International Journal of Integrative Pediatrics and Environmental Medicine

Project SMILE: improving pediatric residents’ use of tools to minimize procedural pain

Adrienne Cheng — 2024-08-23

Background. In medical settings, children are subject to many painful procedures. Pain management during procedures not only reduces psychological and physical trauma but also impacts children’s future responses to pain and procedures. This project aimed to create sustained change in the residents’ culture surrounding procedural pain management in pediatric patients. We hypothesized that an initiative involving education, reminders, and multidisciplinary integration would increase the amount of pain reduction methods used during painful procedures.

Methods. The initiative included all pediatric residents at a single healthcare institution in the northeastern United States, where the pediatric population is only a fraction of the patient load. Project S.M.I.L.E. utilized a novel acronym that incorporates different pain-minimizing techniques to encourage the use of these techniques through educational initiatives, multidisciplinary participation, and increased access to resources. Surveys were conducted pre- and post-intervention to determine the level of change in procedural pain levels.

Results. A total of 24 pediatric residents participated in the survey. The baseline evaluation included 20 procedures, including intravenous line placements, venipunctures/heel sticks, and arterial punctures. Two years after the onset of this initiative, surveyed pediatric residents showed a sustained increase in their use of these methods.

Conclusion. This project demonstrates that the low-cost and simple methods employed in this initiative are efficacious and can be adapted for use in other programs.

Factors associated with the satisfaction of parents of children hospitalized in the pediatric ward in Togo.

Ounoo Elom Takassi — 2024-05-28

Introduction : Patient satisfaction is a central element in the evaluation of the quality of care. The objective of the study was to describe the factors associated with the satisfaction of parents of children hospitalized in the pediatric ward at the Sylvanus Olympio Teaching Hospital.

Patient and method: A cross-sectional study with an analytical aim was carried out between June and August 2022 in the pediatric ward at the the Sylvanus Olympio Teaching Hospital.

Results: A total of 165 parents agreed to participate in our study. The mean age (+/- standard deviation) of the parents was 33.5 years (+/- 8.8). The main elements associated with good satisfaction were: reception (p= 0.009), execution of care (p<0.001) and reaction of caregivers when called (p<0.001). The cost of hospitalization was high according to 69.7% (115) parents and the quality of equipment was poor according to 41.2% (68) others.

Conclusion : Satisfaction was statistically significant between the reception, the care received and the reaction of the caregivers to the children's complaints and not the socio-demographic characteristic.

Childhood Autism Spectrum Disorder: Knowledge, Attitudes, and Practice of Health Professionals in Togo

Foli Agbeko — 2024-05-11

Background. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in behavior, social communication, and interaction.

Objectives. To describe health staff's knowledge, attitudes, and practices regarding ASD in Lomé.

Methods. From January to March 2020, we conducted a multicenter, cross-sectional, descriptive, and analytical study on ASD in childhood. A survey was administered to a sample of healthcare professionals in 5 facilities in Lomé, Togo. A questionnaire assessed the knowledge, attitudes, and practices of ASD among 139 participants (pediatricians, neurologists, general practitioners, psychologists, speech therapists, and nurses).

Results.The participation rate was 84.2 % (117 / 139). One hundred seven health workers (91.5 %) had heard of ASD. Inaccurate knowledge was observed: 65.4 % gave a good definition of autism, 73.2 % did not know the autistic triad, the early warning signs (64.6 %), or the age of onset (61.0 %). Only 22.0 % of staff were familiar with autism screening tools. The highest knowledge was significantly associated with being a speech therapist or pediatrician practicing in a tertiary health facility (p < 0,0001). Higher-graded staff also observed better knowledge levels (p = 0, 0128). Concerning attitudes or practices regarding autistic children, 26 of those surveyed (22,2 %) had already screened for ASD, of whom 23 (88,5 %) worked with other specialties in case management.

Conclusion. This study highlights inappropriate knowledge, attitudes, and practices among health staff. These findings warrant the need for good initial training on ASD, awareness campaigns, and the setting up a specialized center in Togo.