How Do Virtual Visits Compare? Parent Satisfaction With Pediatric Diabetes Telehealth During the COVID-19 Pandemic

BackgroundIn response to the COVID-19 pandemic, many countries relaxed restrictions on telemedicine, allowing for a robust transition to virtual visits for routine care. In response, centers rapidly instituted and scaled telemedicine for pediatric diabetes care. Despite numerous center reports on their experience, little is known about parent perspectives on the widespread increase of telemedicine for pediatric diabetes appointments.ObjectiveTo assess parent satisfaction with virtual care for pediatric diabetes during the COVID-19 pandemic.MethodsWe conducted an online, cross-sectional survey of parents of youth with diabetes who receive care at a large, academic diabetes center regarding their perspectives on newly introduced virtual appointments. Parents were surveyed at two time points during the pandemic using a validated scale which was adapted for diabetes. We explored demographic and clinical factors which may influence parental satisfaction.ResultsOverall, parents expressed high levels of satisfaction (>90%) with functional aspects of the visit, though only approximately half (56%) felt the visit was as good as an in-person encounter. Nearly three-quarters (74%) would consider using telemedicine again in the future. Prior use of telemedicine significantly influenced parent satisfaction, suggesting that parent preferences may play a role in continued use of telemedicine in the future. There was no difference in responses across the two timepoints, suggesting high satisfaction early in the pandemic which persisted.ConclusionsIf permissive policies for telemedicine continue, diabetes centers could adopt hybrid in-person and virtual care models, while considering various stakeholder perspectives (providers and patients) and equity in access to virtual care.

The Influence of Parental Involvement on Parent Satisfaction: The Moderating Effect of Parental Educational Level and the Number of Children

With the change in the location of school education from the classroom to the home during the COVID-19 outbreak, there should be more educational caregiving from children’s parents when children learn online. Parental involvement in children’s online learning including study guide and psychological counseling is the specific content of educational caregiving, which is different from face-to-face learning. More attention should be paid to parental involvement and parents’ satisfaction with the online learning effect. This study therefore conducted a survey on middle school students’ parents to establish a moderating model, exploring the influence of parental involvement on parent satisfaction, and the number of children and parental education level as the moderator variables influencing parental involvement. The results show that there is a significant positive correlation between parental involvement and satisfaction, while the parental education level and the number of children both have a moderating effect on the relationship between parental involvement and parent satisfaction. The moderating effect of the education level of parents shows negative, while the moderating effect of the number of children is positive. An interesting finding is that the number of children has a very low influence on parental involvement.

Parent Satisfaction with Sustained Home Visiting Care for Mothers and Children: An Integrative Review

Aim To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children Background Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement. Design: Integrative review Data sources: PubMed/Medline, CINAHL, Embase, and PsycINFO Methods A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers. Results A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction. Other elements of care parents perceived as important to service satisfaction included the strength of the nurse-client relationship, being treated with respect, empowerment, and emotional support. Conclusion While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care.

A Self-Managed Internet Parent Training Program for Interactive Storybook Reading: Extension to a Public School Setting

Purpose This research note evaluated the collaboration, recruitment, enrollment processes, as well as outcomes of an online, self-managed parent training program (Success With Stories [SWS]) concurrent with a Head Start school curriculum. Method This case examination presents the research processes used to examine an online program concurrent with Head Start school programming. Challenges, outcomes, and next steps in the process were evaluated. The engagement of parents who completed the program was examined. Results Collaborative processes were developed, and recruitment strategies were initiated. Of the 92 parents who expressed immediate interest, 38 registered and 16 consented but only seven completed the program. Of the parents who completed the program, survey data revealed high levels of parent satisfaction, motivation, and perceived competence. Conclusions Results indicate a breakdown in the recruitment, enrollment, and completion processes. Results indicate that SWS has promised to address target areas with the intended audience. However, online interventions are only useful if they are accessed and completed. Future directions to increase program completion are discussed.

Parent’s satisfaction on tele-listening training for children with Hearing impairment during COVID-19

Background and Aim: Rehabilitation services to individuals with hearing impairment were on hold with widespread COVID-19. So, rehabili­tation services were mandated mainly through telepractice for children with hearing loss. Eva­luating the effectiveness of tele-practise compa­red to face-to-face therapy is of utmost impor­tance for evidence-based approaches. Therefore, the present study aimed to evaluate the parent’s satisfaction with tele-listening training for child­ren with hearing impairment during COVID-19. Methods: Fifty-four parents of children with hearing loss participated in the study. The pare­nts satisfaction on tele-listening training was evaluated through the Parent Satisfaction Ques­tionnaire in terms of 1) the audio and video qua­lity during teletherapy; 2) equipment use 3) gen­eral parent-therapist interaction and communi­cation during teletherapy; 4) service delivery and convenience; and 5) overall satisfaction with the teletherapy. Results: The results showed a higher parent satisfaction rating to avail rehabilitation services through tele-modality during the pandemic. Tele-listening training sessions had helped par­ents continue training their children at home with the therapist's guidance online. However, parents were not satisfied with their child's interaction with the therapist as they found it difficult to maintain attention throughout the online session. Conclusion: Although most participants agreed that tele session could not replace face-to-face auditory-verbal therapy (AVT) programs, most of them were satisfied with the outreach AVT program. These favorable responses from pare­nts highlight that the digital revolution and other technological advancements support the service providers in Audiology, especially during the COVID-19 pandemic. Keywords: Tele-listening training; questionnaire; satisfaction; rehabilitation

Standardization of rounds on a general paediatric ward: Implementation of a checklist to improve efficiency, quality of rounds, and family satisfaction

Objective The purpose of this study was to develop a standardized rounding tool for use on the general paediatric ward and to determine if its use can improve quality of rounds as well as patient and parent satisfaction. Methodology The study used a pre- and post-intervention prospective observational methodology. The intervention consisted of the implementation of a Checklist Rounding Tool (CRT) entitled the ‘Paediatric Inpatient Rounding Checklist (PIRC)’ which outlined items deemed essential to discuss during rounds for all patients admitted to the paediatric ward. The PIRC was created by the research team after reviewing the literature and it was peer reviewed by a panel of expert paediatricians. Performance on rounds based on discussion of checklist items as well as patient and parent satisfaction were evaluated by an external observer both pre- and post-PIRC implementation. Results Four of the five less frequently addressed checklist items were discussed significantly more post-intervention. The Rounds Quality Score was significantly improved after checklist implementation, the pre- and post-intervention scores being 8.24 and 9.61/10, respectively (P-value <0.001). Patient and parent satisfaction were rated higher with the use of the checklist. There was no difference in the duration of rounds between the pre- and post-implementation phases. Conclusion In summary, utilization of a standardized rounding tool on an inpatient paediatric ward led to improvement in quality of rounds as well as patient and parent satisfaction.

Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains.Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided.Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67–5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33–5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience.Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.

Language Intervention Isn't Just Spoken: Assessment and Treatment of a Deaf Signing Child With Specific Language Impairment

Purpose This case study describes the language evaluation and treatment of a 5-year-old boy, Lucas, who is Deaf, uses American Sign Language (ASL), and presented with a language disorder despite native access to ASL and no additional diagnosis that would explain the language difficulties. Method Lucas participated in an evaluation where his nonverbal IQ, fine motor, and receptive/expressive language skills were assessed. Language assessment included both formal and informal evaluation procedures. Language intervention was delivered across 7 weeks through focused stimulation. Results Evaluation findings supported diagnosis of a language disorder unexplained by other factors. Visual analysis revealed an improvement in some behaviors targeted during intervention (i.e., number of different verbs and pronouns), but not others. In addition, descriptive analysis indicated qualitative improvement in Lucas' language production. Parent satisfaction survey results showed a high level of satisfaction with therapy progress, in addition to a belief that Lucas improved in language areas targeted. Conclusions This study adds to the growing body of literature that unexplained language disorders in signed languages exist and provides preliminary evidence for positive outcomes from language intervention for a Deaf signing child. The case described can inform professionals who work with Deaf signing children (e.g., speech-language pathologists, teachers of the Deaf, and parents of Deaf children) and serve as a potential starting point in evaluation and treatment of signed language disorders. Supplemental Material https://doi.org/10.23641/asha.16725601

Examining the Likelihood of Parents’ Homework Involvement With Elementary-Aged Students With Individualized Education Plans

Elementary-aged students with individualized education programs (IEPs) tend to experience more challenges and demonstrate lower homework completion as compared with peers without IEPs. Parent involvement in homework can significantly improve a child’s homework achievement, but little research has examined the factors associated with higher levels of homework involvement for parents of children with IEPs. Using the 2016 Parent and Family Involvement survey, weighted hierarchical ordinal logistic regression analysis was implemented to determine how a child’s IEP status, parents’ demographic characteristics, school-level variables, and parents’ expectations predicted parents’ odds of helping their child with homework. Results indicated parents’ race and income, along with school communication, parent satisfaction, and the interaction between a child’s IEP status with parents’ expectations predicted parents’ likelihood of involvement in their child’s homework. The implications of these findings and future directions are discussed.

O002 Medical therapy for sleep disordered breathing in children: a randomised, double-blind placebo-controlled trial

Background Sleep Disordered Breathing (SDB) in children is characterised by snoring and breathing difficulties during sleep. Small clinical trials suggest intranasal corticosteroids reduce SDB severity as defined by polysomnography. We assessed the efficacy of intranasal corticosteroid for improving symptoms and quality of life (QOL) in children with SDB. Methods This is a double-blind, randomised, placebo-controlled trial of healthy children 3-12y referred to a specialist with SDB symptoms. Exclusions were previous adenotonsillectomy, obesity or severe SDB. Participants received daily intranasal mometasone furoate 50micrograms or normal saline for 6 weeks. The primary outcome was resolution of symptoms measured by SDB score. Secondary outcomes were SDB symptom scores, QOL, behaviour, parent and surgeon perceived need for surgery, and parent satisfaction with treatment. Results 276 participants were recruited; 138 in each group. 127 and 123 participants had primary outcome data at 6 weeks in the mometasone and saline groups respectively. Baseline age, atopic history, symptom severity and QOL were similar between groups. Resolution of SDB symptoms occurred in 44% [95%CI 35–53] of the mometasone group and 40% [95%CI 32–49] of the saline group; risk difference 4% [95%CI -0.8–16] p=0.511. Secondary outcomes were not different between groups. Discussion This large RCT, using clinical rather than polysomnographic outcomes to investigate the efficacy of mometasone on symptoms of SDB, found substantial rates of symptom resolution after 6 weeks in both groups. However, we found no difference in treatment effect between 6 weeks of intranasal mometasone over saline, for management of SDB symptoms in childhood.