Search Results (32)

Background/Objectives: Pediatric skin injuries represent a clinical challenge, especially in cases with complex etiology or with severe pain. Blue light is an emerging technology with potential application in pediatric wound care. The aim of this case series was to describe the clinical use of blue light in pediatric patients with injuries of varying etiologies and mechanisms, and to assess its long-term effectiveness and sustainability in treatment. Methods: Twelve hospitalized pediatric patients (0–12 years old) with skin injuries were included in this case series. The etiologies of wounds treated with photobiomodulation were incontinence-associated dermatitis, peristomal injuries, and pressure injuries. The injuries were assessed using specific classification tools and pain scales. The wounds were treated every three days using a medical device that emits blue light (410–430 nm). When necessary, wounds were also treated with appropriate dressings. Results: All injuries responded positively to photobiomodulation therapy and showed a rapid resolution of inflammation. Complete wound resolution was achieved in 11 of 12 cases. The average healing time was 3.7 days. Four injuries achieved resolution with only one application of blue light. Scores from the pain perception scales showed that the blue light treatment was well tolerated by pediatric patients, showing high parental compliance. No side effects or adverse events were observed. Conclusions: Blue light photobiomodulation proved to be a safe, well-tolerated, and effective technology in the treatment of pediatric skin injuries, with good acceptance by young patients and families. More structured clinical trials would be needed to validate the efficacy of blue light in pediatric injuries. Full article

Background: The use of patient-reported outcomes is essential to understand and manage health-related quality of life (HRQOL) in youth with lifelong disabilities. This study evaluated HRQOL in youth with physical disorders and examined its relationship with mobility. Methods: We conducted an IRB-approved retrospective study in which we administered the parent-reported Pediatric Outcomes Data Collection Instrument (PODCI) and Gross Motor Function Measure section D (GMFM-D) to ambulatory youth aged 2–18 years with cerebral palsy (CP; Gross Motor Function Classification System II; n = 258), arthrogryposis (n = 138), achondroplasia (n = 102), and Morquio syndrome (n = 52) during clinical visits to a gait lab. The PODCI has two validated versions, child and adolescent, that assess perceptions about mobility, happiness, and pain. Differences in HRQOL between diagnostic groups, between age groups, and compared with non-disabled youth were examined using non-parametric tests. The relationship between GMFM-D and PODCI scores was analyzed with Pearson’s correlations. Results: Both age cohorts within all diagnosis groups demonstrated higher pain and lower mobility compared with non-disabled youth (p < 0.015). Happiness was lower for both age groups with CP and arthrogryposis, and for the child group with Morquio syndrome compared with non-disabled youth (p < 0.002). In diagnostic groups in both age spans, Global Function was higher (p < 0.0001) for those with achondroplasia compared with other groups. Despite functional differences, there were no significant differences between diagnostic groups in pain scores (p > 0.10). Happiness was lower in the group with CP compared with that with achondroplasia (p = 0.01). GMFM-D was related to PODCI mobility scores for all diagnoses (r = 0.31 to 0.79, p < 0.03) but was not correlated with happiness (r = −0.16 to 0.092; p > 0.14); GMFM-D and PODCI pain scores were associated only for the child group with achondroplasia (r = 0.355; p < 0.001). Conclusions: Significant limitations in HRQOL are present in youth with physical disabilities. Pain levels were higher than those of non-disabled youth, but pain was not related to lower motor function. Happiness was not related to gross motor function, suggesting the need to examine other factors when mental health concerns are present in youth with disabilities. Full article

Background: Parents of children with life-limiting or life-threatening illnesses and/or medical complexity experience intense stress and pain soon after the birth and lifelong. Understanding parents’ experiences and coping strategies is the prerequisite to provide tailored support to families. Aim: To explore the experiences of parents of children with medical complexity (CMCs) during hospitalization in a Family-Centered Care (FCC) neonatal unit and after discharge. Design: Qualitative study. Methods: Semi-structured interviews were administered to the parents of children with medical complexity admitted to the Neonatal Intensive Care Unit (NICU) of Modena between October 2016 and January 2024. The interview was developed based on three time points: birth, hospitalization, and discharge, focusing on parents’ experiences, emotions, and communication with healthcare professionals. The interviews were analyzed using the template analysis. Results: A total of 10 parents were interviewed. Four domains were identified, encompassing eight significant themes in the parents’ experiences and their communication with healthcare professionals. The relevant emotions included anxiety and fear for survival, fatigue, and guilt over the child’s suffering, alongside hope and trust that parents felt entitled to nurture. Relationships with professionals were characterized by expectations and frustrations; mothers and fathers had different perceptions and reactions to the situation they were facing. Conclusions: This qualitative study explores the experiences of parents of CMCs in a neonatal intensive care unit adopting FCC. From admission to discharge, parents’ emotions were influenced by the child’s unique clinical history. Active listening and the humane attitude of healthcare professionals were the aspects most appreciated by parents. Full article

Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents’ and nurses’ participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents’ and nurses’ perceptions of and reflections on experiencing combined parent-delivered pain management. Methods: This qualitative study applies a collaborative participatory action research design using ethnographic data collection methods such as focus groups, video observations, and video-stimulated recall interviews with parents and nurses. Results: The results concern three main categories, i.e., preparation, participation, and closeness, as well as various sub-categories. Preparations were central to enabling combined parent-delivered pain management. Participation was facilitated by parental musical presence, in which parents shifted their attention toward their infant. Closeness and presence during neonatal care helped parents become active during their infant’s painful procedures. Parental lullaby singing created a calm and trusting atmosphere and after the procedure, both parents and nurses felt that they had successfully supported the infant through a potentially painful procedure. Conclusions: Mental and practical preparation is central to implementing combined parent-delivered pain management. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. Full article

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children’s parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city. Full article

There is an anecdotal impression that teenage patients report exaggerated postoperative pain scores that do not correlate with their actual level of pain. Nurse and parental perception of teenagers’ pain can be complemented by knowledge of patient pain behavior, catastrophizing thoughts about pain, anxiety, and mood level. Two hundred and two patients completed the study—56.4% were female, 89.6% White, 5.4% Black, and 5% were of other races. Patient ages ranged from 11 to 17 years (mean = 13.8; SD = 1.9). The patient, the parent, and the nurse completed multiple questionnaires on day one after laparoscopic surgery to assess patient pain. Teenagers and parents (r = 0.56) have a high level of agreement, and teenagers and nurses (r = 0.47) have a moderate level of agreement on pain scores (p < 0.05). The correlation between patient APBQ (adolescent pain behavior questionnaire) and teenager VAS (visual analog scale) and between nurse APBQ and teenager VAS, while statistically significant (p < 0.05), is weaker (r range = 0.14–0.17). There is a moderate correlation between teenagers’ pain scores and their psychological assessments of anxiety, catastrophic thoughts, and mood (r range = 0.26–0.39; p < 0.05). A multi-modal evaluation of postoperative pain can be more informative than only assessing self-reported pain scores. Full article

Background: The inflammatory process represents a specific response of the organism’s immune system. More often, it is related to the rising pain in the affected area. Independently of its origin, pain represents a complex and multidimensional acute or chronic subjective unpleasant perception. Currently, medical doctors prescribe various analgesics for pain treatment, but unfortunately, many of them have adverse effects or are not strong enough to suppress the pain. Thus, the search for new pain-relieving medical drugs continues. Methods: New tetrapeptide analogs of FELL with a generaanalgesic-Glu-X³-X⁴-Z, where X = Nle, Ile, or Val and Z = NH₂ or COOH, containing different hydrophobic amino acids at positions 3 and 4, were synthesized by means of standard solid-phase peptide synthesis using the Fmoc/OtBu strategy in order to study the influence of structure and hydrophobicity on the analgesic activity. The purity of all compounds was monitored by HPLC, and their structures were proven by ESI-MS. Logp values (partition coefficient in octanol/water) for FELL analogs were calculated. Analgesic activity was examined by the Paw-pressure test (Randall-Selitto test). Results: The obtained results reveal that Leu is the best choice as a hydrophobic amino acid in the FELL structure. Conclusions: The best analgesic activity is found in the parent compound FELL and its C-terminal amide analog. Full article

Background and Objectives: Today, oral diseases are well-known for their effects, not only on daily life but also on quality of life (QoL). Dental caries, especially early childhood caries (ECC), are considered a public health concern as regards their impact on the life quality of children and parents from multiple aspects. The present research was conducted to assess the effect of anemia on oral-health-related quality of life (OHRQoL) in terms of children and parents. Materials and Methods: The current study was performed in two independent stages. In the first stage, the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS), and in the second stage, the Turkish version of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) were used to measure the effect of anemia-related dental caries among children and parents. SPSS and Jamovi software were used for all calculations, graphs and comparisons. Results: A total of 204 participants (child–parent pairs) were incorporated in the present study. A considerable number of children (81.5%) reported occasional or more frequent oral/dental pain. Secondly, the subscale scores were determined for child symptoms (2.25 ± 0.067), child function (6.8 ± 0.22), child psychology (3.87 ± 0.128), self-image and social interaction (1.74 ± 0.063), parental distress (3.82 ± 0.143), and family function (3.5 ± 0.121). Additionally, more than half of the parents (56.3%) responded “fair” for the health of their children’s teeth, lips, jaws and mouth. Similarly, the child’s overall well-being was stated as being affected “a lot” by the condition of their child’s teeth, lips, jaws or mouth by half of the parents (49.5%). Conclusions: Anemia-related dental caries has a highly negative impact on the quality of life of children and parents according to both of the questionnaires. Therefore, children with high scores should be prioritized for preventive procedures and timely dental treatments. Full article

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the prevalence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through a house-to-house survey using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain District, India. Excessive screen viewing time was defined as screen viewing for >2 h/day. The prevalence of excessive screen viewing time was 18%. Risk factors identified using the multivariate logistic regression model were age (OR: 1.63, p < 0.001); mobile phone use before bedtime (OR: 3.35, p = 0.004); parents’ perception about the child’s habituation to screen time (OR: 8.46, p < 0.001); television in the bedroom (OR: 35.91, p < 0.001); morning mobile screen viewing time (OR: 6.40, p < 0.001); not reading books other than textbooks (OR: 6.45, p < 0.001); and lack of outdoor play for >2 h (OR: 5.17, p < 0.001). The presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.13, p = 0.012). This study identified multiple modifiable risk factors for excessive screen viewing time. Full article

Pain and quality of life are closely interrelated in children with cerebral palsy (CCP). Even though 67% of CCP experience pain, it is overlooked and untreated. In this study, our purpose was two-fold: first, to examine the relationship between pain and spasticity by evaluating the effects of AbobotulinumtoxinA/Dysport (BoNT), and second, to describe the symptoms and location of pain in CCP. The subjects were 22 CCP in at least moderate pain. They were evaluated for spasticity by the modified Ashworth and Tardieu scale and for pain by the r-FLACC and the pediatric pain profile. After one injection of BoNT, the subjects were re-evaluated. We found a significant reduction in pain, but no significant relationship between the reduction of pain and spasticity. We found no association between the dose of BoNT and pain or spasticity. Pain in the lower extremity was located primarily in the hip region. The effect of ultrasound-guided intermuscular injections of BoNT suggests that pain in CCP has an extra-articular component. We found that pain in CCP manifests as specific tell-tale signs and problems in daily living. In conclusion, we found no relationship between pain and spasticity. Signs and manifestations of pain are described in detail. Lower extremity (hip) pain seems to have a soft tissue/extra-articular component. Full article

(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) levels. The current study aims to assess the effect of maternal singing and speaking on mothers. (2) Methods: During a painful procedure over two days, twenty preterm infants were randomly exposed to their mother’s live voice (speaking or singing). Maternal OXT levels were measured twice: before and after singing, as well as before and after speaking. The anxiety and resilience responses of mothers were studied before and after the two-day interventions, regardless of the speaking/singing condition. OXT levels in mothers increased in response to both singing and speech. Concurrently, anxiety levels decreased, but no significant effects on maternal resilience were found. (3) Conclusions: OXT could be identified as a key mechanism for anxiety regulation in parents, even in sensitive care situations, such as when their infant is in pain. Active involvement of parents in the care of their preterm infants can have a positive effect on their anxiety as well as potential benefits to their sensitivity and care abilities through OXT. Full article

Background: Pediatric patients can provide feedback about their healthcare experiences. However, most do not and are instead represented by their parents. A widely accepted notion is that pediatric patients lack the capacity, vocabulary, and preferences needed to answer meaningful questions related to their healthcare. However, because the pediatric patients’ experience can differ from the perspective of their parents, the use of proxy reporting ultimately reduces the hospital’s ability to address the concerns of pediatric patients directly. Objectives: The overall goals of this survey study were (1) to identify the key domains whereby pediatric patient and parent preferences differ and (2) to investigate the extent to which pediatric patients perceive their healthcare experiences differently from their parents. Methods: This study employed an adult version, an older child version, and a younger child version of a 47-question survey instrument divided into seven key domains: experience with the admission process, interactions with nurses, interactions with doctors, care in the hospital, hospital environment, experience before discharge, and overall score. The instrument was developed to survey children (ages 4–17) recently discharged from the hospital and their parents or guardian. Results: The findings suggest pediatric patients reported interest in engaging with their doctors about their healthcare. However, pediatric patients younger than 13 years old reported having fewer pediatric doctors ask them about their healthcare, with the youngest group reporting the worst experiences. Moreover, differences in perceptions were identified between pediatric patients and their parents regarding hospital quality and performance. Pediatric patients reported less pain and higher satisfaction regarding the cleanliness of the room and their experience in the admission process than their parents. Patient and parent responses were significantly different within each of the seven domains. Conclusion: The results speak to the larger discussion of whether current hospital settings can engage with small children at the level necessary to capture meaningful feedback about their healthcare experience. By providing additional evidence to the contrary, this survey study brings further context to misconceptions regarding pediatric patients’ involvement as crucial actors in the patient-and-family-centered care model. Full article

Chronic pelvic pain (CPP) in women is a highly prevalent condition worldwide and requires multimodal treatment. Adverse childhood experiences have been associated with CPP in women, while allodynia and poor outcomes have been linked to pain catastrophizing in these patients. Pain perception has been associated with parenting style during childhood. The objective of this study was to investigate the association between parenting style, pain catastrophizing, anxiety, depression and CPP in women. A case–control study was conducted between May 2018 and August 2021 with 123 women with CPP and 123 pain-free controls. Questionnaires were used to collect participants’ data. The association between parenting style and CPP was assessed using multiple logistic regression, with odds ratios (OR) and 95% confidence intervals (CI) being calculated. The correlation between catastrophizing, pain intensity, pain duration, anxiety, depression, and parenting style in women with CPP was assessed using Spearman’s rank correlation coefficient (r). A higher frequency of low maternal care (60.7% versus 45.2%; p = 0.026), anxiety (79.7% versus 56.9%; p < 0.001), depression (73.2% versus 56.1%; p = 0.008) and physical violence (31.7% versus 14.6%; p = 0.003) was found in the CPP group compared to the controls. There was no association between parenting style and CPP in the adjusted analysis. A positive correlation was found between catastrophizing and pain intensity (r = 0.342; p < 0.001), anxiety (r = 0.271; p = 0.002), depression (r = 0.272; p = 0.002), and maternal overprotection (r = 0.185; p = 0.046). A negative correlation was found between anxiety and maternal (r = −0.184; p = 0.047) and paternal (r = −0.286; p = 0.006) care and between depression and maternal (r = −0.219; p = 0.018) and paternal (r = −0.234; p = 0.026) care. The present results suggest a significant but weak association of parenting style with pain catastrophizing, the mental health of women with CPP, and the way in which they experience pain. Full article

The purpose of this study was to investigate whether regular physical activity can alter the pressure pain threshold, pain tolerance, and subjective pain perception in individuals who have experienced a cardiovascular event. The study involved 85 individuals aged 37 to 84 years (M = 65.36) who qualified for outpatient cardiac rehabilitation, which consisted of 24 physical training sessions. The patients were all tested twice: on the first and last day of the outpatient cardiac rehabilitation program. Assessments of the pressure pain threshold and pain tolerance were performed with an algometer. To assess the pain coping strategies, the Pain Coping Strategies Questionnaire (CSQ) and parenting styles were measured retrospectively with subjective survey questions. The main results of the study showed that patients achieved significantly higher pressure pain thresholds after a physical training cycle (ps < 0.05, η² = 0.05–0.14), but found no differences in the pain tolerance (ps > 0.05). A lower preference for the better pain coping strategy explanation (ß = −0.42, p = 0.013) and growing up in a family with a less neglectful atmosphere (ß = −0.35, p = 0.008) were associated with increased pressure pain threshold after physical training. The results suggest that physical activity is an important factor in modulating the pressure pain threshold. Full article

In recent years, many studies have attempted to find the main predictors of the development of post-traumatic symptoms in children following medical procedures. Recent studies found a link between parental beliefs and children’s post-traumatic symptoms in various medical contexts such as life-threatening illness, pain, and hospitalization. This study aims to examine the relationship between parental beleifs and post-traumatic symptoms in children and parents after surgical interventions of the children. The study was conducted among 149 children who underwent surgery and their parents. The children and parents were examined at 2 time points- during hospitalization, and 4 months after the hospitalization. Questionnaires were administered measuring parental beleifs pertaining to parental distress, and post-traumatic symptoms among children. results show a correlation between the factors. In addition, it was found that the parents’ distress is a mediating relationship between the parents’ perceptions and the child’s level of distress. It has been found that there is a link between some of the parental beleifs and parental stress symptoms and post-traumatic symptoms in the children. Parental beliefs that were found to influence these variables were related to parental beliefs regarding children’s suffering and pain during surgery. In addition, children of parents with higher levels of religious and spiritual beliefs were found to have fewer post-traumatic symptoms. This study sheds light on parental beliefs that may have the power to influence parental stress levels and children’s post-traumatic symptoms after surgery. Full article