Communication on analgesia and sedation: parents’ opinions in six pediatric ICU in northern Italy

Abstract Introduction Communication between healthcare professionals and parents regarding analgesic and sedative treatments for seriously ill children is challenging. Although appropriate information may help parents during admission to the pediatric intensive care unit (PICU), some areas of communication may be missed. Objectives To explore and describe the opinions of parents of children admitted to PICU about analgosedation, information received about it and its potential adverse effects, and suggestions for improving the comfort of hospitalized children. Methods Parents’ opinions were collected in six PICUs in northern Italy. Parents of children who were hospitalized for more than 48 hours and required analgesia and sedation were asked to provide opinions on the quality of information with respect to the treatments used, possible short- and long-term sequelae, satisfaction with efficacy, environmental factors perceived as disturbing, and suggestions for improving children’s comfort. Results Forty-eight parents participated. Information about analgosedation was rated, as was its effectiveness. Parents pointed out some interesting suggestions to improve their children’s comfort during their hospitalization in PICU. On the other hand, it was found that information about possible complications, withdrawal syndrome, delirium, or difficulties in obtaining the desired level of sedation was often provided poorly or inadequately. In addition, wide differences were found between centres, particularly with regard to analgosedation side effects and withdrawal syndrome. Conclusions Parents should receive early explanations of these potential complications. Even considering the limited number of participating PICUs, distributed exclusively in northern Italy, and the small number of participants, this is the first data collection focused on communication between health professionals and parents of children undergoing analgosedation treatment in pediatric intensive care units. Key messages • This is the first data collection focused on communication between health professionals and parents of children undergoing analgosedation treatment in pediatric intensive care units. • Information about possible complications, withdrawal syndrome, delirium, or difficulties in obtaining the desired level of sedation was often provided poorly or inadequately.


Background:
This review aims to provide an overview of evidence on feasibility and effectiveness in diverse populations of eHealth physical activity (PA) community engagement (CE) interventions. Increasing global PA levels would have a substantial positive impact on population health. Given their diffusion, eHealth technologies may address certain barriers to PA and reach wide audiences. The most recent Italian guidelines on PA highlight inequalities in health, which can be addressed using CE models. The potential scalability of successful eHealth CE interventions and the scarcity of previous reviews on the topic are reasons which convinced us to work on this paper.

Methods:
This mixed-methods systematic review utilized the Joanna Briggs Institute methodologies. Primary quantitative outcome measures were minutes of PA per week. Qualitative outcome measures included self-efficacy and user engagement. Data were processed using a segregated convergent design. A narrative summary and a meta-aggregation were performed for synthesizing quantitative and qualitative data respectively. Only the interventions where CE principles were fulfilled were analyzed.

Results:
Quantitative evidence supported effectiveness and feasibility of interventions to improve PA outcomes and related proxy indicators across studied populations. Qualitative findings suggest the utility of peer-support and that from other health care providers. Conclusions: Implementing CE in future PA interventions will be critical for producing an effective digital application with the potential for considerable impact in the real world. If supported by central governments and the European Union, entities such as primary care hubs and local health units with their professionals and CE capabilities may play the key role in implementing evidence.

Background:
Understanding health information flow in social networks is important for designing effective health communications strategies and to achieve health literacy. Limited information is known about variation in social networks and health information sharing in the COVID-19 pandemic by demographic factors. Young people are of particular interest given their heavy exposure to digital media sources, which include considerable health misinformation.

Methods:
Hawai'i (n = 324) residents between 18-35 completed a Spring 2021 online survey including questions on health information flow in social networks: (1) how many they talked to and (2) listened to about health. Two Poisson regression models were fit with gender, education, and race/ethnicity predicting social network size.

Results:
Respondents were 67.6% female. Respondents discussed their own health with 2-3 people (M = 2.18, SD = 2.95) and listened to roughly the same number. Respondents who talked with a greater number of individuals about their own health were significantly more likely to have larger networks for listening to others (r (317) = .614; p< .001). In the model for discussing their own health, as education increased so did social network size. For the model predicting discussing others' health, gender was significant (p = 0.003); women listened to 30.6% more individuals than men. Most (73%) respondents had conducted a recent digital health search for either themselves or someone else, including for parents, grandparents, and children. Facebook (63%) and Instagram (58%) were the most popular online sources for COVID-19 health information.

Conclusions:
Understanding social networks and digital health sources in young people are important for designing effective health communications to reach all communities, especially those experiencing health inequities, given the amount of health