Cerebral palsy: comprehensive review and update

Cerebral palsy [CP] is a common pediatric disorder occurring in about 2 to 2.5 per 1000 live births. It is a chronic motor disorder resulting from a non-progressive [static] insult to the developing brain. CP is the clinical presentation of a wide variety of cerebral cortical or sub-cortical insults occurring during the first year of life. The commonest cause of CP remains unknown in 50% of the cases; prematurity remains the commonest risk factor. Children with CP suffer from multiple problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. Screening for these conditions should be part of the initial assessment. The child with CP is best cared for with an individualized treatment plan that provides a combination of interventions. This requires the provision of a number of family-centered services that make a difference in the lives of these children and their families. Management of spasticity can be challenging with a wide variety of possible therapeutic interventions. The treatment must be goal oriented, such as to assist with mobility, reduce or prevent contractures, improve positioning and hygiene, and provide comfort. Each member of the child's multidisciplinary team, including the child and both parents, should participate in the serial evaluations and treatment planning

Assessing parental expectations and satisfaction in a pediatric hospital setting

the purpose of this study was to measure parental expectations and satisfaction in the pediatric unit of our hospital and to explore factors that may contribute to an unfavorable experience. interviews with the parents of children admitted to the pediatric unit were conducted on the day of discharge. A structured 36-item questionnaire was designed to examine areas of parental expectations and reactions to the care provided by the hospital. during the study period, 88 randomly selected individuals were interviewed. This represented 17% of the 512 children discharged during this time. In 86% of the cases, the mother was interviewed. Most of the parents [92%] were entirely satisfied with the care received, and 81% felt that the experience was better than they had anticipated. More parents were satisfied with physician care [93%] than with nursing care [72%, p=0.001]. Fewer were satisfied with the explanations provided for investigations [78%] and treatment [69%]. The discharge plan was clearly explained according to 94%. Only 7 parents [8%] reported inconveniences related to the presence of medical students. This correlated with the child's age being less than 1 year [p=0.007] and the chronicity of the disease [OR=7.6, 95% C.I. 1.1-83]. this study shows high percentage of parental satisfaction of the pediatric care, which mainly was of physician care. The main cause of dissatisfaction was the presence of medical students, especially in the case of a young child [<1y], or chronic disease