Paediatrics: developing family information leaflets

Managing anxiety in ICU patients: the role of pre-operative information provision

Hospital-induced patient anxiety and coping mechanisms are discussed. The value of giving pre-operative information to reduce anxiety in elective admissions to intensive care unit is discussed. Recommendations are given based on the literature evidence to aid service and practice development.

Mothers' coping in chronic childhood illness: the effect of presymptomatic diagnosis of vesicoureteric reflux

AIMS OF THE STUDY WERE TO: Assess coping strategies of mothers who have a child with vesicoureteric reflex (VUR), determine mothers' understanding of VUR before and after diagnosis, assess mothers' perceived needs for support when coping with their child's VUR and compare the above aims between two groups of mothers of children with VUR.

BACKGROUND

Vesicoureteric reflex (VUR) is a chronic, congenital, asymptomatic condition which when combined with urinary tract infection (UTI) can result in reflux nephropathy (RN), contributing to 20% of kidney transplants. Unfortunately, VUR is not usually diagnosed until after proven UTI, by which time RN has often developed. However, recent research, the familial ureteric reflux study (FURS) identified for the first time VUR in a cohort of new-borns investigated because of family history. Early detection and prompt treatment of UTI in the presence of VUR may significantly reduce the development of RN but this requires extreme vigilance by mothers, who are usually the primary carers.

DESIGN

As mothers' experiences and perceptions were the focus, a qualitative design using semistructured, in-depth interviews was used. After obtaining ethical approval, mothers of 15 children with VUR diagnosed presymptomatically (i.e. after participation in the FUR study) and mothers of 14 children with VUR diagnosed post symptomatically were selected using a theoretical sampling matrix. All mothers gave informed consent and interviews were taped, transcribed and analysed using the 'Framework' technique.

FINDINGS

Findings for both groups fall into three discrete phases: the prediagnostic, diagnostic and postdiagnostic. Analysis showed that mothers in the post symptomatic diagnosis group experienced most problems in coping, particularly because of difficulty in engaging medical intervention in the prediagnostic phase. Generally, mothers in the presymptomatic group coped well apart from those who themselves had VUR and/or RN who expressed guilt about their child inheriting the condition and consequently difficulty in coping.

CONCLUSION

Early diagnosis of VUR improved mothers' coping. However, both groups identified a major need for improved information provision and support to assist coping with the sustained uncertainty of the condition.

Multiprofessional perceptions of a paediatric nursing development unit

This article describes the final component of the quinquennial evaluation of a King's Fund accredited nursing development unit (NDU) within a paediatric outpatient department of a large district general hospital during the period 1993-1998. The study draws upon descriptive data obtained through a questionnaire distributed to 83 members of staff associated with the outpatient department. Overall, the results demonstrate that NDU status has enabled staff to embrace the change process more readily than might have been possible otherwise. The basic premise that NDUs should promote nursing innovation is explored and critically evaluated.

The role of the nurse in the paediatric out-patient department

The aim of the study was to describe the role and function of the paediatric nurse in a POPD. The work of the three RSCNs and one HCSW employed in the department, was examined. 60% of the work undertaken in the department could be described as 'non-nursing'. The implications of this study are discussed in relation the department involved in the study, and generally in terms of potential development for POPDs.

A descriptive study of the readability of patient information leaflets designed by nurses

Written patient information materials can be valuable communication tools for teaching and reinforcing the verbal message, especially in the present climate of today's health service where patients are in hospital for such short times. They are only useful if the patient is able to read and understand them, otherwise they become an expensive waste of resources. Various studies have shown that many healthcare information leaflets are written at university or postgraduate level and would cause problems with understanding for many people reading them. This study set out to examine the readability of nurse-designed written information leaflets using the Flesch Reading Ease score and the FOG and SMOG readability formulae. This descriptive study used a sample of 24 leaflets designed by trained nurses in a large teaching hospital. The results produced a mean grade of 11.3 with a range of 8.9 to 14.8. This was similar to the results of other studies and meant that patients may have difficulty comprehending the information. It would appear that little progress has been made in 40 years in this area and potential reasons are discussed. Advantages and disadvantages of readability formulae and other guidelines available for developing information leaflets are explored. Recommendations for further research are made.

Can leaflets assist parents in preparing children for hospital?

This article outlines the findings and implications of a small study designed to investigate the perceived usefulness of an information leaflet entitled 'Preparing your child for hospital: a parents' guide'. The study was carried out in an ear, nose and throat unit where children are admitted for elective surgery. A leaflet was developed and field tested before being mailed to a group of parents. An analysis of the data collected demonstrated considerable parental satisfaction with the information contained in the leaflet. The authors believe that similar leaflets should be routinely distributed to families with children awaiting hospital admission.

Developing a centre for health information and promotion

Following the successful application for nursing development unit funding, the children's outpatient department within the Child Health Directorate of the University Hospital, Southampton, has developed a number of ambitious plans to promote nursing initiatives, one of which was the creation of a centre for health information and promotion. This article describes this development.

The growth of an NDU in a paediatric outpatient department

The granting of nursing development unit (NDU) status to a paediatric clinical area indicates the desire to promote excellence in child care. This article describes the progress of the children's outpatient department at Southampton General Hospital since it was granted NDU status.

Pre-operative visits by ITU nurses: recommendations for practice

Pre-operative visiting by theatre nurses is now policy in many hospitals, following an explosion of research studies outlining the benefits to the patient. However, the author could find very little available literature on pre-operative visiting by intensive therapy unit (ITU) nurses, to patients electively admitted to ITU following surgery. The purpose of this project is to explore the need for patient information, outline the aims of an ITU nurse's pre-operative visit, and discuss the timing of the proposed visit, the information to give the patient, the inclusion of the patient's family and the provision of printed literature. Finally, recommendations are made for implementing a pre-operative visiting service by ITU nurses.