Comprehensive child and adolescent nursing最新文献

Parenthood inevitably includes caring for a child suffering from mild-moderate illness requiring access to health care. Most childhood illnesses can be managed in the community, and parents are encouraged to attend the most suitable primary care service for their needs. Yet the number of children visiting emergency departments with non-urgent illness continues to rise annually, with child attendance representing over 25% of the total workload. This study investigated why parents chose to bring their child to an emergency department and explored the concerns, expectations and experiences of parents when making this decision. Parents of children aged 0-16 years presenting with non-urgent conditions were approached over an 18-month period to participate. Prior to discharge, focused interviews were used to explore the antecedent decision-making factors leading up to attendance, and parents' experiences of urgent care were explored. Parents often experienced complex journeys prior to attending the emergency department following multiple health care contacts and referrals from other providers. For most parents, attending the department was a considered decision, often prompted by their experience of interaction with professionals. Health professionals were powerful agents controlling resources and knowledge, but they were influenced by pressures and targets within the health service. The NHS is a complicated system that parents tried to navigate, but they were thwarted by its complexity and conflicting messages. When their child was unwell parents wanted a service that was simple to access, and that would offer a standard of care that would reassure and empower them to continue to care for their child. The findings challenge assumptions that lead nurses to criticize parents for misuse of emergency care, and highlight the culpability of health professionals and systems in generating increased demand for urgent care. It is important for nurses and others to reframe their perception of parental decision-making.

Heart defects are the second most common congenital anomaly in babies born in the UK and standards state families should have access to a children's cardiac nurse specialist telephone advice service. However, there is little published information to describe the nature of calls and the workload associated with telephone support. We conducted a prospective service evaluation of telephone calls received at one UK specialist children's cardiac surgical center from parents/carers (April-June 2019). All inpatient cardiac teams (cardiology secretaries, inpatient cardiac wards, outpatient department and Clinical Nurse Specialist team) were asked to record calls on a purpose-designed template. This included recording of call duration and reason (from pre-defined categories), with the aim to identify the volume and nature of phone calls. Actions and time taken to resolve issues were not recorded. Data was entered into Excel and analyzed using descriptive statistics. In a seven-week period, 204 telephone calls were received; 41% (n = 83) to the clinical nurse specialist team, 25% (n = 51) to medical secretaries, 20% (n = 42) to cardiac ward staff and 14% (n = 28) to the cardiac outpatient department. The mean length of calls was 6.08 mins (SD 5.07 mins). Across all groups phone call duration totaled 20.8 hours. Sixty-two calls (31% of all calls) reflected 70 concerns/queries about a current health issue. The most common reasons included respiratory (n = 13), heart rate or rhythm (n = 12) and chest pain/pallor (n = 11). Sixty-five calls (32% of all calls) related to issues surrounding medications, with 23% (n = 15) related to dose queries and 49% (n = 32) related to repeat prescription requests or challenges obtaining prescriptions. The results demonstrated a high telephone support need for current health issues or medication queries which required timely assessment and support from health care professionals working across cardiac services. Further research is required to identify the time implications of dealing with phone calls and interventions to support parent/guardian assessment and communication about their concerns and medication management.

This discussion paper draws on a range of personal and other published research articles to respond to calls for a re-conceptualization of the concept of Transition. Acknowledging the roots of the concept in developmental and health psychology, the article briefly considers application to fields of practice in formal and informal education, health, social care, counseling, and psychotherapy that underpin approaches to supporting young people to navigate the journey to adulthood. UK service provision is discussed to consider why linear developmental approaches may be problematic, alongside recent calls for a re-conceptualization of what we mean by Transition to successfully understand, support, and enable complex journeys to young adulthood. The paper concludes by proposing a holistic, non-linear bio-ecological systems approach within which it is possible to integrate globally evolving research, pathways, models, and interventions. The approach will be of interest to an international readership because principles can be adapted to respond to shared and country-specific challenges, developments, and models of service provision as we approach the second quarter of the twenty-first century.

This paper focused on the effectiveness of a parent empowerment intervention based on nursing education (PEINE). This study examined whether the intervention improved the quality of life of children with cystic fibrosis (CF) and improved their caregivers learn about the disease and develop problem-solving and coping skills. This randomized-controlled trial used a pretest-posttest parallel-group research design. The sample consisted of 48 parents (caregivers) of children with CF. Participants were randomly assigned to an intervention (n = 24) and a control group (n = 24). The intervention group received PEINE and standard care and treatment for ten weeks. The control group received standard care and treatment. Data were collected using a Disease Information Survey (DIS), the Ways of Coping Inventory (WCI), the Problem-Solving Inventory (PSI), and the Cystic Fibrosis Questionnaire (CFQ-R). After the intervention, the intervention group DIS scores (d: 1,627 [CI: 0.934,2.305], had more correct answers than the control group. Nursing interventions were effective (p < .001). There was no significant difference in the mean pretest-posttest PSI scores (d: 0.378 [CI: -0.221-0.972], posttest WCI scores (d: 0.239 [CI:-0.356-0.831]) between the intervention and control groups (p>.05). There was a significant difference in the mean posttest CFQ-R scores between the intervention and control groups (d: 1.363 [CI: l.698, 2.015]);(p < .001). PEINE increased the intervention group participants develop disease-management skills. However, the increase in their PSI and WCI scores was statistically insignificant. PEINE also increased the quality of life of children with CF. Parents of children followed in pediatric pulmonary diseases participated in the study. Parents were informed during outpatient clinic visits. After the first meeting, the children and parents who voluntarily agreed to participate in the research were contacted by phone. The outpatient nurse assisted in communicating with children and parents.

This paper presents a narrative review protocol to explore how the proportion of child-specific content of pre-registration programmes in universities impact upon newly qualified nurses' perceptions of preparedness to care for children, young people (CYP), and their families. The preparation and education to become a nurse who cares for children and young people differs from country to country. Providers of pre-registration nurse education offer routes into nursing from diploma to degree and in some countries post-graduate routes. The United Kingdom offers pre-registration programmes leading to qualifying as a children's nurse whereas programmes in countries such as the USA and Canada lead to a professional registration as a registered nurse with postgraduate study to specialize in areas such as pediatrics. The role of pre-registration nursing programmes is to facilitate preparedness for practice. Preparation for practice can include theoretical teaching and practice learning through simulation and face-to-face experience with countries requiring different numbers of practice hours to be completed. Although practice hours are central to nursing education, there is limited evidence on the impact and portion of child-specific content, including clinical learning in preparation of newly qualified nurses to care for CYP and their families. A preliminary search of Prospero, CINAHL, Medline and Cochrane Database indicates that there are no current or in progress reviews identified. The Population of interest, Exposure of interest, and Outcome framework were used to define the research question and inform the eligibility criteria. The review will consider different research designs if related to the research question. The search strategy will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for systematic reviews. Two independent reviewers will be involved in the screening progress to determine the final studies for inclusion. Eligible studies will be assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Extraction of study characteristics and data related to the research question will be extracted into a predefined table. Data synthesis will be conducted using a descriptive analytical approach to summarize extracted data.

Dementia not only affects the person living with the condition but also their family and wider social circle. For that reason, it is important to educate family members, the wider public and health professionals. How a child and young people's (CYP) nurse supports and responds to a CYP whose family member has dementia or acts as a carer is of interest to pre-licensure (pre-registration) CYP nursing programs. With serious games becoming more common as a method to educate a diverse population regardless of age and gender, this study aims to learn if playing a kid's dementia awareness game improves CYP nursing student's attitude to dementia using a validated pre-/posttest questionnaire. This study adopted a pretest, posttest design to assess the attitudes of pre-licensure CYP nursing students toward dementia. The Approaches to Dementia Questionnaire (ADQ) was administered before and after playing a serious CYP kid's dementia game developed by children and people living with dementia for 10- to 11-year-old children. The ADQ measured the total score, Hope subscale, and person-centered approaches. Matched paired t-test was used for analysis conducted with SPSS statistics 29. Seventy-two participants, from one university in Northern Ireland, completed pretest measures, of these, 55 also completed the posttest questionnaire. The participating CYP pre-licensure undergraduate and postgraduate nursing students demonstrated a significant increase in overall dementia attitudes post-gameplay, with an increase from 78.31 to 83.27. Subscales for Hope (27.75 to 30.44) and person-centered approaches also exhibited significant improvement (50.56 to 52.84). Demographic data revealed all participants as female, with 50% knowing a person living with dementia, and limited training experiences. In conclusion, this study has shown a positive response to playing a dementia game relevant to the child population. This adds to the literature building on the use of serious games for health education. Attitudes and hope scales increased with the use of the game.

In Brazil, nasal irrigation is a common procedure for children hospitalized with respiratory conditions. However, it often causes stress for both the child and their family. Nurses need to rethink their approach to care, and the use of therapeutic play can be an ally in transforming the stressful context. To understand the family perceptions of nasal irrigation in hospitalized children after an educational intervention mediated by instructional therapeutic play (ITP). This descriptive, exploratory, and qualitative study was conducted from the perspective of Herbert Blumer's Symbolic Interactionism in a hospital in São Paulo, Brazil. The study included family members of hospitalized children aged 3-6 years who participated in an ITP intervention and remained for 6 hours afterward. Participants self-reported literacy with preserved cognition and verbal communication. This study was conducted between March 2023 and January 2024 using semi-structured interviews with 38 family members. Data were analyzed using Bardin's thematic content and lexical analysis with IRAMUTEQ® software. The interaction of families with ITP for nasal irrigation in children led to a redefinition of the procedure from distressing to enjoyable. ITP was evaluated as an essential and stimulating method that familiarized the child with the procedure, facilitating the understanding process for both the child and the family. ITP is a caregiving technology that nurses can use to assist with nasal irrigation, re-signifying the experiences of children and their families during the procedure.