Compared the effects of two methods of preparing children for cardiac surgery. Forty-eight child-caregiver dyads were assigned to a treatment group, receiving information and coping skills training, or a control group, receiving information as routinely provided. Treatment group children were more cooperative and less upset in the hospital; better adjusted at home after discharge; higher functioning in school; and their functional health status improved faster. Treatment group caregivers expressed greater confidence in their ability to care for their children in hospital and at home after discharge. Results are discussed in terms of the cognitive appraisal model of stress coping using a multidimensional assessment of treatment effects.
A program to prepare school age patients for cardiac catheterization is described and evaluated. Children and their parents were provided with a combination of interventions including information, supportive counseling, and stress management training. A team approach was used to reduce anxiety and upset and to increase cooperation of pediatric patients in the hospital and following discharge.
Abstract:The physical and psychological development of 48 children (ages 4 to 12) with congenital heart disease who had average intelligence were examined to evaluate their educational performance. Categorization by diagnosis and surgical procedure placed 25 children in Group 1 with acyanotic, correctible cardiac defects and 23 in Group 2 with cyanotic, palliative defects. We found that the children were at risk for learning problems regardless of the severity of the cardiac defect; however, risk factors increased with the severity of the defect. Gross and fine motor and visual motor integration skills were comparable to the norm group for Group 1, but Group 2 exhibited motor delays. When compared by their teachers to their typical peers at school, overall functioning for Group 1 was within the average range, but Group 2 was below average. However, teachers also stated that both groups were more likely than average to have identified learning disabilities and problems with socialization. For the pediatrician, as well as the educator, there needs to be recognition that children with congenital heart disease can have significant school problems even when the operation is successful.
CATHETERIZATION. Lois Campbel I , Stanley E. K i r k p a t r i c k The purpose of t h e study was t o determine i f mottr e r s can learn t o reduce t h e i r a n x i e t y and f u n c t i o n a s therapeutic a l l i e s in t h e h o s p i t a l t o reduce t h e s t r e s s experienced by t h e i r preschool c h i l d r e n undergoing c a r d i a c c a t h e t e r i z a t i o n . I t was designed t o compare, s i n g l y and in combination t h r e e models of p a t i e n t p r e p a r a t i o n : 1 ) d i r e c t e d a t t e n t i o n and'information about h o s p i t a l i z a t i o n and c a t h e t e r i z a t i o n , 2) s u p p o r t i v e counseling, and3) s t r e s s management t r a i n i n g . F i f t y mothers and t h e i r children were randomly assigned t o 1 of 5 experimental groups. Group E served a s t h e c o n t r o l group and received t h e c u r r e n t r o u t i n e p r e p a r a t i o n f o r c a t h e t e r i z a t i o n . Group D received t h e informat i o n model only. Group C received both t h e information and couns e l i n g models. Group B received both t h e information and s t r e s s management models. Group A received a l l t h r e e models. Assessment of treatment e f f e c t s f o r both mothers and c h i l d r e n included s e l f -r e p o r t measures completed by t h e mothers, behavioral observ a t i o n s recorded a t key s t r e s s p o i n t s by b l i n d r a t e r s and physiol o g i c responses recorded by a computerized biofeedback system. R e s u l t s i n d i c a t e d s i g n i f i c a n t treatment e f f e c t s f o r a l l intervent i o n models. The s t r e s s management model had :he g r e a t e s t e f f e c t a s measured by p o s i t i v e changes in t h e mothers s e l f -r e p o r t e d a n x i e t y s c o r e s , electromyographic readings and electrodermal responses. Both c h i l d r e n and t h e i r mothers who received t h e s t r e s s management model demonstrated more a d a p t i v e behavior in t h e h o s p i t a l and a f t e r d i s c h a r g e than those who d i d n o t . The study would suggest t h a t although information and counseling reduce s t r e s s and a n x i e t y r e l a t e d t o h o s p i t a l i z a t i o n , s t r e s s management t r a i n i n g can provide a d d i t i o n a l b e n e f i t s . In recent efforts directed t o t h e analysis of sensory processing in t h e newborn, neonates and adults were exposed to various reflex modification procedures. Previous work with adults had indicated that when a tone precedes a reflex eliciting stimulus by an appropriate interval the amplitude of t h e reflex is inhibited. If t h e tone is presented simultaneously with t h e reflex-eliciting event, response t o amplitude is augmented. The eye-blink eliciting device consisted of a miniature solenoid with a teflon striker which could deliver a controlled tap; a miniature photo reflective densiometer attached t o a TDH 39 earphone assessed the e y e blinks.For each experiment, 15 healthy term appropriate-for-gestational-age infants wer...
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