Torun M. Vatne

Application of the verona coding definitions of emotional sequences (VR-CoDES) on a pediatric data set.

OBJECTIVE Adult patients present concerns as defined in the Verona Coding Definitions of Emotional Sequences (VR-CoDES), but we do not know how children express their concerns during medical consultations. This study aimed to evaluate the applicability of VR-CoDES to pediatric oncology consultations. METHODS Twenty-eight pediatric consultations were coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES), and the material was also qualitatively analyzed for descriptive purposes. Five consultations were randomly selected for reliability testing and descriptive statistics were computed. RESULTS Perfect inter-rater reliability for concerns and moderate reliability for cues were obtained. Cues and/or concerns were present in over half of the consultations. Cues were more frequent than concerns, with the majority of cues being verbal hints to hidden concerns or non-verbal cues. Intensity of expressions, limitations in vocabulary, commonality of statements, and complexity of the setting complicated the use of VR-CoDES. Child-specific cues; use of the imperative, cues about past experiences, and use of onomatopoeia were observed. CONCLUSION Children with cancer express concerns during medical consultations. VR-CoDES is a reliable tool for coding concerns in pediatric data sets. PRACTICE IMPLICATIONS For future applications in pediatric settings an appendix should be developed to incorporate the child-specific traits.

How Children With Cancer Communicate and Think About Symptoms

Background. For clinicians to effectively help children with their illness and symptoms, it is important to communicate with them in a language they can understand. Methods. This study investigates how well children with cancer and healthy children understood 44 symptom terms; their thoughts about these symptoms in terms of causes, consequences, and cures; and what other terms the children use to express these symptoms. It also explores if there are differences in understanding and thoughts about symptoms between children who have the experience of cancer and those who do not. In all, 6 children with cancer and 8 healthy children participated in semistructured interviews. Results. Children demonstrated a good understanding of symptom terms, yet were not always able to explain the symptoms. They had a rich vocabulary to talk about symptoms but did not use childish terms. Children with cancer had a more varied vocabulary for symptoms, but they did not use more medical terms.This study contributes to knowledge about children’s understanding of symptoms that can be helpful to clinicians when communicating with children about their illness.

Effects of an interactive symptom communication tool for children with heart disease on patient-provider communication in outpatient care: Preliminary results

Abstract While children with chronic illness can experience many physical, functional, and psychosocial symptoms and problems, they do not have the same verbal skills as adults to communicate about distressing symptoms, leaving them at particular risk that their problems remain under-diagnosed and treated. This study investigated the effects of an interactive communication tool for children with heart disease, called Sisom, on patient-provider communication in pediatric cardiology out-patient consultations. Fourty-two children aged 7–13 diagnosed with heart disease used Sisom in preparation for their consultation. The resulting summaries of the childrens perceived problems were shared with their nurses and physicians for use during the consultation. A control group, matched on gender and age (n = 42), received usual care. All consultations were video-taped and analyzed with the Roter Interaction Analysis System. Compared to the control group, almost twice as many symptoms and problems were addressed when Sisom was used (10.7 vs. 5.9; P < 0.001), without increasing consultation time. Physicians provided significantly more information (4.9 vs. 3.5; P < 0.01); nurses asked more follow-up questions (4.0 vs. 2.2; P < 0.05); parents and health care providers directed their conversation more often towards the child (6.7 vs. 2.1; P < 0.001); and children participated more often with information (25.2 vs. 15.6; P < 0.05) and in discussions about medical topics (8.0 vs. 4.3; P < 0.05). While the small sample size necessitates cautious interpretation, study results suggest that Sisom can effectively improve patient-centred communication for children with heart disease in regular pediatric practice.

Cognitive behavioral therapy for adolescents with 22q11.2 deletion syndrome

Purpose – 22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline range. Due to the cognitive and social problems many adolescents with 22q11.2DS experience, adaptions may be needed to teach these adolescents cognitive behavioral therapy (CBT) skills. The purpose of this paper is to assess psychosocial functioning in adolescents with 22q11.2DS and to adapt CBT with this group. Design/methodology/approach – Totally twelve adolescents (M age=14.5 years, SD=1.4, range 12-17 years; 25 percent boys) with 22q11.2DS were recruited from a competence center for rare disorders. Their parents completed the Child Behavior Checklist and the Kiddie SADS screening interview. The adolescents participated in 7×45-minute CBT group sessions, comprising emotional awareness, cognitive restructuring tasks, and problem-solving skills. Findings – Adolescents had poor parent-reported social and school functioning at...

Hvordan støtte foreldre til barn med livsforkortende sykdom

A disorder is regarded as rare when it affects fewer than 500 of the general population (1 : 10 000). More than 30 000 people in Norway live with a rare disorder, many of whom are children. Several of these diseases show a progressive course where the child develops normally early in life. These diseases may be muscular, for example Duchenne muscular dystrophy; neurological, for example neuronal ceroid lipofuscinosis; or metabolic, for example adrenoleukodystrophy (1).