Issues in comprehensive pediatric nursing
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Issues Compr Pediatr Nurs · Jan 1999
Identification of nurse-family intervention sites to decrease health-related family boundary ambiguity in PICU.
The most common explanation of parental stress associated with hospitalized children is based on individual stress theory. Using a family stress and family systems approach with an emphasis on examining family integrity, this qualitative study selected families in the Pediatric Intensive Care Unit (PICU) with high boundary ambiguity in the caregiving environment and identified potential sites for nursing actions that impede or assist families in maintaining family integrity. Within three days of admission of their child to a major tertiary children's hospital PICU, 29 families were recruited and screened with a Health-Related Family Boundary Ambiguity Scale. ⋯ Data were analyzed using a content analysis method, and results were interpreted within a family systems framework. The following three potential areas of intervention to encourage family integrity during acute illness of a child were identified: fostering family normalcy, respecting family rights, and strengthening the family boundary. Implications for initiating or improving family centered care in the PICU are discussed.
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The purposes of this study were threefold: (a) to describe self-care agency, (b) to describe self-care practice, and (c) to describe the relationship between self-care agency and self-care practice in adolescents. The usefulness of Orem's Self-Care Deficit Nursing Theory (SCDNT) with adolescents also was evaluated. Participants in this study included 173 adolescents, 14 to 19 years of age. ⋯ Although self-care practice was lower than self-care agency, a significant positive correlation was found between the two concepts. The lower self-care practice scores, as compared with the self-care agency scores, suggest that characteristic adolescent behaviors may or may not interfere with self-care practice. The results of this study support the usefulness of Orem's SCDNT with adolescent populations and identify the critical need for further research examining self-care in adolescents.
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Issues Compr Pediatr Nurs · Jul 1998
Randomized Controlled Trial Clinical TrialChildren's responses to immunizations: lullabies as a distraction.
The purpose of this study was to investigate the effects of audiotaped lullabies on physiological and behavioral distress and perceived pain among children during routine immunization. An experimental design was used to study 99 healthy children ages 3 to 6 years. Half the children received the musical intervention during the immunizations, while the other half did not. ⋯ However, total distress scores were significantly less for the experimental group. These results indicate that immunization is a stressful experience for children. Recommendations include further study incorporating pharmacological and nonpharmacological interventions.
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Issues Compr Pediatr Nurs · Jan 1998
Nurses' assessments and management of pain in children having orthopedic surgery.
The specific aims of this research project were to (a) describe selected verbal, nonverbal, and physiological arousal indicators of the child's pain; (b) describe which pain indicators were most influential to nurses in decision-making about interventions for managing the child's pain; (c) describe pain interventions used by nurses; (d) compare postoperative analgesic orders to recommended dosages for the children; and (e) explore relationships between the child's self-report of pain and medication dosages administered. Subjects included 19 children aged 5-17 years who experienced 20 orthopedic surgical procedures (one child had two surgeries one week apart). Data were collected by staff nurses for the first five days after surgery. ⋯ All children received medications for pain; 49% of the orders were within the recommended therapeutic dosage range. A small but significant correlation was found between the child's reported pain level and the morphine equivalents of pain medication received. Recommendations included development of nursing flow charts that provide space to record pain levels and nursing interventions, in-service education for nurses on nonpharmacological interventions, and further research with a larger sample and a single pain rating scale.