Alyson Campbell, Vickie Plourde PhD, Lisa Hartling PhD, Shannon D. Scott
Purpose
To explore the experiences, information needs and preferences of children who have had a concussion and their parents who have cared for them.
Design
Qualitative description.
Methods
Semi-structured qualitative interviews were conducted via Zoom with children who have had a concussion between ages 5 and 16 years and parents who have cared for a child with a concussion. Interviews were audio-recorded and transcribed.
Results
Fourteen interviews were conducted with children and parents who have experiences with concussion. Four major themes were identified: (1) mechanism of injury and concussion symptoms experienced by children, (2) parent concerns, emotions, and health care experience with child's concussion, (3) concussions affect more than just your head and, (4) health information seeking, and preferences of parents and children related to concussion. Children and their parents have unique experiences, information needs and preferences regarding concussion.
Practice Implications
This information offers valuable insights about developing resources about childhood concussion that parents and children will find useful and relevant. This research has direct relevance to healthcare professionals who may encounter children with concussion in their daily practice so they can ensure the needs of children and families are being met. Our findings will be used to create the content for an innovative knowledge translation tool about pediatric concussion.
{"title":"“You Can't Fix Your Brain”: Exploring concussion experiences of children and parents","authors":"Alyson Campbell, Vickie Plourde PhD, Lisa Hartling PhD, Shannon D. Scott","doi":"10.1111/jspn.12357","DOIUrl":"10.1111/jspn.12357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To explore the experiences, information needs and preferences of children who have had a concussion and their parents who have cared for them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative description.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured qualitative interviews were conducted via Zoom with children who have had a concussion between ages 5 and 16 years and parents who have cared for a child with a concussion. Interviews were audio-recorded and transcribed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen interviews were conducted with children and parents who have experiences with concussion. Four major themes were identified: (1) mechanism of injury and concussion symptoms experienced by children, (2) parent concerns, emotions, and health care experience with child's concussion, (3) concussions affect more than just your head and, (4) health information seeking, and preferences of parents and children related to concussion. Children and their parents have unique experiences, information needs and preferences regarding concussion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This information offers valuable insights about developing resources about childhood concussion that parents and children will find useful and relevant. This research has direct relevance to healthcare professionals who may encounter children with concussion in their daily practice so they can ensure the needs of children and families are being met. Our findings will be used to create the content for an innovative knowledge translation tool about pediatric concussion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39393727","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}
Jennifer Shearer Miller PhD, RN, Joel G. Anderson PhD, CHTP, FGSA
Purpose
Few studies have addressed the impact of prior prenatal substance exposure and current household environment on neurodevelopmental health in children with a history of neonatal abstinence syndrome (NAS). This study aimed to describe the prenatal exposures, household environment, and neurodevelopmental health at 10 years of age among children with a history of NAS.
Design and Methods
This study was a retrospective, descriptive design using data from the Maternal Lifestyle Study. Descriptive analyses were conducted. A total of 234 children with a history of NAS were included in this study. Variables selected based on the socio-ecological model included prenatal exposures, household environment, and neurodevelopmental health outcomes.
Results
In this sample, most children were male (63%) with prenatal polysubstance exposure (80%). The majority lived in a home where substance use occurred (68%). Children experienced abnormal cognitive development (26%), language disorders (24%), learning disorders (23%), and abnormal behavioral development (16%).
Implications
This study extends the description of children with a history of NAS beyond 5 years of age. Pediatric nurses can ensure that children with a history of NAS receive neurodevelopmental screening up to and beyond 10 years of age.
{"title":"Factors in children with a history of neonatal abstinence syndrome at 10 years of age: Evidence from the maternal lifestyle study","authors":"Jennifer Shearer Miller PhD, RN, Joel G. Anderson PhD, CHTP, FGSA","doi":"10.1111/jspn.12358","DOIUrl":"10.1111/jspn.12358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Few studies have addressed the impact of prior prenatal substance exposure and current household environment on neurodevelopmental health in children with a history of neonatal abstinence syndrome (NAS). This study aimed to describe the prenatal exposures, household environment, and neurodevelopmental health at 10 years of age among children with a history of NAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This study was a retrospective, descriptive design using data from the Maternal Lifestyle Study. Descriptive analyses were conducted. A total of 234 children with a history of NAS were included in this study. Variables selected based on the socio-ecological model included prenatal exposures, household environment, and neurodevelopmental health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this sample, most children were male (63%) with prenatal polysubstance exposure (80%). The majority lived in a home where substance use occurred (68%). Children experienced abnormal cognitive development (26%), language disorders (24%), learning disorders (23%), and abnormal behavioral development (16%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This study extends the description of children with a history of NAS beyond 5 years of age. Pediatric nurses can ensure that children with a history of NAS receive neurodevelopmental screening up to and beyond 10 years of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377559","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}
Current routine circumcision rates declined indicating a procedure reduction and because of this, nurses will encounter more intact male patients. Best practices are needed to provide appropriate, safe nursing care. The research aim was to understand what American nurses presently know about intact care and if any knowledge deficits exist.
Design and Methods
The research was conducted using a cross-sectional survey design. American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention.
Methods
American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention.
Results
A convenient sample of 345 nursing professionals participated indicating an intact care knowledge deficit across the lifespan. Fourteen percent of respondents did not indicate that replacing the foreskin back over the glans was necessary with adult genital hygiene for intact patients. In pediatrics, 41.7% answered yes to the item statement “Do you retract the foreskin of an infant male child for catheter placement.”
Practice Implications
The results indicate a knowledge deficit among American nurses regarding genital hygiene, particularly for pediatric patients. Practicing without knowledge of intact care that scientifically based can endanger the caring relationship between nurse and patient, resulting in physical harm and may open themselves and their health systems to legal liability.
{"title":"As nurses, are we meeting the unique needs of the intact client?","authors":"Nadine Wodwaski DNP, MSN-ed, RN, ACNS, Kristen Munyan DNP, RN, FNP-BC","doi":"10.1111/jspn.12356","DOIUrl":"10.1111/jspn.12356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Current routine circumcision rates declined indicating a procedure reduction and because of this, nurses will encounter more intact male patients. Best practices are needed to provide appropriate, safe nursing care. The research aim was to understand what American nurses presently know about intact care and if any knowledge deficits exist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>The research was conducted using a cross-sectional survey design. American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A convenient sample of 345 nursing professionals participated indicating an intact care knowledge deficit across the lifespan. Fourteen percent of respondents did not indicate that replacing the foreskin back over the glans was necessary with adult genital hygiene for intact patients. In pediatrics, 41.7% answered yes to the item statement “Do you retract the foreskin of an infant male child for catheter placement.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The results indicate a knowledge deficit among American nurses regarding genital hygiene, particularly for pediatric patients. Practicing without knowledge of intact care that scientifically based can endanger the caring relationship between nurse and patient, resulting in physical harm and may open themselves and their health systems to legal liability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39343541","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}
Siddika S. Mulchan PsyD, Katherine A. Hinderer PhD, RN, Jennifer Walsh MD, Ashley McCool MHA, Jamie Becker PhD
Purpose
An emerging need to improve health care transition planning has developed worldwide as more youth with special health care needs are surviving to adulthood. Nurses have been instrumental in facilitating transition planning and supporting youth throughout this process. While various transition tools have been developed, health professionals' utilization and perception of these tools have yet to be explored. Furthermore, there are no universally-accepted documentation tools for transition planning. The purpose of this study was to develop and implement a transition process planning and communication tool to facilitate transition planning among multiple, pediatric subspecialties within a system-wide transition program.
Design and Methods
This project was a cross-sectional quality improvement initiative. Eligible encounters in the electronic medical record (N = 20,645) were obtained from 38 subspecialty clinics at a large, freestanding pediatric health system. Transition planning documentation was monitored for 8 months pre-implementation and 14 months post-implementation of the tool. Health professionals (N = 89) completed a survey to assess the tool's feasibility.
Results
Implementation of the tool was feasible and corresponded with increased transition planning documentation post-implementation. Nurses represented 33% of the sample that utilized the tool. Survey results revealed barriers to documentation and utilization of the tool, along with strategies for improvement.
Practice Implications
This study demonstrates that health professionals, especially pediatric nurses and nurse practitioners, are willing to adopt new, electronic documentation tools to enhance multidisciplinary transition planning consistent with best practices. Future studies should address identified barriers, assess the effectiveness of the tool on improving transition outcomes, and consider implications for integration into global health care models. System-wide implementation of such tools may improve multidisciplinary communication and coordination of care for youth with special health care needs.
{"title":"Feasibility and use of a transition process planning and communication tool among multiple subspecialties within a pediatric health system","authors":"Siddika S. Mulchan PsyD, Katherine A. Hinderer PhD, RN, Jennifer Walsh MD, Ashley McCool MHA, Jamie Becker PhD","doi":"10.1111/jspn.12355","DOIUrl":"10.1111/jspn.12355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>An emerging need to improve health care transition planning has developed worldwide as more youth with special health care needs are surviving to adulthood. Nurses have been instrumental in facilitating transition planning and supporting youth throughout this process. While various transition tools have been developed, health professionals' utilization and perception of these tools have yet to be explored. Furthermore, there are no universally-accepted documentation tools for transition planning. The purpose of this study was to develop and implement a transition process planning and communication tool to facilitate transition planning among multiple, pediatric subspecialties within a system-wide transition program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This project was a cross-sectional quality improvement initiative. Eligible encounters in the electronic medical record (<i>N</i> = 20,645) were obtained from 38 subspecialty clinics at a large, freestanding pediatric health system. Transition planning documentation was monitored for 8 months pre-implementation and 14 months post-implementation of the tool. Health professionals (<i>N</i> = 89) completed a survey to assess the tool's feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Implementation of the tool was feasible and corresponded with increased transition planning documentation post-implementation. Nurses represented 33% of the sample that utilized the tool. Survey results revealed barriers to documentation and utilization of the tool, along with strategies for improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This study demonstrates that health professionals, especially pediatric nurses and nurse practitioners, are willing to adopt new, electronic documentation tools to enhance multidisciplinary transition planning consistent with best practices. Future studies should address identified barriers, assess the effectiveness of the tool on improving transition outcomes, and consider implications for integration into global health care models. System-wide implementation of such tools may improve multidisciplinary communication and coordination of care for youth with special health care needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39301421","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}
Children with cerebral palsy (CP) typically receive care from multiple specialty providers including Developmental Pediatrics, Orthopedics, Physical Medicine, Occupational Therapy, Physical Therapy, Speech Therapy, Clinical Social Work, Clinical Nutrition, Nursing and Orthotists, which often require many individual visits to the hospital annually. The potential for conflicting plans of care is increased by this fragmented approach, which may lead to duplication of services and increased healthcare costs.
Solution
To address the problem and alleviate burden for families, the Comprehensive Cerebral Palsy Program implemented a nurse-led comprehensive interdisciplinary team approach to provide optimal care coordination to patients and families, using an Integrative Holistic Care Plan (IHCP). During an annual 3–4 hour Comprehensive CP Clinic appointment, a team of specialists meets with the family, and a holistic, evidence-based plan of care is developed. The family-centered care plan includes summaries of each discipline's plan of care with individualized goals, recommendations, and evidence-based outcomes. After the visit, the plan of care is communicated with the family, primary care provider, and other community providers to ensure continuity of care.
Results
Early in the program and electronic IHCP development stage, clinical, and financial outcomes were improved. In addition to significant cost savings, family satisfaction surveys showed continuous improvement in the areas of access, communication, and coordination of care.
Practice Implications
Nurses working in interdisciplinary clinics are in a position to facilitate improved outcomes by developing and implementing a family-centered care plan that provides a comprehensive holistic approach to impacting the areas of quality, effectiveness, and efficiency of care delivery. The use of an IHCP decreases fragmentation of care and duplication of services leading to healthcare cost savings and enhanced patient satisfaction.
{"title":"Lessons learned in the development of a nurse-led family centered approach to developing a holistic comprehensive clinic and integrative holistic care plan for children with cerebral palsy","authors":"Lamara Love BSN, RN, CPN, HNB-BC, Amy Newmeyer MD, Nancy Ryan-Wenger PhD, RN, FAAN, Garey Noritz MD, Micah A. Skeens PhD, RN, CPNP","doi":"10.1111/jspn.12354","DOIUrl":"10.1111/jspn.12354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Problem</h3>\u0000 \u0000 <p>Children with cerebral palsy (CP) typically receive care from multiple specialty providers including Developmental Pediatrics, Orthopedics, Physical Medicine, Occupational Therapy, Physical Therapy, Speech Therapy, Clinical Social Work, Clinical Nutrition, Nursing and Orthotists, which often require many individual visits to the hospital annually. The potential for conflicting plans of care is increased by this fragmented approach, which may lead to duplication of services and increased healthcare costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Solution</h3>\u0000 \u0000 <p>To address the problem and alleviate burden for families, the Comprehensive Cerebral Palsy Program implemented a nurse-led comprehensive interdisciplinary team approach to provide optimal care coordination to patients and families, using an Integrative Holistic Care Plan (IHCP). During an annual 3–4 hour Comprehensive CP Clinic appointment, a team of specialists meets with the family, and a holistic, evidence-based plan of care is developed. The family-centered care plan includes summaries of each discipline's plan of care with individualized goals, recommendations, and evidence-based outcomes. After the visit, the plan of care is communicated with the family, primary care provider, and other community providers to ensure continuity of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Early in the program and electronic IHCP development stage, clinical, and financial outcomes were improved. In addition to significant cost savings, family satisfaction surveys showed continuous improvement in the areas of access, communication, and coordination of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Nurses working in interdisciplinary clinics are in a position to facilitate improved outcomes by developing and implementing a family-centered care plan that provides a comprehensive holistic approach to impacting the areas of quality, effectiveness, and efficiency of care delivery. The use of an IHCP decreases fragmentation of care and duplication of services leading to healthcare cost savings and enhanced patient satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39299157","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}
Elizabeth Perry Caldwell PhD, RN, CNE, Erin Killingsworth PhD, RN, CNE
Purpose
There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.
Design and Methods
This is a cross-sectional, descriptive, exploratory study. One hundred and thirty-four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples t tests.
Results
There was a significant relationship between health literacy, age (r = .286, p < .01) and grade level (r = .317, p = .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (r = .235; p < .05) and parental education (r = .263; p < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (t = 4.772; p < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD.
Practice Implications
There are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is need
{"title":"The health literacy disparity in adolescents with sickle cell disease","authors":"Elizabeth Perry Caldwell PhD, RN, CNE, Erin Killingsworth PhD, RN, CNE","doi":"10.1111/jspn.12353","DOIUrl":"10.1111/jspn.12353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This is a cross-sectional, descriptive, exploratory study. One hundred and thirty-four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples <i>t</i> tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant relationship between health literacy, age (<i>r</i> = .286, <i>p</i> < .01) and grade level (<i>r</i> = .317, <i>p </i>= .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (<i>r</i> = .235; <i>p </i>< .05) and parental education <i>(r</i> = .263; <i>p</i> < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (<i>t</i> = 4.772; <i>p</i> < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>There are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is need","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39260284","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 research aim was to investigate the effects of therapeutic clowning on pain and fear during the process of venous blood sampling in children.
Design and Methods
This study was conducted in a randomised controlled trial from January to March 2020. The study population consisted of children from 7 to 12 years of age who came to the research centre for blood sampling. The research sample consisted of 166 children (83 in the intervention group and 83 in the control group) who met the research criteria and came to the research centre on a specific date through probable sampling. For the data collection, a questionnaire form, the Visual Analogue Scale and the Children's Fear Scale were used. Therapeutic clowning was used in this process for the intervention group. There was no intervention for children who were in the control group. The calculation of percentage distribution and means, χ2 test, analysis of variance analysis in repeated measures and least significant difference and independent t-test were used to analyse the data.
Results
The results of the research indicated that children in the intervention group had significantly lower pain and fear than children in the control group (p < .001). Therapeutic clowning seems to effectively reduce pain and fear during venous blood sampling for children from 7 to 12 years of age. Our results support using therapeutic clowns which is an inexpensive, safe, and effective method for lowering children's pain and fear during venous blood sampling.
Practice Implications
The use of therapeutic clowns could become the standard of care in blood sampling for children from 7 to 12 years of age in hospitals. Therapeutic clowning, which is an easy-to-use, low-cost and practical method to provide better communication and cooperation with the family and the child, can be used as a complementary therapy in all nursing areas, especially in the field of paediatrics. Nurses could be encouraged to be trained on the use of therapeutic humour based upon a standardised approach and offered guidance on how to apply entertaining methods such as clowns. Therapeutic clowning can be examined in other applications in nursing care in light of these results.
{"title":"Effects of therapeutic clowning on pain and anxiety during venous blood sampling in Turkey: Randomised controlled trial","authors":"Fatma Kurudirek PhD, Duygu Arikan PhD, Arzu Sarialioğlu PhD","doi":"10.1111/jspn.12352","DOIUrl":"10.1111/jspn.12352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The research aim was to investigate the effects of therapeutic clowning on pain and fear during the process of venous blood sampling in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This study was conducted in a randomised controlled trial from January to March 2020. The study population consisted of children from 7 to 12 years of age who came to the research centre for blood sampling. The research sample consisted of 166 children (83 in the intervention group and 83 in the control group) who met the research criteria and came to the research centre on a specific date through probable sampling. For the data collection, a questionnaire form, the Visual Analogue Scale and the Children's Fear Scale were used. Therapeutic clowning was used in this process for the intervention group. There was no intervention for children who were in the control group. The calculation of percentage distribution and means, <i>χ</i><sup>2</sup> test, analysis of variance analysis in repeated measures and least significant difference and independent <i>t</i>-test were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of the research indicated that children in the intervention group had significantly lower pain and fear than children in the control group (<i>p</i> < .001). Therapeutic clowning seems to effectively reduce pain and fear during venous blood sampling for children from 7 to 12 years of age. Our results support using therapeutic clowns which is an inexpensive, safe, and effective method for lowering children's pain and fear during venous blood sampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The use of therapeutic clowns could become the standard of care in blood sampling for children from 7 to 12 years of age in hospitals. Therapeutic clowning, which is an easy-to-use, low-cost and practical method to provide better communication and cooperation with the family and the child, can be used as a complementary therapy in all nursing areas, especially in the field of paediatrics. Nurses could be encouraged to be trained on the use of therapeutic humour based upon a standardised approach and offered guidance on how to apply entertaining methods such as clowns. Therapeutic clowning can be examined in other applications in nursing care in light of these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39077612","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 purpose of this study was to explore adolescents' experiences and knowledge of type 2 diabetes (T2D) and identify appropriate T2D education and prevention interventions for this population.
Design and Methods
This interpretive description study was conducted at two urban high schools in midwestern Canada. Participants had been previously screened and considered at high risk for T2D, prediabetes, or as having T2D. Individual, semistructured interviews were conducted with twelve adolescents between the age of 14–19 years meeting these criteria. Thematic analysis was completed using interview transcripts.
Results
Themes and subthemes identified included (1) Type 2 Diabetes: More Than Too Many Sweets (Mostly Diet but Insulin Does Play a Role, and A Serious but Common Disease); (2) Who Holds the Power? (Personal Responsibility for Health, Family as Role Models, and Community Connections); and (3) Bringing Home the Message (Our Considerations for Schools, I need the Expert's Support, and Using Technology to Get the Points Across).
Practice Implications
Findings from this study provide target areas for education and prevention interventions and approaches for working with adolescents surrounding prediabetes and T2D that may be effective.
{"title":"Beyond “Watching the Sweets”: An interpretive description of adolescent's understandings and insights into preventing prediabetes and type 2 diabetes","authors":"Shelley Spurr RN, PhD, Jill Bally RN, PhD, Solomon K. Mcharo RN, PhDc, Shannon Hyslop RN, MNc","doi":"10.1111/jspn.12351","DOIUrl":"10.1111/jspn.12351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to explore adolescents' experiences and knowledge of type 2 diabetes (T2D) and identify appropriate T2D education and prevention interventions for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This interpretive description study was conducted at two urban high schools in midwestern Canada. Participants had been previously screened and considered at high risk for T2D, prediabetes, or as having T2D. Individual, semistructured interviews were conducted with twelve adolescents between the age of 14–19 years meeting these criteria. Thematic analysis was completed using interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Themes and subthemes identified included (1) <i>Type 2 Diabetes: More Than Too Many Sweets</i> (Mostly Diet but Insulin Does Play a Role, and A Serious but Common Disease); (2) <i>Who Holds the Power?</i> (Personal Responsibility for Health, Family as Role Models, and Community Connections); and (3) <i>Bringing Home the Message</i> (Our Considerations for Schools, I need the Expert's Support, and Using Technology to Get the Points Across).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Findings from this study provide target areas for education and prevention interventions and approaches for working with adolescents surrounding prediabetes and T2D that may be effective.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38987770","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}
Beth Wathen MSN, RN, PNP, CCRN-K, Heidi L. McNeely MSN, RN, PCNS-BC, Christine Peyton MSN, CPNP-AC, Zhaoxing Pan PhD, Robin Thomas BSN, RN, CCRN, Cayla Callahan BSN, RN, CCRN, Sara Fidanza MSN, RN, CNS-BC, CPNP-PC, James Brown BSN, RN, CPN, Madalynn Neu PhD, RN, FAAN
Purpose
Evaluate the accuracy of an electromagnetic device (EMD) guided nasogastric tube (NGT) placement compared with standard confirmation methods. A secondary aim was to determine if EMD guided NGT placement would avert potential pulmonary misplacements of the tube.
Design and Methods
Pediatric Intensive Care Unit (PICU) patients were enrolled if they had an NGT order during the study period of April 2014 through December 2016. Patients were included if they were one through 18 years of age. An EMD trained nurse inserted the NGT using EMD guidance. An insertion questionnaire, confirming if the nurse determined the NGT to be gastric per EMD, was completed immediately after NGT placement and before confirmation via either pH testing or radiographic imaging.
Results
Forty-five patients were enrolled in the study. Nurses reported, based on EMD, that 86.7% (n = 39) of placements were gastric. Overall agreement between EMD guided tube placement and pH testing was 58% (n = 26). The marginal distribution was significantly different between the two methods (p = .0029). When compared to radiographic confirmation, sensitivity of the pH method was 32% (95% confidence interval [CI]: 17%–51%) compared with 85% (95% CI 69%–95%) for the EMD method.
Conclusions
EMD guidance was superior to pH testing when compared with radiographic confirmation of nasogastric tube placement in children.
Practice Implications
EMD guided NGT placement is a potentially viable method for confirming nasogastric tube placement in children when done by appropriately trained clinicians. More research on EMD guided NGT placement in children is needed before any practice recommendation can be made.
{"title":"Comparison of electromagnetic guided imagery to standard confirmatory methods for ascertaining nasogastric tube placement in children","authors":"Beth Wathen MSN, RN, PNP, CCRN-K, Heidi L. McNeely MSN, RN, PCNS-BC, Christine Peyton MSN, CPNP-AC, Zhaoxing Pan PhD, Robin Thomas BSN, RN, CCRN, Cayla Callahan BSN, RN, CCRN, Sara Fidanza MSN, RN, CNS-BC, CPNP-PC, James Brown BSN, RN, CPN, Madalynn Neu PhD, RN, FAAN","doi":"10.1111/jspn.12338","DOIUrl":"10.1111/jspn.12338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Evaluate the accuracy of an electromagnetic device (EMD) guided nasogastric tube (NGT) placement compared with standard confirmation methods. A secondary aim was to determine if EMD guided NGT placement would avert potential pulmonary misplacements of the tube.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Pediatric Intensive Care Unit (PICU) patients were enrolled if they had an NGT order during the study period of April 2014 through December 2016. Patients were included if they were one through 18 years of age. An EMD trained nurse inserted the NGT using EMD guidance. An insertion questionnaire, confirming if the nurse determined the NGT to be gastric per EMD, was completed immediately after NGT placement and before confirmation via either pH testing or radiographic imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-five patients were enrolled in the study. Nurses reported, based on EMD, that 86.7% (<i>n</i> = 39) of placements were gastric. Overall agreement between EMD guided tube placement and pH testing was 58% (<i>n</i> = 26). The marginal distribution was significantly different between the two methods (<i>p</i> = .0029). When compared to radiographic confirmation, sensitivity of the pH method was 32% (95% confidence interval [CI]: 17%–51%) compared with 85% (95% CI 69%–95%) for the EMD method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EMD guidance was superior to pH testing when compared with radiographic confirmation of nasogastric tube placement in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>EMD guided NGT placement is a potentially viable method for confirming nasogastric tube placement in children when done by appropriately trained clinicians. More research on EMD guided NGT placement in children is needed before any practice recommendation can be made.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38970191","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}
Henrik Hjelmgren MSN, Anna Nilsson MD, Ida H. Myrberg BSc, Nina Andersson PhD, Britt-Marie Ygge, Björn Nordlund PhD
Purpose
The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling.
Design and Methods
This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs).
Results
Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, p = .001, adj-OR 2.88 (CI 1.79–4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (n = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50–0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38–0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76–1.55).
Conclusion
This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors.
Practice Implications
This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. Altogether, this study also indicates that implementing more venous blood sampling and improve the cases of capillary sampling could reduce the number of preanalytical errors in pediatric hospitals.
目的血液取样程序复杂且容易失败，这反映在儿科医院护理的分析前错误中。本研究的主要目的是评估毛细管采血是否比静脉血采血发生分析前错误的风险更高，其次是探讨与分析前错误相关的具体因素，包括毛细管和静脉血采血的总体和分层。设计与方法本观察性儿科医院研究收集了2014 - 2016年的医疗记录和血液抽样调查结果。分析前误差风险采用校正优势比(adjor)，多变量logistic回归，95%置信区间(ci)。结果951份血样中共发现128例(13%)分析前错误。与静脉血样本相比，毛细血管样本的错误比例和误差比均显著高于静脉血样本，分别为354例中的72例(20%)和597例中的56例(9.4%)，p =。001, ji - or 2.88 (CI 1.79-4.64)。多管采血与分析前错误风险增加显著相关(n = 97 / 601, 16%)，而对数体重(kg)显著降低分析前错误风险(or为0.66)(CI为0.50-0.86)，表明增加体重具有保护作用。然而，分层分析表明，增加静脉血取样的对数重量具有保护作用，比值为0.52 (CI 0.38-0.72)，而毛细血管取样则没有，比值为1.08 (CI 0.76-1.55)。结论本研究表明，毛细管采血增加了分析前错误的风险。此外，儿童体重的增加降低了分析前错误的风险，而多次采集样管显著增加了分析前错误的风险。实践启示这一新信息可能有助于护士提高他们对儿科血液采集的认识。综上所述，本研究还表明，实施更多的静脉血采样和提高毛细管采样的情况可以减少儿科医院分析前错误的数量。
{"title":"Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study","authors":"Henrik Hjelmgren MSN, Anna Nilsson MD, Ida H. Myrberg BSc, Nina Andersson PhD, Britt-Marie Ygge, Björn Nordlund PhD","doi":"10.1111/jspn.12337","DOIUrl":"10.1111/jspn.12337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, <i>p</i> = .001, adj-OR 2.88 (CI 1.79–4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (<i>n</i> = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50–0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38–0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76–1.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. Altogether, this study also indicates that implementing more venous blood sampling and improve the cases of capillary sampling could reduce the number of preanalytical errors in pediatric hospitals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38957800","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}
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