Caregivers' knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital.

Background: The use of complementary and alternative medicine (CAM) therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period.

Behavioral and nutritional treatment for preschool-aged children with cystic fibrosis: a randomized clinical trial.

Importance: Evidence-based treatments that achieve optimal energy intake and improve growth in preschool-aged children with cystic fibrosis (CF) are a critical need.

Objective: To test whether behavioral and nutritional treatment (intervention) was superior to an education and attention control treatment in increasing energy intake, weight z (WAZ) score, and height z (HAZ) score.

Design, Setting, And Participants: This randomized clinical trial included 78 children aged 2 to 6 years (mean age, 3.

Predictors of health-related quality of life over time among adolescents and young adults with sickle cell disease.

Little is known about what factors affect the health-related quality of life (HRQoL) of adolescents and young adults (AYAs) with sickle cell disease (SCD), and how their HRQoL changes over time. This retrospective study included 87 AYAs attending a SCD Adolescent Clinic who completed a measure of HRQoL at each visit over the course of approximately 1.3 years.

Stigma and optimism in adolescents and young adults with cystic fibrosis.

Background: Despite increased life expectancy among patients with cystic fibrosis (CF), few studies have examined coping among adolescents and young adults with CF. Previous research suggests that stigma associated with chronic disease is related to worse physical and psychological health, but optimism may be protective. This study examined stigma and optimism among patients with CF.

Perceived barriers to clinic appointments for adolescents with sickle cell disease.

Purpose: The purpose of this study was to examine perceived barriers to clinic attendance and strategies to overcome these barriers for adolescents with sickle cell disease.

Materials And Methods: This was a 2-phased study, which used focus groups (n=13) and individual semistructured interviews (n=32) with adolescent patients (aged 13 to 21 y) from 3 pediatric sickle cell clinics in the Midwest.

Results: Adolescents identified competing activities, health status, patient-provider relationships, adverse clinic experiences, and forgetting as barriers to clinic attendance.

A randomized controlled trial of massage therapy in children with sickle cell disease.

Objective: This randomized controlled trial investigated the short-term effects of massage therapy on youth with SCD and their parents.

Methods: Thirty-four children and adolescents, and their parents were assigned to a massage therapy or an attention control group. Parents were trained in massage in their homes once a week for 4 weeks, with instructions to provide nightly massages.

Evidence-based assessment of pediatric pain.

Objective: To conduct an evidence-based review of pediatric pain measures.

Methods: Seventeen measures were examined, spanning pain intensity self-report, questionnaires and diaries, and behavioral observations. Measures were classified as "Well-established," "Approaching well-established," or "Promising" according to established criteria.

Evidence-based assessment of adherence to medical treatments in pediatric psychology.

Objectives: Adherence to medical regimens for children and adolescents with chronic conditions is generally below 50% and is considered the single, greatest cause of treatment failure. As the prevalence of chronic illnesses in pediatric populations increases and awareness of the negative consequences of poor adherence become clearer, the need for reliable and valid measures of adherence has grown.

Methods: This review evaluated empirical evidence for 18 measures utilizing three assessment methods: (a) self-report or structured interviews, (b) daily diary methods, and (c) electronic monitors.

Parent perspectives on pain management, coping, and family functioning in pediatric sickle cell disease.

Pediatric sickle cell disease is a chronic illness for which recurrent pain is a ubiquitous experience. This study used quantitative and qualitative methods to examine relationships between patient and family coping and health care utilization in children with sickle cell disease and to assess parents' recommendations for ensuring patient and family-centered care. Participants were 53 parents of children aged 7 to 13 with sickle cell disease across three large urban children's hospitals.

Functional outcome at adolescence for infants less than 801 g birth weight: perceptions of children and parents.

Objective: To compare functional, emotional, and academic status of adolescents who had been extremely low birth weight (ELBW) with those who were full term.

Study Design: Twenty-six adolescents who were born in 1983 to 1984 at less than 801 g birth weight were compared with 26 adolescents born at term. Adolescent-perceived status was assessed using the Behavior Assessment System for Children (BASC-SR) and the Self-Perception Profile.

Dysfunctional eating patterns and symptoms of pica in children and adolescents with sickle cell disease.

The objective of this study was to examine the incidence and relationship of pica symptoms and dysfunctional eating patterns in children and adolescents with sickle cell disease (SCD). Children and caregivers (n = 146) completed questionnaires assessing eating difficulties and symptoms of pica. Information also was collected from medical records and analyzed for relationships with dysfunctional eating patterns.

Steps toward a clinically relevant science of interventions in pediatric settings: introduction to the special issue.

Objective: To describe methods and strategies to advance the science of interventions in pediatric psychology.

Methods: We consider the advantages of various strategies to develop and extend the applications of intervention research in pediatric practice settings.

Results: Strategies are needed to enhance application of empirically supported interventions to pediatric settings, including testing the generalizability of empirically supported interventions in clinical samples, developing interventions based on clinical experience and tested in controlled clinical trials, designing program evaluations in the context of practice settings, and conducting case studies and series.

Empirically supported treatments in pediatric psychology: regimen adherence.

Objective: To review empirical studies of psychological interventions for nonadherence to medical regimens for three chronic illnesses: asthma, juvenile rheumatoid arthritis (JRA), and type 1 diabetes.

Methods: The Chambless criteria for "promising," "probably efficacious," or "well-established" were applied to 8 intervention studies on asthma, 4 on JRA, and 11 on type 1 diabetes.

Results: For asthma, organizational strategies appear probably efficacious in promoting adherence, whereas educational and behavioral strategies appear promising.

Too little, too late: primary vs. secondary interventions for adolescents with sickle cell disease.

The cognitive, biological, and psychological characteristics of adolescents affect their adaptation to a chronic medical condition. This article reviews the literature on how sickle cell disease alters the normal developmental challenges facing adolescents. Examples of these challenges include delayed maturation, neurologic complications, sequelae of pain episodes, and prolonged financial and family dependence.

Pain and fear ratings: clinical implications of age and gender differences.

The study investigated the relationships among children's self-report of anticipatory pain and fear, physiological measures of distress, and previous medical experience in 62 outpatients during allergy skin testing. Younger (aged 3-7 years) and older (aged 8-12 years) children reported similar amounts of pain and fear. Girls reported more pain than boys.

Environmental factors influencing weaning of a young child from mechanical ventilator support.

We examined the contribution of physiologic and environmental variables to the process of weaning a child with chronic respiratory failure from mechanical ventilation support. Surveillance measures, e.g.

Improving adherence to medication regimens for children with asthma and its effect on clinical outcome.

We examined the effects of a combined education and token system intervention to improve adherence to inhaled corticosteroids for an 8-year-old girl and a 10-year-old boy with asthma. Adherence was measured by an electronic chronolog monitor, and disease outcome was assessed by repeated pulmonary function testing. A withdrawal design demonstrated improved adherence and, for 1 child, an associated improvement in pulmonary function occurred.

Assessment as a process in pediatric psychology.

In this editorial, we have highlighted several key aspects of the assessment process. First, we consider it critical that pediatric psychologists view "assessment as a process," and not as a test or measure. Assessment begins with the formulation of a precise, answerable question--and this maxim is equally important for researchers and clinicians.

Case reports in pediatric psychology: uses and guidelines for authors and reviewers.

Described uses of case reports in pediatric psychology and guidelines for authors and reviewers. Case reports have several important functions: to document the efficacy of new treatment applications, describe interesting new clinical phenomena, to develop hypotheses, to illustrate methodological issues, difficult diagnostic issues, or novel treatment approaches, and to identify unmet clinical and research needs. Authors should carefully document the scientific purpose and clarify the new information contributed by their reports, provide evidence for their conclusions, and articulate clinical, theoretical, and/or research implications.

A multiperspective investigation of social competence in children with sickle cell disease.

Compared the social competence and self-perceptions of 4- to 8-year-old children with sickle cell disease (SCD) to a comparison group of healthy children. Social competence ratings were obtained from multiple perspectives, including parents, teachers, and clinic staff members; children provided ratings of self-perceived acceptance and competence. Children in the SCD group were rated as socially competent as their peers in the comparison group and the normative group.