Child development refers to the continuous but predictably sequential biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence. Developmental surveillance should be incorporated into every child visit. Parents play an important role in the child's developmental assessment. The primary care physician should educate and encourage parents to use the developmental checklist in the health booklet to monitor their child's development. Further evaluation is necessary when developmental delay is identified. This article aimed to highlight the normal child developmental assessment as well as to provide suggestions for screening tools and questions to be used within the primary care setting.
Adolescent ; Checklist ; Child ; Child Development ; Child, Preschool ; Developmental Disabilities ; diagnosis ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infant ; Infant, Newborn ; Male ; Parent-Child Relations ; Parents ; psychology ; Physicians, Primary Care ; psychology ; Primary Health Care ; Professional-Family Relations ; Singapore

Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or preventative action. The role of the family physician is to rule out sinister causes while providing counselling and reassurance for parents. The mainstay of management is parental support and reassurance while looking out for red flags in the baby such as fever, lethargy, distended abdomen and failure to thrive. This article provides a framework to approaching infantile colic and practical pointers to share with parents.
Caregivers ; Colic ; diagnosis ; therapy ; Crying ; Evidence-Based Medicine ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Muscle Hypertonia ; diagnosis ; Parenting ; Parents ; Pediatrics ; methods ; Physicians, Family ; Primary Health Care ; methods ; Professional-Patient Relations

PURPOSE: Nurses and physicians must be competent enough to provide care for the clients. As a lack of knowledge and a poor attitude result in a low performance of delivering care, this study aimed to explore the nurses versus physicians' knowledge, attitude, and performance on care for the family members of dying patients (FMDPs). METHODS: This descriptive study was conducted at the educational hospitals in Isfahan, Iran. The samples were 110 nurses and 110 physicians. The data were collected through a convenience sampling method and using a valid and reliable questionnaire. RESULTS: The average knowledge, attitude, and performance on care for the FMDPs were not significantly different between nurses and physicians (p>0.05). The majority of nurses (55.4%) and physician (63.6%) were at a moderate and a fair level of knowledge of care for the FMDPs. Most of the nurses (81%) and physicians (87.3%) had a positive attitude towards caring the FMDPs. Most of the nurses (70%) and physicians (86.3%) had a moderate and fair performance. CONCLUSION: Having enough knowledge and skills, and a positive attitude are necessary for caring the FMDPs. Nurses' and physicians' competencies must be improved through continuing educational programs and holding international and national conferences with a focus on the palliative care.
Adult ; *Attitude of Health Personnel ; *Attitude to Death ; Clinical Competence ; Empathy ; Family ; Female ; Humans ; Iran ; Male ; *Nurses ; *Palliative Care ; Personnel, Hospital ; *Physicians ; *Professional-Family Relations ; Surveys and Questionnaires ; *Terminal Care

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.
Diagnosis ; Early Detection of Cancer ; General Practitioners ; Humans ; Mass Screening* ; Patient Compliance ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care* ; Professional-Patient Relations

PURPOSE: In this study self-efficacy, emotional labor, pediatric nurse-parent partnership and job stress of pediatric nurses were examined. Factors affecting job stress of pediatric nurses were also investigated. METHODS: The study was done between June and September 2014, with a convenience sample of 145 nurses from 3 advanced general hospitals, 5 general hospitals and 2 children's hospitals. Research data were collected via questionnaires and analysed using SPSS version 18.0. RESULTS: Average levels of self-efficacy, emotional labor and job stress were similar to other general nurses and the average level of pediatric nurse-parent partnership was also similar to other pediatric nurses. Job stress of pediatric nurses showed a positive correlation with emotional labor and negative correlations with self-efficacy and pediatric nurse-parent partnership. The most significant factor affecting job stress in pediatric nurses was emotional labor (beta=0.372, p<.001). The combination of emotional labor, pediatric nurse-parent partnership and self-efficacy accounted for 25.4% of job stress in pediatric nurses. CONCLUSION: These results suggest that nursing management strategies to decrease emotional labor and improve pediatric nurse-parent partnerships and self-efficacy are critical to decrease job stress for pediatric nurses. Continued development of nursing management interventions to decrease job stress in pediatric nurses is suggested.
Child ; Hospitals, General ; Humans ; Nursing ; Parents ; Professional-Family Relations

Advance care planning (ACP) is a process of discussion of healthcare decisions with regard to a patient's future health and personal care, should they become unable to make or communicate their own decisions in the future. ACP can be as simple as a chat about the patient's end-of-life wishes with their trusted loved ones, and may involve their doctors, organisations and trained facilitators. The process can be documented with available online resources, such as structured tools. Family physicians, with whom patients share unique therapeutic relationships, are in the best position to introduce and start the ACP conversation with their patients.
Advance Care Planning ; Cultural Characteristics ; Decision Making ; Humans ; Living Wills ; Physicians, Family ; Professional-Patient Relations ; Singapore ; Terminal Care ; methods

Anticoagulation therapy is effective in preventing primary and secondary thromboembolic events due to atrial fibrillation. Warfarin, which was approved by the United States in 1954, was the only long-term oral anticoagulation therapy till the approval of dabigatran in 2010, and of rivaroxaban and other direct factor Xa inhibitors from 2011, forming a group known as novel oral anticoagulants (NOAC). NOAC have fewer food and drug interactions compared to warfarin; hence, the patient will require fewer clinic visits. However, the short half-life of NOAC means that twice-a-day dosing is needed and there is higher risk of a prothrombotic state when doses are missed. Other disadvantages are the lack of long-term data on NOAC, their high cost and the current lack of locally available antidotes.
Administration, Oral ; Anticoagulants ; administration & dosage ; Atrial Fibrillation ; drug therapy ; Cardiology ; methods ; Dabigatran ; administration & dosage ; Family ; Humans ; Professional-Patient Relations ; Rivaroxaban ; administration & dosage ; Stroke ; prevention & control ; Thromboembolism ; prevention & control ; Warfarin ; administration & dosage

PURPOSE: The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. METHODS: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. RESULTS: Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". CONCLUSION: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.
Adolescent ; Adult ; Child ; Child, Preschool ; *Decision Making ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Middle Aged ; Palliative Care/*psychology ; Parents/*psychology ; *Professional-Family Relations ; Qualitative Research ; Resuscitation Orders/*psychology ; Taiwan ; Young Adult

PURPOSE: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. METHODS: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. RESULTS: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis.treatment-related-words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression-words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician.husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband . people . mother . physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past . present . future'. CONCLUSION: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.
Family Relations ; Female ; Humans ; Male ; Neoplasms/diagnosis/*psychology/therapy ; Patient Acceptance of Health Care ; Professional-Patient Relations ; Program Development ; Self Care ; User-Computer Interface

PURPOSE: The purpose of this descriptive study was to determine the perception of physicians and nurses on family presence during invasive procedures. METHODS: The study population consisted of 100 physicians and 100 nurses from five hospitals which have more than 500 beds in B city. Data collection was done from August 20 to September 19, 2007. The Family Presence During Resuscitation (FPDR) Inventory developed by Fulbrook, Albarran and Latour (2005) was used as the study instrument. The collected data was analyzed by t-test, ANOVA and Duncan's multiple range test using SPSS/WIN 14.0 version. RESULTS: Nurses had more positive attitudes to allowing family members to be present during invasive procedures than physicians did. However, compared to physicians, nurses had more concern about problems of confidentiality, arguing with medical team, and increased rate of legal action if family members were present during invasive procedure. CONCLUSION: The results of this study indicate that educational programs and policy for family presence be required within the hospital to enhance the perception of physicians and nurses to the family presence.
Adult ; Attitude of Health Personnel ; Data Collection ; Data Interpretation, Statistical ; *Family ; Female ; Humans ; Male ; Nursing Staff/*psychology ; Organizational Policy ; *Perception ; Physicians/*psychology ; Professional-Family Relations ; Punctures ; *Resuscitation