Journal of Child and Adolescent Psychiatric Nursing最新文献

Problem

Via a network analysis approach, following 2 weeks of the medication Ritalin, the present study investigated the quality of symptom interactions and the pattern of behavior changes to identify locations of functional weaknesses in the network interactions of symptomology.

Methods

Ritalin® prescribed for 112 children (aged 4–14) with attention deficit hyperactivity disorder (ADHD) as diagnosed by five child and adolescent psychiatrists. Their parents completed Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV) before and after Ritalin® onset as the pre and post-test, respectively. Then, the network analysis approach was used to discover the pattern of changes in symptom interactions.

Findings

The results indicated that in 2 weeks following its initiation, Ritalin significantly reduced restlessness and interactions between symptoms of impulsivity. “Inability to follow instructions” and “difficulty waiting their turn” symptoms were the most central symptoms of strength. Three symptoms, “Often has difficulty waiting their turn,” “runs and climbs in situations where it is inappropriate” and “does not follow through on instructions,” had the most expected influence. In the 14-day period of investigation, Ritalin® was effective in breaking some interactions and components of ADHD, but no significant mitigation of other components of the detected symptomatology network.

Conclusion

Follow-up investigations using network analysis can clarify the dynamics of the network changes after initiation of medications.

Problem

The research aimed to determine the relationship between internet addiction and peer bullying in sixth and seventh-grade students.

Method

The population of the study consisted of students in the sixth and seventh grades of secondary schools in a province in eastern Turkey. The data were collected throughout the 2021–2022 academic year from 1201 sixth and seventh graders who voluntered to participate in the research. The data were collected using the Bullying Scale and the Internet Addiction Scale for Adolescents (IAA).

Finding

It was determined that gender, grade level, status of having a mobile phone, and age influenced children's participation in peer bullying. Also, variables of gender, grade level, and status of having a mobile phone affected internet addiction levels. Furthermore, when the correlation between the two scales was analyzed, a strong positive correlation was determined.

Conclusions

In line with the findings of this study, interventions that may lower levels of bullying include delivering training on bullying and internet addiction to families, encouraging children to participate in activities that would reduce the amount of time they spend on the internet, and investigating the reasons for bullying.

Problem

The death of a parent is a traumatic experience for adolescents. Studies to ensure post-traumatic growth in adolescents are limited. The aim of this study to evaluate the effect of nursing care based on Watson's Theory of Human Caring on posttraumatic growth in parentally bereaved adolescents.

Methods

This study was participatory action research. The study was carried out with four participants through online interviews. In the study, pre- and post-action data were obtained through individual interviews and scales. During the action process, nursing care based on the Theory of Human Caring was provided to the participants individually tracked through the Omaha System. Pre and post-action qualitative data were analyzed using the descriptive analysis method. In quantitative data, scale total and sub-scores were documented.

Findings

During the action, it was determined via Omaha System coding that the participants mostly experienced grief and mental health problems. In the pre-action, the participants stated that they experienced various difficulties regarding grief. In the post-action, the participants stated that the meaning of parental loss,its effects on life, and their ability to cope with loss changed and they experienced positive changes. In addition, when the scale scores of the participants' pre- and post-action were compared, it was found that the Mourning Scale scores decreased, and the Post-traumatic Growth Inventory scores increased.

Conclusions

The result of this study demonstrate that nursing care based on Theory of Human Caring reduces the grief symptoms and contributes to post-traumatic growth in parentally bereaved adolescents.

Problem

Art- and narrative-based interventions are an integral component of pediatric inpatient psychiatric care. We describe a novel therapeutic comic book we developed for hospitalized children and young adolescents.

Methods

A Hero's Journey is a 38-page zine that can be freely downloaded and photocopied for distribution. The short booklet is intended to demystify and offer guidance throughout the experience of hospitalization, promote interaction and socialization, provide scaffolding for skill-building, and prepare patients for moving forward after discharge.

Findings

The underlying foundations of the booklet include: 1) Theoretical sources (Joseph Campbell's hero's journey; Donald Schön's reflective practice; and the principles of narrative medicine); and 2) Clinical sources (collaborative problem solving; cognitive-behavioral therapy, and trauma-informed care). We articulate how each page relates to the different components, and how individual pages can be used as worksheets for practice of specific skills. We next provide suggestions on how best to use the booklet: from arrival at the emergency room, through inpatient hospitalization, and toward discharge. We also propose ways for staff, caregivers, and any child-facing adult to make use of this clinical resource in support of a patient's recovery and reintegration into their community.

Conclusions

Even though not yet empirically tested, this therapeutic comic book is available for dissemination free of cost. We encourage leaders in nursing and therapeutic recreation to try using this resource in their emergency room and milieu settings.

Problem

This study was conducted to investigate the relationship between peer bullying, loneliness and perceived social support in refugee adolescents.

Methods

This research was conducted with 514 refugee adolescents living in the Central Anatolia region of Turkey. In this descriptive correlational study, data were collected using the Peer Bullying Scale Adolescent Form, the Loneliness Scale, and the Multidimensional Scale of Perceived Social Support.

Findings

The mean score of the refugee adolescents on the victim subscale of the Peer Bullying Scale was 86.71 ± 27.51, and on the bully subscale was 68.08 ± 16.41. The mean score of the adolescents on the Loneliness Scale was 49.63 ± 9.50, on the Perceived Social Support was 52.19 ± 1.66. A positive moderate relationship was observed between the bully subscale and the victim subscale of the Peer Bullying Scale (p < 0.05). No relationship was found between the bully and victim subscales of the Peer Bullying Scale and the scores for the Loneliness Scale and the Perceived Social Support (p > 0.05). The male refugee youth were found to have higher mean victim and bully scores than the female refugee youth.

Conclusion

In light of these results, the reasons for the peer bullying of refugee adolescents should be investigated and solutions should be developed based on the reasons. It is recommended to conduct quantitative and qualitative research aimed at revealing the reasons why refugee adolescents may engage in bullying and be exposed to bullying in the future.

Topic

Nurses are uniquely positioned to provide early diagnoses and interventions for abused, neglected, or at-risk children. They are also required, by law, to report suspected child abuse. However, little is known about the attitudes of student and registered nurses in reporting cases of abuse.

Purpose

This study aimed to identify nursing students' attitudes and related factors toward reporting child abuse and neglect in Turkey.

Sources

This cross-sectional study was carried out with the online participation of 1170 nursing students. The scale for determining the attitudes of health professionals in reporting child abuse (ACAS) was administered together with questions on demographic information.

Conclusions

ACAS scores of nursing students toward reporting child abuse were average. Younger age, poor perceived academic success, suspecting of a child abuse and neglect case during clinical practice, and male sex were independently associated with higher ACAS scores. Therefore, education programs for nursing students should focus on improving their attitudes toward reporting child abuse and neglect.

This pediatric psychiatric mental health hospital implemented a new mechanical restraint, the chair restraint, as an additional safety management intervention, to join the already utilized six-point board.

Purpose

The purpose of this project was to assess perceptions, thoughts, and feelings of psychiatric mental health nursing staff when utilizing the chair restraint on an adolescent unit. Furthermore, to explore decision making related to choosing the chair restraint verses choosing to use the six-point board as a safety management intervention.

Methodology

This was a phenomenological qualitative study, utilizing semistructured interviews to explore the experiences of nursing staff, consisting of behavioral health specialists, and direct-care staff nurses who work on an adolescent psychiatric unit utilizing both chair restraint and the six-point board. Ten nursing staff were interviewed. Using thematic analysis, staff perceptions, thoughts, and feelings when using mechanical restraints for safety management were explored. Demographics were collected however, there was no variability in the responses and saturation was reached.

Findings

Five themes emerged from the interviews. The Five themes that emerged were: Restraint chair was less traumatic and preferred, feelings of defeat when de-escalation was not successful, pushing away emotions as protection, units were short staffed, and patient behaviors were seen as a potential barrier to eliminating the six-point board.

Conclusion

The results of this study will be used to guide to further develop behavioral health education, orientation for new staff, and to understand ways to support staff through their experiences in managing a patient's unsafe behaviors.

Problem

Although physical restraint practices and psychotropic/sedative pro re neta (PRN, as needed) medications have been commonly used for managing inpatient aggression, little is known about the characteristics of adolescents who receive them in psychiatric adolescent inpatient units. We aimed to determine the relationship between the use of physical restraints and psychotropic/sedative PRN medications, and to characterize individual attributes, substance use, clinical factors, and time of the first restraint episodes of the use of physical restraints and psychotropic/sedative PRN medications.

Methods

A retrospective case-control study approach was used with the data from electronic health records at a pediatric psychiatric hospital in the United States. Descriptive statistics, χ², multivariate logistic regression, and Cox proportional hazard model were used.

Findings

Participants of younger age and participants with a longer length of stay were significantly associated with the use of physical restraints and psychotropic/sedative PRN medications, although the substance-related risks were not significantly associated with the use of restraints. Physical restraints were more likely to have occurred soon after the admission and tapered off as the length of stay increased.

Conclusions

This study provides important information in understanding the risk factors of the use of restraints and psychotropic/sedative PRN medications in psychiatric adolescent inpatient units.