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- Björkman, Berit, et al.
(författare)
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Are radiographers prepared to meet children with special needs, when seen for an examination?
- 2017
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455. ; 58:1 Suppl., s. 16-16
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Anxiety is often experienced by children undergoing health care procedures, and children with autism spectrum disorders (ADS) experience more anxiety than typically developed children. A prerequisite for obtaining an optimum procedure is firstly based on the health care provider’s knowledge about children with ASD, but may also depend on the use of guidelines. Two previous national surveys showed, that none radiology or paediatric departments and a minority of anaesthesiology departments throughout Sweden use specific guidelines when seeing children with ASD. Following, the purpose was to develop guidelines to use when caring for and preparing children with ASD in those settings.Methods: A modified Delphi method was used, including19 experts identified from the two afore mentioned surveys. The questions considered in the process, proceeded from previous research and the results from the surveys. The experts’ responses regarding the importance of each item, were analysed and scrutinized between each round.Results: The Delphi process resulted in guidelines consisting of 15 items and a checklist with 16 aspects. The items cover the areas: planning and involving parents, features in the environment, use of time, communication, thehealth care professionals. The checklist covers the child’spattern of communication, anxiety, sensory stimuli, special interests and likes/dislikes.Conclusions: To obtain an optimum caring encounter when a child with ASD is seen in the preoperative and radiology setting, a meticulous planning is important and the environment should be adjusted for the needs of the child. To accomplish this, guidelines need to be in place and be followed.
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| 2. |
- Björkman, Berit, et al.
(författare)
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Peri-radiographic guidelines for children with autism spectrum disorder : a nationwide survey in Sweden
- 2017
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Ingår i: Child Care Health and Development. - : Wiley-Blackwell. - 0305-1862 .- 1365-2214. ; 43:1, s. 31-36
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process.METHOD: A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics.RESULTS: In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD.CONCLUSION: It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.
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| 3. |
- Gimbler Berglund, Ingalill
(författare)
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Developing guidelines in nursing care of children with Autism Spectrum Disorder in high technology health care settings
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction. The high technology environment such as a radiology and anaesthesia department in a typical health care setting can many times be a frightening environment for children. Children with neurodevelopmental disorders, such as Autism Spectrum Disorder (ASD), have problems with communication and social interaction. They are dependent on routines and can have higher sensitivity to sensory stimuli than other children. These children are one group who constitutes special challenges in reducing anxiety and creating participation in a high technology environment. This can make them prone to frightening encounters in health care settings if not cared for with special consideration.Aim: The overall aim of this thesis was to audit and enhance the care of children in a high technology environment in the health care system with a focus on children with Autism Spectrum Disorder.Methods: A descriptive design was used with both qualitative and quantitative methods. In Study I, 32 nurse anaesthetists were interviewed to explore the actions and experiences of caring for children in a high technology environment using a qualitative method, known as the Critical Incident Technique (CIT). In the two following studies (Study II, III) a cross-sectional design was used and two national surveys were performed to obtain knowledge on the status in Sweden regarding the care of children with ASD in high technology environments. Sixty-eight anaesthesia departments, 38 paediatric departments and 86 radiology departments responded to the survey. Descriptive statistic was used for the answers apart from the comments part of the questionnaire where qualitative content analysis was used. Due to the limited existence of guidelines in these environments, the creation ofevidence-based guidelines was performed in Study IV, using a Delphi method. The Delphi study was based on information gleaned from the previous studies and from the literature, and 21 experts identified in Study II and III were the expert panel developing the guidelines.Result: Nurses identified children with special needs such as children with ASD as a vulnerable group in a high technology environment (Study I). Seven departments in the anaesthesia context had guidelines for caring for children with ASD in the perioperative context. In the other departments, the care of children with ASD was dependent on the knowledge of the nurse presently working there (Study II). None of the radiology departments in Sweden had guidelines on how to care for children with ASD going through a radiographic examination without anaesthesia (Study III). As a result of Study I, II and III, the need for structured guidelines for caring for children with ASD in a high technology context was identified and a set of guidelines and a checklist was created. The guidelines relate to the organisational structure for the care of children with deficits in social interaction, communication, sensory sensitivity and dependence on routines. The checklist relates to gleaning information about the specific child to be able to give person-centred care based on the specific characteristic of the child (Study IV).Conclusion: Nurses working in a high technology environment in health care have diverse experiences of preventing anxiety in children with ASD coming for a challenging procedure. There are a limited number of evidence-based guidelines to decrease anxiety and to create participation in this group ofchildren. Evidence-based guidelines were created as a tool for enhancing person-centred care in a high technology environment for this group of children. The fact that several problems are assembled under one disorder makes ASD a useful condition to have as a basis for formulating national guidelines. Guidelines that cater for the care of children with ASD in a high technology environment using a person-centred approach may also extend to the care for children with other neurodevelopmental disorders that exhibit some of the same problems as children with ASD.
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| 4. |
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| 5. |
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| 6. |
- Gimbler Berglund, Ingalill, et al.
(författare)
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Management of children with Autism Spectrum Disorder in the anesthesia and radiographic context
- 2017
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Ingår i: Journal of Developmental and Behavioral Pediatrics. - : Wolters Kluwer. - 0196-206X .- 1536-7312. ; 38:3, s. 187-196
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Tidskriftsartikel (refereegranskat)abstract
- Objective: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures.Methods: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus.Results: The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the child's needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child.Conclusion: A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASD's particular manifestation in the child entrusted to their care, is required from the health care workers. The organization needs to have structures in place to facilitate this process.
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| 7. |
- Gimbler Berglund, Ingalill, et al.
(författare)
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Perioperative and anesthesia guidelines for children with autism : A nationwide survey from Sweden
- 2016
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Ingår i: Journal of Developmental and Behavioral Pediatrics. - : Wolters Kluwer. - 0196-206X .- 1536-7312. ; 37:6, s. 457-464
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail.Method: An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis.Results: Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: "lacking the necessary conditions," "no extra considerations needed," and "care with specific consideration for children with ASD." These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child.Conclusion: There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.
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| 8. |
- Gimbler Berglund, Ingalill
(författare)
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Är vi rustade att möta barn med speciella behov?
- 2018
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Ingår i: Abstract AnIva Höstkongress 2018. - : Riksföreningen för Anestesi och Intensivvård.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Att komma till ett sjukhus för en undersökning eller behandling kan vara en skrämmande upplevelse för barn. När de kommer till en främmad miljö som inte är anpassad för dem kan de uppleva känslor av osäkerhet, hjälplöshet och oro. Barn med autismsspektrumtillstånd (AST) har problem med kommunikation, social interaktion, är känsliga för sensoriska stimuli, till exempel ljud, ljus eller beröring, och är dessutom beroende av rutiner. Dessa barn utgör en utsatt grupp i den högteknologiska miljön inom sjukvården och detta gör att de löper en stor risk att ett besök inom denna miljö riskerar att bli en skrämmande upplevelse. Detta i sin tur kan leda till att barnen inte medverkar och besöket blir en upplevelse som ytterligare förstärker deras rädsla för sjukvården. Att möta barn med AST kan vara en utmaning för vårdpersonalen, där riktlinjer för omhändertagande kan vara en hjälp för att kunna ge en person-familjecentrerad omvårdnad men det är få anestesiavdelningar i Sverige som har strukturerade riktlinjer för omhändertagandet av barn med autismsspektrumtillstånd. Dessa barns besök behöver vara välplanerade och genomföras på ett sätt som tar hänsyn till det individuella barnets fungerande och behov. En förutsättning för att kunna ge dessa barn ett bra omhändertagande är att man vet i förväg att det är ett barn med denna diagnos som är planerad för en procedur. Har man denna kunskap kan man ta kontakt med föräldrarna och skräddarsy planeringen och vården efter barnets specifika behov. Det behövs också en kunskap hos personalen om autismspektrumtillstånd och hur man kan möta barn med denna funktionsnedsättning för att skapa en gott bemötande för dessa barn.
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| 9. |
- Huus, Karina, et al.
(författare)
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Caring for children in pain : a Vietnamese perspective
- 2016
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Ingår i: Annals of Nursing and Practice. - : JSciMed Central. - 2379-9501. ; 3:7
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to identify and describe Vietnamese nurse’s pain management in children.Methods: A quantitative cross-sectional study using a questionnaire measuring 110 registered Vietnamese nurse’s perception of pain and pain management in children.Results: The results showed that many nurses in Vietnam are using pain assessment instruments as well as non-pharmacological alleviations methods extensively. Vietnamese nurses had high levels of knowledge in physiology of pain. Nurses’ knowledge about the use of pain medication was correlated to attitudes. The higher level of knowledge the nurses had about pain medication, the more positive was their attitude towards pain management in general.Conclusion: In conclusion, the most commonly used non-pharmacology pain alleviation method among the nurses was talking to the child and be close to the child. This method to attempt to relive pain is valuable as it doesn’t require any specific equipment. Vietnamese nurses had high levels of knowledge about physiology of pain.
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