A systematic review and proposed conceptual model of sleep disturbances during pediatric hospitalizations.

STUDY OBJECTIVES: The current review aims to examine factors that influence pediatric inpatient sleep and determine the effectiveness of sleep promotion interventions among hospitalized children. METHODS: A systematic literature search was conducted across PubMed, PsycINFO, CINAHL, Cochrane Central, Web of Science, Embase, and Scopus databases. Studies included children with a mean age between 1 and 18 years old that either described factors affecting the sleep of children who are hospitalized on a non-intensive care unit or reported on sleep-related intervention outcomes. We conducted separate narrative reviews for each of the two aims and then synthesized findings from quantitative and qualitative studies across both aims. RESULTS: Forty-five articles were included for review. Despite most sleep disturbances being attributed to environmental disruptions (e.g. noise, staff interruptions), most interventions targeted the child level using relaxation techniques. Although the majority of interventions were small pilot studies, preliminary findings appear to positively impact sleep duration. The Pediatric Inpatient Sleep Model was proposed to illustrate connections between sleep disturbances, factors influencing sleep, and existing intervention components. CONCLUSIONS: Replication studies are needed, including larger-scale sleep promotion interventions among hospitalized children. Given the identification of environmental factors as the main cause of night wakings, environmental modifications are crucial. Additional research examining contributors to intraindividual variability in disrupted sleep patterns during hospitalizations as well as the consequences of these disturbances is warranted.

Using Mobile Health to Improve Asthma Self-Management in Early Adolescence: A Pilot Randomized Controlled Trial.

PURPOSE: Early adolescence is an important developmental period where youth take primary responsibility for asthma self-management. Helpful caregiver support during this time is pivotal in determining whether early adolescents successfully develop asthma self-management behaviors. AIM2ACT is a dyadic mobile health intervention designed to increase helpful caregiver support as early adolescents engage in asthma self-management behaviors. We conducted a pilot randomized controlled trial to determine the feasibility and acceptability of AIM2ACT and conduct preliminary tests of efficacy. METHODS: We randomized adolescents (12-15 years old) and a caregiver to receive AIM2ACT (n = 17) or a self-guided attention control condition (n = 16) for 20 weeks. We conducted assessment visits at baseline, postintervention, and 4-month follow-up. Outcomes included family asthma management (primary outcome), adolescent asthma control, lung function (forced expiratory volume in 1 second), asthma-related quality of life, asthma management self-efficacy, and family communication. RESULTS: We randomized 33 dyads and had 100% retention in the trial among AIM2ACT participants. Dyads frequently engaged with AIM2ACT (M = 21 days for adolescents, 32.65 days for caregivers) and reported very high satisfaction with content, functionality, and helpfulness. Participants randomized to AIM2ACT had significant improvements in asthma control scores (p = .04) compared to control that surpassed the minimally clinically important difference threshold. Although not statistically significant, the magnitude of improvements in family asthma management, asthma-related quality of life, and family communication was larger in the AIM2ACT group. CONCLUSIONS: AIM2ACT is a feasible and acceptable dyadic mobile health asthma self-management intervention that improves asthma control.

Predicting Success for Student Physical Therapists on the National Physical Therapy Examination: Systematic Review and Meta-Analysis.

BACKGROUND: In physical therapist education, the National Physical Therapy Examination (NPTE) is the predominant measure of student success. Because the NPTE is a high-stakes examination, predicting NPTE performance is important for physical therapist students and programs. PURPOSE: The purpose of this study was to determine the relationships between first attempt NPTE performance, physical therapist applicant variables, and physical therapist student variables. The 4 identified physical therapist applicant variables were undergraduate cumulative grade point average (GPA), undergraduate GPA for prerequisite courses, Graduate Record Examination verbal and quantitative subscale scores, and admission scores. The 4 identified physical therapist student variables were first- and third-year physical therapist student GPA, clinical performance scores (first and final clinical experiences), noncognitive student variables, and comprehensive examination scores. DATA SOURCES: A systematic search was performed using the databases PubMed and EBSCO (1966-2018). STUDY SELECTION: Studies included in the review met the following criteria: the physical therapist education program offered an entry-level master's or doctorate degree, pertinent data were available for each independent variable, the relationship between the independent variable and the NPTE was investigated, the NPTE was a continuous variable, the program was a US entry-level therapist education program, and the study was peer reviewed. DATA EXTRACTION: Two independent reviewers completed data extraction and quality appraisal using the McMaster Appraisal Tool. DATA SYNTHESIS: Random-effects meta-analyses using the Pearson product-moment correlation coefficient as the measure of effect size was used. LIMITATIONS: Limitations of the review included a lack of homogeneity, high NPTE pass rates, modifications to the McMaster Appraisal Tool, small sample sizes, and publication bias. CONCLUSIONS: No one physical therapist applicant variable should be used as an independent predictor of first attempt NPTE performance. For physical therapist students, first- and third-year physical therapist student GPA had a strong relationship with first attempt NPTE performance; clinical performance had a weak and nonsignificant relationship with first attempt NPTE performance.

A Systematic Evaluation of Asthma Management Apps Examining Behavior Change Techniques.

BACKGROUND: Mobile health (mHealth) apps have the potential to facilitate asthma self-management by including medication reminders, allowing self-monitoring of symptoms, improving access and quality of information communicated with provider, and providing educational resources to patients and parents. Many apps exist for asthma management; however, the extent to which apps include evidence-based behavior change strategies has not been examined. OBJECTIVE: To review the content and quality of mHealth asthma management apps that are available to patients. METHODS: Asthma apps were identified using a systematic search process. Twenty-three apps were coded for presence or absence of behavior change techniques (BCTs) using the taxonomy of BCTs as defined by Abraham and Michie in 2008. Quality ratings were also determined for each app using the Mobile App Rating Scale (MARS). RESULTS: The number of BCTs each app used ranged from 1 to 11 (mean, 4). BCTs that were most commonly used were instruction, behavior-health link, self-monitoring, feedback, teach to use prompts/cues, consequences, and others' approval. Overall app quality based on MARS scores ranged from 2.45 to 4.50 (mean, 3.32). Two apps, Kiss myAsthma and AsthmaMD, used at least 8 BCTs and had high quality ratings. CONCLUSIONS: Kiss myAsthma and AsthmaMD used at least 8 BCTs and had good quality scores.

Social support in cancer: How do patients want us to help?

Objective: Social support is fundamentally important to the well-being of patients with cancer, and informal caregivers often wish they had better insight into how to help. The aims of this study were to quantify the types of social support that patients qualitatively expressed as important, and examine whether demographics and mental health symptoms explained the type of support desired. Methods: A sample of 82 patients with cancer (Gender: 65.9% Male, Age: M = 57.5, Race/Ethnicity: 90.2% White, non-Latino/a) completed measures of demographics, health, anxiety, and depression, and responded to an open-ended question asking them to list three types of support that they desire from their caregivers. These responses were then reliably coded into 18 different categories. Results: Most commonly, participants expressed a desire for companionship (45%). Other common requests included empathy (33%), home care support (28%), information support (16%), being treated the same (15%), and help with appointments (13%). Patients who were more anxious were more likely to desire companionship (OR = 4.41, p = .033), and younger patients were more likely to desire home care support (OR = 7.24, p = .016). Conclusion: Findings have implications for providing individually-tailored social support to patients with cancer.