Pub Date : 2021-01-01Epub Date: 2020-09-23DOI: 10.1111/jspn.12310
Gail Macartney, Michelle Woodfield, Ivan Terekhov, Michael Vassilyadi, Kristian Goulet
Purpose: To describe and explore the relationship between baseline anxiety, depression and symptom experience in children and youth assessed at a concussion clinic.
Design and methods: A retrospective chart review of concussed children and youth referred to a pediatric teaching hospital concussion clinic over a 15-month period was completed. Kutcher Adolescent Depression Scale (KAD-6), General Anxiety Disorder Scale (GAD-7), and the Post-Concussion Symptom Inventory (PCSI) scores were extracted.
Results: A total of 155 patients were included. The most common symptoms (PCSI) at baseline were headache, fatigue, and feelings of head pressure. Symptoms were rated as mild to moderate in intensity. Overall, mean depression and anxiety scores were low. The mean anxiety scores, as measured by the GAD-7 (n = 108), was 7.4 (range, 0-24). The mean depression score, as measured by the KAD-6 (n = 94), was 4.7 (range, 0-18). A statistically significant, moderate positive correlation between PCSI scores with KAD-6 scores for male (r = .64, p < .001) and female (r = .61, p < .001) participants was identified. Similarly, a statistically significant, moderate positive correlation between PCSI scores with GAD-7 scores for male (r = .68, p < .001) and female (r = .60, p < .001) participants was identified.
Practice implications: Concussed children may experience a wide array of symptoms, including emotional challenges such as anxiety and depression. Feelings of anxiety and depression may contribute to overall post concussive symptoms in concussed children. The electronic health record can be leveraged to provide important patient data. Clinicians should systematically assess symptoms at each visit in concussed children and youth so that appropriate interventions can be implemented and monitored.
{"title":"Anxiety, depression, and symptom experience in concussed children and youth.","authors":"Gail Macartney, Michelle Woodfield, Ivan Terekhov, Michael Vassilyadi, Kristian Goulet","doi":"10.1111/jspn.12310","DOIUrl":"https://doi.org/10.1111/jspn.12310","url":null,"abstract":"<p><strong>Purpose: </strong>To describe and explore the relationship between baseline anxiety, depression and symptom experience in children and youth assessed at a concussion clinic.</p><p><strong>Design and methods: </strong>A retrospective chart review of concussed children and youth referred to a pediatric teaching hospital concussion clinic over a 15-month period was completed. Kutcher Adolescent Depression Scale (KAD-6), General Anxiety Disorder Scale (GAD-7), and the Post-Concussion Symptom Inventory (PCSI) scores were extracted.</p><p><strong>Results: </strong>A total of 155 patients were included. The most common symptoms (PCSI) at baseline were headache, fatigue, and feelings of head pressure. Symptoms were rated as mild to moderate in intensity. Overall, mean depression and anxiety scores were low. The mean anxiety scores, as measured by the GAD-7 (n = 108), was 7.4 (range, 0-24). The mean depression score, as measured by the KAD-6 (n = 94), was 4.7 (range, 0-18). A statistically significant, moderate positive correlation between PCSI scores with KAD-6 scores for male (r = .64, p < .001) and female (r = .61, p < .001) participants was identified. Similarly, a statistically significant, moderate positive correlation between PCSI scores with GAD-7 scores for male (r = .68, p < .001) and female (r = .60, p < .001) participants was identified.</p><p><strong>Practice implications: </strong>Concussed children may experience a wide array of symptoms, including emotional challenges such as anxiety and depression. Feelings of anxiety and depression may contribute to overall post concussive symptoms in concussed children. The electronic health record can be leveraged to provide important patient data. Clinicians should systematically assess symptoms at each visit in concussed children and youth so that appropriate interventions can be implemented and monitored.</p>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38412516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Herr RN, BSN, Ronald Ferdman MD, Melinda Braskett MD
Purpose
Patients with certain types of allergic reactions to medication may safely receive the culprit medication through an elaborate allergy procedure called a drug desensitization. Nurses play a key role in this process which is only performed when a certain medication is absolutely indicated as optimal therapy. Nurses are instrumental in the planning stages of drug desensitizations for coordination of interdisciplinary care and anticipation of adverse effects. Thus, it is paramount that nurses performing this procedure understand the mechanism of desensitizations and have access to the resources needed to safely complete these procedures in pediatric patients.
Conclusion
Excellence in nursing clinical acumen and a detailed order set are essential to patient safety during dug desensitization. With the following methodology and coordination by nursing, we have had great success at Children's Hospital Los Angeles in over one hundred drug desensitizations in pediatric patients which allowed them to received first line therapies. We have created order sets from published references and years of clinical experience. The nursing care of adult patients undergoing drug desensitization procedures is well described in the literature but few resources exist for pediatric nurses. There is paucity of published nursing resources for pediatric drug desensitizations. Repeated PubMed searches for “pediatric drug desensitizations” in 2019-2020, revealed only one recent reference geared toward physicians.
Practice Implications
With appropriate training, staffing, and coordination, drug desensitizations can be safely performed in pediatric patients with close observation by a multi-disciplinary team. The bedside nurse has a pivotal role as coordinator and clinician for these high-risk resource-intensive procedures.
{"title":"Safe administration of drug desensitizations in pediatric patients","authors":"Sarah Herr RN, BSN, Ronald Ferdman MD, Melinda Braskett MD","doi":"10.1111/jspn.12322","DOIUrl":"10.1111/jspn.12322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients with certain types of allergic reactions to medication may safely receive the culprit medication through an elaborate allergy procedure called a drug desensitization. Nurses play a key role in this process which is only performed when a certain medication is absolutely indicated as optimal therapy. Nurses are instrumental in the planning stages of drug desensitizations for coordination of interdisciplinary care and anticipation of adverse effects. Thus, it is paramount that nurses performing this procedure understand the mechanism of desensitizations and have access to the resources needed to safely complete these procedures in pediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Excellence in nursing clinical acumen and a detailed order set are essential to patient safety during dug desensitization. With the following methodology and coordination by nursing, we have had great success at Children's Hospital Los Angeles in over one hundred drug desensitizations in pediatric patients which allowed them to received first line therapies. We have created order sets from published references and years of clinical experience. The nursing care of adult patients undergoing drug desensitization procedures is well described in the literature but few resources exist for pediatric nurses. There is paucity of published nursing resources for pediatric drug desensitizations. Repeated PubMed searches for “pediatric drug desensitizations” in 2019-2020, revealed only one recent reference geared toward physicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>With appropriate training, staffing, and coordination, drug desensitizations can be safely performed in pediatric patients with close observation by a multi-disciplinary team. The bedside nurse has a pivotal role as coordinator and clinician for these high-risk resource-intensive procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38763923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcela C. M. Z. Vasques, Brenda B. Silva, Marla A. G. de Avila
Purpose
Educational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.
Design and Methods
A descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.
Results
The content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7–12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled “Getting to know the Surgery Center” was created in the form of a 19-page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.
Practice Implications
This study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.
{"title":"Construction and validation of a Brazilian educational comic book for pediatric perioperative care","authors":"Marcela C. M. Z. Vasques, Brenda B. Silva, Marla A. G. de Avila","doi":"10.1111/jspn.12320","DOIUrl":"10.1111/jspn.12320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Educational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>A descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7–12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled “Getting to know the Surgery Center” was created in the form of a 19-page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38711445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To develop the Chinese version of the Pediatric Patient-Reported Outcome Measurement Information System (PROMIS)-Emotional Distress item bank version 2.0—both conceptually equivalent to the original and relevant in the Chinese culture.
Design and Methods
The Pediatric PROMIS-Emotional Distress item bank was translated, following the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology, by a translation team. Eight children aged 8–17 years from the general population were cognitively interviewed.
Results
Most items were well understood by children, and some revisions were made after the cognitive interviewing based on the suggestions of the interviewees. The Chinese version of the Pediatric PROMIS-Emotional Distress-v2.0 item bank was conceptually and semantically equivalent to the original.
Practice Implications
The Chinese version of the Pediatric PROMIS-Emotional Distress item bank is now available for further studies to develop computer adaptive tests (CATs). Future CAT version measures may become a new standard measure for children in the general population and those living with a chronic condition in China.
{"title":"Translation and cultural adaptation of the Pediatric Patient-Reported Outcome Measurement Information System-Emotional Distress item banks into Chinese","authors":"Wenjun Gao PhD, Changrong Yuan PhD, FAAN","doi":"10.1111/jspn.12318","DOIUrl":"10.1111/jspn.12318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To develop the Chinese version of the Pediatric Patient-Reported Outcome Measurement Information System (PROMIS)-Emotional Distress item bank version 2.0—both conceptually equivalent to the original and relevant in the Chinese culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>The Pediatric PROMIS-Emotional Distress item bank was translated, following the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology, by a translation team. Eight children aged 8–17 years from the general population were cognitively interviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most items were well understood by children, and some revisions were made after the cognitive interviewing based on the suggestions of the interviewees. The Chinese version of the Pediatric PROMIS-Emotional Distress-v2.0 item bank was conceptually and semantically equivalent to the original.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The Chinese version of the Pediatric PROMIS-Emotional Distress item bank is now available for further studies to develop computer adaptive tests (CATs). Future CAT version measures may become a new standard measure for children in the general population and those living with a chronic condition in China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38671420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael I. Axelrod PhD, Ray J. Larsen BS, Keith Jorgensen BS, Bobbie Stratman BS
Objective
Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4-year-old well child care visit with their toilet trained peers.
Design and Methods
Parent reports of internalizing and externalizing behavior using the Child Behavior Checklist (CBCL) were compared across groups, non-toilet trained and toilet trained, for 150 children recruited during their 4-year-old well child health care visit. Independent samples t tests of group means and χ2 analyses were performed on all CBCL scales.
Results
Results found no clinically or statistically significant differences between groups on parents' reports of internalizing and externalizing behavior. The current study provides no evidence that delays in successfully completing toilet training by 4 years of age were related to psychological problems for this sample of children.
Practice Implications
Nursing professionals in primary care settings are positioned to provide anticipatory guidance to parents of children not yet toilet trained. Findings from the current study offer evidence that delays in toilet training might not be related to psychopathology, and these children are not likely to require intervention outside the pediatric setting and could be effectively managed by primary care health providers employing evidence-based toilet training protocols.
{"title":"Psychological differences between toilet trained and non-toilet trained 4-year-old children","authors":"Michael I. Axelrod PhD, Ray J. Larsen BS, Keith Jorgensen BS, Bobbie Stratman BS","doi":"10.1111/jspn.12319","DOIUrl":"10.1111/jspn.12319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4-year-old well child care visit with their toilet trained peers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Parent reports of internalizing and externalizing behavior using the Child Behavior Checklist (CBCL) were compared across groups, non-toilet trained and toilet trained, for 150 children recruited during their 4-year-old well child health care visit. Independent samples <i>t</i> tests of group means and <i>χ</i><sup>2</sup> analyses were performed on all CBCL scales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results found no clinically or statistically significant differences between groups on parents' reports of internalizing and externalizing behavior. The current study provides no evidence that delays in successfully completing toilet training by 4 years of age were related to psychological problems for this sample of children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Nursing professionals in primary care settings are positioned to provide anticipatory guidance to parents of children not yet toilet trained. Findings from the current study offer evidence that delays in toilet training might not be related to psychopathology, and these children are not likely to require intervention outside the pediatric setting and could be effectively managed by primary care health providers employing evidence-based toilet training protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38561377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study is a qualitative interview study. The authors used the stimulated recall interview (SRI) with nurses working at a children's hospital in southern Sweden for the data collection. In total twelve nurses were interviewed and qualitative content analysis was used for the data analysis.
Results
The results are presented as one theme: Need for higher competencies and evidence, and three categories: Routines can enable pain assessment, Trusting one's own assessment of the whole picture, and Pain assessment scales as an extra workload. The interviewed nurses acknowledged that pain assessment tools are a vital part of the field of pain treatment. They also had trust issues with measuring and estimating pain by means of a tool such as pain scale. Furthermore, their opinion was that too many different tools and methods add up towards a more blurry and stress-related environment and due to a lack of consistent routines, pain assessment is seen as a work-related burden in the daily routines.
Conclusion
Results from the present study indicated that nurses need clear routines in combination with continued education regarding pain assessment with pain scales, which might be the key to successful pediatric pain assessment and thus to better pain management within pediatrics.
{"title":"Pain assessment from Swedish nurses' perspective","authors":"Nina Skog MNSc, RSCN, RN, Mirella Mesic Mårtensson MNSc, RSCN, RN, Anna-Karin Dykes Prof, RN, RM, Vedrana Vejzovic PhD, MNSc, RSCN, RN","doi":"10.1111/jspn.12317","DOIUrl":"10.1111/jspn.12317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a qualitative interview study. The authors used the stimulated recall interview (SRI) with nurses working at a children's hospital in southern Sweden for the data collection. In total twelve nurses were interviewed and qualitative content analysis was used for the data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results are presented as one theme: Need for higher competencies and evidence, and three categories: Routines can enable pain assessment, Trusting one's own assessment of the whole picture, and Pain assessment scales as an extra workload. The interviewed nurses acknowledged that pain assessment tools are a vital part of the field of pain treatment. They also had trust issues with measuring and estimating pain by means of a tool such as pain scale. Furthermore, their opinion was that too many different tools and methods add up towards a more blurry and stress-related environment and due to a lack of consistent routines, pain assessment is seen as a work-related burden in the daily routines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results from the present study indicated that nurses need clear routines in combination with continued education regarding pain assessment with pain scales, which might be the key to successful pediatric pain assessment and thus to better pain management within pediatrics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38560416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a growing number of youth and their parents seeking assistance from care providers related to gender dysphoria and transitional care for transgender and gender-nonconforming (TGNC) youth. The purpose of this study was to determine pediatric nurse practitioners’ (PNP) attitudes/beliefs and knowledge/competence in caring for TGNC youth.
Design and Methods
This cross-sectional descriptive study surveyed PNPs (N = 93) from eight states using two survey instruments to measure attitudes and beliefs and knowledge and perceived competence related to caring for TGNC youth.
Results
Eighty-one percent of PNPs reported caring for TGNC youth in their practice. Despite this, only 15% of the PNPs received education related to transgender patients during their advanced practice education. Results showed that attending continuing education offerings related to caring for TGNC patients increases PNP perceived competence as well as knowledge. Attitudes and behaviors towards the transgender population were also more positive if the PNP had attended continuing nursing education offerings. Three themes emerged from a qualitative portion of the survey, asking the participant to share thoughts related to caring for transgender youth: lack of education for healthcare providers, the need to refer patients to comprehensive gender services, and the need for support for transgender patients and their families.
Practice Implications
Education plays an important part in nurses’ attitudes, beliefs, and perceived competence in caring for transgender patients. Because the PNP is likely to be exposed to patients with TGNC, it is imperative they seek out opportunities to learn about transgender issues and caring for transgender patients.
{"title":"Pediatric nurse practitioners' attitudes/beliefs and knowledge/perceived competence in caring for transgender and gender-nonconforming youth","authors":"Cathleen A. Collins PhD, RN, CNE","doi":"10.1111/jspn.12321","DOIUrl":"10.1111/jspn.12321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There is a growing number of youth and their parents seeking assistance from care providers related to gender dysphoria and transitional care for transgender and gender-nonconforming (TGNC) youth. The purpose of this study was to determine pediatric nurse practitioners’ (PNP) attitudes/beliefs and knowledge/competence in caring for TGNC youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This cross-sectional descriptive study surveyed PNPs (<i>N</i> = 93) from eight states using two survey instruments to measure attitudes and beliefs and knowledge and perceived competence related to caring for TGNC youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-one percent of PNPs reported caring for TGNC youth in their practice. Despite this, only 15% of the PNPs received education related to transgender patients during their advanced practice education. Results showed that attending continuing education offerings related to caring for TGNC patients increases PNP perceived competence as well as knowledge. Attitudes and behaviors towards the transgender population were also more positive if the PNP had attended continuing nursing education offerings. Three themes emerged from a qualitative portion of the survey, asking the participant to share thoughts related to caring for transgender youth: lack of education for healthcare providers, the need to refer patients to comprehensive gender services, and the need for support for transgender patients and their families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Education plays an important part in nurses’ attitudes, beliefs, and perceived competence in caring for transgender patients. Because the PNP is likely to be exposed to patients with TGNC, it is imperative they seek out opportunities to learn about transgender issues and caring for transgender patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38548805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danae Dinkel PhD, John P. Rech MA, Kailey Snyder PhD
Purpose
Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs).
Design and Methods
We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (n = 16) and overweight (n = 11) infants. Data were analyzed using a two-tailed Mann–Whitney U nonparametric test and a summative content analysis approach.
Results
Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider.
Practice Implications
To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.
{"title":"Exploring parents' provision of factors related to the establishment of physical activity between normal weight and overweight infants","authors":"Danae Dinkel PhD, John P. Rech MA, Kailey Snyder PhD","doi":"10.1111/jspn.12315","DOIUrl":"10.1111/jspn.12315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (<i>n</i> = 16) and overweight (<i>n</i> = 11) infants. Data were analyzed using a two-tailed Mann–Whitney <i>U</i> nonparametric test and a summative content analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38543796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen E. Montgomery PhD, RN, PCNS-BC, CPHON, Kaylee Vos BSN, RN, CPHON, Jennifer L. Raybin MSN, RN, CPNP, Jessica Ward PhD, MPH, RN, CPNP, Chelsea Balian MSN, RN, CNS, CPNP, Elizabeth A. Gilger MSN, APRN-BC, CPON, Zhanhai Li PhD
Purpose
This report represents a subanalysis of data from a primary study and addresses a gap in understanding the similarities and differences of symptom reporting between children with advanced cancer and their parents. The objectives of this subanalysis were to (1) compare reports of symptom prevalence, symptom burden, and symptom frequency, severity, and distress between groups of children and adolescents and their parents, and (2) describe concordance of symptom reports within individual child–parent dyads.
Design and Methods
Forty-six children with relapsed, refractory, or progressive cancer and their parents from five pediatric cancer centers prospectively reported symptoms every 2 weeks for up to 61 weeks. The abbreviated Pediatric Quality of Life and Evaluation of Symptoms Technology—Memorial Symptom Assessment Scales were used to measure symptom prevalence, frequency, severity, and distress.
Results
Children and parents reported pain, fatigue, nausea, and sleeping difficulties as the most frequently occurring symptoms. With the exception of shortness of breath, parents reported symptom prevalence more often than children. The differences in parent reports were statistically significant for fatigue, nausea, lack of appetite, feeling nervous, and sadness. Parents reported higher symptom burden scores compared to children for all individual symptoms except shortness of breath. Children reported higher scores for 19 of 32 possible symptom frequency, severity, and distress ratings. Children's scores were higher for frequency and severity, while parents’ scores were higher for distress. Sleeping difficulties, pain, nausea, and diarrhea demonstrated the highest concordance, while feeling nervous, sadness, irritability, and fatigue yielded the lowest concordance between children's and parents’ symptom reports.
Practice Implications
Eliciting the symptom experience from the child, when appropriate, rather than a parent proxy is best practice given evidence supporting the overestimation of symptom prevalence by parents and underestimation of symptom frequency and severity for some symptoms. When proxy raters must be used, pediatric nurses should educate proxy raters regarding symptom assessment, and assess and tend to symptoms that may not exhibit visual cues. Pediatric nurses should conduct a comprehensive symptom assessment and evaluate beyond the presence of symptoms and include an assessment of frequency, severity, and distress for physical and psychological symptoms to optimize symptom
{"title":"Comparison of child self-report and parent proxy-report of symptoms: Results from a longitudinal symptom assessment study of children with advanced cancer","authors":"Kathleen E. Montgomery PhD, RN, PCNS-BC, CPHON, Kaylee Vos BSN, RN, CPHON, Jennifer L. Raybin MSN, RN, CPNP, Jessica Ward PhD, MPH, RN, CPNP, Chelsea Balian MSN, RN, CNS, CPNP, Elizabeth A. Gilger MSN, APRN-BC, CPON, Zhanhai Li PhD","doi":"10.1111/jspn.12316","DOIUrl":"10.1111/jspn.12316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This report represents a subanalysis of data from a primary study and addresses a gap in understanding the similarities and differences of symptom reporting between children with advanced cancer and their parents. The objectives of this subanalysis were to (1) compare reports of symptom prevalence, symptom burden, and symptom frequency, severity, and distress between groups of children and adolescents and their parents, and (2) describe concordance of symptom reports within individual child–parent dyads.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Forty-six children with relapsed, refractory, or progressive cancer and their parents from five pediatric cancer centers prospectively reported symptoms every 2 weeks for up to 61 weeks. The abbreviated Pediatric Quality of Life and Evaluation of Symptoms Technology—Memorial Symptom Assessment Scales were used to measure symptom prevalence, frequency, severity, and distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children and parents reported pain, fatigue, nausea, and sleeping difficulties as the most frequently occurring symptoms. With the exception of shortness of breath, parents reported symptom prevalence more often than children. The differences in parent reports were statistically significant for fatigue, nausea, lack of appetite, feeling nervous, and sadness. Parents reported higher symptom burden scores compared to children for all individual symptoms except shortness of breath. Children reported higher scores for 19 of 32 possible symptom frequency, severity, and distress ratings. Children's scores were higher for frequency and severity, while parents’ scores were higher for distress. Sleeping difficulties, pain, nausea, and diarrhea demonstrated the highest concordance, while feeling nervous, sadness, irritability, and fatigue yielded the lowest concordance between children's and parents’ symptom reports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Eliciting the symptom experience from the child, when appropriate, rather than a parent proxy is best practice given evidence supporting the overestimation of symptom prevalence by parents and underestimation of symptom frequency and severity for some symptoms. When proxy raters must be used, pediatric nurses should educate proxy raters regarding symptom assessment, and assess and tend to symptoms that may not exhibit visual cues. Pediatric nurses should conduct a comprehensive symptom assessment and evaluate beyond the presence of symptoms and include an assessment of frequency, severity, and distress for physical and psychological symptoms to optimize symptom","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38547085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to examine the psychometric properties of the Turkish version of the Diabetes Family Impact Scale (DFIS).
Methods and Design
The study was carried out methodologically with 121 parents who have 6–18 year-old children with type 1 diabetes (n = 121). The collected data were analyzed by conducting confirmatory factor analysis, t test, and Pearson's correlation analysis and by computing Cronbach's α and intraclass correlation coefficients (ICCs).
Results
The linguistic validity of the scale was ensured by undertaking translation and back-translation. Expert opinions were analyzed and all the content validity indices were found to be ≥0.80. The factor loadings of all the items ranged from 0.47 to 0.89, and the model fit indices were as follows: χ²/df = 1.21 and RMSEA = 0.04. Scores that were obtained across two temporally separated administrations were not significantly different (p > .05), and there was a strong correlation between the two sets of scores (ICC = 0.892; p < .001). The Cronbach's α of the scale was .881. The item-total correlation coefficients of the scale items ranged from .34 to .72.
Conclusions
Similar to the original assessment, the Turkish version of the DFIS consists of 14 items and 4 subscales. It is a valid and reliable measure that is suitable for use with Turkish samples. Researchers can use this scale to assess the effect of type 1 diabetes mellitus on the family of an affected child.
{"title":"Psychometric properties of the Turkish version of the Diabetes Family Impact Scale","authors":"Ismail Cetintas RN, MSc, Melahat Akgün Kostak RN, PhD","doi":"10.1111/jspn.12308","DOIUrl":"10.1111/jspn.12308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The objective of this study was to examine the psychometric properties of the Turkish version of the Diabetes Family Impact Scale (DFIS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Design</h3>\u0000 \u0000 <p>The study was carried out methodologically with 121 parents who have 6–18 year-old children with type 1 diabetes (<i>n</i> = 121). The collected data were analyzed by conducting confirmatory factor analysis, <i>t</i> test, and Pearson's correlation analysis and by computing Cronbach's <i>α</i> and intraclass correlation coefficients (ICCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The linguistic validity of the scale was ensured by undertaking translation and back-translation. Expert opinions were analyzed and all the content validity indices were found to be ≥0.80. The factor loadings of all the items ranged from 0.47 to 0.89, and the model fit indices were as follows: <i>χ</i>²/<i>df</i> = 1.21 and RMSEA = 0.04. Scores that were obtained across two temporally separated administrations were not significantly different (<i>p</i> > .05), and there was a strong correlation between the two sets of scores (ICC = 0.892; <i>p</i> < .001). The Cronbach's <i>α</i> of the scale was .881. The item-total correlation coefficients of the scale items ranged from .34 to .72.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Similar to the original assessment, the Turkish version of the DFIS consists of 14 items and 4 subscales. It is a valid and reliable measure that is suitable for use with Turkish samples. Researchers can use this scale to assess the effect of type 1 diabetes mellitus on the family of an affected child.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2020-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38308520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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