Using process evaluation to describe a hospital-based clinic for children coping with medical stressors.
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OBJECTIVE: To use process evaluation methods to describe the development of a hospital-based mental health clinic for children facing medical stressors. METHODS: Over a 21-month time period, we collected data regarding presenting concern, service use, and referral source using hospital administrative, clinic intake, and clinical records for 356 children. RESULTS: Nearly 90% of the children were referred to the clinic from sources within the hospital. With the exception of single session interventions, there were no differences in average length of services according to presenting concern. Hospital pediatric specialists and psychology consultants were the primary referrers to the program. Pediatric specialists referred more often for procedural concerns and chronic illness than other hospital referrers. CONCLUSIONS: These findings support the feasibility and usefulness of a process evaluation approach in shaping clinical program directions, creating opportunities for collaboration with medical providers, and planning effectiveness research. (+info)
Clinical profile of depressive disorder in children.
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The aim of this retrospective study was to evaluate the risk factors, clinical features and co-morbid disorders of depressive disorder in children below the age of 12 years. Children who attended the child guidance clinic between January 2000 and December 2003 formed the subjects for the study. The diagnosis of depressive disorder was based on DSMIV diagnostic criteria for Major Depressive Disorder, Single episode. There were 26 boys and 19 girls. Stress at school and in the family was significantly associated with depressive disorder. Children with depressive disorder had significantly more family members affected with mental illnesses. The clinical features included diminished interest in play and activities, excessive tiredness, low self- esteem, problems with concentration, multiple somatic complaints, behavior symptoms like anger and aggression, recent deterioration in school performance and suicidal behavior. Majority of children had other associated psychiatric disorders which included dysthymic disorder, anxiety disorders, conduct disorder and conversion disorder. (+info)
Co-sleeping and clinical correlates in children seen at a child guidance clinic.
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INTRODUCTION: Co-sleeping or bed-sharing is a common practice that has been little researched. While often viewed as being "cultural" in nature, there is a suggestion that it may be a parental response to sleep problems. Some studies link co-sleeping with behavioural and temperamental difficulties. The objectives of the current study were to determine the prevalence of co-sleeping and how they relate to sleeping problems among a cohort of children and adolescents seen in a child guidance clinic. METHODS: Parents or guardians of all new patients seen at the child guidance clinic were asked to complete a questionnaire upon their consent to participate in the study. The questionnaire included socio-demographical data and frequency of sleep problems in the past six months. A list of nine common sleep problems was included. RESULTS: The prevalence of co-sleeping was found to be 72.7 percent. The children who co-sleep were significantly younger and there was a decrease in the practice with increasing age. Sleep starts and nightmares were significantly more among those sleeping alone. CONCLUSION: Co-sleeping was not associated with significant sleep problems in our cohort. Co-sleeping may have been initiated in response to an existing sleep problem but eventually resolved the problem. If co-sleeping is not permitted, the sleep problem could be compounded, giving rise to a higher prevalence of sleep starts and nightmares among those in our cohort who slept alone. (+info)