Journal of Child and Adolescent Psychiatric Nursing最新文献_第9页

The association of adverse family experiences, physical activity, and depression in a national sample of US adolescents 不良家庭经历、体育活动和抑郁症在美国青少年国家样本中的关联。

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-12-07 DOI: 10.1111/jcap.12444

Fanghong Dong

Problems

Sufficient engagement in physical activity could foster resilience in adolescents and help alleviate the impact of adverse family experiences (AFEs), such as depression. However, the association between cumulative AFEs exposure, physical activity, and depression remains unclear. The aims of this study are to determine the relationship between AFEs and adolescent depression and whether physical activity moderates this relationship.

Methods

Secondary analyses were conducted on 29,617 adolescents aged 12–17 years from the 2016–2017 National Survey of Children's Health. Binomial logistic regression was used to examine the relationship among AFEs, child depression, and physical activity. Covariates include individual-level, social-level, and societal-level factors.

Findings

This study reveals that 7.3% of US adolescents had a depression diagnosis. The odds of having a depression diagnosis among US children were 1.6 times (adjusted OR: 1.6, 95% CI: 1.37–1.86) greater for adolescents with one type of AFEs, and 3.4 times greater (adjusted OR: 3.39, 95% CI: 2.78–4.13) for adolescents with three or more AFEs, compared with children living without AFEs. Physical activity for 1–3 days per week remained a significant, substantial protector of childhood depression among children with at least one type of AFEs (adjusted OR: 0.73, 95% CI: 0.62–0.87).

Conclusions

These results suggest a clinical concern for adolescents with more AFEs. Trauma-informed care to address multiple types of trauma and physical activity interventions to reduce depression symptoms may be particularly important.

问题:充分参与体育活动可以培养青少年的适应能力，并有助于减轻不良家庭经历(AFEs)的影响，如抑郁症。然而，累积afe暴露、身体活动和抑郁症之间的关系尚不清楚。本研究的目的是确定急性发作和青少年抑郁之间的关系，以及体育活动是否会调节这种关系。方法:对2016-2017年全国儿童健康调查中的29617名12-17岁青少年进行二次分析。采用二项logistic回归检验急性发作、儿童抑郁和体育活动之间的关系。协变量包括个人水平、社会水平和社会水平因素。研究结果:这项研究表明，7.3%的美国青少年被诊断患有抑郁症。在美国儿童中，有一种AFEs的青少年患抑郁症的几率是没有AFEs的儿童的1.6倍(校正OR: 1.6, 95% CI: 1.37-1.86)，有三种或三种以上AFEs的青少年患抑郁症的几率是没有AFEs的儿童的3.4倍(校正OR: 3.39, 95% CI: 2.78-4.13)。对于至少有一种急性发作的儿童来说，每周进行1-3天的体育锻炼仍然是儿童抑郁的重要保护因素(调整后的OR: 0.73, 95% CI: 0.62-0.87)。结论:这些结果提示临床关注更多的青少年AFEs。创伤知情护理，以解决多种类型的创伤和身体活动干预，以减少抑郁症状可能特别重要。

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引用次数: 0

Health-risk behaviors and peer pressure of adolescents in the child protective services in Türkiye: A cross-sectional study 土耳其儿童保护服务中青少年的健康风险行为和同伴压力：一项横断面研究。

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-10-10 DOI: 10.1111/jcap.12442

Zahide İyi RN, MSN, İlknur Kahriman RN, PhD

Problem

This study was carried out to investigate the health-risk behaviors and peer pressure of adolescents aged 12–18 years in need of protection at child protective services.

Methods

The data of this cross-sectional study were collected using individual interviews with 85 adolescents living in child homes and child homes buildings complex between February 25 and May 31, 2019. The data were collected using the “Descriptive Information Form,” the “Health-Risk Behaviors Questionnaire,” and the “Peer Pressure Questionnaire.”

Findings

The results of study in adolescents were 34.1% were in the risk group in terms of weight, and 41.2% had a psychiatric problem. Among the health-risk behaviors of adolescents; 56.5% did not pay attention to daily nutrition, 51.8% had fast food every day, 54.1% injury behaviors were doing dangerous sports, only 15.3% wore seat belts, 78.8% did not exercise three or more days per week, 38.8% watched television and computer three or more hours per day, 27.1% used painkillers without consulting a doctor, 24.7% applied the health recommendations they read on the internet, 20.0% of the adolescents reported that they went on a diet without consulting the healthcare personnel, and 14.1% voluntary vomited to lose or maintain their weight. And 21.2% of the adolescents were exposed to peer pressure.

Conclusions

It was concluded that adolescents in need of protection at child protective services have health-risk behaviors and low-level peer pressure.

问题：本研究旨在调查12-18岁需要儿童保护服务的青少年的健康风险行为和同伴压力。方法：这项横断面研究的数据是通过对2019年2月25日至5月31日期间居住在儿童之家和儿童之家建筑群中的85名青少年的个人访谈收集的。数据是使用“描述性信息表”、“健康风险行为问卷”和“同伴压力问卷”收集的。研究结果：在青少年中，34.1%的人在体重方面属于风险组，41.2%的人有精神问题。在青少年健康风险行为中；56.5%的人不注意日常营养，51.8%的人每天吃快餐，54.1%的受伤行为是做危险的运动，只有15.3%的人系安全带，78.8%的人每周三天或三天以上没有锻炼，38.8%的人一天看电视和电脑三个或三个小时以上，27.1%的人在没有咨询医生的情况下使用止痛药，24.7%的人应用了他们在网上阅读的健康建议，20.0%的青少年报告说，他们在没有咨询医护人员的情况下节食，14.1%的青少年自愿呕吐以减肥或维持体重。21.2%的青少年受到同伴压力。结论：需要儿童保护服务的青少年存在健康风险行为和低水平的同伴压力。

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引用次数: 0

Taking a broad view of COVID-19, stressors and youth mental health 对新冠肺炎、压力源和青少年心理健康有广泛的认识。

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-10-10 DOI: 10.1111/jcap.12443

Kathleen R. Delaney PhD, PMH-NP, FAAN

引用次数: 0

Inpatient pediatric nursing staff experiences treating psychiatric patients: A mixed methods study 住院儿科护理人员治疗精神病患者的经验：一项混合方法研究。

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-09-25 DOI: 10.1111/jcap.12441

Katelyn DeAlmeida BSN, RN, Keli Blanco BSN, RN, Katherine Metz DNP, RN, CPNP-PC, CCRN, Nicole L. Bohr PhD, RN

Problem

A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff.

Methods

A mixed-method research study was conducted among full- and part-time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale. Surveys were followed by semistructured interviews.

Findings

Of the 158 staff eligible, 47 (29.7%) participated in the quantitative portion. [Correction added on 29 September 2023, after the first online publication: In the preceding sentence, the participation rate was revised from 23.5% to 29.7% in this version.] Significant differences were found between roles, with nurses experiencing lower levels of compassion satisfaction and higher levels of burnout. Role differences were seen in supervisor support and nonwork support, with nurses reporting less support from both. Supervisor support showed a significant correlational relationship with compassion satisfaction and burnout. Nonwork support showed similar correlations with compassion satisfaction and burnout. Themes that emerged from the interviews were Barriers to Care, Emotional Impact, and “Help Me Help You.”

Conclusion

Nurses may be at greater risk for compassion fatigue due to perceived inadequate support from leadership, unclear role expectations, and lack of resources.

问题：文献中存在空白，试图了解儿科精神病患者的涌入对住院的全科医学儿科护理人员的影响。方法：采用混合方法对在普通儿科工作的全职和兼职儿科护士和护理助理进行研究。定量数据是通过匿名调查收集的，使用职业生活质量量表第5版和工作压力者支持评估量表。调查之后是半结构化访谈。调查结果：在158名符合条件的工作人员中，47人（29.7%）参加了定量部分。【在第一次在线发布后，于2023年9月29日添加了更正：在前一句中，本版本的参与率从23.5%修订为29.7%。】发现不同角色之间存在显著差异，护士的同情满意度较低，倦怠程度较高。在主管支持和非工作支持方面存在角色差异，护士报告两者的支持较少。主管支持与同情满意度和倦怠呈显著相关。非工作支持与同情满意度和倦怠表现出相似的相关性。访谈中出现的主题是“护理障碍”、“情感影响”和“帮助我帮助你”。结论：由于领导层的支持不足、角色期望不明确和缺乏资源，护士可能更容易产生同情疲劳。

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引用次数: 0

COVID-19 pandemic impact among adolescents with eating disorders referred to Italian psychiatric unit 新冠肺炎大流行对患有饮食失调的青少年的影响被转诊至意大利精神科。

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-09-22 DOI: 10.1111/jcap.12440

Pietro Cappelletto MD, Lisa De Luca PsyD, Benedetta Taddei PsyD, Silvia Taddei PsyD, Annalaura Nocentini PhD, Tiziana Pisano MD

Problem

The COVID-19 pandemic has triggered or exacerbated eating disorders (EDs), especially in adolescents. This study examined the prevalence of admissions of patients with EDs at the Child and Adolescent Psychiatry Unit from the pre-COVID-19 pandemic to March 2023 and explored the differences in dimensions of ED's symptomatology according to the year of access.

Methods

We included 174 children and adolescents, 94.3% females and 5.7% males, with a diagnosis of ED (M_age = 14.87; SD = 1.72). The Eating Disorder Inventory-3 (EDI-3), the Body Uneasiness Test (BUT) and Youth Self Report ASEBA (YSR) were assessed. A one-way analysis of variance test was performed.

Findings

EDs' hospitalization prevalence was higher in the years 2020 and 2021 compared to pre-COVID-19 and the year 2022. Considering the ED psychopathology (EDI-3), findings showed a higher score in the dimension of the push to thinness, body dissatisfaction, asceticism, and fear of maturity in the year 2021 compared to pre-pandemic. Regarding the discomfort related to the image of one's own body (BUT), results showed an increase in the global severity index in the year 2022 compared to pre-pandemic and in weight phobia in the year 2021 compared to the year 2020. Concerning the internalizing symptoms (YSR), a tendency was found for withdrawal/depression, with higher levels in the year 2022 compared to the year 2020.

Conclusions

Our study highlighted the increase of different types of EDs symptomatology related to concerns about weight, especially 2 and 3 years after the outbreak of the pandemic, on which the literature is still scarce, especially in the Italian context.

问题：新冠肺炎大流行引发或加剧了饮食失调（ED），尤其是青少年。这项研究调查了从COVID-19大流行前到2023年3月，儿童和青少年精神病学科ED患者的入院率，并探讨了ED症状学各维度根据入院年份的差异。方法：我们纳入174名儿童和青少年，94.3%的女性和5.7%的男性，诊断为ED（Mage = 14.87；SD = 1.72）。评估饮食障碍量表-3（EDI-3）、身体不适测试（BUT）和青少年自我报告ASEBA（YSR）。进行了单因素方差分析检验。研究结果：与COVID-19前和2022年相比，2020年和2021年ED的住院率更高。考虑到ED精神病理学（EDI-3），研究结果显示，与疫情前相比，2021年在追求苗条、身体不满、禁欲主义和对成熟的恐惧方面的得分更高。关于与自身身体形象相关的不适（BUT），结果显示，与疫情前相比，2022年的全球严重程度指数有所上升，与2020年相比，2021年的体重恐惧症有所上升。关于内化症状（YSR），发现了戒断/抑郁的趋势，与2020年相比，2022年的戒断/抑郁水平更高，尤其是在意大利背景下。

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引用次数: 0

Metabolic monitoring of pediatric patients prescribed second-generation antipsychotic medication 对服用第二代抗精神病药物的儿科患者进行代谢监测

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-08-16 DOI: 10.1111/jcap.12438

Julie Henshaw Roebuck DNP, APRN, PMHNP-BC

Introduction

The prevalence of psychotropic medication prescription use in youth has increased over the past several years. Despite recommendations and practice parameters established by the American Diabetes Association-American Psychiatric Association (ADA-APA) outlining metabolic monitoring of patients prescribed second-generation antipsychotic (SGA) medication, monitoring adherence for the pediatric patient population remains inadequate.

Aims

This project aimed to improve metabolic monitoring of pediatric patients prescribed SGAs and discharge recommendations for follow-up monitoring within a small, child, and adolescent psychiatric hospital.

Methods

This project compared metabolic monitoring adherence rates pre and postimplementation of a metabolic monitoring organizational policy developed to provide procedural guidance, using ADA-APA guidelines. Participants included prescribing clinicians (physicians and psychiatric nurse practitioners).

Results

Phase 1 chart reviews found no records of fasting blood glucose, fasting lipid profile or waist circumference. Following project implementation, chart review found that fasting blood glucose and fasting lipid profile was recorded in 21 (72.4%) of the charts, and waist circumference was recorded in 18 (62.1%) of the charts for patients prescribed SGA medication. For patients discharged on an SGA, written recommendations for follow-up metabolic monitoring improved from 13% to 70% (<0.001).

Conclusions

Implementing an organizational metabolic monitoring policy and protocol can improve clinician adherence to ADA-APA guidelines for recording in-patient monitoring of metabolic parameters and discharge recommendations for pediatric patients prescribed SGA medication.

导言：在过去几年中，青少年精神药物处方使用率有所上升。尽管美国糖尿病协会-美国精神病学协会（ADA-APA）提出了对开具第二代抗精神病药物（SGA）的患者进行代谢监测的建议和实践参数，但对儿科患者的监测仍然不足。目的本项目旨在改善对开具 SGA 药物的儿科患者的代谢监测，并对一家小型儿童和青少年精神病医院的出院随访监测提出建议。方法本项目比较了采用 ADA-APA 指南制定代谢监测组织政策以提供程序指导前后的代谢监测依从率。参与者包括开处方的临床医生（医生和精神科执业护士）。结果第一阶段的病历审查没有发现空腹血糖、空腹血脂或腰围记录。项目实施后，病历审查发现，在 21 份（72.4%）病历中记录了空腹血糖和空腹血脂，在 18 份（62.1%）病历中记录了开具 SGA 药物的患者的腰围。对于服用 SGA 出院的患者，书面建议进行后续代谢监测的比例从 13% 提高到 70% (<0.001)。结论实施组织代谢监测政策和方案可提高临床医生对 ADA-APA 指南的遵守程度，以记录住院患者的代谢参数监测情况，并为开具 SGA 药物的儿科患者提供出院建议。

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引用次数: 0

Implementing the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure child 6−17 in a community mental health clinic 在社区心理健康诊所实施 DSM-5 家长/监护人评定的 6-17 岁儿童一级交叉症状测量法

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-08-13 DOI: 10.1111/jcap.12439

Hervé Corbel DNP, PMHNP-BC, AHN-BC, Elizabeth Kinchen PhD, RN, AHN-BC, SGAHN

Problem

Despite their relevance to assessment and clinical decision-making in behavioral health, measurement tools are still rarely used in clinical settings. With an increase in undiagnosed and untreated mental health problems in children and adolescents, a southeastern US Community Health System was the ideal setting for the implementation of a behavioral health assessment tool.

Methods

This quality improvement project was conducted to address the question: “Among mental health clinicians at the Community Health System, will the use of the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure 6−17 (CCSM) improve diagnosis and treatment choices of children with mental health conditions, over a 4-week period?” A convenience sample was recruited from among behavioral health counselors working at various out-patient clinics and school-based counseling sites in the Community Health System. After nurse-led training on use of the CCSM, including a PowerPoint intervention and individual coaching sessions, the five clinical participants were encouraged to use the CCSM screening tool on their patients presenting for mental health assessment. Knowledge of the tool was assessed using a pre- and post-training survey. Completed screening tools were collected from participants over the 4-week duration of the project.

Findings

A chart audit comparing the project period with the previous year showed an increase in diagnosis and treatment in 6−17 year-old patients at the outpatient clinic.

Conclusions

This project demonstrated the usefulness of the CCSM for behavioral health assessment in the child/adolescent population at the Community Health System and supported use of the intervention in other clinics.

问题尽管测量工具与行为健康的评估和临床决策息息相关，但在临床环境中仍很少使用。随着儿童和青少年未诊断和未治疗的心理健康问题的增加，美国东南部的一个社区卫生系统成为实施行为健康评估工具的理想场所。方法该质量改进项目旨在解决以下问题："在社区卫生系统的心理健康临床医生中，使用 DSM-5 家长/监护人评分的 6-17 级交叉症状量表（CCSM）能否在 4 周内改善对患有心理疾病儿童的诊断和治疗选择？我们从社区卫生系统各门诊诊所和学校咨询点的行为健康咨询师中招募了方便样本。在经过护士指导的 CCSM 使用培训（包括 PowerPoint 干预和个别辅导课程）后，我们鼓励五名临床参与者对前来进行心理健康评估的患者使用 CCSM 筛查工具。培训前和培训后的调查对工具知识进行了评估。在为期四周的项目期间，我们收集了参与者填写的筛查工具。研究结果对项目实施期间和上一年的病历进行比较后发现，门诊中 6-17 岁患者的诊断和治疗率都有所提高。结论该项目证明了 CCSM 在社区卫生系统的儿童/青少年行为健康评估中的实用性，并支持在其他诊所使用该干预措施。

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引用次数: 0

Nurses should respond to critical quality questions of child/adolescent inpatient treatment 护士应该对儿童/青少年住院治疗的关键质量问题作出回应

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-08-02 DOI: 10.1111/jcap.12437

Kathleen R. Delaney PhD, PMHNP, FAAN

引用次数: 0

Child and adolescent psychiatry outpatient clinic admissions of anorexia nervosa patients before and during the COVID-19 Pandemic (January 2015–January 2022)—A retrospective cohort from a tertiary referral hospital in Turkey COVID-19 大流行之前和期间（2015 年 1 月至 2022 年 1 月）儿童和青少年精神病学门诊收治的神经性厌食症患者--土耳其一家三级转诊医院的回顾性队列

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-07-13 DOI: 10.1111/jcap.12435

Hatice Ünver MD, Beyzanur Gökçe Ceylan MD, Ayşe Burcu Erdoğdu Yıldırım MD, Neşe Perdahlı Fiş MD

引用次数: 0

A qualitative analysis of child and family complaints related to child mental health services 对与儿童心理健康服务相关的儿童和家庭投诉的定性分析

IF 1.5 Q2 NURSING

Journal of Child and Adolescent Psychiatric Nursing

Pub Date : 2023-07-13 DOI: 10.1111/jcap.12436

Laura Darcy PhD, RN, Anna Råberus MScN, RN, Annelie J. Sundler PhD, RN

Problem

Little is known about issues of patient-reported problems, in particular within psychiatric services for children with mental ill health. Child and family complaints related to child mental health services can be analyzed and discussed in light of the universal human right to health and healthcare. Therefore, the aim of this study was to analyze child and family complaints related to child mental health services.

Methods

A retrospective, descriptive design was used. Child and family complaints were analyzed with a qualitative thematic analysis.

Findings

The findings were described in three themes describing lack of access to care, inadequate communication between services and children with mental ill health and their families, and lack of clarity of who is responsible for care, leading to neglect of children's needs. These issues place a huge responsibility on parents or relatives.

Conclusion

Better communication within mental health services, and better collaboration with other services such as school and social services, could limit children's suffering. Healthcare services with named professionals who specialize in child mental health and provide continuity in care, are required. General human rights principles should guide planning and care of children.

问题我们对病人报告的问题知之甚少，尤其是在为患有精神疾病的儿童提供的精神科服务中。与儿童精神健康服务相关的儿童和家庭投诉可以从健康和医疗保健的普遍人权角度进行分析和讨论。因此，本研究旨在分析与儿童精神健康服务相关的儿童和家庭投诉。方法采用回顾性、描述性设计。对儿童和家庭的投诉进行了定性专题分析。研究结果研究结果分为三个主题，分别描述了缺乏获得护理的途径、服务机构与患有精神疾病的儿童及其家人之间沟通不足，以及护理责任人不明确，从而导致忽视儿童的需求。这些问题使父母或亲属承担了巨大的责任。结论心理健康服务机构内部更好的沟通，以及与其他服务机构如学校和社会服务机构更好的合作，可以减少儿童的痛苦。医疗保健服务机构需要配备专门从事儿童心理健康工作的专业人员，并提供持续的护理。规划和护理儿童的工作应遵循一般的人权原则。

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引用次数: 0