Healthcare decision-makers’ perspectives on evaluating conflict management training in paediatric healthcare: a utilisation-focused qualitative study

This article outlines updates in social determinants of health (SDOH) screening practices in pediatric healthcare and community settings. The transition to value-based care and the COVID-19 pandemic have both had significant impacts on screening practices, with implications for providers, communities, and policymakers. The COVID-19 pandemic has exacerbated social needs for vulnerable patients and families, resulting in increased recognition by healthcare teams through screening. Policy frameworks like value-based care that aim to deliver whole-child care in the community are reorienting the logistics of screening, including screening in acute-care settings and community settings. Recent studies on family and provider perspectives should be integrated into screening practices. Despite significant advances in and expansion of SDOH screening in the pediatric healthcare setting, there remain limitations and future research needs. More data is needed to evaluate social need screeners and interventions, and determine how healthcare systems, communities, and states can spread and scale such interventions based on outcomes and value measurements. Population-based social indices have the potential to augment individual patient screening, but this remains a future research need.

Compassion in Pediatric Healthcare: A Scoping Review

The COrona VIrus Disease 2019 (COVID-19) pandemic is posing an unprecedented challenge to healthcare systems around the globe. Europe has been struggling for 1 year now, and despite some encouraging progress (above all, the beginning of vaccination), the second wave is ongoing. Even though children are less affected than adults, the COVID-19 pandemic—and in particular the measures to counter it—is having a considerable impact on the paediatric healthcare setting. It is, therefore, the duty of paediatric teams in Europe to prepare for the challenges ahead. We wish to contribute to this necessary preparedness in two ways: firstly, by assessing the direct and indirect impact of the pandemic on children and on the paediatric setting; secondly, and more importantly, by identifying the various responsibilities of paediatric healthcare professionals, in light of established ethical principles. Only abiding by these responsibilities will it be possible to ensure that ill children and their families are properly supported even in these difficult times and to grant that decisions about children’s healthcare remain morally justified and lawful. What is Known:• The COVID-19 outbreak is posing an unprecedented challenge to healthcare systems around the globe• Despite the children are less affected than adults, the COVID-19 pandemic is having a huge impact also on paediatric settingWhat is New:• The COVID-19 pandemic lays out specific responsibilities of paediatric professionals towards our pa-tients, society and ourselves• The paediatric teams in Europe should assess the direct and indirect impact of the pandemic on the chil-dren and on the paediatric settings, ensuring consistency between centres and across regions in Europe

Adverse childhood experiences screening in healthcare settings: A focus on pediatric primary care

ABSTRACTBackground: Care coordination (CC) is integral to improving health care quality. Research on CC by health care social workers (HSWs) in pediatric health care settings is limited. This paper aims to operationalize and quantify CC functions fulfilled by HSWs in one large urban pediatric hospital.Methods: Twenty-three discrete CC tasks across four categories of assessment, meetings, consultations, and facilitation were identified and operationalized by an HSW CC committee through a consensus-driven decision-making process. Over three workdays, 22 HSWs from 18 unique health care clinic settings recorded total time spent daily on each CC activity.Results: Participants spent an average of 78.3% of a typical workday on CC activities. Regardless of setting, participants completed tasks across all general activity categories of assessment, meetings, consults, and facilitation. The most time-consuming CC tasks included biopsychosocial assessment, medical team consultations, multidisciplinary care plan facilitation, and family meetings. Tasks related to child protection were among the least frequently completed.Conclusion: CC is a cornerstone of HSW service provision in pediatric health care settings. HSWs can be vital collaborators in developing innovative transdisciplinary CC models.

Procedural-Support Music Therapy in the Healthcare Setting: A Cost–Effectiveness Analysis

Parental depression affects as many as 1 in 5 US families. Pediatric professionals can play an important role in detecting parental depression, yet most studies on parental depression screening focus only on the postpartum period. The authors performed this scoping review to understand the existing literature on parental depression screening outside the postpartum period (child >12 months old) and to identify knowledge gaps. Sources for this research include PubMed, CINAHL, SCOPUS, Web of Science, and APA Psych Info. We included English language papers concerning screening for maternal and/or paternal depression or mood disorders outside of the postpartum period by pediatric clinicians or in a pediatric health care setting. Extracted variables included publication year, title, author(s), country, geographic setting, clinical setting, child age range (in years), parental focus, sample size, study type, approach, screening instrument(s), and findings. Forty-one papers were included. The proportion of positive parental depression screens was consistently high across the included studies. Relatively few structured screening programs outside of the postpartum period were identified, especially for fathers. The included studies suggest that screening can be accomplished in pediatric settings, but appropriate referral and follow-up of positive screens poses a major challenge. This review was limited to English language papers concerning parental depression outside of the postpartum period. These findings suggest that screening for parental depressive symptoms outside the postpartum period could identify families in need of support. Research is required to identify best practices for referral and follow-up of parents who screen positive.

This case series study evaluated the feasibility and acceptability of a behavioral/cognitive psychological intervention in a pediatric primary health care setting during standard well-baby visits. The aim of the intervention was to support caregivers’ sensitivity and mentalization in order to promote infant mental health (IMH). Four neonates from birth to 8 months were consecutively enrolled to test a short video-feedback intervention (Primary Care – Video Intervention Therapy, an adaptation of George Downing’s Video Intervention Therapy to primary care) conducted by a pediatrician. The 5 min interaction recording and the video-feedback session were performed during the same well-baby visit and in the same pediatrician’s office where the physical examination was conducted. During the study period, six video-feedback sessions were performed for each baby at different ages (1, 2, 3, 4, 6, 8 months). A series of different interactional situations were filmed and discussed: touch, cry, affective matching, descriptive language, feeding, separation and autonomy. The intervention was easily accepted and much appreciated by all four families enrolled. This study aimed to answer a dilemma which pediatric providers generally face: if the provider wishes to respond not only to physical but also IMH issues, how on a practical level can this be done? This case series study indicates that Primary Care – Video Intervention Therapy can be a promising new tool for such a purpose.

PPediatric patient safety is a public health concern. Implementing unsafe practices, taking unnecessary risks, and making nursing practice errors can contribute to pediatric patient injury, disability, poor prognosis, or even death. Our study aimed to investigate the effect of implementing a safety program to improve nurses' performance in pediatric health care settings. Our study had a quasi-experimental design and was conducted at the National Cancer Institute, Cairo University, Cairo, Egypt. Our sample population included a convenience sample of 36 pediatric nurses and 36 pediatric patients. We used three tools to collect data. The first tool was a structured interview questionnaire we administered before and after implementing a safety program for pediatric nurses at the health care setting. The second tool was an observational checklist to assess the nurses' practices related to pediatric patient safety. The third tool was an assessment sheet to determine the effectiveness of the safety program. We found there was a statistically significant correlation between the knowledge and practice competency of the nurses before and after implementing the safety program (r = 0.76, p < .000). We also found that after implementing the safety program, the length of the patients' hospital stay, number of unscheduled hospitalizations, need for additional medications, and number of complications decreased among the pediatric patient participants. We recommend implementing similar safety education and training programs for nurses in other facilities to update their knowledge and improve their practices related to pediatric patient safety.

The following text is the de-identified and edited transcript of an invited presentation by Professor Clare Delany on the topic of 'How clinical ethics discussions can be a model for accommodating and incorporating plural values in paediatric and adult healthcare settings.' Professor Delany's presentation formed part of the Conference on Accommodating Plural Values in Healthcare and Healthcare Policy, which was held in Melbourne, Australia, on Monday, October 30, 2023. This conference was a key output of the Australian Research Council Discovery Project grant DP190101597, 'Religion, pluralism, and healthcare practice: A philosophical assessment'. Professor Delany's presentation was introduced by Doctor Lauren Notini, Research Fellow and Lecturer at Monash Bioethics Centre, Monash University.

Soccer is one of the most participated in sports in the world, and referees ensure the laws are abided by. Growing attention has been given to researching the psychological aspects of refereeing because of the awareness of how refereeing performance is impacted. This scoping review aimed to map the extent of peer-reviewed and grey literature that identifies conflicts and conflict management training for soccer referees. This scoping review identified various events, perceived conflicts, and outcomes of conflicts experienced by soccer referees. No outright conflict management interventions were identified. This scoping review is the first to investigate soccer refereeing conflict management and illustrates the need to understand potential links between events surrounding a game, the conflicts and outcomes. It also highlights the need to understand what conflicts underrepresented demographics face, what conflict management approaches are used, the impact different approaches have on the game, and maps out a research agenda.

ObjectiveThe purpose of this review is to examine recent research on contextual and behavioral factors that will lead to better understanding of adolescent food insecurity and health outcomes.DesignA literature search for peer‐reviewed, English language, research articles published between 2009 and 2019, using CINAHL, Embase®, Pubmed, and the Cochrane Library.SampleThe final sample represents thirty studies on food insecurity with a sample including adolescents, and that employ a measure of food insecurity.ResultsVariables of interest and results on topics such as weight‐related factors, maternal parenting and behaviors, mental health, and adolescent‐level behavioral factors are summarized.ConclusionFood insecurity is associated with poor adolescent health and mental health. All adolescents should be screened for food insecurity, involving pediatric and mental health care settings. Future research on adolescent food insecurity should explore parent and parenting factors, household composition and family dynamics, psychological factors, health behaviors, and stress; peer influences might also be an important area of research with adolescents. While previous research has relied on parents’ reports, adolescents'experiences are unique, and they are willing and reliable research participants; they should be included in future food insecurity research.

Breastfeeding is often compromised when clinical nutrition interventions are implemented for complex paediatric patients, in a healthcare environment where breastfeeding supports are currently under-resourced. This systematic review aimed to investigate how breastfeeding can be supported when it is disrupted for clinical nutrition interventions in the paediatric healthcare setting. The experience of mothers who breastfeed their child requiring nutrition support and/or therapeutic dietary measures is also explored. A search was conducted across five databases; Ovid-Medline, Ovid-Embase, CINAHL Complete, Scopus and Cochrane Library. Eligible papers included breastfeeding dyads where the infant/child required a nutrition intervention in the global paediatric healthcare setting, limited to those published in the English language and year 2000 onwards. Manuscripts that focused on preterm infants, maternity or neonatal care settings, healthcare professionals, or a maternal clinical condition impacting breastfeeding were excluded. Results were synthesised into key measures to support breastfeeding and overarching themes illustrating a mother's experience breastfeeding her child with complex nutritional needs. From 13,177 manuscripts screened, a total of 36 manuscripts were included. Clinical conditions in the manuscripts identified included congenital heart disease, congenital anomalies, inborn errors of metabolism, acute and chronic respiratory conditions, trisomy 21, faltering growth and hyperbilirubinaemia. Measures to support breastfeeding (n = 19 primary research studies and n = 5 case studies) encompassed environmental modifications and improvements to hospital procedures; access to lactation support professionals and education; and clinical practices that facilitated breastfeeding. Key themes across papers exploring maternal experience (n = 12 manuscripts) were difficulties breastfeeding a child with complex nutritional needs; a desire to breastfeed that informed maternal identity and emotions; and a supportive healthcare team that promoted breastfeeding. This review highlights environmental and practical strategies that can optimise breastfeeding for paediatric patients receiving clinical nutrition interventions and support maternal feeding intentions. Many strategies to support breastfeeding are geared towards supporting lactation physiology to increase maternal milk supply. More research is needed to explore what psychological and emotional supports mothers need from the healthcare team when encountering breastfeeding difficulties and unmet expectations feeding a nutritionally complex child.

Optimizing Care for Autistic Patients in Health Care Settings: A Scoping Review and Call to Action

Introduction: Patient-reported Experience Measures (PREMs) are validated questionnaires, that gather patients' and families' views of their experience receiving care and are commonly used to measure the quality of care, with the goal to make care more patient and family-centered. PREMs are increasingly being adopted in pediatric population, however knowledge gaps exist around understanding the use of PREMs in pediatrics.Objective: To identify and synthesize evidence on the use of PREMs in pediatric healthcare settings and their characteristics.Evidence Review: Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines governed the conduct and reporting of this review. An exhaustive search strategy was applied to MEDLINE, EMBASE, PsycINFO, Cochrane Library, and CINAHL databases to identify relevant peer-reviewed articles from high-income countries. Additionally, gray literature was searched to capture real-world implementation of PREMs. All the articles were screened independently by two reviewers in two steps. Data was extracted independently, synthesized, and tabulated. Findings from gray literature was synthesized and reported separately. Risk of bias for the studies identified through scientific databases was assessed independently by two reviewers using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.Results: The initial search identified 15,457 articles. After removing duplicates, the title and abstracts of 11,543 articles were screened. Seven hundred ten articles were eligible for full-text review. Finally, 83 articles met the criteria and were included in the analyses.Of the 83 includes studies conducted in 14 countries, 48 were conducted in USA, 25 in European countries and 10 in other countries. These 83 studies reported on the use of 39 different PREMs in pediatric healthcare settings. The gray literature retrieved 10 additional PREMs. The number of items in these PREMs ranged from 7 to 89. Twenty-three PREMs were designed to be completed by proxy, 10 by either pediatric patients or family caregivers, and 6 by pediatric patients themselves.Conclusion and Relevance: This comprehensive review is the first to systematically search evidence around the use of PREMs in pediatrics. The findings of this review can guide health administrators and researchers to use appropriate PREMs to implement patient and family-centered care in pediatrics.