Caregivers’ burden of caring for children with chronic illnesses at a tertiary health facility in southern Nigeria

Background: The responsibilities perceived by caregivers of children with chronic diseases can impose significant burden on their physical, emotional and mental well-being. Objective: To explore the burden of caregivers of children with chronic illnesses at a tertiary-care health facility in southern Nigeria, in order to devise effective ways of reducing them. Methodology: It was a descriptive cross-sectional survey amongst parents/caregivers of children with chronic illnesses in the Children’s Outpatient clinics /wards and emergency room, who presented for care and/or follow-up visits between October and December 2020. A validated Caregiver Burden Scale (CBS) that assesses the level of burden in five domains: general strain, isolation, disappointment, emotional involvement and environment, was used to obtain data. Caregivers’ and the children’ socio-demographic characteristics were also ascertained and compared with the level of burden. Data were analyzed using SPSS version 25.0. A p-value of < 0.05 was considered significant. Result: A total of 109 caregivers completed the questionnaire. Half (n=55; 50.5%) of the caregivers were aged 30-39years; 88 (80.7%) were females; 58 (53.2%) had post-secondary education and 51 (46.8%) were self-employed. Of the 109 children studied, 70 (64.2%) were males and the commonest diagnosis was sickle cell anaemia (SCA) (n=62; 56.9%) followed by Human Immunodeficiency Virus (HIV) disease (n=35; 32.1%). The age at diagnosis was 1-5years in 70 (64.2%) of cases while 76 (69.7%) of them had received care for 1-5years. The mean caregiving burden score was highest in disappointment (2.0) and lowest in the domain of isolation (1.5), while the overall mean score was 1.7 (SD=0.6). There was a statistically significant relationship between the caregivers’ age and all the domains studied except the general strain, while the other socio-demographic variables had varying significance with the different domains of burden. Conclusion: Severe burden of caregiving was experienced by more caregivers in the domains of disappointment and general strain while the isolation domain experienced the lowest frequency of caregivers with severe burden. Improving social support and advocacy to stakeholders, including the government to take over the financing of medical expenses of children with chronic diseases will reduce the burden of care experienced by their caregivers.

Imbuing Occupations with Spiritual Significance Fosters Experiences of Hope

In theories of occupational therapy, occupation serves as a conduit for creating meaning and well-being. A crucial component of occupational therapy is developing and maintaining hope of clients during periods of major difficulty. Understanding the relationship between hope and occupation can prove helpful in stressful situations, such as caring for children with chronic illnesses. The aim of the present study was to identify occupations that foster experiences of hope among mothers of adult children with mental illness. A qualitative approach, informed by a constructivist framework and thematic analysis, was used to interpret and explicate relevant occupation-related themes that fostered hope in four mothers. The mother-participants reported engaging in various occupations, yet only occupations that were imbued with spiritual significance fostered experiences of hope. This study brings to the forefront of occupational therapy discourse the issue of spiritual connectedness as a potential link between occupations and hope.

Family mealtime behaviors in children who are tube fed and preparing to transition to oral eating: A comparison to other pediatric populations

This study examined differences in observed mealtime behaviors between children preparing to transition to oral feeding and children with various other chronic illnesses using a standardized measure of mealtime beaviors. The parent-child mealtime relationship can become strained due to problematic mealtime behaviors that limit food intake, as well as inadvertent reinforcement of disruptive behavior by caregivers. Frequency/rate of behaviors were compared between children with tube feeding (CwTF) and from previous studies of children with chronic illnesses using the Dyadic Interactive Nomenclature for Eating (DINE). Parents of CwTF used more coaxing, physical prompts, and reinforcement during meals, while parents of children with chronic illnesses used more direct commands and engaged in more parent talk. Findings support differences in parent-child mealtime interactions and eating behaviors across pediatric illness subgroups.

Adherence to vaccination for various populations: survey results

Voluntary anonymous questioning of groups of parents (n = 120), students of junior and senior courses of medical faculty (n = 250), оutpatient doctors (n = 45) concerning vaccination is carried out.Parents showed a generally positive (60%) attitude to vaccination, high anxiety (90%) in connection with the possible development of post-vaccination complications, as well as lack of awareness and inertia in acquiring knowledge about vaccination. The positive trend in knowledge among students from junior to senior courses is adjacent to the lack of practical orientation on vaccination. Outpatient doctors are cautious about vaccination, especially for children with chronic illnesses.