Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.

Navigating Silence: A Comprehensive Review of Parental Roles in the Rehabilitation of Children with Hearing Loss

This narrative literature review delves into the multifaceted realm of parental involvement in the rehabilitation of children with permanent hearing loss. While existing research has made strides in elucidating parental roles in this context, critical gaps persist, necessitating a comprehensive exploration to inform future endeavors. Our review synthesizes a wide array of studies, identifying these gaps and emphasizing the significance of addressing them. Themes emerging from the literature include the varying degrees of parental engagement, the impact of cultural and socio-economic factors, and the challenges faced by families navigating rehabilitation processes. The synthesis of this literature not only highlights the current state of knowledge but also provides a roadmap for future research efforts. By addressing these gaps, we aim to contribute to a more nuanced understanding of parental involvement in the rehabilitation of children with permanent hearing loss, ultimately fostering improved support systems and holistic care for affected families.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

“I Dread the Heart Surgery but it Keeps My Child Alive”—Experiences of Parents of Children with Right Ventricular Outflow Tract Anomalies during the Assessment for Cardiac Reoperation

Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.

Meta-analysis on the effectiveness of parent education for children with disabilities

BACKGROUND Parents of children with disabilities often have difficulty understanding their child’s behavior and are unable to do it appropriately because they do not know what to do.The more we properly understand children with disabilities,the more positive the importance of parent education becomes in various aspects.AIM To demonstrate the effectiveness of parent education for children with disabilities in various aspects and present it as evidence that can be used clinically.METHODS For a meta-analysis on the effectiveness of parent education for children with disabilities,literature was collected from 2002 to 2022 using PubMed,Embase,Web of Science,Directory of Open Access Journals,and Europe PMC.Search terms were“disabled children,”“disabled children,”“parent education,”“parent training,”and“parent coaching.”The final searched literature included a total of 11 articles.To calculate the effect size,the mean,standard deviation,and sample size of the experimental and control groups were analyzed,and a meta-analysis was performed using RevMan version 5.4.1.To analyze statistical heterogeneity,a chi-square test was performed to evaluate the significance of Q statistics to indicate statistical heterogeneity.RESULTS The final literature totaled 11 articles,and a total of 4 items were analyzed.There were 5 studies on parental depression,the heterogeneity was 98%,and the effect size for parental depression was 0.35[confidence interval(CI:0.30-0.40)],indicating a small but statistically significant effect size.There were 4 studies on parenting attitude,the heterogeneity was 100%,the effect size on parenting attitude was 0.41(CI:0.37-0.46),which was a medium effect size,and the P value showed a statistically significant score.Additionally,face-to-face parent education was found to have a larger effect size than non-face-to-face education.Regarding parent education methods,face-to-face parent education had a medium effect size[0.57(CI:0.52-0.61)],while non-face-to-face parent education had a small effect size[0.23(CI:0.18-0.28)].CONCLUSION Parental education has shown high effectiveness in child development,and it has proven to be even more effective when face-to-face parenting education is conducted.Accordingly,more effective and objective data was presented.Based on this study,it is believed that parent education research applying various diagnostic groups should continue to be conducted.

Lived experiences with unmet supportive care needs in pediatric cancer:Perspective of Chinese children and their parents

Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.

Validity and reliability of Turkish version of the scales of perceived stigma for children with epilepsy and their parents

Purpose:This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al.This study also aims to analyse the scales'validity and reliability in evaluating stigma perceptions amongst the aforementioned population.Methods:The population of this methodological study consisted of parents and 85 epileptic children between 9 and 16 years old.This population visited the paediatric neurology clinic of a hospital in Erzurum Province,Turkey,between April 2015 and January 2016.The scales of perceived stigma amongst children with epilepsy and their parents,as well as its Turkish version,were used as measuring tools.Experts were also consulted for their opinions.Meanwhile,Bartlett's test,Kaiser-Meyer-Olkin(KMO)index,exploratory factor analysis,principal component analysis,varimax rotation and scree plot test were used to determine the validity of the study,Moreover,the coefficients of Cronbach'sαand Pearson's product-moment correlation were used to identify internal consistency,homogeneity and thus reliability.Results:Evaluations and analyses indicated that the Turkish version of the child and parent scales can be used with a single dimension.The mean scores of such scales were 24.02±8.47 and 15.68±4.04,respectively.All item-total score correlations of the child and parent scales were found to be significant(P<0.05).The KMO coefficient of the child scale was 0.94,whereas the chi-square value of Bartlett's test of sphericity was significant at 209.311(P<0.05).Moreover,the KMO coefficient of the parent scale was found to be 0.80,whereas the chi-square value of Bartlett's test of sphericity was found to be significant at 209.311(P<0.05).The Cronbach'sαcoefficients were 0.95 and 0.87 for the child and parent scales,respectively.Conclusion:The Turkish version of the child and parent scales of perceived stigma is valid and reliable in measuring the perception of stigma amongst children with epilepsy and their parents.

A Study to Assess the Psychosocial Problems and Quality of Life of Parents with Asthmatic Children in Opd’s of Ramaiah Hospitals, Bengaluru

The study was undertaken to assess the level of psychosocial problems and quality of life of parents with asthmatic children in Ramaiah hospitals, Bengaluru. Statement of the problem: “A study to assess the psychosocial problems and quality of life of parents with asthmatic children in opd’s of Ramaiah hospitals, Bengaluru”. Objectives of the study: 1) To assess the level of psychosocial problems and level of quality of life of parents with asthmatic children. 2) To find the correlation between scores of psychosocial problem and quality of life among parents with asthmatic children. 3) To find the association between level of psychosocial problem and selected socio demographic variables. 4) To find the association between level of quality of life and selected socio-demographic variable. Method: A descriptive survey approach was used for the study. Purposive sampling technique was used to select 50 parents with asthmatic children. Data was collected through interview schedule by using structured rating scale to assess psychosocial problems and quality of life. Data was collected and analyzed using descriptive and Inferential statistics in terms of frequencies, Percentage, Mean, Mean percentage, Standard deviation, Karl Pearson’s correlation co-efficient and chi-square test. Findings: The major findings of the study indicated that majority of the parents with asthmatic children that is 33 (66%) were having moderate psychosocial problems and 16 (32%) were having mild psychosocial problem and 1 (2%) were having severe psychosocial problem and 38 (76%) were having good quality of life, 8 (16%) were having better quality of life and 4 (8%) were having poor quality of life. Karl Pearson’s correlation co-efficient test revealed that there is a correlation that exists between psychosocial problem and quality of life of parents with asthmatic children 0.314 weak positive correlation. Chi-square test revealed that there was no significant association between level of psychosocial problems and quality of life with selected socio demographic variables at 0.05 level of significance. Interpretation and conclusion: The findings show that majority of the parents with asthmatic children had moderate level of psychosocial problems (66%) and majority had good quality of life (76%). There is no significant correlation between psychosocial problem and quality of life. There is no significant association between psychosocial problem and quality of life with selected socio demographic variable. This null hypothesis was accepted.

Disclosure of Parental HIV Positive Status: What, Why, When, and How Parents Tell Their Children in the Era of HAART in South Africa

The aim of the study was to explore the decision to and the process of disclosure of parental HIV status to children. Focus group interviews were conducted with 21 parents of 39 children aged 7 - 18 years. Participants were recruited from a highly active antiretroviral treatment (HAART) program of an academic hospital in South Africa. Parents disclosed more to older children than to younger children in the same family, and the breadth and depth of the information shared was depended on the age of the child. Communication with adolescent children included topics on HIV prevention and unsafe sexual practices. For parents with a long history of sickness, disclosure occurred soon after the diagnosis was made, when they had not commenced with antiretroviral treatment (ART). They disclosed to prepare their children for HIV related emergencies and imminent death. Parents also expected support from their older children after disclosure. Some parents were forced to disclose because children suspected their HIV status, and parents could not continue to hide symptoms like severe weight loss. In addition, parents disclosed to educate children on how to protect themselves from HIV infection. For most parents, disclosure was unplanned, emotive, and burdened with anxiety and fear of rejection by their children. However, when the decision to disclose was made, parents were honest and open and informed their children that they were HIV positive. Parents may benefit from disclosure support services, and health care providers can assist parents in deciding when and how to disclose.

A comparison of the quality of life of parents of children using hearing aids and those using cochlear implants

Objective:The goal of this study was to evaluate the quality of life of parents of children who use hearing aids(HA)with those who use cochlear implants(CI)in the Indian context and document any differences found.Methods:The Kannada version of the AQoL-4D was administered in a modified fashion to 131 parents(87 HA and 44 CI).Sociodemographic details were collected for supplemental information on the intervention strategy used.Results:A total of 49 parents(29 HA and 20 CI)responded to the questionnaire sent.The mean total scores for both the groups were similar(HA group=17.9(SD=5.5),CI group=17.2(SD=3.4)),as was the score for the first subscale(HA group=8.6(SD=2.9);CI group=8.5(SD=2.6))of the AQoL-4D.No significant differences were found between the two groups on either scores[Total Score:U(N_(HA)=29,NCI=20)=280.5,z=0.194,p>0.05;Subscale 1 Score:U(N_(HA)=29,NCI=20)=281.5,z=-0.176,p>0.05].The degree of hearing loss in the hearing aid group was equivalent to that of the cochlear implant group but this did not appear to influence parental quality of life.Conclusion:Parents of children with hearing aids and cochlear implants appear to be similar on several psychosocial factors in the realms of functional,social,and psychological well-being.In terms of parental quality of life,hearing aids and cochlear implants appear to be equally effective intervention techniques.

The Lived Experience of Parents of Children with Sickle Cell Disease: A Qualitative Study

Background: Sickle cell disease is an inherited hematological disorder that inflects complex demands on the lives of the children and their families. Aim: To describe the lived experience and everyday strains of parents of sickle cell disease children. Methods: A descriptive qualitative approach was used. Data were collected using face-to-face interviews with 11 parents of children with sickle cell disease in Jordan. Results: Emerged themes were: 1) the catastrophe, which summarized the effect of the confirmed diagnosis of sickle cell disease in the children on the parents, 2) parenting hardships, which highlighted aspects of parents’ reported challenges and needs while caring for their sickle cell disease children, and 3) networking and support, which described patterns of support that parents sought to fulfil needs for support and information. Conclusions: Healthcare providers should carefully assess the complex caregiving demands and altered family dynamics that the parents of children with sickle cell disease face. Parents’ psychosocial health issues should be essential elements in planned care of children with sickle cell disease. Nursing and social work professionals can play a vital role in developing and implementing a comprehensive model of care with community-based approach and strategies to maximize the wellbeing of sickle cell disease children and their parents.

Exploring the Views of Parents of Children Following Telephone Advice from Nurses Working in a GP Out-of-Hours in Ireland

This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Executive (HSE) to be a highly significant quality initiative for patient care, and the health service as a whole. Outside of normal GP surgery hours, parents of children can call a dedicated telephone number, to have their urgent health concerns assessed and to be advised about the appropriate level of care. Experienced nurses, who are often based in a GP OOHs centre, assess the call over the telephone and provide advice to the callers. The spur for conducting this study arose from my personal and professional experience which, I believe, underscores the need for exploring and understanding parents’ views of GP OOHs services, in order to bring about change in nurses’ practice of delivering advice over the telephone. The overall aim of the study is to explore and understand the views of parents of children, aged two years and under, following telephone advice received from nurses in the context of a GP out-of-hours service. A qualitative, exploratory, and descriptive design was used to examine the views and experiences of parents of children aged two years and under, who used a GP out-of-hours service provider in Ireland. Nine parents who had received phone advice from a nurse were purposively sampled to take part in the study. Data were collected using semi-structured interviews by telephone. Data were transcribed and analysed thematically. Themes included parents’ perceptions of illness in children with the need to be heard, parents’ views about accessibility to GP OOHs, parents’ expectations that the service would offer guidance and reassurance, parents’ satisfaction with the nurse’s advice, and parents’ experiences of hospital emergency departments (EDs). Suggestions for improving the GP OOHs service were made across these themes. The suggestions include: higher staffing levels, wanting a quicker call back, preference for face-to-face assessment over telephone advice and a preference for a children’s area in the GP OOHs. The study revealed that parents are satisfied with the GP OOHs service and the parental decision-making model has the potential to provide an opportunity to continue the progress of the establishment of GP OOHs services in Ireland.

The more love, the more hurt： Analysis of parents and children＇s relationship in Sons and lovers

The novel Sons and lovers, written by D. H. Lawrence, describes the state that the relationship between husband and wife loses balance. That is to say, power of the wife in the family is so strong that the wife, Mrs. Morel controls the whole family but not Mr. Morel. It also informs readers the process of how she comes to change her pure maternity to the passion between man and woman after she can＇t reform her husband and can＇t find the ideal lover image in her husband. This thesis tries to analyze the formation of imbalanced relationship between husband and wife, its expression, its influence on the children and significance on family education. Meanwhile, it also warns us of the importance of family atmosphere and family education to the healthy growth of children.

Depression and Anxiety among Parents of Children with Cystic Fibrosis Related to the Children’s Health Related Quality of Life

The aim was to examine depression and anxiety among parents of children with Cystic Fibrosis and the association between the parents’ symptoms and the child’s quality of life as rated by the parents. Parents completed HADS (Hospital Anxiety and Depression Scale), and CES-D (Center of Epidemiologic Studies Depression Scale), and assessed the children’s quality of life with CFQ-R (Cystic Fibrosis Questionnaire-Revised). Anxiety amongst the parents was higher than the general population (m = 6.55, SD = 3.54, p < 0.001). The level of depression does not differ from that of the general population. Mothers showed more anxiety symptoms than fathers (p < 0.001). Gender differences were not significant for depression symptoms. There is a strong association between the fathers’ self-rated depression and their rating of their child’s health. Both children and parents should be paid attention to in order to identify mental ill-health and take measures in good time.

Stages of Emotional Experience of Parents of Children with Cochlear Implantation (CI)

Rehabilitation is a set of measures aimed at compensating or fully restoring the functions of the patient impaired by the disease. In the rehabilitation of children with a cochlear implant, a comprehensive, systematic approach is essential in the work of doctors, teachers, sign language teachers, psychologists, and families. Rehabilitation and social adaptation of children with a cochlear implant depend not only on specialists but also on the ability of parents to help the child organize educational activities in an optimistic mood and the ability to provide emotional support. This means that the role of parents in the way to successful rehabilitation is high, and therefore this topic is especially relevant today. .

Effectiveness of a multifaceted intervention for the improvement of nutritional status and nutrition knowledge of children in poverty-stricken areas in Shaanxi Province, China

Objectives:Compare the differences between the intervention and control groups in changes of primary outcomes(body mass index[BMI]and waist-to-height ratio[WHtR])and secondary outcomes(nutrition knowledge of children and parents),from baseline to the 6-and 12-month follow-ups;examine the associations of changes in nutrition knowledge of children and their parents with children’s changes in BMI and WHtR.Data sources:Data collected from four schools in two poverty-stricken counties in northern Shaanxi Province in 2020‒2021.Methods:A multifaced intervention program targeted children(promoting healthy diet and nutrition education)and their parents(promoting nutrition knowledge)was conducted in the interventional group.Four schools,with two in each group,were randomly allocated to the intervention or control group,with 814 eligible children aged 7.1 to 12.8 years.The control group conducted myopia promotion.Differences in changes of BMI and WHtR between groups were compared with t-test.Mixed-effects model was used to examine the associations between changes in nutrition knowledge of children and parents with changes in children’s BMI and WHtR.Results:At the 6-month follow-up,the difference in changes in BMI between the intervention and control groups was 0.4 kg/m 2(P<0.001).At the 12-month follow-up,the difference in changes in BMI and WHtR between intervention and control groups was 0.1 kg/m^(2)(P<0.001)and 0.01 kg/m^(2)(P<0.001).In the intervention group,the nutrition knowledge awareness rate of children increased from 16.9%(69/409)at baseline to 21.3%(87/409)at 6-month,and 22.7%(93/409)at 12-month.The awareness rate of nutrition knowledge of parents also fluctuated,from 5.6%(23/409)to 6.6%(27/409)and 5.4%(22/409).However,the difference in changes in nutrition knowledge between intervention and control groups was non-significant.The 6-month follow-up changes in children’s nutrition knowledge scores were negatively associated with changes in BMI in girls(β=−0.26,95%confidence interval[CI]:−0.38 to−0.14,P<0.001),while positively associated with changes in WHtR in boys(β=0.003,95%CI:−0.0002 to 0.005,P=0.035).The 12-month follow-up changes in children’s nutrition knowledge scores were positively associated with changes in children’s WHtR(β=0.003,95%CI:0.0004 to 0.01,P=0.018).Conclusions:The intervention strategies did not reduce the BMI and WHtR of children,and the nutrition knowledge of children and parents increased after the intervention in intervention group.Changes in nutrition knowledge of children and their parents are associated with changes in children’s BMI or WHtR.Interventions with a new focus on obesity are needed to help improve children’s nutritional status in poverty-stricken areas in Shaanxi Province of China.

Parental Migration and the Academic Performance of Left-behind Children——Evidence from a Two-wave Panel Dataset of 10 Thousand Students in 5 Provinces in China

Since the 1990s, the large-scale migrant labor force from rural to urban areas has made great contributions to the growth in China. However, migration does not come without costs. The potential impacts of parental migration on the left-behind children have aroused wide concerns. Based on a two-wave panel dataset of nearly 10 thousand students in 166 schools from 13 counties in 5 provinces between 2014 and 2015, differences-in-differences （DID） and propensity score matching plus DID （PSMDID） approaches were used to examine the changes in academic performances before and after the parental out-migration. The results indicated that the mother only migration has a significant negative impact on the a- cademic performances of left-behind children, and it was especially true when the mother only migration lasted more than a semester. For left-behind children whose parents were out or only the father was out, their academic performances were not affected.

Parental Disclosure of Own HIV Status to Children in Two Ghanaian Regions;Examining the Determinants within a Child Vulnerability Context

Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.

Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi

Background: Inadequate pain management is a problem in hospitalized children. Objectives: To explore knowledge and attitudes of nurses in management of pain in children. Methods: A descriptive design using qualitative methods was used to conduct the study. 17 nurses with prior pain management training were interviewed using a semi-structured interview guide. Ethical approval was obtained from College of Medicine Research and Ethics Committee. Data were analysed using thematic content analysis. Results: Nurses had some knowledge of pain assessment methods, treatment and use of morphine. Gaps, however, existed on how to use pain assessment scales, analgesics to use at each step of the WHO analgesic ladder, and how to effectively use morphine for pain relief. Although most nurses had positive attitudes towards children’s pain and use of morphine, negative attitudes were evident in some nurses regarding administration of morphine to neonates or acutely ill children. Conclusion and Implications: The study has revealed knowledge and attitude gaps which may reflect deficiencies in the pain education nurses received, non-availability of pain scales and lack of support for nurses to link theory with practice. Nurse leaders are challenged to provide repeated comprehensive education for nurses on pain assessment and management. Furthermore, user friendly pain scales should be developed, and nurses educated and demonstrated on their use. In addition, opportunities for supportive supervision with nurses in the clinical setting should be created for linkage of theory and practice.