Pediatric nursing最新文献

Deformational plagiocephaly (DP) is a common condition and the leading cause of head shape abnormalities in infants. It is characterized by asymmetrical distortion of the skull resulting from external forces on the back of the head. DP has become more prevalent in infants and has increased dramatically since the introduction in 1994 of the “Back to Sleep” campaign. Management of this condition is not often covered by insurance, and can be costly and lengthy; However, DP can be prevented. Early recognition and management can make a significant difference in patients’ outcomes and reduce the cost of treatment. Nurses play a key role in recognition and prevention, are instrumental in educating parents and caregivers, and have a significant impact on preventing and reducing the risk of DP. Current systematic approaches to clinical assessment, diagnosis, and management strategies of DP can help nurses who care for infants and their families understand DP and take the necessary steps to prevent it.

Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

More than 600,000 people die each year as a result of exposure to secondhand smoke (SHS); 28% of those deaths are children. Most exposure for children occurs in the home and is due to a parent smoking. Parental awareness and understanding of the exposure to SHS and the risk that parental smoking brings to the child may be an effective impetus for smoke avoidance and parental tobacco cessation. This descriptive, correlational study used data provided by a convenience sample of 184 smoking parental-figures, representing 376 children, recruited in community settings. Seven research questions were posed regarding the exposure of children to parental figures who smoke, the degree of the parents’ dependence on nicotine, and their level of motivation to stop smoking. Comparisons were made between income levels and ethnic/racial groups. Children’s exposure to SHS was low; Asian children had the highest likelihood of exposure. The areas of most frequent exposure were multiunit residential communities and in a vehicle. Parents’ dependence on nicotine was moderately high, and parental motivation to quit smoking was high. However, parents who were the most dependent on nicotine were the least motivated to quit. Nurses working with both adult and pediatric populations should address the opportunities for exposure to SHS for their patient population. Community health nurses should specifically target workplaces, businesses, and communities with high numbers of Asian residents for public health education related to childhood exposure to SHS.

Over 400,000 children are in foster care in the United States, and more than 100,000 of them are waiting to be adopted. Yet many will age out of foster care into adulthood without an adoptive family. Teens and young adults aging out of foster care, even those with preparation and training for the transition, often do not fare well in young adulthood. Many face challenges in areas of education, employment, homelessness, finances, the criminal justice system, and meeting health and mental healthcare needs. Research demonstrates what only makes sense: teens with tangible support from meaningful adult relationships fare better than those without. This article describes an innovative program that connects teens in foster care with supportive adults through social events that can lead to meaningful long-term teen-adult connections - including friendships, mentoring, and even, in some cases, adoption. Pediatric nurses, aware of the challenges these teens face adjusting to adulthood, can begin to explore referral and support options for such teens in their own locales using the resources herein.

Complex regional pain syndrome (CRPS) is a clinically diagnosed chronic pain syndrome characterized by severe pain and functional disability following a minor injury. The affected limb often has evidence of changes in sensory, vasomotor, sudomotor/edema, and/or motor/tropic function. The diagnosis of CRPS in the pediatric population is increasingly common, especially among female adolescents. The pain experience of adolescents with CRPS is best understood using the biopsychosocial framework, and the most effective treatment programs target biological, psychological, and social factors. Treatment for CRPS is multidisciplinary and typically includes physical therapy, occupational therapy, and psychology. The parent-child dyad that develops when the child has CRPS is complex and characterized by significant psychological distress, ineffective parenting, and poor coping. The purpose of this article is to describe the role of parents in the treatment of adolescents with CRPS. To promote successful remission from pain and restoration of functional ability, parents should be included in treatment programs. Nurses caring for adolescents with CRPS can assist parents in developing adaptive parenting skills.

An increase in vaccine hesitancy is contributing to an increase of vaccine refusal and the use of an alternative vaccine schedule (AVS) in the United States. Increasing vaccine knowledge and correcting vaccine misinformation has the potential of shifting parental attitudes, decreasing vaccine hesitancy, and increasing parental intent to vaccinate. The aim was to examine the impact of a voice-over PowerPoint™ presentation on vaccine education and decision-making by vaccine-hesitant parents in a pediatric primary care clinic. A quasi-experimental study using the Parent Attitude about Childhood Vaccine (PACV) Survey was conducted in a suburban pediatric clinic to explore the impact of vaccine education on decision-making by vaccine-hesitant parents. PACV Survey scores were collected over three months. Surveyed parents reported they trust their healthcare provider. Unfortunately, although parents trust the information their medical providers give them on vaccine safety, they continue to be concerned about vaccine side effects. Mothers tended to provide more vaccine-hesitant scores than fathers related to safety and efficacy concerns. The utilization of the PACV Survey and voice-over PowerPoint presentation on vaccine education is an intervention that may be used in pediatric clinics to assist in vaccine education and identify vaccine-hesitant parents. The study contributes to the addition of evidence- based vaccine education.

Dental caries is one of the most prevalent and significant health problems in the United States. According to the American Academy of Pediatric Dentistry, more than one-fourth of children between the ages of two and five years experience early childhood caries before entering kindergarten. The purpose of this study was to explore parent’s knowledge of preschool children’s oral health risk factors. A descriptive design was used with a convenience sample of 87 parents of children who attended day care centers and preschools. Seventeen knowledge questions were used to assess parents’ knowledge of their child’s oral health. Results showed that parents lacked knowledge in some aspects of oral health care. The majority of parents knew that baby teeth are important, and both baby and permanent teeth should be brushed. Fewer, however, perceived that cavities in baby teeth lead to cavities in permanent teeth. Similarly, parents knew the role of food in the dental caries, but fewer perceived that cavities may be caused by using a bottle or infant drinking cup to drink fluid other than water and frequent snacking. Findings illuminate the knowledge gaps in this sample of parents of preschoolers. Pediatric nurses can play a key role in promoting children’s oral health and preventing dental caries by proving anticipatory guidance and education to children and their parents at well child visits, during hospitalization, and in school and community settings.