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  • 1.
    Mangrio, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Wremp, Anna
    Moghaddassi, Mahnaz
    Merlo, Juan
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS).
    Rosvall, Maria
    Antibiotic use among 8-month-old children in Malmö, Sweden - in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors2009In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 9, article id 31Article in journal (Refereed)
    Abstract [en]

    In the county of Scania, Sweden, antibiotic use among small children is among the highest in the country. The aim of this study was to investigate the associations between antibiotic use among 8-month-old children in Malmö and characteristics of the child as well as parental sociodemographic characteristics, lifestyle factors, and psychosocial support. The study was a population-based cross-sectional survey. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmö for their 8-month health checkup during 2003–2006 and whose parents answered a self-administered questionnaire (n = 7266 children). The questionnaire was distributed to parents of children registered with the CHC and invited for an 8-month checkup during the study period. The odds of using antibiotics increased as parental educational level decreased. Using high educational level as a reference group, low maternal educational level was associated with an increased antibiotic use for the child, odds ratio (OR) = 1.61 (95% CI: 1.34–1.93). Furthermore, children whose parents were born outside Sweden showed higher antibiotic use, OR = 1.43 (95% CI: 1.24–1.65), in comparison with children whose parents were born in Sweden. Exposure to environmental smoking, parental experience of economic stress, and a low level of emotional support increased the odds for antibiotic use. Boys had higher odds of use of antibiotics than girls, OR = 1.40 (95% CI: 1.25–1.57). Having a low birth weight, having an allergy and having siblings also increased the odds for early antibiotic use, while breastfeeding seemed to have a protective role. Conclusion There were clear associations between parental factors such as sociodemographic, psychosocial and lifestyle factors and antibiotic use at this early stage of life. Several characteristics of the child also affected the use of antibiotics.

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  • 2.
    Ngwalangwa, Fatsani
    et al.
    Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi.
    Chirambo, Chawanangwa Mahebere
    MACHI Initiative, P.O Box 30012, Chichiri Blantyre, Malawi.
    Lindsjö, Cecilia
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Dube, Queen
    Department of Paediatrics, Queen Elizabeth Central Hospital, P.O Box 95, Blantyre, Malawi.
    Langton, Josephine
    Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi.
    Baker, Tim
    Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi; Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
    Hildenwall, Helena
    Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 52, Huddinge, Sweden.
    Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi: a mixed method study2020In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 20, no 1, article id 423Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The presence of low or hypo glycaemia in children upon admission to hospital in low income countries is a marker for poor outcome. Fasting during illness may contribute to low blood glucose and caretakers' feeding practices during childhood illnesses may thus play a role in the development of low or hypo glycaemia. This study aims to describe the caretaker's feeding practices and association of fasting with low or hypo glycaemia in sick children in Malawi.

    METHODS: A mixed method approach was used combining quantitative cross-sectional data for children aged 0-17 years admitted to Queen Elizabeth Central Hospital (QECH), a tertiary hospital in Malawi, with qualitative focus group discussions conducted with caretakers of young children who were previously referred to QECH from the five health centres around QECH. Logistic regression was used to analyse the quantitative data and thematic content analysis was conducted for qualitative data analysis.

    RESULTS: Data for 5131 children who were admitted through the hospital's Paediatric Accident and Emergency Department (A&E) were analysed whereof 2.1% presented with hypoglycaemia (< 2.5 mmol/l) and 6.6% with low glycaemia (≥2.5mmoll/l - < 5 mmol/l). Fasting for more than eight hours was associated with low glycaemia as well as hypoglycaemia with Adjusted Odds Ratios (AOR) of 2.9 (95% Confidence Interval (CI) of 2.3-3.7) and 4.6, (95% CI 3.0-7.0), respectively. Caretakers demonstrated awareness of the importance of feeding during childhood illness and reported intensified feeding attention to sick children but face feeding challenges when illness becomes severe causing them to seek care at a health facility.

    CONCLUSION: Results suggests that caretakers understand the importance of feeding during illness and make efforts to intensify feeding a sick child but challenges occur when illness is severe leading to fasting. Fasting among children admitted to hospitals may serve as a marker of severe illness and determine those at risk of low and hypoglycaemia.

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  • 3.
    Vejzovic, Vedrana
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bozic, J.
    School of nursing, Vinogradska, Zagreb, Croatia.
    Panova, G.
    University Goce Delcev, Stip, Macedonia.
    Babajic, M.
    Clinic for Anaesthesiology and Rheumatology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
    Bramhagen, Ann-Cathrine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Children still experience pain during hospital stay: a cross-sectional study from four countries in Europe2020In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 20, no 1, article id 39Article in journal (Refereed)
    Abstract [en]

    Background Little is known whether children experience pain during hospital stay from the child's own perspective or not. The existing studies tend to be based on a small number of children and therefore have limitations concerning the generalisability of the results. Aim The aim of this study was to describe children's self-reported pain and experience concerning pain management during hospital stay. Methods This study has a quantitative cross-sectional design with descriptive statistics as data analysis. Results A total of 786 questionnaires, Pain in Children in Hospital, were distributed in four countries with the response rate of 75% which was almost equal between countries. Our result showed that 87% (503/579) children at hospital self-reported pain during the past 24 h. Nearly 63% of the children reported a pain score of > 5 the last 24 h. Most of children reported that they had received a question about pain from the hospital staff, and that the staff observed and assessed their pain. Totally 95% reported that they were satisfied with their pain relief during the last 24 h. Conclusion Our study showed that when children were given the possibility to self-report pain, nearly 2/3 expressed that they had experienced pain during hospital stay. However, most of them reported satisfaction with pain management and their pain relief.

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  • 4.
    Wennick, Anne
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Schoug, Dorota
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Ekwall, Anna
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Translation, adaptation and testing of an emergency care satisfaction scale in Swedish pediatric emergency departments2021In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 21, no 1, article id 486Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pediatric healthcare today shows a rising demand for research focusing on children's perspectives on and consumer satisfaction with the nursing care they receive. Therefore, the purpose of this study was to translate and adapt the Consumer Emergency Care Satisfaction Scale (CECSS), a paper-based, self-administered 19-item questionnaire originally developed in the United States and targeted towards adults, and then test the new version in Swedish pediatric emergency departments.

    METHODS: The study was designed with a two-phase approach. Firstly, a forward-backward translation of the CECSS, involving expert consensus, was performed, and then the questionnaire was adapted for children aged 10-18 and assessed for face and content validity. Secondly, the translated and adapted questionnaire was tested with a clinical sample for construct validity, internal consistency, and reliability. This last aspect was assessed using a structured telephone interview 7-10 days after the participant visited a pediatric emergency department. All children participating in this study gave their assent (< 15 years) or consent (≥ 15 years), and their guardian's written informed consent was also obtained.

    RESULTS: The paper-based, self-administered 19-item Swedish version of the CECSS was tested on a clinical sample consisting of 203 nonurgent children (boys: n = 109, 53.7 % and girls: n = 94, 46.3 %) between 10 and 18 years (mean age 13.8, SD 2.29). The factor analysis revealed three factors that explain 63.1 % of the total variation in the 15 items. The Cronbach's alphas for the three dimensions (caring, teaching, and clinical competence) varied between 0.79 and 0.88. The intraclass correlation coefficient (ICC) for the entire Swedish version of the CECSS was 0.58, and the ICCs for the three dimensions varied between 0.56 and 0.71.

    CONCLUSIONS: The results show that the developed Swedish Pediatric Consumer Emergency Care Satisfaction Scale (p-CECSS-S) is a valid, stable and easy-to-use-questionnaire that can be used to assess children's satisfaction with nursing care.

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