Coping with what, when, where, how--and so what? 1994.
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Adaptation, Psychological↗
Biomedical subjects
J A Ritchie
Publications and source records attributed to J A Ritchie.
Tag team parenting of children with cancer.
During their child's treatment period for cancer, parents have identified many needs they experienced (Mercer & Ritchie, 1997). This article describes findings from a subset of those parents who were interviewed in order to determine what resources they believed were necessary to meet their needs. The parents (n = 20), representing families who lived in close proximity to the major children's tertiary hospital as well as families who were distanced from the major center, described resources that included informational, emotional, and instrumental support. Although most parents indicated that information was readily available to them, many parents described a lack of instrumental support, such as respite care or financial assistance. When resources were inadequate, it was often because informal support from family and friends was unavailable. Single parents and parents of children with solid tumors indicated that they had fewer resources. The findings demonstrate the experience of parents during their children's treatment period and indicate the need for identifying family supports early in the treatment period.
Attitude to Health↗
Home community cancer care: parents' perspectives.
This article reports on the results of a survey on the needs of parents of children with cancer and explores the needs of the parents, the parents' perceived importance of the needs, and whether the needs have been met. The study was designed to identify any differences in needs between parents whose children received all of their care at the major tertiary center (n = 16) and parents whose children received at least some of their care in their local community (n = 40). There were no significant differences between the two groups. Parents reported that their important needs for information were met, but other needs (financial assistance, time, and rest) were unmet. Findings indicate that health care providers who care for families of children with cancer need to perform careful individual assessments throughout the treatment period.
Adolescent↗
Social support in children with a chronic condition.
This study used a descriptive exploratory design to describe social support in children with a chronic condition and how children use social support in coping with everyday demands and demands related to their condition. Participants comprised 62 school-aged children (16 with diabetes, 16 with cystic fibrosis, 15 with spina bifida, and 15 with no chronic illness). Data were collected about their social-support networks, the support functions provided by the networks, and their satisfaction with support. The children also described the social support they received and their use of social support as a coping strategy in specific stressful situations. The healthy children had the largest support networks overall and the largest peer networks. Children with spina bifida had the smallest networks overall and the smallest number of peers in their networks. Healthy children reported more support overall than the children in the illness groups. Both the healthy children and the children with a chronic condition described academic issues as the main source of everyday stress. Children with a chronic condition identified restriction due to illness as the key illness-related stressor. Children with a chronic condition reported more stress and more support-seeking in everyday stressful situations than in illness situations. The results will guide the design of a future social-support intervention for children with a chronic condition.
Adaptation, Psychological↗
Sterol composition of Cryptococcus neoformans in the presence and absence of fluconazole.
Analysis of the sterol compositions of 13 clinical isolates of the pathogenic yeast Cryptococcus neoformans obtained from five patients with recurring cryptococcal meningitis showed that, unlike Candida albicans, the major sterols synthesized by this yeast were obtusifoliol (range, 21.1 to 68.2%) and ergosterol (range, 0.0 to 46.5%). There was considerable variation in the sterol contents among the 13 isolates, with total sterol contents ranging from 0.31 to 5.9% of dry weight. The isolates from the five patients who had relapses had different total sterol contents and compositions in comparison with those of the pretreatment isolates, indicating either that the sterols had been changed by therapy or that the patients were infected with new isolates with different sterol compositions. Growth of the cryptococcal isolates in the presence of subinhibitory concentrations of fluconazole (0.25x the MIC) significantly altered the sterol content and pattern. The total sterol content decreased in nine isolates and increased in four isolates in response to pretreatment with fluconazole. Fluconazole had no consistent effect on ergosterol levels. In contrast, fluconazole caused a decrease in obtusifoliol levels and an increase in 4,14-dimethylzymosterol levels in all isolates. These results indicate extensive diversity in sterol content, sterol composition, and sterol synthesis in response to subinhibitory concentrations of fluconazole in C. neoformans strains. We propose that fluconazole inhibits the sterol synthesis of C. neoformans by interfering with both 14 alpha-demethylase-dependent and -independent pathways. No correlation between the sterol compositions of C. neoformans isolates and their susceptibilities to fluconazole was found.
Cholestadienols↗
Mothers of children with chronic conditions: supportive and stressful interactions with partners and professionals regarding caregiving burdens.
Ninety mothers appraised the specific sources and types of social support they received in relation to specific types of demands of caring for a child with a chronic condition. Qualitative data were collected during home interviews with the mothers of children with diabetes, spina bifida, or cystic fibrosis. Virtually all of the mothers described primary caregiver demands that were directly related to the child's condition, such as physical care, health care in illness situations, and the child's psychological and social development. Many mothers also reported secondary demands related to their own needs, family roles and relationships, and the mother's activities outside the home. Mothers experienced gaps in the support provided for specific caregiving burdens and encountered stressful interactions with their partners and health professionals in particular.
Adolescent↗
Asthma: a new look at helium therapy.
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Administration, Inhalation↗
Caring for chronically ill children at home: factors that influence parents' coping.
This study examined 29 parents' perceptions of the stressfulness of copying with their chronically ill child's home care. The parents were primarily responsible for care regimes that represented a continuous range of caregiving burden. Data were obtained using the Clinician's Overall Burden Index (COBI) (Stein & Jessop, 1982), the Coping Health Inventory for Parents (CHIP) (McCubbin & Patterson, 1981), visual analogue scales, and home interviews with parents. Parents described many dimensions of caregiving burden. Increased caregiving burden was associated with greater stressfulness and the use of fewer helpful coping strategies. Three clusters of coping strategies were most helpful: (a) using family support, (b) maintaining a positive outlook, and (c) ensuring that care was performed. The need for a reconceptualization of caregiving burden is discussed.
Adaptation, Psychological↗
School-aged children's interpretation of their experience with acute surgical pain.
This study examined the intensity of pain children experience following surgical procedures, the relationship between analgesic administration patterns and perceived level of pain, and children's affective, cognitive, and sensory interpretation of their experiences with pain. The sample included 24 children between 7 and 11 years of age who were hospitalized after abdominal, orthopedic, or urologic surgery. Children rated the intensity of their pain on a visual analog scale three times on the day after surgery. A chart review examined analgesic administration. On the third day after surgery, children were interviewed about their experiences with pain. The findings provide insight into the content of children's fears and concerns when they have postoperative pain, and how they interpret their responses and the responses of others in the management of their pain experience.
Adaptation, Psychological↗
Nurses' perceptions of parent and nurse roles in caring for hospitalized children.
Twenty-five nurses were interviewed and asked to describe their perceptions of parent and nurse roles in caring for hospitalized children. Data were analyzed using content analysis. Six types of roles were identified: providing nonmedical care; providing technical and medical care; being a gatekeeper; being an advocate; providing psychosocial care; and providing general care. It seemed that often the nurses' need for control influenced the psychoemotional care they provided for parents.
Attitude of Health Personnel↗
Control of gingivitis and calculus by a dentifrice containing a zinc salt and triclosan.
The effect of unsupervised brushing with a dentifrice containing two antiplaque agents, 0.5% zinc citrate and 0.2% triclosan, on gingival health, plaque, supragingival calculus, and the oral flora was compared to brushing with a non-active control dentifrice. Volunteers were given oral hygiene instruction and their teeth were professionally cleaned. They then used a placebo dentifrice for a pre-experimental phase of 1 month, before being stratified into two groups on the basis of their initial plaque, gingival bleeding, and calculus levels, sex, and age. Over the following 6 months, one group used the control while the other used the test dentifrice. Plaque levels, gingival bleeding, and calculus were assessed at baseline and at 3 and 6 months. Supragingival plaque was sampled for microbiological analysis at the initial examination, at 3 and 6 months (conclusion of study period) and 3 months after the study. Representative oral bacteria and the development of bacterial resistance to triclosan were monitored. Results showed that plaque was reduced and gingival health significantly improved during the 1-month pre-experimental period. During the experimental period, this improvement was not maintained by the control group as gingival bleeding and calculus increased. In contrast, gingival bleeding and calculus levels of the test group were maintained significantly below those of the placebo group. Plaque levels were lower in the test group after 3 and 6 months, but the groups were not significantly (P = 0.05) different. No shifts in oral flora or development of bacterial resistance to triclosan were detected.
Adolescent↗
Microbiological and clinical effects of a dentifrice containing zinc citrate and Triclosan in the human experimental gingivitis model.
A partial mouth experimental gingivitis model was employed to establish the effect of a dentifrice containing 0.2% Triclosan and 0.5% zinc citrate on the development of chronic gingivitis. In addition, changes in the plaque flora associated with the developing gingivitis have been monitored. Following a period of stringent oral hygiene, volunteers were allocated to 1 of 2 treatment groups. A toothshield was constructed to fit 4 posterior mandibular teeth. During the 21-day experimental period test or placebo dentifrice was applied to the experimental teeth via the tooth shield. The toothshield also prevented plaque removal from those teeth during habitual brushing of the remaining dentition. Supragingival plaque was collected at baseline and day 21 for analysis of the total bacterial flora. At the end of the experimental period, plaque and gingivitis had developed in both groups. However, the test group had significantly less plaque and gingivitis than the placebo group. The microbiological data demonstrated that plaque from the test group contained significantly lower numbers of anaerobes compared to plaque from the placebo group. This was considered particularly significant as these bacteria are generally associated with chronic inflammatory periodontal disease. There was also a trend for the numbers of actinomyces to decrease in plaque from the test group but not in the placebo group.
Actinomyces↗
Helping hospitalized preschoolers manage stressful situations: the mother's role.
This study examined mothers' perceptions of the most stressful situation their children experienced during hospitalization and how they and the children responded in these situations. The mothers described four types of situations; the most prevalent were intrusive procedures and separation events. The most frequent coping behaviors they described were seeking others, eliciting help, controlling, and self protection behaviors. The predominant strategies the mothers used to help their children were Providing Comfort and Providing Information. The mothers' emotional responses to their children's behaviors included both pleasant and unpleasant affective states. Implications for practice and research are addressed.
Child, Hospitalized↗
Nurses' perceptions of their relationships with parents.
Twenty-five children's nurses were interviewed and asked to select and describe two relationships, one satisfying and one dissatisfying, that they had had with parents of hospitalized children. The data were analyzed using interpretive strategies, and five types of parent-nurse relationships were identified: negotiated, reciprocal, adversarial, asynchronous, and ineffective. It seemed that the nurses' relationships with parents were social rather than professional, and that the nurses had difficulty caring for certain parents. The nurses' descriptions indicated that they either did not have knowledge of communication skills, conflict management and family-centered care to provide therapeutic, goal-oriented care for parents, or had difficulty utilizing that knowledge in practice. Various factors in the environment may have contributed to these difficulties. This descriptive study was conducted to provide some understanding of the interpersonal difficulties that often exist in relationships between nurses and the parents of hospitalized children.
Adult↗
Mothers' perceptions of coping behaviors in hospitalized preschool children.
This study determined mothers' perceptions of coping in their hospitalized preschool children. Thirty-two mothers were interviewed using open-ended questions to determine their views of coping, what behaviors they described their children using in difficult situations, and what they did to help their children cope. They indicated which of the 40 items on the Children's Coping Strategies Checklist (CCSC) they considered to be coping behaviors. The answers to the open-ended questions were content analyzed. Twenty-two mothers described coping as an outcome--that is, as the degree of adaptational success. Seventy-five percent or more of the mothers identified 22 of the CCSC behaviors as coping; 15 of these behaviors were from the subscales of Information Seeking, Seeking Comfort/Help, and Growth/Independence. Eight items were viewed by fewer than half of the mothers as coping, and included regression, denial, withdrawal, and control by preventing events. The mothers described the strategies they used to help their children manage difficult situations; the predominant strategies were providing information and comfort. The implications of the findings are discussed.
Adaptation, Psychological↗
Nurses' perceptions of coping behaviors in hospitalized preschool children.
This study examined nurses' perceptions of coping in hospitalized preschool children. Thirty nurses were interviewed using a structured questionnaire and open-ended questions. Analysis included content analysis of the nurses' definitions of coping, strategies used to help children during stressful procedures, and classification of nurses' emotional responses to specific coping behaviors. The majority of nurses defined coping as an outcome, fewer than one third as a process, and none as a trait. Over 80% saw 21 of 40 coping behaviors as coping. Most of these included information-seeking, direct action, seeking help, and movement toward growth or independence. Behaviors that 80% or more of the nurses saw as coping elicited pleasant emotional responses; those that fewer than 50% saw as coping elicited unpleasant responses. Overall, the nurses described 10 types of strategies to help children cope. Only six nurses described more than five types. The clinical implications of these findings are discussed.
Adaptation, Psychological↗
Long-term exposure of plaque to zinc citrate.
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Adolescent↗