Journal of pediatric nursing
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This article reviews the current state of the knowledge in the management of children and adolescents with sickle cell disease (SCD). A thorough review of the literature concerning physiological issues including the clinical manifestations of SCD as well as current treatment modalities is included. Therapeutic management of health and illness for a child with SCD is discussed in relation to primary, secondary, and tertiary prevention. Recommendations for nursing practice and research are made.
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Clinical Trial Controlled Clinical Trial
Reducing children's immunization distress in a primary care setting.
The purpose of this study was to compare two brief, inexpensive distraction techniques for children receiving immunizations during a county-sponsored immunization clinic. Preschool children (n = 80) were assigned to a party blower intervention, a pinwheel intervention, or a control group. ⋯ Results of planned comparisons indicated significant party blower results in the children's ratings of reduced distress (P < .01) and the parents' ratings of having to hold their child less strongly (P = .04), and showed it to be more distracting than the pinwheel (P < .02). The overall pattern of results on all rating scales supports the efficacy of using a party blower for reducing children's immunization distress, with minimal staff training and no procedural delay.
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The Pre-Verbal, Early Verbal Pediatric Pain Scale (PEPPS) is conceptualized to measure the established pain response in toddlers, a pediatric group void of pain assessment scales. It consists of seven categories, each with weighted indicators. Scores can range from 0 to 26. ⋯ Vignettes were randomly selected and viewed by four experienced pediatric nurses. Results indicated that the PEPPS was easy to use and demonstrated acceptable inter-rater and intrarater reliability. Early evidence of construct validity was established by statistically significant differences in premedication and postmedication pain scores.
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This report describes the development of an instrument, the Nurse-Parent Support Tool (NPST) designed to measure parents' perception of nursing support during their child's hospitalization. The NPST was based on the Nurse Parent Support Model developed from House's conceptualizations of four domains of support. Thus, the 21-item NPST assesses four dimensions of support: (1) supportive communication and provision of information related to the child's illness, treatments, care, and related issues; (2) parental esteem support focused on respecting, enhancing, and supporting the parental role; (3) emotional support to help the parents cope with their own emotional responses and needs related to the child's illness; and (4) caregiving support involving the quality of care provided to the child. ⋯ Factor analysis provides support for the underlying construct and significant correlations with another instrument measuring a similar construct provides support for the concurrent validity. The internal consistency reliability is very high. The NPST holds promise for use in nursing research and quality improvement programs in pediatric and neonatal in-patient settings.
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Flexible bronchoscopy provides a powerful tool to evaluate pulmonary abnormalities in the pediatric population. Nursing involvement may range from age-appropriate preparation of the patient and family to administration of conscious sedation agents. ⋯ Preparation of the physical environment as well as physiological and psychological preparation of the child increase the likelihood of a positive experience. By increasing their familiarity with the procedure, sedation strategies, and monitoring standards, nurses increase the probability of safe and successful flexible bronchoscopic evaluations.