Journal of Pediatric Health Care最新文献

英文中文

Secondhand Smoke Exposure in Pediatric Patients: What Is the Nurse Practitioner's Role? 儿科患者的二手烟暴露：执业护士的作用是什么？

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.01.003

Bailey Vevon BSN, RN, Heide S. Temples PhD, APRN, PPCNP-BC, IBCLC

引用次数: 0

Delivering a Smartphone Serious Game-Based Intervention to Promote Resilience for Adolescents With Type 1 Diabetes: A Feasibility Study 提供基于智能手机严肃游戏的干预措施，提高 1 型糖尿病青少年的复原力：可行性研究。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.05.009

Yi Wu, Tian-Xue Long, Jing Huang, Qi Zhang, Angus Forbes, Ming-Zi Li

Introduction

The aim of this study is to test the feasibility of a smartphone serious game-based intervention to promote resilience for adolescents with type 1 diabetes mellitus (T1DM).

Method

A two-arm feasibility study was employed. Adolescents with T1DM were recruited. Adolescents in intervention group completed the serious game (named “WeCan”) in one month. We evaluated feasibility and acceptability using criteria such as the recruitment response rate, the follow-up response rate, and satisfaction.

Results

Sixty-one adolescents with T1DM were included in this study. The study had a recruitment response rate of 62.89% (61/97) and an intervention completion rate of 64.52% (20/31). Eighty-two percent of the adolescents were satisfied with WeCan, which they perceived to have the advantages of being a lively format, attractive, and privacy, easy to operate, and improved attitude towards diabetes.

Conclusions

These findings suggest that WeCan demonstrated good feasibility among the target population. However, the efficacy of health-related outcomes needs to be clarified in future studies.

内容简介本研究旨在测试基于智能手机严肃游戏的干预措施的可行性，以促进 1 型糖尿病（T1DM）青少年的复原力：方法：采用双臂可行性研究。招募了患有 T1DM 的青少年。干预组的青少年在一个月内完成了严肃游戏（名为 "WeCan"）。我们用招募响应率、后续响应率和满意度等标准评估了可行性和可接受性：共有 61 名患有 T1DM 的青少年参与了这项研究。招募响应率为 62.89%（61/97），干预完成率为 64.52%（20/31）。82%的青少年对WeCan表示满意，他们认为WeCan具有形式活泼、有吸引力、保护隐私、易于操作、改善糖尿病态度等优点：这些研究结果表明，WeCan 在目标人群中具有良好的可行性。结论：这些研究结果表明，WeCan 在目标人群中表现出了良好的可行性，但与健康相关的疗效还需要在今后的研究中加以明确。

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引用次数: 0

Managing Pediatric Burns: A Case Report of Fecal Scalding 处理小儿烧伤：粪便烫伤病例报告。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.07.002

Andrea Sebastian DNP, APRN, CPNP-AC/PC, AFN-C, SANE-P, DM-AFN, Erin Wade MD, MS, Lauren Burge MD

Scald burns occur when the skin encounters hot liquid or steam. Although most scald burns are accidental, the medical provider must assess for possible abuse. We report a case of a 2-year-old female who presented to the hospital with her parents due to a burn to the buttocks with a history of stool expelling from the anus and becoming trapped against the skin. Medical providers need to consider accidental and inflicted differentials, as accidental injuries do occur in children, and an incorrect diagnosis may have severe medicolegal consequences.

皮肤遇到热液体或蒸汽时会发生烫伤。虽然大多数烫伤都是意外造成的，但医疗人员必须评估是否存在虐待的可能性。我们报告了一例 2 岁女童的病例，她因臀部烫伤随父母到医院就诊，有大便从肛门排出并紧贴皮肤的病史。医疗服务提供者需要考虑意外伤害和人为伤害的鉴别，因为意外伤害确实发生在儿童身上，而错误的诊断可能会造成严重的医疗法律后果。

引用次数: 0

Behavioral Counseling for Weight Management by Pediatric Nurse Practitioners: A Quantitative Cross-Sectional Study 儿科执业护士的体重管理行为咨询：定量横断面研究

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.06.019

Natasha Smith-Holmquist DNP, APRN, CPNP-PC, Sherry J. McCormick DNP, APRN, FNP-BC, Melissa J. Benton PhD, RN, FACSM, FGSA

Introduction

This study assessed counseling by pediatric nurse practitioners (PNPs) for management of overweight and obesity.

Method

Using a cross-sectional design, 1,058 PNPs completed a one-time survey regarding counseling for healthy body weight, physical activity, and consumption of protein, fruits and vegetables.

Results

Study findings suggest PNPs are using behavioral counseling for weight management in pediatric patients. Counseling was more frequent for healthy body weight, fruit and vegetable intake, and physical activity than for protein consumption and muscle strengthening. Furthermore, when PNPs counseled for healthy body weight they were also more likely to counsel for physical activity (OR = 25.99 [95% CI: 19.25, 35.11]), fruit and vegetable intake (OR = 22.35 [95% CI: 16.71, 29.88]), protein intake (OR = 9.82 [95% CI: 7.60, 12.69]), and muscle strengthening (OR = 6.41 [95% CI: 4.98, 8.24]).

Discussion

PNPs are counseling for healthy body weight and necessary behavioral tools, but increased emphasis on muscle strengthening may benefit overweight and obese youth.

简介：本研究评估了儿科执业护士（PNPs）在管理超重和肥胖方面提供的咨询服务：这项研究评估了儿科执业护士（PNPs）在管理超重和肥胖方面提供的咨询服务：方法：采用横断面设计，1,058 名儿科执业护士完成了一项一次性调查，内容涉及健康体重、体育锻炼、蛋白质、水果和蔬菜摄入量等方面的咨询：研究结果：研究结果表明，PNP 正在对儿科患者的体重管理进行行为咨询。对健康体重、水果和蔬菜摄入量以及体育锻炼的咨询比对蛋白质摄入量和增强肌肉的咨询更为频繁。此外，当 PNP 对健康体重进行咨询时，他们也更有可能对体育活动（OR = 25.99 [95% CI: 19.25, 35.11]）、水果和蔬菜摄入量（OR = 22.35 [95% CI: 16.71, 29.88]）、蛋白质摄入量（OR = 9.82 [95% CI: 7.60, 12.69]）和肌肉力量（OR = 6.41 [95% CI: 4.98, 8.24]）进行咨询：讨论：PNP 是健康体重的咨询和必要的行为工具，但加强对肌肉强化的重视可能对超重和肥胖青少年有益。

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引用次数: 0

Decreasing Social Media Use Through Motivational Interviewing: A Pediatric Primary Care Quality Improvement Project 通过动机访谈减少社交媒体的使用：儿科初级保健质量改进项目》。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.05.006

Jessica Ballesteros-Holmes DNP, APRN, CPNP (Pediatric Nurse Practitioner), Malinda Teague DNP, APRN, CPNP-AC/PC (Pediatric Nurse Practitioner, Assistant Professor), Anne Derouin DNP, APRN, CPNP, PMHS, FAANP (Pediatric Nurse Practitioner, Lead Faculty)

Background

Social media use has been correlated to worsening anxiety and depression in teenagers.

Local Problem

In the United Staes, social media is frequently used amongst adolescents, and rates of anxiety and depression in this population have increased over time.

Methods

A convenience sample of adolescents aged 12 to 18 years old were evaluated using a pre-post design.

Interventions

This quality improvement project introduced screen time assessment and motivational interviewing to decrease social media use and improve mental health among adolescents.

Results

PHQ-9 scores remained consistent throughout the project. There was an overall decrease in participant SCARED scores and social media use declined over the 12-week period.

Conclusions

Results from this project suggest an opportunity for pediatric healthcare providers to standardize social media use screening in adolescent care and utilize motivational interviewing to promote adolescent wellbeing.

背景：社交媒体的使用与青少年焦虑症和抑郁症的恶化有关：当地问题：在美国，青少年经常使用社交媒体，随着时间的推移，这一人群的焦虑症和抑郁症发病率有所上升：方法：对 12 至 18 岁的青少年进行方便抽样评估，采用前后期设计：干预措施：该质量改进项目引入了屏幕时间评估和动机访谈，以减少青少年使用社交媒体并改善其心理健康：在整个项目中，PHQ-9 分数保持一致。在为期 12 周的时间里，参与者的 SCARED 分数总体下降，社交媒体使用率也有所下降：该项目的结果表明，儿科医疗服务提供者有机会在青少年护理中对社交媒体使用情况进行标准化筛查，并利用动机访谈来促进青少年的健康。

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引用次数: 0

Urinary Tract Infection in a Transgender Male: A Primary Care Approach 变性男性的尿路感染：初级保健方法。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.08.002

Amy Manion PhD, APRN, CPNP-PC, Tiffany St. James DNP, APRN, CPNP-PC

Navigating health care as a transgender adolescent presents a multitude of unique challenges that warrant careful consideration. Transgender individuals often encounter barriers such as a lack of knowledgeable health care providers, limited access to gender-affirming care, and concerns about confidentiality, safety, and acceptance. This case report of a transgender male with a history of a urinary tract infection examines the issues facing transgender adolescents in their pursuit of appropriate and sensitive health care and the need for normalizing gender-affirming medical care.

变性青少年在医疗保健方面面临着许多独特的挑战，值得仔细考虑。变性人经常会遇到各种障碍，如缺乏知识渊博的医疗服务提供者、获得性别确认医疗服务的途径有限，以及对保密性、安全性和接受度的担忧。这篇关于一名有尿路感染病史的变性男性的病例报告探讨了变性青少年在寻求适当和敏感的医疗保健时所面临的问题，以及将性别认同医疗保健正常化的必要性。

引用次数: 0

NAPNAP Position Statement on Child Health Equity NAPNAP 关于儿童健康平等的立场声明

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.07.017

引用次数: 0

Nonsexual Genital Ulcers Secondary to Epstein-Barr Virus in a Pediatric Patient 一名小儿患者继发于爱泼斯坦-巴氏病毒的非性生殖器溃疡

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.05.002

Lien Morcate MD, MPH, Imani Sanders MD, Karen Chen Chen MD, Yurima Strubinger Galavis MD, Ines Villarroya-Marquina MD, Nadia Makkoukdji MD, Maura Alvarez MD, Jonathan Tolentino MD

This case report focuses on a rare presentation of Epstein-Barr virus as genital ulcers in a 14-year-old girl with no sexual activity history. Despite initial misdiagnosis and failed acyclovir treatment, investigations ruled out sexually transmitted causes but revealed elevated Epstein-Barr virus antibodies. Subsequent treatment with a 14-day prednisone course led to significant improvement. This case emphasizes the importance of considering nonsexual etiologies for genital ulcers to prevent delayed or inappropriate treatment and highlights the need for broader education on such atypical presentations.

本病例报告的重点是一名没有性活动史的 14 岁女孩因生殖器溃疡而感染爱泼斯坦-巴氏病毒的罕见病例。尽管最初被误诊，且阿昔洛韦治疗失败，但调查排除了性传播的原因，但发现爱泼斯坦-巴氏病毒抗体升高。随后，她接受了为期 14 天的强的松治疗，病情明显好转。本病例强调了考虑生殖器溃疡非性病因的重要性，以防止延误或不当治疗，并突出了就此类非典型表现开展更广泛教育的必要性。

引用次数: 0

Changes in Self-Efficacy During COVID-19 Among Adolescents With Type 1 Diabetes Mellitus: A Qualitative Study 1 型糖尿病青少年在 COVID-19 期间自我效能感的变化：定性研究。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.07.005

Nkemjika Okonkwo BA, Erin M. Bergner PhD, MPH, Sarah S. Jaser PhD

Introduction

The purpose of this longitudinal, qualitative study was to examine the impact of the COVID-19 pandemic on self-efficacy and diabetes management among youth diagnosed with type 1 diabetes mellitus (T1DM).

Methods

We conducted two semi-structured interviews with adolescents diagnosed with T1DM (n = 18) and their maternal caregivers (n = 20) over 6–9 months, to understand how their confidence in the adolescent's ability to manage their diabetes changed during the pandemic. Interviews were transcribed and coded by four raters, establishing inter-reliability.

Results

Four themes emerged: Preventing Adverse Glycemic Events, Useful Glucose Trend Information, Improved Diabetes Management, and Downsides of Technology. Most adolescents (63%) reported increased confidence in their ability to manage diabetes during the pandemic. Over half of these adolescents were already using an insulin pump, and a substantial number (33%) updated their insulin delivery method. Both adolescents and caregivers cited diabetes devices as a factor in their self-efficacy for diabetes management.

Discussion

Findings illustrate the importance of diabetes management in the daily lives of adolescents diagnosed with T1DM, and the potential benefits of diabetes devices during disruptions to care.

简介：本纵向定性研究旨在探讨 COVID-19 大流行对确诊为 1 型糖尿病（T1DM）的青少年的自我效能感和糖尿病管理的影响：我们对确诊为 1 型糖尿病的青少年（18 人）及其母亲照顾者（20 人）进行了两次半结构式访谈，历时 6-9 个月，以了解他们对青少年糖尿病管理能力的信心在大流行期间发生了哪些变化。访谈内容由四位评分者进行誊写和编码，以确保相互之间的可靠性：结果：出现了四个主题：预防不良血糖事件、有用的血糖趋势信息、改善糖尿病管理以及技术的缺点。大多数青少年（63%）表示，他们对自己在大流行期间管理糖尿病的能力增强了信心。其中一半以上的青少年已经在使用胰岛素泵，相当多的青少年（33%）更新了他们的胰岛素注射方法。青少年和护理人员都认为糖尿病设备是影响他们糖尿病管理自我效能的一个因素：讨论：研究结果表明了糖尿病管理在确诊为 T1DM 的青少年日常生活中的重要性，以及糖尿病设备在护理中断期间的潜在益处。

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引用次数: 0

Measuring Toxic Stress in Childhood and Youth: A Systematic Review 测量儿童和青少年的有毒压力：系统回顾。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-11-01 DOI: 10.1016/j.pedhc.2024.08.008

Mackaully Lucia Parada MSW, LCSW, Juan L. Parada JD, MBA

Introduction

Toxic stress among children/youth is a significant public health concern that has been linked to serious morbidities and premature mortality in adulthood. Uniformity in measurement of a toxic stress variable for use in scholarly research can aid in a more comprehensive understanding of its indicators and implications.

Method

The purpose of this systematic review was to aggregate, organize, and summarize the literature around current practices for operationalizing toxic stress among children/youth. A strategic methodology was conducted according to PRISMA guidelines, and two databases were consulted for relevant studies.

Results

Over 30 different measurement tools were identified across 13 included studies, ranging from biomarkers and physiological indicators to scales, diagnoses, and other assessment instruments.

Discussion

By synthesizing current measurement methods, this review informs research and clinical communities of different approaches to toxic stress measurement, advances standardization efforts, and justifies the necessity of a singular, scientifically validated tool.

导言：儿童/青少年的有毒压力是一个重大的公共健康问题，与成年后的严重疾病和过早死亡有关。在学术研究中统一测量毒性压力变量有助于更全面地了解其指标和影响：本系统性综述的目的是汇总、整理和总结有关当前儿童/青少年毒性压力操作方法的文献。根据 PRISMA 指南制定了战略方法，并查阅了两个数据库中的相关研究：结果：在纳入的 13 项研究中发现了 30 多种不同的测量工具，包括生物标志物、生理指标、量表、诊断和其他评估工具：讨论：本综述综合了当前的测量方法，向研究和临床界介绍了不同的毒性应激测量方法，促进了标准化工作的开展，并证明了科学验证单一工具的必要性。

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