Pediatric nursing
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This observation study examined the behaviors of 20 sedated, mechanically ventilated children, ages 1 month to 14 years. Observations were made using the Comfort Scale at the beginning and end of the two-hour observation period and of body and facial movements, behavior state, and environmental activity occurring during the 2-hour period. Mean Comfort scores at both measurement points were 16, below the target sedation level. ⋯ Body movements were related to behavior state but not to Comfort scores. Environmental activity was not significantly related to child activity, behavior state, or Comfort scores. Sedation scales in children may be best used in conjunction with behavior observations although further research is needed to determine the predictive capabilities of either scales or behavior on actual ventilation outcomes.
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Comparative Study
Caring for adoptive families: lessons in communication.
To describe the experiences of families whose adopted children were hospitalized and to compare those experiences to the experiences of families of hospitalized biological children. ⋯ Health care providers need to be aware of adoptive parents' concerns about their child's response to hospitalization, attachment issues, and limited family medical history. The quality of communication with adoptive parents is especially important.
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One parent's experience with her daughter in a neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) setting sheds light on parental involvement in end-of-life decision making. For this parent, collaborative decision making was facilitated in an environment where the parents had gotten to know the health care providers over time. Health care provider style was a factor in providing parents with access to information needed to participate in decisions. ⋯ This parent also used outside advice in making key decisions. In contrast, interaction with a minimally communicative and authoritarian style health care professional added greatly to this parent's stress in an already difficult circumstance. These are her own words.