Journal of Pediatric Health Care最新文献

Background: The transition to adult health care is challenging for adolescents and young adults (AYA) with Chronic Granulomatous Disease (CGD). This pilot study aimed to facilitate the learning of AYA with CGD about their health care and to aid in the development of life skills to enhance self-care.

Methods: AYA and caregivers (for participants <18 years of age) completed an adapted Transition Readiness Assessment. Educational sessions were held both in person and via telehealth and included virtual meetings with subject matter experts or a designated program mentor. Twenty-five participants were invited, 13 entered the pilot and 8 completed the transition readiness assessment.

Results: The pilot study was well-received by CGD participants and caregivers. In the future, a larger cohort may provide more data to comment on efficacy and outcome in the AYA population.

Conclusion: Expansion of an educational transition program for AYA with primary immunodeficiencies (PIDs) might be useful.

Suicidal ideation in the pediatric population has increased by 50% over the last decade. Suicide is the primary contributor to violent deaths and ranks as the second leading cause of mortality within the 10-24-year-old age group. The lethality of the methods selected notably elevates the likelihood of children and adolescents dying by suicide. Awareness of the commonly chosen means of suicide at each developmental stage and understanding their respective lethality are vital in developing prevention strategies. Lethal means safety counseling is a specific evidence-based suicide prevention strategy that pediatric providers can use during patient encounters to help mitigate the risk of self-inflicted injuries and suicide. Providers are well-positioned to integrate discussions of lethal means restriction with patients and their families into their protocols for suicide prevention, screening, and assessment. This article explores the data and practice evidence for lethal means restriction and counseling, focusing on clinical strategies and policy changes to reduce access to lethal means. Emphasis is given to how pediatric providers speak with parents about the importance of restricting access when developing a safety plan.

Introduction: Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method: Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n = 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results: Targeted PROM met feasibility goals (80%) and exceeded youth and family acceptance (70%). Time and low confidence using PROM affected healthcare team acceptance (64%). Families' experiences included increased learning, trust, and partnership with the clinic team. Providers appreciated partnerships, resources, and mental health support for families.

Discussion: Integrating PROM into clinical services promoted engagement, partnership, and individualized, strength-based care among youth, their parent/guardian (family), and their healthcare team.

Introduction: This study investigated the factors influencing suicidal ideation in female adolescents with smartphone overdependence in South Korea.

Method: Based on the secondary analysis of national survey data collected in 2023, 8,314 female adolescents identified as being in the smartphone overdependence group participated in the study. Complex sample logistic regression analysis was used to assess the influencing factors.

Results: Depressive symptoms, Generalized Anxiety Disorder (GAD), loneliness, stress, smoking, alcohol consumption, and smartphone usage time were found to be significant factors influencing suicidal ideation in female adolescents.

Discussion: This study is the only one to examine the factors influencing suicidal ideation specifically in female adolescents with smartphone overdependence. The findings can contribute to research aimed at preventing suicide among female adolescents.

Vascular anomalies usually present at the beginning of life and vary in their course of progression and treatment. The pinpoint diagnosis of each lesion is often misdirected, owing to the complexity surrounding the classification. At the broadest level, differentiation between tumoral structures such as hemangiomas and other vascular malformations is required to not only select the correct procedure, but more importantly determining whether treatment is necessary. A 3-year-old patient presented to our institution with a vascular lesion in the scrotum, which had been labeled as a hemangioma. The unusual prognosis and continuous growth of the lesion suggested otherwise. Comprehensive clinical assessment was conducted, and the physical examination allowed for the accurate diagnosis of an arteriovenous malformation. The lesion was successfully excised without harm to the underlying structures. The authors uphold that misdiagnosis across vascular lesions is preventable through the correct clinical approach.

Introduction: The pediatric mental health crisis has intensified, especially during the COVID-19 pandemic. Social media and electronic use have been significant contributors to this issue.

Methods: This paper explores existing literature and clinical guidelines to assess the impact of electronic overuse on pediatric mental health, focusing on practical interventions for healthcare providers.

Results: Studies show that increased screen time correlates with heightened levels of anxiety, depression, and suicidal ideation, particularly among vulnerable populations such as racial minorities and LGBTQ+ youth.

Discussion: Healthcare providers, especially nurse practitioners, are in prime position to address these issues through evidence-based screening tools, setting boundaries for electronic use, and supporting caregivers. Proactive, holistic interventions are key to mitigating the long-term effects of social media on adolescent mental health.

Stimulant medications are a central component of management for youth with attention deficit hyperactivity disorder (ADHD) and their access has been impacted by supply shortages since 2022. Disruptions to treatment can lead to increased morbidity and mortality for youth with ADHD. Factors that contribute to pharmaceutical supply chain shortages include surges in demand, reduced capacity for production or distribution, and failures in coordination. This paper provides an overview of the recent stimulant medication shortage and leverages a framework for building resilience in the supply chain to help pediatric health providers take action and improve health outcomes for for youth with ADHD and their families.

Introduction: Adolescents' child abuse and neglect experiences are often under-documented in primary care, leading to missed opportunities for interventions. This study compares the prevalence of child abuse and neglect cases identified by diagnostic codes versus a natural language processing approach of clinical notes.

Method: We retrospectively analyzed data from 8,157 adolescents, using ICD-10 codes and a natural language processing algorithm to identify child abuse and neglect cases and applied topic modeling on clinical notes to extract prevalent topics.

Results: The natural language processing approach identified more cases of child abuse and neglect cases (n = 294) compared to ICD-10 codes (n = 111). Additionally, topic modeling of clinical notes showed the multifaceted nature of child abuse and neglect as captured in clinical narratives.

Discussion: Integrating natural language processing with ICD codes has the potential to enhance the identification and documentation of child abuse and neglect, which could lead to earlier and more targeted interventions and coordinated care.

Introduction: Adverse Childhood Experiences (ACEs) increase the risk of chronic diseases in adulthood and contribute to neurobehavioral challenges during childhood and adolescence.

Method: This retrospective study reviewed the medical records of 102 pediatric patients to describe interventions for children screening positive for ACEs in a pediatric primary care setting with integrated behavioral health services. It further assessed whether these interventions led to improvements in psychosocial functioning and mood.

Results: Immediate responses to positive ACE screenings included psychoeducation, crisis interventions, mental health referrals, and case management. Follow-up interventions involved skills training, cognitive-behavioral therapy, behavior management, motivation-based interventions, and symptom surveillance. Significant decreases in psychosocial problems and adolescent depression were observed.

Discussion: Integrated behavioral health interventions in pediatric primary care improved psychosocial functioning and mood in children with positive ACE screenings. These findings offer valuable insights for nurse practitioners implementing effective ACE screening and intervention programs in primary care.