Social stigma stops adolescents from using inhalers for asthma Forgetfulness, poor routines, inadequate inhaler technique, organisational difficulties and families not understanding or accepting their children’s asthma are described as barriers to the use of inhalers among adolescents with asthma. A study by Asthma UK Centre for Applied Research analysed posts by 39 adolescents aged 16 or under, five parents of adolescents and ten adults with asthma who took part in an online forum between 2006 and 2016. It was found that the social stigma of asthma can play a role in teenagers choosing not to use their inhalers. Teenagers taking part in the forum talked about feeling embarrassed with their diagnosis and having to use inhalers. Some said that people around them had negative reactions to their condition. Other reasons given as barriers to inhaler use include: »» Asthma being portrayed on TV and in films as an emotional problem experienced by anxious people. »» Dislike of being labelled with a chronic illness. »» Some inhalers ‘resemble sex toys’. »» Concerns about side effects, such as weight gain and spots. »» Lack of routine. It was concluded that the social stigma of asthma and its role in adherence were prominent and continue to be underestimated, warranting further research and action to improve public awareness of asthma. ++Simoni A, Horne R, Fleming L et al (2017) What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum. BMJ Open. doi: 10.1136/bmjopen-2016-015245

See evidence & practice, page 27

12 / July 2017 / volume 29 number 6

Latest research from the nursing and medical journals

Improvements needed in mental health care for young people A study of child and adolescent mental health services (CAMHS) in all 28 countries of the EU, including legal aspects of adolescent care, has found provision needs to be improved. The characteristics and activities of CAMHS, such as the availability of services, inpatient beds, clinicians and organisations, and delivery of specific CAMHS services and treatments, were found to vary considerably between countries, as do funding sources and user access. For example, the number of public CAMHS relative to target population ranges from 12.9 per 100,000 young people in Finland to 0.5 per 100,000 young people in Bulgaria. On average, young people constitute one fifth of the general population of Europe. In total, 20 countries reported having official national child and adolescent mental health policies covering young people until their official age of transition to adulthood. In several countries, specific subgroups of children and adolescents had poor access to specialised mental health services dedicated to them. For example, of data from 27 countries, only ten provided access to refugees. Neurodevelopmental disorders were found to be the most frequent diagnostic group – up to 81% – for people seen at CAMHS, although data were available from only 13 (46%) countries. The study is part of the five-year milestone project that aims to improve transitions for young people from CAMHS to adult mental health services across Europe. ++Signorini G, Singh SP, BoricevicMarsanic V (2017) Architecture and functioning of child and adolescent mental health services: a 28-country survey in Europe. The Lancet Psychiatry. doi: org/10.1016/S2215-0366(17)30127-X

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Aftyka A, Rozalska-Walaszek I, Wróbel A et al (2017) Support provided by nurses to parents of hospitalized children – cultural adaptation and validation of Nurse Parent Support Tool and initial research results. Scandinavian Journal of Caring Sciences. doi: 10.1111/scs.12426. [Epub ahead of print] Bellin MH, Collins KS, Osteen P et al (2017) Characterization of stress in low-income, inner-city mothers of children with poorly controlled asthma. Journal of Urban Health. doi: 10.1007/s11524-017-01621. [Epub ahead of print] Bruce E, Sundin K (2017) Pediatric nurses’ perception of support for families with children with congenital heart defects. Clinical Nursing Research. doi: 10.1177/1054773817713419. [Epub ahead of print] Chang YH, Yu MS, Wu KH et al (2017) Effectiveness of parenteral glutamine on Methotrexateinduced oral mucositis in children with acute lymphoblastic leukemia. Nutrition and Cancer. doi: 10.1080/01635581.2017.1324995. [Epub ahead of print] Choe K, Kim Y, Yang Y (2017) Pediatric nurses’ ethical difficulties in the bedside care of children. Nursing Ethics. doi: 10.1177/0969733017708330. [Epub ahead of print] Ferrara LR, Saccomano SJ (2017) Constipation in children: diagnosis, treatment, and prevention. The Nurse Practitioner. 42, 7, 30-34. Gill PJ, Saunders N, Gandhi S et al (2017) Emergency department as a first contact for mental health problems in children and youth. Journal of the American Academy of Child and Adolescent Psychiatry. 56, 6, 475-482. e4. Pope N, Tallon M, McConigley R et al (2017) Experiences of acute pain in children who present to a healthcare facility for treatment: a systematic review of qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports. 15, 6, 1612-1644. Raucci U, Parisi P, Vanacore N et al (2017) Acute diplopia in the pediatric emergency department. a cohort multicenter Italian study. European Journal of Paediatric Neurology. doi: 10.1016/j.ejpn.2017.05.010. [Epub ahead of print]

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