Showing papers in "Issues in Comprehensive Pediatric Nursing in 1991"
TL;DR: The book concludes that none of these preparations for paediatric practice has any documented benefits, some actually prolong diarrhoea, and others have been shown to produce severe and, in some cases, fatal side-effects.
Abstract: (1991). The Rational Use of Drugs in the Management of Acute Diarrhoea in Children. Issues in Comprehensive Pediatric Nursing: Vol. 14, No. 2, pp. 139-139.
54Â citations
TL;DR: Bereaved parents' intensity of grieving scores were generally higher than those reported on the TRIG norms, and in response to The Bereavement Questionnaire, they were able to identify what health care professionals did or said that was helpful or unhelpful before, during, and after their child's death.
Abstract: The death of a neonate, infant, or child is a tragedy that greatly impacts on many individuals' lives. Nurses and other health-care professionals provide care for not only the dying child but also the grieving parents and families. It is imperative that health care professionals are cognizant of the components and intensity of parental grieving and the critical role that they must assume in supporting bereaved parents prior to, at the time of, and after the child's death. The purpose of this study was to measure the intensity of parental grieving and collect information from bereaved parents regarding their perception of health care professionals' interventions. The results indicated that bereaved parents' intensity of grieving scores were generally higher than those reported on the TRIG norms. In response to The Bereavement Questionnaire, they were able to identify what health care professionals did or said that was helpful or unhelpful before, during, and after their child's death.
42Â citations
TL;DR: Although there were differences between groups on their mean pain ratings, the correlation between nurses and physicians was highly significant, indicating that the use of a VAS may help nurses and Physicians explore the cues used to estimate children's pain.
Abstract: Children's ratings of their postoperative pain were compared to nurses' and physicians' ratings of the children's postoperative pain. Children and adolescents were able to rate their pain using a visual analogue scale CVAS). Although there were differences between groups on their mean pain ratings, the ratings of the nurses and physicians correlated significantly with the children's pain ratings. Also, the correlation between nurses and physicians was highly significant, indicating that the use of a VAS may help nurses and physicians explore the cues used to estimate children's pain. This dialogue may enhance communication and collaboration between professionals about pain management strategies specific to each child's pain experience.
40Â citations
TL;DR: The results suggest that the intervention program was primarily beneficial to adolescents' achievement of the maternal role through enhancement of maternal-fetal attachment and raises questions about theoretical assumptions concerning the relationship between affective and behavioral components of mothering.
Abstract: The purpose of this study was to evaluate the effects of a nursing intervention program on affective and behavioral dimensions of maternal role attainment. The sample comprised 20 primiparous adolescents, ages 12-19 years, from predominantly black and Hispanic backgrounds. Adolescents were randomly assigned to either an experimental or a control group. Participants in the experimental group received an intervention that included four 1 1/2 hour classes held at weekly intervals, selected maternal-fetal interactive activities, recording of fetal movements, and maintaining of maternal diaries. Five instruments were used in the study: Cranley's Maternal-Fetal Attachment Scale (MFAS); the two Semantic Differentials, Myself as Mother and My Baby; the Pharis Self-Confidence Scale; and the Nursing Child Assessment Feeding Scale (NCAFS). Adolescents receiving intervention demonstrated a significant increase in prenatal attachment (MFAS scores) but showed no differences in actual mothering behaviors (NCAFS scores) as compared with adolescents in the comparison group. Although significant correlations existed among the affective measures, they were not significantly related to the measures of mothering behaviors. These results suggest that the intervention program was primarily beneficial to adolescents' achievement of the maternal role through enhancement of maternal-fetal attachment. The data also raise questions about theoretical assumptions concerning the relationship between affective and behavioral components of mothering.
39Â citations
TL;DR: The study attempts to examine the presence or nonpresence of chronic sorrow in three mothers through the use of observation and intensive interview techniques and by following the Schatzman and Strauss (1973) method of field research.
Abstract: A qualitative study is presented following the hybrid model of concept development to examine the emotions present in mothers who care for their chronically ill children at home. In particular the study attempts to examine the presence or nonpresence of chronic sorrow in three mothers through the use of observation and intensive interview techniques and by following the Schatzman and Strauss (1973) method of field research. The population for this study varied in diagnosis, sex, age, prognosis, and family structure. The commonalities included an uncertain future, a significantly changed life-style as a result of the child's illness, and the presence of nursing care in the home. The emotion called chronic sorrow, introduced in 1962 by Olshansky, has had limited exposure in the literature. The concept was originally intended for examinations of parents of severely mentally retarded children. Recently it has been examined in varied populations. Although many different reactions have been presented in the literature regarding the emotions of parents of chronically ill children, chronic sorrow has not been one of them. The examination of this emotion has been disease specific. The presence of this emotion in this population has implications for nurses working in all care settings.
38Â citations
TL;DR: A congruency is found between statements about needs of parents of hospitalized 2- to 6-year-olds in the literature and the needs ofParents expressed by parents themselves and pediatric health care professionals on the other hand.
Abstract: The present study uses a qualitative approach to explore and identify areas of needs among parents of 2- to 6-year-old children who are hospitalized. An extensive literature review and informal in-depth interviews with five parents and six pediatric health care professionals were analyzed by content to develop a representative list of statements about needs. Six groups of needs were recognized: (a) the need to be able to trust doctors and nurses, (b) the need for information, (c) needs related to other family members, (d) a need to feel that they are trusted, (e) needs related to human and physical resources, and (e) the need for support and guidance. A congruency is found between statements about needs of parents of hospitalized 2- to 6-year-olds in the literature on the one hand and the needs of parents expressed by parents themselves and pediatric health care professionals on the other hand.
37Â citations
TL;DR: The results of this study indicate that the BCHAPS is a tool that can be used clinically to assess maternal behaviors in the NICU and that can predict the mother-infant relationship long after the discharge of the infant.
Abstract: Because it is becoming increasingly evident that the sensitivity of mothers to their premature infants can affect the mother-infant relationship, means to assess maternal sensitivity to infants are essential. The Boston City Hospital Assessment of Parental Sensitivity (BCHAPS) was the tool used in this study to assess maternal competence and sensitivity to premature infants in the Neonatal Intensive Care Unit (NICU). The concurrent validity of the tool was determined by examining the relation between scores on the BCHAPS and several maternal characteristics (i.e., family income, education, and parity) and infant characteristics (i.e., weight, gestational age, APGAR scores, and severity of illness). The predictive validity of the BCHAPS was determined by comparing the BCHAPS scores to mother-infant interaction behaviors when infants were 8 months old. Scores obtained on the BCHAPS correlated with mother-infant interaction scores at 8 months and to parity. There was no correlation between the BCHAPS scores and other maternal-infant characteristics. The results of this study indicate that the BCHAPS is a tool that can be used clinically to assess maternal behaviors in the NICU and that can predict the mother-infant relationship long after the discharge of the infant.
23Â citations
TL;DR: Observations revealed that comforting occurs in response to infant cues, comfort touch had limited effect in settling the infants, infants were often distressed for long periods without being comforted, and the infants were handled as normal infants without regard for their incisions.
Abstract: The comforting behaviors of nurses caring for four postoperative neonates were examined by analyzing 40 hours of videotaped caregiving. Using the techniques of qualitative ethology, 30 periods of distress were identified. During these periods, 98 episodes of direct tactile and verbal comforting occurred. The types and patterns of comforting touch are delineated. Observations revealed that comforting occurs in response to infant cues, comfort touch had limited effect in settling the infants, infants were often distressed for long periods without being comforted, and the infants were handled as normal infants without regard for their incisions. Suggestions for further research are presented.
22Â citations
TL;DR: Advances in technology and health care have increased the number of technology-dependent children and have prolonged their survival, so that children who would have succumbed to their illnesses 5 to 10 years ago are not only surviving but going home and participating in family, community, and school life.
Abstract: Technology-dependent children being cared for at home is a recent phenomenon. Advances in technology and health care have increased the number of technology-dependent children and have prolonged their survival. These children, who would have succumbed to their illnesses 5 to 10 years ago, are not only surviving but going home and participating in family, community, and school life (Grammatica, 1989)
17Â citations
TL;DR: Although all nurses expressed explicit support for the concept of family-centered care, some of their practices and beliefs suggested otherwise, and recommendations for future research, education, and nursing practice are suggested.
Abstract: Children's hospitals throughout North America have implemented many changes during the past 15 years. In recognition of the central role of parents in the lives of their children, policies and procedures have been implemented to enable parents to participate in various aspects of their children's care. However, the extent to which attitudes of nurses have changed to support a more active parental role is less evident. In a project to formulate a philosophy of nursing for a children's hospital, 22 nurses were asked a wide range of questions about nursing and family-centered care. Although all nurses expressed explicit support for the concept of family-centered care, some of their practices and beliefs suggested otherwise. This article describes their responses and suggests recommendations for future research, education, and nursing practice.
16Â citations
TL;DR: An instrument that assesses injury prevention health beliefs and social influence perceptions in mothers of young children based on the Health Belief Model has utility for nursing investigations on the predictors of injury prevention behavior and for development of nursing interventions to prevent injuries in young children.
Abstract: Unintentional home related injuries are a major cause of morbidity and mortality among children under the age of five years. Injury incidence in homes for these children continues at high levels despite injury prevention education programs for their caregivers. This article reports the development of an instrument that assesses injury prevention health beliefs and social influence perceptions in mothers of young children. Based on the Health Belief Model, the tool is composed of six scales that measure injury susceptibility and seriousness, benefits and barriers of injury prevention, self efficacy of injury prevention performance, and social influence. Reliability measurements showed that all scales produced high Cronbach alphas (.83 to .98) and significant test-retest correlations (.30 to .62, p Language: en
TL;DR: The findings from a descriptive study that investigated 76 homeless school-age children's level of depression as measured with the Children's Depression Inventory are reported and the relevance of these findings for pediatric nurses and nursing interventions specific to this population are discussed.
Abstract: Homelessness continues to be a social problem that many children experience. The loss of a home and all that is familiar to the child may have devastating short- and long-term effects on the child's psychological well-being. Some of these ill effects can potentially be mitigated by prompt nursing intervention. In this article the findings from a descriptive study that investigated 76 homeless school-age children's level of depression as measured with the Children's Depression Inventory are reported. The relevance of these findings for pediatric nurses and nursing interventions specific to this population are discussed.
TL;DR: Clinical implications of the study point to the need for greater support for mothers of young children with MR, mothers who are sole caregivers, and parents with many children, as well as the importance of some father characteristics to maternal coping skills in two-parent households.
Abstract: The study focused on the variables influencing the functioning of 62 families with MR (mentally retarded) persons, living at home, in various stages of the life cycle. Results demonstrated the importance of some father characteristics to maternal coping skills in two-parent households. Although mean maternal coping scores were not statistically different between two-parent and single-parent households, single mothers' coping skills showed strong negative associations with both the number of children in the household and the age of the mother. This was not true of mothers in two-parent households. Single-parent mothers also appeared to be considerably more dissatisfied with family functioning than mothers in two-parent households. The supportive role of older fathers in mothers' coping in two-parent households also was apparent. Clinical implications of the study point to the need for greater support for mothers of young children with MR, mothers who are sole caregivers, and parents with many children. Dif...
TL;DR: A composite of research findings has been derived to develop not only a risk profile that identifies potential problem areas, but also an advantage profiles that identifies specific strengths of parents with mental retardation.
Abstract: Health professionals concerned about the needs of parents with mental retardation are beginning to distinguish characteristics which facilitate and inhibit their parenting abilities. Child health is dependent on adequate parenting abilities. A composite of research findings has been derived to develop not only a risk profile that identifies potential problem areas, but also an advantage profile that identifies specific strengths of parents with mental retardation. The advantage profile uniquely focuses on parental assets that can be reinforced and used to foster child health.
TL;DR: Two studies conceptualized within Orem's (1991) general theory of nursing were undertaken: one involving ethnographic interviews to determine what pain relief actions are taken by nurses with recognized expertise in caring for children in pain and another, follow-up survey to examine the frequency with which these actions are used by general nursing staff.
Abstract: Nurses are confronted daily with the responsibility to care for hospitalized children in pain, yet the substantive knowledge base about that care and how effective it is remains extremely limited. Although there is initial evidence of effectiveness of several pharmacologic and nonpharmacologic pain relief approaches, little evidence of use or effectiveness in clinical nursing practice exists. To begin to address this knowledge deficit, two studies conceptualized within Orem's (1991) general theory of nursing were undertaken: one involving ethnographic interviews to determine what pain relief actions are taken by nurses with recognized expertise in caring for children in pain and another, follow-up survey to examine the frequency with which these actions are used by general nursing staff. Data about perceived effectiveness of the actions were also obtained. The results of these two studies of nursing actions to prevent and alleviate pain in hospitalized children document that nurses use a wide variety of creative methods to relieve pain. From interviews with the nurse experts both specific actions and action patterns and themes were identified. Furthermore, these patterns were congruent with methods of helping used by nurses as described by Orem. Results of this research currently serve as the basis for development and testing of nursing action protocols for alleviation of pain in hospitalized children.
TL;DR: As very little is known about boys' subjective and emotional experiences when going through puberty, the qualitative research method of grounded theory was used in this study to address the question: "What is the experience of the physical maturational changes in male adolescents?"
Abstract: As very little is known about boys' subjective and emotional experiences when going through puberty, the qualitative research method of grounded theory was used in this study to address the question: "What is the experience of the physical maturational changes in male adolescents?" A Basic Social Psychological Process emerged, Minimizing Embarrassment, with four stages: waiting for the change, noticing the change, dealing with the change, and feeling comfortable with the change. Boys developed expectations from listening to others, by looking at older males, and by wondering and imagining what the changes would eventually be like for them. After developing these expectations, they compared their physical changes to others and to their own expectations. If the boys felt they were different from their peers, they worried about this difference. They used strategies such as avoiding, pretending, and joking to avoid embarrassment or to deal with embarrassing situations. If the boys felt they were "normal," they accepted the fact that they were maturing properly.
TL;DR: The purposes of this article are to highlight how differences in perspectives and ideologies create misunderstanding and to provide nurses with some examples of how their behavior might be interpreted by African- and Mexican-American children.
Abstract: This article is based on the premise that African-and Mexican-American children's responses to health and illness are rooted in their socialization into group perspectives that have been shaped by particular social and economic realities. Nurses are expected to provide care to African-and Mexican-American children, even though nurses may not have been educated to understand the effect of socialized perspectives on their practices. The purposes of this article are to highlight how differences in perspectives and ideologies create misunderstanding and to provide nurses with some examples of how their behavior might be interpreted by African-and Mexican-American children. The major practice implications center around the points that the motivations for African-and Mexican-American children's behavior may be different from those of European-American children, even though the observable behaviors may be similar and the children of these two groups may bring additional socialized fears and anxieties to the hosp...
TL;DR: This article addresses the health problems and care needs of young children in American cities and summarizes the nursing knowledge and skills needed for urban nursing practice.
Abstract: Societal problems, including drug use, poverty, and violence, are the basis of many severe health problems of urban children. This article addresses the health problems and care needs of young children in American cities and summarizes the nursing knowledge and skills needed for urban nursing practice.
TL;DR: A clinical example is used to illustrate why important data fail to be assessed and communicated and how this compromises care in families of preterm infants.
Abstract: Working with families of preterm infants challenges the ability of professionals to address several issues and to provide continuity of care. A clinical example is used to illustrate why important data fail to be assessed and communicated and how this compromises care.
TL;DR: The families and services provided in a parent-infant enrichment program in a rural setting based on a realistic assessment of the family's ability to actively participate in the case management process are described.
Abstract: Nurse case managers assist families with children with special health-care problems to receive services. This article describes the families and services provided in a parent-infant enrichment program in a rural setting. The interdisciplinary program encourages a parent-provider supportive case management model based on a realistic assessment of the family's ability to actively participate in the case management process. The program empowers families to become advocates for their children.
TL;DR: This study identified how children with chronic, recurrent nonmalignant headaches communicated their headache occurrences to their mothers and how mothers responded to suspected headache occurrences.
Abstract: Although headache is one of the most common somatic complaints of children and adolescents, little is known about its phenomenology. Pediatric headache diagnosis and implications for treatment are often based on parental reports of consequent pain behaviors. Information on how parents assess and respond to children's headache activity is needed. This study identified how children with chronic, recurrent nonmalignant headaches communicated their headache occurrences to their mothers and how mothers responded to suspected headache occurrences. Specific guidelines are offered to assist nurses in the behavioral assessment and management of chronic pediatric headaches.
TL;DR: The high total mean scores for the principles of autonomy and beneficence/nonmaleficence indicated that all three ethical principles were influential in the decision-making process of parents of well children.
Abstract: The purpose of this descriptive study was to survey the parents of well children to determine the ethical principles that influenced the decisions they made in regard to hypothetical choice of treatment options. Sixty-one parents responded to a mailed survey designed to measure the principles of autonomy, beneficence/nonmaleficence, and justice. The high total mean scores for the principles of autonomy and beneficence/nonmaleficence indicated that all three ethical principles were influential in the decision-making process of parents of well children. A student /-test revealed that the mean score for the principle of autonomy was significantly higher than the mean score for the principles of beneficence/nonmaleficence. Open-ended questions regarding the principle of justice revealed many frustrations of the sample population regarding the health care system. The study identified the need for nurses and other health care providers to be aware of the influence these ethical principles have on decision makin...