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  • 1
    Electronic Resource
    Electronic Resource
    Family-centred service: moving ideas into practice (2005)
    Oxford, UK : Blackwell Science Ltd
    Child 31 (2005), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Background  With parents more involved in their child's day-to-day care, concepts of family-centred service (FCS) are increasingly adopted in children's health and rehabilitation service organizations.Methods  In this paper, we report the results of a study to develop and evaluate educational materials for parents, service providers and health sciences students about FCS. The materials focus on the nature and philosophy of FCS, and the practical skills and systemic changes required for its implementation.Results  Thirty-six participants (12 families, 12 service providers and 12 rehabilitation science students) were randomly assigned to receive one of the six FCS educational packages, each containing three FCS educational sheets. Participants’ ratings of the format and content, and the impact of the FCS Sheets were very high, with overall means above 5.0 on a 7-point scale. Using a mixed model analysis, we found significant differences in participants’ ratings of familiarity with the materials (students were less familiar than service providers). After statistical adjustment for familiarity, there were no significant differences between the groups or the packages on ratings of format and content or impact.Conclusions  There were no significant differences in the way in which the participant groups rated the impact of the FCS Sheets and the specific packages did not have an effect on the participants’ ratings. The FCS educational materials, even those less familiar to participants, were rated highly on format and content, and impact. Results indicate that the material was perceived to be important to each group, and was formatted and written in a way that was easy to understand. This finding counters current recommendations in the knowledge transfer literature that suggest different versions should be written for different target groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2214.2005.00568.x
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  • 2
    Electronic Resource
    Electronic Resource
    Factors affecting family-centred service delivery for children with disabilities (2003)
    Oxford, UK : Blackwell Science Ltd
    Child 29 (2003), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Background  The provision of family-centred services (FCS) emphasizes a partnership between parents and service providers so that families are involved in every aspect of services for their child. There is evidence that providing FCS is associated with improvements in parents’ satisfaction with services, decreased parental stress, and positive child outcomes.Methods  The purpose of this study was to examine factors that are most important in determining parent perceptions of the family centredness of care and parent satisfaction with service. A cross-sectional survey was completed by 494 parents, 324 service providers, and 15 CEOs from 16 organizations delivering children's rehabilitation services. Analyses were completed using a structural equation modelling approach.Results  Survey return rates ranged from 77 to 94%. Findings indicate that the principal determinants of parent satisfaction with services are the family-centred culture at the organization and parent perceptions of FCS. Parent satisfaction with services was also influenced by the number of places where services were received and the number of health and development problems experienced by their child.Conclusion  Parent satisfaction with services is strongly influenced by the perception that services are more family centred, fewer places where services were received and fewer health and development problems for their child. Ways in which organizations can improve satisfaction through carrying out family-centred behaviours are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2214.2003.00351.x
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  • 3
    Electronic Resource
    Electronic Resource
    In my opinion: reflections of a journal reviewer (2002)
    Oxford, UK : Blackwell Science Ltd.
    Child 28 (2002), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2214.2002.00277.x
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  • 4
    Electronic Resource
    Electronic Resource
    Chronic childhood illnesses: what aspects of caregiving do parents value? (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Child 21 (1995), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Parents of children with chronic iiinesses are at significantly increased risk to experience mental health problems. Because such families are in frequent contact with the health care system, it is possible that aspects of the organization and content of health services might contribute to the development or prevention of these emotional burdens. The purpose of the present study was to examine the patterns of parental values about a variety of aspects of care and services, assessing both the absolute and relative importance of 22 defined components of care (COCs). Respondents were 80/111 parents (72%) of children with diabetes mellitus and 45/56 parents (80%) of children with cystic fibrosis, followed at a regional university-affiliated children's hospital. They completed a two-part mailed questionnaire, rating independently each COC, and then ranking all 22 COCs using a modified Q-sort technique. While the majority of COCs were judged as 'somewhat’or‘very’important by over 75% of respondents, there was also significant agreement between the two groups on their rankings of the COCs (Spearman rank coefficient r= 0.92, P〈 0.001). The COCs ranked most highly by both groups were diagnosis, treatment, education/information, continuity/ consistency, accessible and available care, evaluation of chronic illness, and parental involvement. Furthermore, the concordance between this combined medical illness group and a previously-studied neurodevelopmental group was r = 0.72 (P 〈 0.001). These results are discussed in relation to the
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2214.1995.tb00759.x
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  • 5
    Electronic Resource
    Electronic Resource
    Evaluating family-centred service using a measure of parents’ perceptions (1997)
    Oxford BSL : Blackwell Science
    Child 23 (1997), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: This article describes the use of a newly-developed measure of parents’ perceptions of health care providers’ behaviours (Measure of Processes of Care — MPOC) to evaluate the family centredness of children’s rehabilitation services. The measure was developed with the participation of more than 1600 parents of children with chronic neurodevelopmental conditions throughout Ontario. It assesses five domains: enabling and partnership; providing general information; providing specific information about the child; coordinated and comprehensive care; and respectful and supportive care. By comparing the perceptions of parents receiving services from three different types of organizations or programmes, we demonstrated that the MPOC can pick up differences between parents in their experiences of caregiving. We also demonstrated that the MPOC is able to detect differences in how parents view the family-centredness of services provided by individual centres. The data indicate that the MPOC has appreciable utility in providing programmes and services with a description of their current level of family-centred service as perceived by parents. The strengths, limitations and potential uses of the measure in other contexts are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2214.1997.840840.x
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  • 6
    Electronic Resource
    Electronic Resource
    Frequency and determinants of formal respite service use among caregivers of children with cerebral palsy in Ontario (2004)
    Oxford, UK : Blackwell Publishing Ltd
    Child 30 (2004), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Objective  To describe the use of formal respite services among caregivers of children with cerebral palsy in Ontario and discuss the factors that may contribute to respite use and non-use.Methods  A total of 468 caregivers were interviewed about their experience with formal respite services. Interviews were part of a larger cross-sectional study on caregiver health. Caregivers were asked about their knowledge of formal respite services; their use of formal respite services in the past year; financial implications relating to formal respite use; perceived barriers to formal respite service use; and reasons for not using formal respite services (if applicable).Results  Nearly half (46%) of caregivers in the sample reported using respite services in the past year. Most of the caregivers who used respite services used more than one source of respite, had services provided in their home, often for less than 1 day, and reported using them more than six times. The most commonly cited reason for using formal respite services was for a planned break. Many factors influenced caregivers’ use of formal respite services. Caregivers who had a child with a lower level of function, with multiple additional conditions, or who was male, were more likely to use formal respite services. Although over 90% of caregivers indicated that respite use is beneficial for both their family and child, over 60% reported facing many barriers while attempting to access respite services.Conclusion  Results from this cross-sectional study indicate that caregivers who used respite services used them frequently for breaks from caregiving. Caregivers described facing many barriers while attempting to access respite services therefore to improve caregiver's experience with respite services, strategies are suggested.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2214.2004.00391.x
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  • 7
    Electronic Resource
    Electronic Resource
    Early rehabilitation service utilization patterns in young children with developmental delays (2002)
    Oxford, UK : Blackwell Science Ltd.
    Child 28 (2002), S. 0 
    Details
    ISSN: 1365-2214
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Objective There is a growing demand for interdisciplinary rehabilitation services for children with developmental disabilities, however, information is lacking on service utilization patterns. This study describes the type, frequency and location of initial rehabilitation services provided to young children recently diagnosed with a developmental delay. Methods A telephone survey was conducted on a consecutive cohort of children referred to subspecialists for the first investigation of their delay. Results Out of 129 respondents, only 30 (23%) did not receive any rehabilitation services within the first 6 months following medical evaluation, and 61 (47%) received two or more services. Services were provided most frequently in the hospital setting, especially for occupational or physical therapy (73–80%). Services were less often rendered in a rehabilitation centre (5–13%) or in the community (〈 10%). Services were provided privately for a subset, particularly for speech language pathology and psychology (34% and 30% respectively). Interventions were typically given weekly or bi-weekly. Children receiving physical therapy were significantly younger whereas children referred to speech language pathology were older than the age of our cohort at intake. Overall, parents’ educational level did not influence services received with the exception of private services, which were more likely to occur in children of fathers with university education. Conclusions The findings would suggest that long waiting times and lack of resources may limit access to comprehensive services, particularly in community settings. Service utilization patterns were not consistent within types of developmental disability, suggesting that formal and co-ordinated interdisciplinary programmes are not in place for this population of interest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2214.2002.00237.x
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  • 8
    Electronic Resource
    Electronic Resource
    Effects of general anaesthesia vs. sedation on fertilization, cleavage and pregnancy rates in an IVF program (1999)
    Springer
    Archives of gynecology and obstetrics 263 (1999), S. 56-59 
    Details
    ISSN: 1432-0711
    Keywords: Key words IVF ; Sedation ; General anaesthesia ; Remifentanil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Anaesthetic management for oocyte retrieval may interfere with the results and success rate of an in vitro fertilization (IVF) program. This study was conducted to compare the effects of two different anaesthetic techniques (general anaesthesia versus sedation) used for oocyte retrieval on IVF outcome. For general anaesthesia we used a combination of remifentanil (UltivaTM) with either propofol or isoflurane in hypnotic concentrations. For sedation the protocol included midazolam, diazepam or propofol according to clinical needs. In total, 202 women were enrolled in the study. 96 women opted for sedation and 106 for general anaesthesia. The number of collected oocytes was significantly higher with general anaesthesia (10.54±5.43 [mean±SD]) than with sedation (6.25±3.65, p〈0.0001), whereas the number of fertilized oocytes was not different (4.70±3.57 vs. 4.23±2.90). There were no significant differences in cleavage and pregnancy rates. We therefore believe that remifentanil-based general anaesthesia without nitrous oxide is a suitable alternative to sedation and may be recommended for IVF oocyte retrieval if general anaesthesia is requested.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004040050263
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  • 9
    Electronic Resource
    Electronic Resource
    Erste klinische Erfahrungen bei der Behandlung der Endometriose mittels dem LH-RH-Analogon Zoladex Depot (1989)
    Springer
    Archives of gynecology and obstetrics 245 (1989), S. 940-941 
    Details
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02417629
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    Development of a health-related quality of life instrument for use in children with spina bifida (1997)
    Springer
    Quality of life research 6 (1997), S. 0-0 
    Details
    ISSN: 1573-2649
    Keywords: Health-related quality of life ; pediatrics ; spina bifida
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to develop a spina bifida health-related quality of life (HRQOL) instrument. Items were generated through semi-structured interviews, and reduced by frequency- importance product ranking. Validity was assessed by correlating the HRQOL score with a global question concerning the child's well-being using the Spearman's rank coefficient, and the Piers-Harris Children's Self-Concept Scale (P-H) using the Pearson correlation coefficient. Reproducibility was assessed at 2-week intervals using the intra-class correlation coefficient (ICC). Field testing was undertaken in a larger sample to evaluate item-total correlation, internal consistency and construct validity. Patients taking part in the study were 329 children and adolescents with spina bifida attending two treatment centres. Over 600 items were generated. These were reduced to 47 questions and 50 questions, for children and adolescents respectively. The correlation between the HRQOL score and the global question was r=0.57, and with the P-H was 0.26 (children). These values for adolescents were 0.63, and 0.89, respectively. Reproducibility was ICC=0.78 (children) and 0.96 (adolescents). Following field testing, the questionnaire was further reduced to 44 questions (children) and 47 questions (adolescents) by eliminating questions with an item-total correlation less than 0.20. Cronbach's alphas for the final instrument were 0.93 (children) and 0.94 (adolescents), and construct validity correlations were 0.63 (children) and 0.37 (adolescents). The spina bifida HRQOL instrument has good measurement properties and may be used as a discriminative instrument. Assessment of responsiveness is necessary before using it to evaluate therapy in clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026486016212
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