Search Results (101)

Background/Objectives: Given the limited evidence internationally, this qualitative study employed discovery interviews to explore the lived experience of patients who developed Hospital-Acquired Malnutrition (HAM) and that of their carers. Methods: Seven (two patients [(n = 1 female] and five carers [n = 3 female]) completed discovery interviews with an experienced independent interviewer. Carers were either spouses or parents. Responses were thematically analyzed using a constant comparative approach. Results: A key theme was ‘It’s not about the food, it’s the hospital system’ with the needs of the system dominating, including when patients were feeling at their worst. Subthemes were ‘integration of care’ and ‘patient acuity’, including symptoms that impacted food intake. Another theme was ‘Who is looking out for the patient?’, exploring ‘reliance on carer advocacy’, and ‘variation in staff involvement’. One carer said, “… the girl that delivered the meal tray was the only one in our hospital stay who actually said to [the patient], ‘I’m so glad you’re sitting up. I was worried about you because you hadn’t eaten for so long?” A persistent but comparatively less strong theme was ‘When it is about the food’ which explored ‘the quality of the food’ and ‘receiving information on eating and drinking’. Conclusions: The three key themes identified from carers and patients were hospital system impacts, care co-ordination and, less strongly, experiences with food quality and information. The key opportunities to prevent, or better support the nutritional care of patients with, HAM may be through improving systems and care co-ordination. Full article

This paper presents a usability evaluation of EduAbility, an Android application that supports inclusivity through assistive technology recommendations and training to pupils with disabilities, teachers, teaching assistants and parents/carers. EduAbility consists of a Recommendation System and Training Package that increases awareness of assistive technology (AT) to improve quality of life for individuals with disabilities. Following a previous usability evaluation at a higher education institution, EduAbility was subsequently developed from the qualitative feedback. A further evaluation at a secondary school and college (n = 9) are presented, where System Usability Scale (SUS) and NASA Task Load Index (TLX) quantitatively measure usability and workload, with Think Aloud providing qualitative data. The results highlight the significant potential of EduAbility to educate teachers, teaching assistants and parents/carers on AT, with the product recommendations being particularly valuable to increase awareness. Suggestions for future work are also discussed as well as the wider impacts of EduAbility on promoting the use of AT in education. Full article

Autistic people experience lower rates of employment, education, and participation, and the identification of autistic people is growing rapidly with improved early identification, increased community awareness, and improved identification in previously under-diagnosed populations. Although inclusive education policies and practices present an opportunity to bolster the transition into adulthood for autistic young people, there is little mandate around these processes and supports. This qualitative study gathered the perspectives of people with direct experience of mainstream school transition supports through 46 interviews with autistic young people, educators, and parents/carers. The participants’ narratives were interpreted through the lens of self-determination theory to understand how inclusive schools can best fulfil autistic young peoples’ needs for competence, autonomy, and relatedness. The findings enable recommendations for inclusive school practice and supports, informed by the stories of those who have experience with the phenomenon. Full article

Background: Foster children exhibit higher rates of psychiatric and physical disorders than children living with their biological families. This places a high burden on the parenting skills of foster parents and potentially increases the risk of placement failure. One possibility to increase foster carers’ parenting skills and to reduce child problems is through parent training. In this study, the feasibility and effectiveness of the German-translated version of Fostering Changes, a parent training programme for foster parents, was investigated. The aims of Fostering Changes are the reduction in child behavioural problems, supporting children’s affect regulation, and improving the quality of the foster parent–child relationship through the promotion of foster parents’ sensitivity and parenting skills. Methods: We conducted six Fostering Changes courses in 2022 and 2023, with a total of 33 foster carers (i.e., foster parents) participating. Child behavioural problems (Carer-Defined Problems Scale; primary outcome), child psychopathology (Strengths and Difficulties Questionnaire), carer–child relationship quality (Child Relationship Behavior Inventory, Quality of Attachment Relationship Questionnaire), foster carers’ stress (Parental Stress Scale), and foster carers’ parenting strategies (Parenting Scale) were assessed at the start (t0) and end of each course (t1) and three months after course completion (t2). To examine the effect of training participation, mixed linear models and generalised estimating equations were applied. Additionally, effect sizes (Cohen’s d) were calculated. Results: When comparing t0 with t1 scores, there was a significant reduction in child behavioural problems (d = 1.87) and child psychopathology (d = 0.70), and improvement in foster carers’ parenting skills (d = 0.76) and the quality of the foster parent–child relationship (CRBI: d = 0.77, QUARQ: d = 0.72). Effect sizes for changes in the abovementioned variables between t0 and t2 were also moderate to large, with the exception of child psychopathology (d = 0.44). Conclusions: The results of this feasibility study, which is the first trial of Fostering Changes outside the UK, suggest that the German version of Fostering Changes could be an effective intervention for foster families. The largely comparable results for the periods t0–t1 and t0–t2 suggest constancy of the observed changes three months after course completion. Trial registration: DRKS-ID: DRKS00029014; date of registration: 23 May 2022. Full article

Background and Objectives: Paediatric palliative care in Romania is underdeveloped and unevenly distributed, which creates major difficulties in accessing services for children with life-limiting illnesses and their families. The lack of a dedicated national strategy, the shortage of specialised staff, and socio-economic barriers exacerbate the vulnerability of these groups. This study aimed to explore parents’ and caregivers’ experiences, to analyse the perspectives of public institutions and NGOs involved in supporting these children, and to identify the main barriers and facilitators in accessing paediatric palliative care. Materials and Methods: Given that all data were collected exclusively through focus group discussions, this study employed a qualitative design based on three focus groups guided by a semi-structured interview guide. The analysis was conducted using MAXQDA software, which enabled the coding and synthesis of emerging themes. Participants were parents/caregivers of children with life-limiting illnesses, representatives of public institutions, and members of relevant NGOs in Bacău County, Romania. Purposive sampling was used to capture diverse and experience-based perspectives, resulting in a total of 24 participants across three focus groups—parents and caregivers (n = 11), public institution representatives (n = 7), and NGO representatives (n = 6). No individual semi-structured interviews were conducted. Results: The analysis highlighted a complex typology of medical, emotional, social, educational, and spiritual needs of children and their families. Parents reported experiences of abandonment in the curative system, emphasising the importance of pain control, safety, and community support. Public institutions acknowledged the lack of skills and inter-sectoral coordination, while NGOs pointed to structural barriers and the low visibility of these children. Major needs include access to specialised care, psychological support, respite services for carers, financial and administrative assistance, education, and spiritual counselling. A significant obstacle is the lack of up-to-date statistical data needed to inform public policy. Conclusions: Paediatric palliative care should be considered a national priority through the development of a dedicated strategy, the expansion of specialised services, and the strengthening of partnerships between the public and non-governmental sectors. An integrated, child- and family-centred approach addressing the medical, social, emotional, and spiritual dimensions of care is essential. The results highlight the need for continuous staff training, information campaigns, and community support mechanisms to reduce inequalities and improve the quality of life of children with life-limiting illnesses. Full article

There have been many evaluations of specific parent programs, but there is minimal evidence of evaluation of the broader landscape of established advice or support services for parents of children under 18 years old. This paper investigates parent/carer perceptions of support services in their case study city. We explore and examine their perspectives on existing support services and how far they are meeting their needs. Through a thematic analysis of semi-structured interviews with parents and carers from across the city, a range of key themes emerged. These included the supportive environment and positive ethos of services accessed, lack of trust in some professionals, and perceived gaps in provision, highlighting the need for more activities, support, and accessible information, especially for families with special educational needs and disabilities (SEND). These findings underscore the complexity of navigating the landscape of support services and advocate for more coordinated, accessible, and trustworthy support systems for parents and carers. Full article

From a critical feminist perspective, it is hypothesised that the gender digital divide may be related to new forms of virtual gender-based violence that particularly affect girls and young women. If this is the case, these forms of violence would fall within the dimension of exploitation or quality of use of technologies that characterises the digital divide. To test this hypothesis, a documentary analysis of the phenomenon was carried out by reviewing different cases reported in various media outlets, which show that the well-being of girls and adolescents is at risk when technology is involved. Four categories emerge that reflect situations in which technology becomes a tool for promoting self-harm and suicide among minors through exposure to harmful content, grooming, sexting and/or sextortion; the digital sexual exploitation of underage girls through deepfakes or intimate images generated with artificial intelligence; the consumption of violent and hateful content in mass chats; and the incitement of gender-based violence through video games. The results show the reproduction and perpetuation of gender-based violence in the digital world. To guarantee safe, inclusive and equitable digital environments, various measures are essential, including European policies or plans aimed at guaranteeing digital security and rights, and those related to critical digital literacy with a gender perspective in formal education (school and university) and informal education (parents, carers and guardians). Finally, we urge that the focus be placed on personal digital resilience, since thinking of a completely secure digital world is a naive and unattainable utopia. Full article

Background/Objectives: The child and adolescent mental health service (CAMHS) hand-over to adult mental health service (AMHS) remains an ongoing shortfall in eating disorder (ED) treatment, typically in tandem with diagnostic drift, heightened suicide risk, and carer burn-out. We created one 14-to-25 Transition—ED track within our own unit, where a single multidisciplinary team continuously follows each patient and family across the CAMHS–AMHS boundary (via weekly joint paediatric and adult clinician meeting) without changing the individual psychotherapist, family therapist, or dietitian at the age 18 transition. We investigated the manner in which patients and parents perceive this model. Methods: A survey of two naturalistic parent cohorts—CAMHS (n = 16) and Transition—Adult arm (n = 15)—also joined, alongside the original group of young adults who had entered the programme during its set-up phase (n = 9). Here, the 14–25 pathway denotes one unified route of care across adolescence and young adulthood; the Transition—Adult arm is its ≥ 18-years component. All index patients had a primary DSM-5-TR diagnosis of restricting-type anorexia nervosa. Participants completed the Client Satisfaction Questionnaire-8 (CSQ-8; range 8–32) and four bespoke Continuity-of-Care items (1–4 Likert). Results: Overall, the caregivers in both cohorts were pleased (median CSQ-8 = 28.5 [CAMHS] vs. 27.0 [Transition]; p = 0.75). Continuity items were universally well rated across cohorts. Cohort parents reported a median of two unchanged core clinicians (i.e., the individual psychotherapist, the family therapist, or the dietitian), which was nonsignificantly positively correlated with CSQ-8 scores (ρ = 0.22). Early-group patients mirrored caregiver impressions (mean CSQ-8 = 27.0 ± 3.9). Conclusions: It is feasible and highly acceptable to both caregivers and anorexia nervosa young adults to have the same key staff and family-centred sessions over the 14-to-25 age span. Constrained by single-site study and small sample size, these preliminary data provide a rationale for wider implementation and controlled follow-up studies. Full article

Objectives: The aim of this study is to describe and examine reconciliation strategies for reconciling work and informal care that are aimed at different types of working carers (carers of the following: family members with dementia; partners; children under 18; adult children; parents; other family members). Methods: We conducted a cross-sectional survey to examine structural strategies for a work–care balance throughout the caregiving period, followed by the frequency of the use of strategies in the last 12 months to better understand what is an effective work–care balance strategy for different working carer types. Hierarchical cluster analysis was conducted in February 2025 on 299 working carers drawn from a representative sample of adult Slovenian residents in an online probability panel. Results: The results show five clusters of carers that clearly indicate their use of reconciliation strategies depends on the national context, the work organisation and employees, the family structure, the value orientation of informal carers, and the type of care recipient. Conclusions: A variety of policy measures are needed to enable informal carers to remain active in the labour market while they care for dependent family members and relatives. Full article

Background: Motor performance in childhood predicts physical fitness, cognitive capacity, socio-emotional development, and academic success. Parenting styles are especially important to such performance in the preschool period, as children’s gross motor abilities are shaped in part by their interactions with parents. Young children’s physical activity is also declining as they spend more time on screens. Methods: This quantitative survey-based study examined the relationships among 252 preschoolers’ gross motor skills, their tendency to become addicted to digital games, and their parents’ parenting styles. Results: The sampled preschoolers’ gross motor skill development and game addiction tendencies were both low, while the participating parents reported high levels of democratic and overprotective parenting attitudes, low levels of authoritarian ones, and moderate levels of permissive ones. Motor skills were not associated with children’s addiction tendency or parents’ democratic (also known as authoritative), authoritarian, or permissive styles. However, overprotective parenting was positively and significantly associated with gross motor skill scores. While no significant relationship was found between children’s digital game addiction tendencies and their parents’ adoption of a democratic parenting style, such tendencies were positively and statistically correlated with the authoritarian and permissive parenting styles. One dimension of such tendencies, constant gameplay, was also positively and significantly correlated with overprotective parenting. Conclusions: Although the participating children’s digital game addiction tendencies were low, the findings indicate that parents and carers should guide children to reduce their screen time and promote increased interaction with their surroundings and other people to mitigate screen time’s known negative effects on gross motor coordination. Full article

Few studies have explored the views of children and young people (CYP) with selective mutism (SM), and even less is understood regarding their experiences in relation to the support that they receive within school. Across three case studies, direct interviews with CYP with SM attending mainstream secondary school were conducted non-verbally, aiming to explore their current experiences of school and support. Subsequent interviews were conducted with the CYP’s key stakeholders, including parents/carers, school staff, and professionals with ongoing involvement. These interviews aimed to build on information shared by the CYP. Analysis highlighted the importance of individual experiences and support, relationships with peers and trusted adults, collaboration, communication across the setting, and importantly, a secure understanding of SM across the school setting. Clear implications for school professionals emerged. Future research should continue to work toward the exploration and development of knowledge and understanding of SM and gather the experiences of a wider range of CYP and families. Full article

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article

Cisheteronormativities inform and distort what LGBTQ+ young people’s bodies can be and do, and what choices about the body are possible, profoundly impacting mental health. This article presents findings from a UK study examining ‘what works’ in early intervention mental health support for LGBTQ+ youth to examine how these impacts can be addressed. Data were collected across 12 mental health support services via the following: interviews with LGBTQ+ youth aged 12–25, service staff/volunteers, and parents/carers (n = 93); document review; and non-participant observation. In analysis, ‘Body’ was identified as a key principle underpinning effective early intervention mental health support. This article presents three key areas: the ability to name and define the body; the body’s ability to ‘do’; and the ability to make informed decisions about one’s body, life, and future. This article highlights the urgent importance of upholding bodily autonomy for LGBTQ+ youth if efforts to address mental health inequalities are to have any chance at success. Full article

Background: Poor nutrition in childhood can have irreversible impacts on development and health, potentially resulting in cognitive impairments and an increased risk of chronic disease later in life. Aim: This study aimed to develop and validate the Parent Carer-Food Choice Questionnaire (PC-FCQ) to determine the key factors influencing the parental food choices of children aged between two and five years. Methods: A sample of 737 Australian parents and carers completed the questionnaire consisting of 98 items on a 10-point frequency of influence anchored at 1 never to 10 always. Principal component analysis (PCA) was employed to identify the key factors and refine the questionnaire. Results: The PCA extracted 65 items organized into 12 factors explaining 62.8% of the total variance. The factors were named ethical concerns, nutritional attributes, child preferences, child mood, awareness, parent sensory, convenience, situation, culture, professional advice, accessibility and weight control. The final Kaiser–Meyer–Olkin measure was 0.93, and the Bartlett test of sphericity was statistically significant X2(4753) = 39,643.87, p < 0.001. Moderate intercorrelations were detected between seven factors. Conclusions: This research resulted in a PC-FCQ that includes factors specifically relevant to parental food choice. The PC-FCQ will enable researchers and clinicians to more effectively provide nutrition education and dietary interventions to suit the parent and child. The next phase of this research will be to test the accuracy and reliability of the PC-FCQ in an independent sample via confirmatory factor analysis. Full article