these parents could pass through that liminal space to mastery of a new normal (post-liminal phase), which encompassed competence, integration, and comfort. [ABSTRACT FROM AUTHOR]

The purpose of the research were to describe eHealth literacy and identify factors affecting the eHealth literacy of early adolescents. This descriptive and correlational study was conducted in a government secondary school in the west of Turkey. The research sample consisted of 1347 adolescents in the sixth, seventh, and eighth grades in the academic year 2016–2017. An adolescents' description form and the eHealth Literacy Scale (eHEALS) were used to collect the data. The mean score on eHEALS was 23.81 ± 6.94. Multiple regression analysis showed that being in the 11–12 year age group (β = 0.528, p < 0.001), having a father with a high school or university level education (β = 0.055, p = 0.038), and carrying out research in the internet on health related topics (β = 0.118, p < 0.001) were determinant at 32% (F = 56.901, p < 0.001, R2 = 0.32) on the adolescents' eHealth literacy. The mean eHEALS score in the study demonstrated that the e-health literacy of the adolescents was rather low and inadequate, and that there were gaps in the adolescents' knowledge and skills about how and where to find quality eHealth information. Nurses are expected to provide eHealth literacy training that will help to find information on the internet and interpret and assess it, and this will develop eHealth literacy of adolescents. Integrating online health information sources into the school health education curriculum in line with developed strategies can be suggested because it is an attempt to improve the eHealth literacy of adolescents. [ABSTRACT FROM AUTHOR]

Asthma is a leading cause of acute health care use (AHCU) as defined by hospitalization and emergency department visits (ED). Little was known about factors associated with asthma-related AHCU. This study aimed to identify factors determining AHCU in children and adolescents with asthma. A descriptive study was conducted among children with mild to severe asthma referred to the pediatric outpatient clinic of "Farhat Hached" University Hospital of Sousse (Tunisia) over a period of three months (April-June 2018). We collected data regarding clinical information, the number of hospitalizations and ED visits related to asthma in the past 12 months, asthma management behaviors, and quality of life of children. Multivariable logistic regression was performed using SPSS (20.0). A total of 90 children have participated in the study. The percentage of children aged 7 to 11 years was higher than the percentage of adolescents aged 12 to 17 years (67.8%; 32.2%, respectively). The final logistic regression model demonstrated that asthma severity and inhaler technique increased the odds of AHCU (OR a = 4.6; 95% CI: 1.1-18.1; p = .03, OR a = 2.9; 95%CI: 1.1-7.8; p = .02, respectively). Also, increased quality of life score reduced the odds of AHCU (OR a = 0.6; 95% CI: 0.4-0.9; p = .01). These results suggest that the organization of programs targeting the management of these factors can reduce the workload on hospital services and emergencies. [ABSTRACT FROM AUTHOR]

This study aimed to reduce maternal anxiety scores and heart rates, increase oxygen saturation linked to vaccination processes with Skin-to skin contact (SSC). The study is a prospective, multicenter, paired, randomized, controlled trial. This experimental study was conducted with a pretest‐posttest control group. The study was carried out with 128 mothers of infants. A Sociodemographic Questionnaire, the State Anxiety Inventory and a pulse oximeter were used in the data collection. In the study, SSC began to be given to the infants in the intervention group five minutes before vaccination and the infant was left in SSC for an uninterrupted 15 minutes following the vaccination. The maternal anxiety scores were noted before and after the vaccination process. The mothers' heart rates and oxygen saturation were monitored a total of three times. The anxiety scores of the intervention group decreased while oxygen saturation increased after the vaccination as compared to the control group. The heart rate decreased in the intervention group but increased in the control group. The study revealed that SSC reduced scores of maternal anxiety and heart rates and increased oxygen saturation during the vaccination process. [ABSTRACT FROM AUTHOR]

Risky behaviors are common in developing countries, especially in adolescence. Moreover, sensation seeking is an important factor in personality. This study was conducted to evaluate the relationship between risky behaviors and sensation-seeking in a sample of Iranian adolescents. This study used a cross-sectional method with 400 high school adolescents (age between 15 and 21 years old) in Kashan city from multistage random sampling. The research instrument consisted of three parts: a socio-demographic questionnaire, the Youth Risk Behavior Surveillance System (YRBSS) and the Zuckerman Sensation-Seeking Scale-V (SSS-V). Data analysis was performed using the t-test, ANOVA, chi-square, regression and Spearman correlation coefficient in SPSS v 11.5. Risky behaviors were found in 51.2% of students, and a significant difference was found between the male and female students in this regard (p <.021). The overall sensation-seeking score and the scores in the dimensions of experience seeking, disinhibition, and boredom susceptibility were higher in males than females (p <.0001). All dimensions of sensation-seeking other than disinhibition dimension could significantly predict risky behavior. Sensation seeking can be used as an indicator for screening risky behaviors. Detailed planning on the part of the health care system and public authorities is recommended for appropriate screening and counseling adolescents with risky behaviors. [ABSTRACT FROM AUTHOR]

Asthma is a condition where the airways become tiny and swollen producing extra mucus. This can cause breathing difficulty and wheezing, coughing, and shortness of breath. Self-care education affects the quality of life of children. This study examined the effect of self-care education on quality of life for children between 8 and 11 years with allergic asthma. This study was a randomized controlled trial. Study sample included 70 children between 8 and 11 years with asthma allergy referred to Children's Hospital Clinic of Khorramabad, Lorestan Province in 2015; they were selected by possible non-consecutive sampling method. Children were divided by random sampling of blocks, and classified into two groups of 35 patients each in the experimental and control groups. Both groups were matched for age and sex of children's and parents' educational level and initial quality of life scores were analyzed (using covariance analysis). At the beginning, quality of life was calculated by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) for each of the group. The intervention was carried out in four sessions of 45 minutes of self-care education for children in the case group. No intervention was done in the control group. Eight weeks later quality of life was measured in each of the group. There was a significant difference between increase values of PAQLQ in the intervention group and control group (p < 0.001). These results show that self-care education enhances the quality of life in asthmatic children. [ABSTRACT FROM AUTHOR]

The main objective of this study is to describe incidence rates (IRs) of low-speed vehicle run-over events among children aged 0 to 14 years in Queensland, Australia, from 1999 to 2009, by Indigenous Australian status. Data on low-speed vehicle run-over events among children aged 0 to 14 years in Queensland were obtained for 11 calendar years (1999-2009) from all relevant data sources using International Classification of Diseases (ICD) codes, text description, word searches, and medical notes and were manually linked. Crude fatal and nonfatal IRs were calculated for Indigenous and non-Indigenous children; trends over time were analyzed by chi-square test for trend. Relative risks (RRs) were also calculated. Data on demographics, health service usage/outcomes, incident characteristics, and injury characteristics were obtained. Descriptive and multivariate analyses were performed in order to investigate whether these characteristics varied with Indigenous status. IRs were higher among Indigenous Australian children aged 0 to 14 years (21.76/100,000/annum) than other Australian children (14.09), for every year of the 11-year study. The age group most at risk for low-speed vehicle run-over events were young children aged 0 to 4 years, where incidence was 2.13 times greater among Indigenous Australian children (95% confidence interval [CI] = 1.67-2.71). There were no significant changes in incidence of low-speed vehicle run-overs among Indigenous Australian children for 0 to 4, 5 to 9, and 10 to 14 years or overall (0-14 years), during the 11-year study period. Over three quarters (n = 107) of low-speed vehicle run-over events involving Indigenous Australian children occurred outside of major cities (43.7% in other Australian children). These data indicate that Indigenous Australian children are at increased risk of low-speed vehicle run-over events and that characteristics of these events may vary as a function of Indigenous status. These results highlight that culturally specific interventions to reduce low-speed vehicle run-over events are required. [ABSTRACT FROM AUTHOR]