OBJECTIVE: Crying is a common but seldom studied phenomenon in palliative care. The aim of this study was to explore the significance of patients crying in a palliative care context. METHODS: Tape-recorded interviews with 14 cancer patients in palliative home care were carried out. To gain deeper understanding, a hermeneutic analysis and interpretation was used. RESULTS: Crying was described in different dimensions: (1) intense and despondent crying as a way of ventilating urgent needs, (2) gentle, sorrowful crying as a conscious release of emotions, and (3) quiet, tearless crying as a protection strategy. Crying seems to be an expression for an inner emotional force, provoked by different factors, which cause changes in the present balance. To cry openly but also to cry on the inside meant being able to achieve or maintain balance. Crying may be something useful, which could create release and help reduce tension, but it may also have a negative impact as it consumes energy and creates feelings of shame. SIGNIFICANCE OF RESULTS: Professionals need to understand the different levels of crying. In such situations sometimes comforting the patient may not be the best solution, as some may need privacy.
We studied mother-infant, father-infant and mother-father interaction in 32 families with an excessively crying infant and in 30 control families. The group with excessive criers was divided further into subgroups of severe colic (n=13) and moderate colic (n=19). The three dyads of the family were video-recorded when the infants were an average of 5 weeks old. The assessment was carried out during the infant's feeding, nappy change and discussion between the parents. During the assessment, only four infants were crying. The Parent Child Early Relational Assessment Scale and the Beavers Scale were used.
The main findings suggest that both parents of colicky infants had less optimal parent-child interaction compared with the control parents. The problems in the interaction were most pronounced between the fathers and infants in the severe colic group. The father-infant interaction was less optimal in 13 items of 65 (20%) in the severe colic group, in one item of 65 (2%) in the moderate colic group and in none of the items in the control group. The mother-infant interaction was less optimal in six items out of 65 (9%) in the severe colic group, in three items out of 65 (5%) in the moderate colic, and in none of the items in the control group. Severely colicky infants were also less competent in interacting with their parents. In addition, interaction between the parents was more often dysfunctional in the severe colic group.
The problems in early family interaction may threaten the well-being of families with excessively crying infants and they therefore deserve special attention from the health care professionals.
The objective of this study is to determine whether advice in parenting magazines reflects current evidence-based understanding of early infant crying and colic, where (1) "colic" is the upper end of a spectrum of crying behavior reflective of normal infant development, and (2) physical abuse--in particular, shaken baby syndrome (SBS)--is a serious medical consequence of early crying. All available issues of 11 popular Canadian parenting magazines published between January 2000 and December 2004 were hand-searched and systematically reviewed. Fifty-one articles were found with information on: (1) causes of, (2) responses to, and/or (3) mention of SBS or abuse as a consequence of crying and/or colic. There were 105 specific causes suggested, but almost no agreement concerning the causes of crying and colic. Similarly, there were 231 specific responses to crying and colic mentioned, but little agreement among the suggested responses. For both crying and colic together, the consequence of abuse was mentioned only 7 times, and SBS only twice. Making the advice literature a truly helpful vehicle for parents concerning normal behavioral development and its consequences for their new infant seems to be a significant challenge. Arguably, this is an important shared responsibility of physicians, researchers, and journalists.
Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.
In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse's responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.
A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32-63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient's wishes. A few examples of the patients' need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.
A Dutch study is described, in which the occurrence of potentially detrimental parental actions induced by infant crying were assessed and thereafter related to various factors, including the parents' judgment that the crying was "excessive". commentary in the same Lancet issue questions whether this might be interpreted as a "blaming of the victim" process. Official Swedish and international statistics on child abuse, especially a recent UNICEF report, are summarized. The co-occurrence of spouse and child abuse is briefly discussed. Southall and co-workers' report on covert video recordings of life threatening child abuse is related, as well as some of the public reactions following it, and a proposed new categorization of child abuse.
OBJECTIVE: Childhood overweight and rapid weight gain during the first months of life have been shown to be major risk factors for the development of later overweight. Studies in children show that there are temperamental risk factors for the development of overweight, but little is known about early infancy. METHODS: The present study investigated the relationship of infant difficult temperament, assessed at age 6 months, with overweight status at birth and at 6 months of age and with rapid weight gain during this period. Data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health (1999-2006). The analyses are based on data retrieved from the Medical Birth Registry of Norway, health charts, and maternal reports during pregnancy and when the child was 6 months of age. After application of eligibility criteria, 29,182 infants could be included in the study. RESULTS: In adjusting for infants' sex, formula feeding, maternal age, body mass index and diabetic status, and parental duration of education, infant difficult temperament was slightly negatively associated with overweight status at birth but not at age 6 months. In addition, infant difficult temperament was slightly positively associated with rapid weight gain during the first 6 months of life. CONCLUSIONS: Despite statistical significance, these associations do not appear to be clinically relevant. Future studies should explore whether the impact of temperament increases with age.
We aim to estimate the pathways between maternal symptoms of anxiety and depression and child nocturnal awakenings via structural equation modeling using a sibling design.
Structural equation modeling on data from 14,926 sibling dyads or triads from the Norwegian Mother and Child Cohort Study.
At 6?months, we estimated the association between maternal symptoms of anxiety and child nocturnal awakenings to be owing to several nonsignificant pathways. Child nocturnal awakenings at 18?months, however, were influenced by concurrent maternal symptoms of anxiety (ß?=?.10) and depression (ß?=?.12). Neither maternal symptoms of anxiety (ß?=?.04) nor depression (ß?=?-.00) was influenced by concurrent child nocturnal awakenings.
Our findings suggest that maternal mental health influences child sleep behavior at 18?months after birth, and not vice versa. This is in support of hypotheses on maternal mental health influencing child sleep during toddlerhood.
Colic is widely believed to remit by 3 months of age, with little lasting effect on the infant or the family.
To determine the prevalence of colic at 3 months and the proportion of cases of colic (identified at 6 weeks) that remitted by 3 months; to identify the factors predictive of colic's remission; and to explore the potential lasting effects of colic on maternal mental health.
Prospective cohort study of 856 mother-infant dyads. Self-administered questionnaires were mailed to mothers at 1 and 6 weeks and 3 and 6 months post partum. Standardized instruments were incorporated into the first and last questionnaires to assess maternal anxiety, postnatal depression, and social support. At 6 weeks and at 3 months, mothers completed the Barr diary and/or the Ames Cry Score.
Data from 547 dyads were available for analysis. The prevalence of colic at 3 months was 6.4%. More than 85% of cases of colic had remitted by 3 months of age. These infants were more likely to be female, whereas the mothers of these infants were more likely to have received pain relief during labor/delivery and to have been employed during pregnancy. Reductions in scores for trait anxiety and postnatal depression, although smaller for mothers whose infants were colicky at 6 weeks of age, were not significantly different from those of mothers whose infants were never colicky.
This study provides support for the belief that, in most cases, colic is self-limiting and does not result in lasting effects to maternal mental health.
On the basis of a descriptive, prospective investigation, the patterns of fussing and crying in normal Danish infants aged from 2-3 to 14 weeks are described. A total of 102 infants were included in the investigation and 85% completed the investigation. The parents carried out daily registration of the periods of fussing and crying. The great majority of the infants were very placid. The mean duration of fussing for the entire group was half an hour per week during the third week of life. This increased to 2 1/2 hours per week at the sixth week of life and then decreased gradually to 0 hours per week from the 12th week of life. The material was subdivided into quartiles. Infants in the first and second quartiles showed practically no fussing. Infants in the third quartile were fussy at the commencement of the period and became gradually more placid from the fifth week of life. Infants in the fourth quartile were fussy during the first 9-10 weeks of life, after which the fussing gradually diminished. In infants in the third and fourth quartiles, fussing was most marked in the evenings. Two pairs of parents considered that their infants had colic. Ten infants were defined as having infantile colic. In these infants, the patterns of fussing and crying showed a common pattern and this was significantly different from the remainder of the group. The basic variables for the 25% most placid infants and the ten infants presumed to have colic are compared.
To explore how people experience grief and what factors are perceived as facilitating successful grief work, a survey was distributed to people who had completed a grief recovery course. The results showed that emotions, cognitions, physical expressions, and behaviors all characterize grief, but that emotions are the most central component. The course brought relief and was regarded most favorably by those having at least 1 year between the grief trigger event and participation in the course. Writing a letter in which course participants express their feelings to the loss object was perceived as the most successful aspect of the course. The letter might help with grief recovery by bringing aspects that have not been dealt with into conscious awareness.