Comprehensive child and adolescent nursing最新文献

This article presents the findings of a service evaluation on the role of the youth worker offered to young people in the hospital setting across the United Kingdom and what differentiates the role of the youth worker from other health-care professionals, as described by young people, parents, and members of the existing multidisciplinary team. Young people, parents, and members of multidisciplinary teams were approached by a youth worker in the hospital regarding the purpose of the evaluation and the online survey relating to their views and experiences of working with a youth worker in the hospital setting. Data were analyzed descriptively. The n value represents the total number of responses: Young people 11-25 years (n = 47), mothers/fathers (n = 16), and members of the multidisciplinary team (n = 76). The findings suggested that the youth worker was highly valued by all, with a consensus that they had a positive impact on the experiences of young people, their parents, and members of the multidisciplinary teams. Youth workers were reported as offering a more relatable style of engagement that connected with young people on a different and more informal level than other members of the multidisciplinary team. Their approach to the support provided was also different as their focus was guided by what young people valued. Youth workers acted as the bridge between young people, their parents, and the multidisciplinary team and were considered by the multidisciplinary teams to be a fundamental ingredient when working with young people in the hospital setting. The findings from this evaluation provide unique insights into the role the youth worker offers to young people in hospital settings that is different from what other health-care professionals provide, as reported by young people, parents, and the multidisciplinary team. However, further evaluation of the service should include objective outcome measures of the role and in-depth qualitative research to gain a greater and more detailed understanding of young peoples', parents', and members of the multidisciplinary team's views and experiences of what makes this role different.

A partnership between a nursing program and a rural obstetric office provided education to pregnant and postpartum women about coping with infant crying and the dangers of shaking a baby. Undergraduate nursing students delivered the Period of PURPLE Crying (PURPLE) educational program to 148 mothers. Change in knowledge about infant crying and the community clinical experience was evaluated. Pre and post intervention data were collected. Descriptive statistics indicated higher scores on mothers' posttest for knowledge about normal newborn crying behaviors and coping strategies. Students further developed the role of educator and researcher. These findings suggest the intervention contributed to mothers' improved knowledge about infant crying. Results of the pilot study are encouraging because the intervention had a significant effect on mothers' knowledge about infant crying and Shaken Baby Syndrome (SBS).

A child's illness and admission in a hospital are stressful and can negatively affect the child and his/her caregivers. The stress is further exacerbated when a child is critically ill and has been admitted to an intensive care unit (ICU). The effects can be reduced when caregivers of the sick children are present and involved in decision making and actual care of their hospitalized children, a care model called family-centered care. Malawi has adopted family-centered care model in the newly instituted Mercy James Pediatric ICU. Little is known about experiences of caregivers with FCC in Malawi. This qualitative study was therefore conducted to explore experiences of caregivers on their involvement in decision making and care at Mercy James Pediatric ICU in Blantyre, Malawi. This was a descriptive qualitative study with a sample size of fifteen participants, however, data saturation was reached with ten participants. One on one in-depth interviews were conducted among a purposively selected sample of ten caregivers whose children had been discharged from the PICU. Content analysis was deductively and manually undertaken to analyze data with the aid of delve software to organize the data. Findings show that not every caregiver was involved in the decision making of their children's care, and if they did, it was not adequate. Barriers to effective involvement such as using a foreign language had a negative impact on comprehensive involvement of caregivers in decision making for their children's care. All participants were, however, involved in the physical care of their children. It is important that health care workers should continuously encourage caregivers to get involved in the decision making and care of their children.

Children's nurses in African pediatric settings are often responsible for leading practice improvements. There is a shortage of contextually relevant guidance to inform the design of practice improvement projects in African care settings. Distinctive features of children's nursing practice in Africa include high levels of family caregiver involvement, and organizational and professional cultures which value participation. While established practice improvement methods offer many strengths, methods developed in other geographies should not be adopted uncritically. Our purpose in undertaking this review was to inform selection of methods for a multi-center practice improvement project in Africa. Our aim was to identify types of participatory methods used to improve and develop pediatric nursing practice. We used the PRISMA-ScR method to conduct a scoping review to identify published reports of participatory methods used to improve and develop pediatric nursing practice. We undertook structured searches of five bibliographic databases to identify articles. Only articles written in the English language were included and no limitation was applied to publication date. We identified 7,406 titles and abstracts. After screening, 76 articles met the inclusion criteria. A wide range of participatory methodologies were identified; just under half (n = 34) reported on methods that were not recognized or named methodologies but can be described as collaborative in nature. Plan-do-study-act cycles were reported in 22 articles. There was considerable heterogeneity in frameworks, practical tools and/or nursing models on which the participatory methods were based and there was no apparent relationship between these and the choice of participatory methods. The outcomes identified were also heterogenous in nature and were grouped according to whether they improved structure and/or processes and patient outcomes. Most of the included articles stem from high-income countries with little evidence from low-middle-income countries and none in African settings. Less than half of the included articles involved family caregivers in their practice improvement methodologies. This review highlights the need for greater application of formalized methods for practice improvement and improved rigor and consistency in reporting outcomes. There is also a need to formalize participatory practice improvement methodologies specifically suited to Africa's context of children's nursing.

The purpose of the research were to describe eHealth literacy and identify factors affecting the eHealth literacy of early adolescents. This descriptive and correlational study was conducted in a government secondary school in the west of Turkey. The research sample consisted of 1347 adolescents in the sixth, seventh, and eighth grades in the academic year 2016-2017. An adolescents' description form and the eHealth Literacy Scale (eHEALS) were used to collect the data. The mean score on eHEALS was 23.81 ± 6.94. Multiple regression analysis showed that being in the 11-12 year age group (β = 0.528, p < 0.001), having a father with a high school or university level education (β = 0.055, p = 0.038), and carrying out research in the internet on health related topics (β = 0.118, p < 0.001) were determinant at 32% (F = 56.901, p < 0.001, R² = 0.32) on the adolescents' eHealth literacy. The mean eHEALS score in the study demonstrated that the e-health literacy of the adolescents was rather low and inadequate, and that there were gaps in the adolescents' knowledge and skills about how and where to find quality eHealth information. Nurses are expected to provide eHealth literacy training that will help to find information on the internet and interpret and assess it, and this will develop eHealth literacy of adolescents. Integrating online health information sources into the school health education curriculum in line with developed strategies can be suggested because it is an attempt to improve the eHealth literacy of adolescents.

Suicide is the second leading cause of death for children and adolescents ages 10-19 in the United States. Globally, suicide is the fourth leading cause of death among adolescents and young adults ages 15-29. The World Health Organization identifies suicide prevention and promotion as a public health priority. In the United States, one of the key prevention strategies has been the recognition of the need for screening, particularly for children and adolescents. The American Academy of Pediatrics (AAP), National Institute of Mental Health (NIMH), and the Joint Commission recommend suicide risk screening for those ages 10 and older. Research has shown that children and adolescents won't disclose suicidal thoughts unless directly asked. Perioperative units in pediatric hospitals are uniquely positioned to integrate suicide screening as part of the nurses' pre-operative assessment of surgical patients. Utilizing pre-operative units for screening can identify at-risk patients who otherwise may not be screened. The purpose of this evidence-based practice (EBP) project was to determine if a one-time, educational intervention highlighting the importance of universal suicide screening in pediatric patients 10 years old or older would affect the beliefs and comfort level of pediatric perioperative nurses. The survey assessed perioperative nurses' beliefs and comforts around suicide screenings for patients ages 10 and older in the perioperative unit. Twenty-minute educational unit-based in-services were provided over a 2-week period to all current staff. The survey was then repeated to assess for changes in nurses' beliefs and comfort. Pre-educational intervention, 43.5% of participants did not believe it is important to ask patients about suicidal thoughts. Only 60.9% of participants agreed that all patients 10 years and older should be assessed for suicidal risk, regardless of behavioral health history. After the educational intervention, all perioperative nurse participants (n = 22) agreed it was important to ask patients about suicidal thoughts and to screen all patients 10 years and older for suicidal risk, not just behavioral health patients. Post-education, all participants (100%) agreed it was important to ask patients about suicidal thoughts and believed patients 10 years and older should be assessed for suicidal risk. Early detection through screening is crucial to combating this growing health crisis for children and adolescents. Educational in-services strengthened this group of perioperative nurses' understanding of the importance and feasibility of universal suicide screening in their unit. Responses from this EBI can potentially help guide the educational component of pediatric hospitals' initiatives to implement suicide screening.

The sudden, unexpected death of a child (SUDC) is a devastating experience. It is vital that supportive and investigative services are effective and promote the best outcomes for families. Analysis of 5 years of data from 309 SUDC cases in Greater Manchester, United Kingdom (UK) shows how a number of key service outcomes can be measured and achieved through a raft of actions which are commensurate with and exceed the service level recommended by the UK Government. Annual reports covering the work of the Greater Manchester SUDC team are compiled from audit forms completed by the attending SUDC pediatrician for each case. Data from these reports from April 1, 2015 to March 31, 2020 were analyzed. Most cases happened out of normal working hours, predominantly on Sundays. This supports the need for a 24-hour, 7 days per week SUDC service to enable early investigation and timely support for families. The review demonstrated that the Greater Manchester model is able to deliver this in a rapid response with early attendance in emergency departments and early home visits; effective joint agency working with police, children's social services, and other agencies; and provision of support to families. The proposed instigation of a key worker role in the SUDC team is a welcome development. This is central to ameliorating the experience for parents by providing bereavement support separate from the investigative role of the SUDC team. Research is needed into the role of the key worker, potentially as a dedicated bereavement nurse, and understanding of families' experiences to ensure that support is optimal.