Journal of Pediatric Nursing - Articles in Press

Letter to the Editor by Butler in Response to “Obesity and Cholesterol in Japanese, French, and U.S. Children” - Corrected Proof

Mary R. Butler — 2010-02-26

In response to the article: Obesity and Cholesterol in Japanese, French, and U.S. Children by Bingham, M., Harrell, J., Takada, H., Washino, K., Bradley, C., Berry, D., Park, H., & Charles, M.

Differences on Psychosocial Outcomes Between Male and Female Caregivers of Children With Life-Limiting Illnesses - Corrected Proof

Monica Schneider, Rose Steele, Susan Cadell, David Hemsworth — 2010-02-26

This secondary analysis of data examined the psychosocial outcomes of meaning in caregiving, self-esteem, optimism, burden, depression, spirituality, and posttraumatic growth in 273 parents caring for children with life-limiting illnesses to (a) determine if there were gender differences and (b) identify gender-specific correlations among these outcomes. Findings suggest that significant gender differences exist. Women reported higher average scores compared with men for meaning in caregiving, depression, burden, and posttraumatic growth and lower average scores for optimism. Correlations also revealed some significant differences. Health care professionals need to be aware of gender differences and tailor their interventions appropriately.

In response to Mary Butler's letter to the Editor discussing the article: Obesity and Cholesterol in Japanese, French, and U.S. Children by Bingham, M., Harrell, J., Takada, H., Washino, K., Bradley, C., Berry, D., Park, H., Charles, M. - Corrected Proof

Mona O. Bingham — 2010-02-18

Thank you for your thoughtful letter to the editor. This article contributes to the evidence highlighting overweight in children worldwide and the associated development of prediabetes, Type 2 diabetes, hypertension, and hyperlipidemia. We are encouraged by the questions you have raised. The science continues to grow examining these associations in children and the risk of developing cardiovascular disease. We agree that dietary and exercise patterns, as well as cultural and ethnic variations, affect cardiovascular disease processes and that body mass index (BMI) alone may not be the most reliable indicator. Still, it is important to note the development and progress for BMI-measurement programs in only a few years. In 2005, the highlighted childhood obesity sparking multiple reviews, organizational position statements, and legislation (). recently published an overview of the CDC's (Centers for Disease Control) guidance on BMI-measurement programs, practices, and recommendations. This report concludes that surveillance is less controversial than screening, but more evaluation and outcomes are needed to determine the health benefits.

Nursing Students Apply Evidence-Based Research Principles in Primary Burn Prevention Projects - Corrected Proof

2010-02-15

The purpose of this project was for registered nursing students in a baccalaureate nursing program to look at different prevention strategies that could be utilized in the community to impact change in a family's burn prevention knowledge. The prevention strategies and their corresponding interventions were written in a narrative form, and then a poster was created to serve as a supplemental visual aid for the information. Firefighters from a local fire department evaluated posters and their abstracts based on criteria developed by the students. Five posters were revised and submitted to a national burn prevention contest. Students gained valuable experience in developing and revising evidence-based research (EBR) projects to promote community education in primary burn prevention with firefighter collaboration.

Emancipation of Youth in Foster Care: The Dilemma - Corrected Proof

Cecily L. Betz — 2010-01-25

Currently, national estimates indicate that approximately 510,000 children and youth live in the foster care system. Of this number, 40% are between the ages of 13 and 21 years; about 9% of youth, amounting to 26,000, are emancipated annually from the foster care system () The term emancipation refers to children who are emancipated as minors and have yet not achieved the age of majority (usually age 18 years) or have reached the age of majority (the statutory language varies and depends on state regulations). The criteria for determining emancipation status refers to the termination of eligibility for foster care services that are, for the most part, not predicated on the youth's readiness but rather on criteria based on age or high school graduation. The youth's readiness for emancipation is not based on developmental aptitude or maturity, although there has been widespread recognition of the need to better prepare youth for this monumental transition out of this service system (). As the data indicate, these young people are not well prepared to assume the overwhelming responsibilities of adulthood. The outcome data of foster youth and alumni demonstrate that they fail to achieve comparable levels of education, encounter difficulties with employment and housing, experience adverse health outcomes, and engage in at-risk behaviors.

Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients - Corrected Proof

2010-01-25

The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years.

Obesity Risk Knowledge and Physical Activity in Families of Adolescents - Corrected Proof

Elaine M. Rutkowski, Cynthia D. Connelly — 2010-01-25

Health risk knowledge has been identified as a key to making informed decisions regarding healthy lifestyle choices (J. Swift, C. Glazebrook, & I. Macdonald, 2005). This article describes a descriptive, correlation study conducted with adolescents and their parents to examine the relationship between obesity risk knowledge and physical activity levels in families of adolescents. A statistically significant inverse relationship is found between parental physical activities and the activity levels of adolescents (r=−.23, p<.05). Although a relationship between physical activity and obesity risk knowledge in parents is supported, the phenomenon is not found in adolescent participants.

Parent–Provider Communication During Hospitalization - Corrected Proof

Mark J. Fisher, Marion E. Broome — 2010-01-25

Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended.

Comparison of Temporal Artery to Rectal Temperature Measurements in Children Up to 24 Months - Corrected Proof

2010-01-25

This descriptive study compared temporal artery (TA) and rectal temperature measurements, patient comfort during temperature measurements, and nursing time required to obtain temperature measurements. Study participants (n = 40) included children 0–24 months old with fever higher than 38°C, admitted to a freestanding children's hospital in the Midwest. Statistical analysis of 450 paired TA and rectal temperature measurements revealed a 0.776 correlation, mean difference of 0.03°C, and 94.7% of measurements differing by less than 1.0°C. Patient comfort, measured via the Face, Legs, Activity, Cry, Consolability Scale, was enhanced with TA thermometry compared to rectal. TA thermometry resulted in an 87% savings of nursing time.

Unaccompanied Hospitalized Children: A Review of the Literature and Incidence Study - Corrected Proof

Cristine A. Roberts — 2010-01-15

The aim of this study was to review literature on unaccompanied hospitalized children and report the incidence at a pediatric hospital over 2 weeks. The philosophical model of most pediatric hospitals is family-centered care (FCC) and reducing separation effects. Although the FCC model includes parents/guardians as collaborators and participants in the care of the child, parents cannot always be present. Nurses try to meet the needs of unaccompanied children. Children and parents express that they want to be together, but many parents have obstacles to participation including increased expectations. The incidence study found that about one third of children were sometimes unaccompanied.

Caregiver Self-Report of Children's Use of the Sippy Cup Among Children 1 to 4 Years of Age - Corrected Proof

Patricia A. Sealy, Neil Farrell, Ashley Hoogenboom — 2009-12-28

Purpose: This research examined the prevalence of the use of the sippy cup, as compared to the baby bottle, among children 1 to 4 years of age.Method: Using a population-based telephone surveillance survey in Ontario, caregivers of children 1 to 4 years of age were asked about their child's use of the sippy cup/baby bottle from the Rapid Risk Factor Surveillance System Module: Early Childhood Tooth Decay.Results: Most caregivers reported that children 1 to 4 years of age were currently using the sippy cup (69.7%), with the proportion increasing to 94.4% when including children with past use of the sippy cup. Younger children were significantly more likely to use the sippy cup, and 10.8% of children 4 years of age continued to use the baby bottle. Diluted fruit juice was the most frequently used liquid in the sippy cup (58.2%). Most of the caregivers did not report the use of the sippy cup at night.Conclusion: Caregivers need education as to potential increases in exposure to sugared/acidic liquids through the use of the sippy cup. Future research is needed to understand the extensive and prolonged use of the sippy cup/baby bottle by young children.

Ensuring Children Eat a Healthy Diet: A Theory-Driven Focus Group Study to Inform Communication Aimed at Parents - Corrected Proof

LeeAnn Kahlor, Michael Mackert, Dave Junker, Diane Tyler — 2009-12-21

The Theory of Planned Behavior (TPB) served as a framework for analyzing focus group transcripts (N = 43) focused on parents' perceptions of the challenges of ensuring their children eat a healthy diet. The results suggest that parents consider their beliefs and behaviors as individuals within a society, within families, within cultures, as inheritors of family traditions, and as parents who influence or fail to influence the attitudes and behaviors of their children. The results showed the particular salience of factors related to the TPB concepts of perceived norms and control. Approaches to building theory-driven nursing interventions are suggested.

Nursing Strategies to Reduce the Incidence of Early Childhood Caries in Culturally Diverse Populations - Corrected Proof

Donna Hallas, Jill Fernandez, Lily Lim, Macy Carobene — 2009-12-17

In the United States, early childhood caries (ECC) is a major unmet health care need adversely affecting the overall health of young children from diverse ethnic populations. Nurses who work in the newborn nursery, pediatrics, public, and community health centers have a unique opportunity to positively influence a change in this epidemic of ECC. Guided by Leininger's theory of cultural care, these authors describe ways to implement a comprehensive culturally sensitive oral health education program for parents of newborns and infants. Interventions based on the best available evidence for oral health education, a culturally sensitive caries risk assessment, recommendations for fluoride varnish treatments, and ways for parents to establish a dental home for the infant by 12 months old are presented.

Parental Support in Neonatal Intensive Care Units: A Cross-Cultural Comparison between New Zealand and Japan - Corrected Proof

Emiko Ichijima, Ray Kirk, Andrew Hornblow — 2009-12-14

This is a cross-cultural comparative study involving both quantitative and qualitative data analyses. This study examines sources of parental stress in the two neonatal intensive care units (NICUs) located in New Zealand and Japan and explores how cultural norms of NICU care environments influence parental stress-related experiences and nursing support. The three main sources of data collection were the following: a NICU staff interview, parental interview, and parental questionnaire survey, the PSS: NICU. Thirty-one pairs of parents in each NICU (N = 121) participated in this study. The differences between the two NICUs in terms of the NICU care environment and sources of parental stress within the NICU contexts were identified, highlighting NICU characteristics associated with the sources of stress in the two NICUs. Recognition of the norms of NICU care environments that may hinder parent–staff communication is an important element of NICU nursing practice.

Consequences of the “Back to Sleep” Program in Infants - Corrected Proof

Lauren C. Miller, Arlene Johnson, Lisa Duggan, Melissa Behm — 2009-12-07

Sudden infant death syndrome (SIDS) is the third leading cause of infant mortality in the United States and the leading cause of death among infants 28–364 days of age. The “Back to Sleep” program was implemented in 1992 to promote supine sleeping in efforts to prevent SIDS. Along with this implementation came several consequences that are avoidable in infants. The purposes of this article are to describe the Back to Sleep program and its intended purpose, to identify the adverse consequences, and to develop a teaching program for nurse practitioners to use with parents that will both promote safe sleeping and reduce the untoward consequences of the back to sleep program while maintaining the integrity of the SIDS prevention advice.

Asthma: A Health Disparity Among African American Children: The Impact and Implications for Pediatric Nurses - Corrected Proof

Annette Baker Hines — 2009-12-07

Asthma is the most common chronic illness among children and is a significant health disparity for African American children and their families. This article provides current statistics that clearly define the problem of asthma and explains the relevance of this health problem for pediatric nurses. The Healthy People 2010 objectives for pediatric asthma care are discussed as outcome measures. The individual, sociocultural, and environmental characteristics of asthma are described. The impact and implications for pediatric nurses in the roles of (a) coordinator of care, (b) child/family advocate, and (c) evaluator of care are explained.

Improved Nurse Readiness Through Pediatric Mock Code Training - Corrected Proof

Denice von Arx, Robert Pretzlaff — 2009-11-19

A pediatric cardiopulmonary arrest in a community hospital is the perfect storm of medical complexity. It is a demanding, high-risk procedure requiring teamwork among a variety of disciplines and is performed on a rare basis. We instituted a novel program of mock code training to improve nurse readiness. The focus of our program was to establish the knowledge, teamwork, and leadership skills necessary for successful resuscitation. Participants were given a pre and post program survey to assess confidence and comfort with pediatric resuscitation. Results were obtained from 27 participants. Two-sample Wilcoxon rank sum testing demonstrated significant improvement in participant comfort and confidence. A model of mock code training that emphasizes teamwork and reinforcement of skills improves a participant's perception of comfort and knowledge base.

Addressing Children's Beliefs Through Fowler's Stages of Faith - Corrected Proof

Michelle E. Neuman — 2009-10-19

Knowledge of child development, including faith development, is important in providing holistic care to the child. Pediatric nurses and nurse practitioners may be inadequately prepared to meet the spiritual needs of children in developmentally appropriate ways. This article demonstrates why it is necessary to asses a child's or an adolescent's religious and spiritual beliefs and when and how a nurse intervenes. Modeled here is one way in which pediatric nurses can effectively combine their knowledge of child development and Fowler's theory of faith development to address the child and adolescent's spiritual needs.

Association of Changes in Self-Efficacy, Voluntary Physical Activity, and Risk Factors for Type 2 Diabetes in a Behavioral Treatment for Obese Preadolescents: A Pilot Study - Corrected Proof

Alice E. Smith, James J. Annesi, Ann M. Walsh, Vivian Lennon, Ruth A. Bell — 2009-10-19

Childhood obesity is increasing in the United States; thus, physicians, nurses, and other health care professionals seek to refer patients to interventions that will reliably improve physical activity and nutrition behaviors. The present 12-week, two-session-per-week protocol, based on social cognitive theory, was given preliminary testing with 23 obese children (Mage = 11.7 years) with risk factors for Type 2 diabetes. A significant within-group improvement in number of days per week of 60 or more minutes of voluntary physical activity was reported. Changes in measures of both task self-efficacy (β = .39) and self-regulatory efficacy (β = .44) significantly contributed to the significant portion of the variance explained in change in voluntary physical activity (R2 = .40). Significant improvements in total cholesterol and body mass index (kg/m2) were also found. Correlations between changes in physical activity and changes in each physiological factor tested were each in the expected direction but did not reach statistical significance. Results suggest that replications and extensions of this pilot study, with greater experimental power, are warranted.

Attitude of Israeli Mothers With Vaccination of Their Daughters Against Human Papilloma Virus - Corrected Proof

Merav Ben Natan, Osnat Aharon, Sharon Palickshvili, Vicky Gurman — 2009-09-23

The purpose of the study is to examine whether the model based on the Theory of Reasoned Action (TRA) succeeds in predicting mothers' intention to vaccinate their daughters against the human papilloma virus infection. Questionnaires were distributed among convenience sample of 103 mothers of daughters 18 years and younger. Approximately 65% of mothers intend to vaccinate their daughters. Behavioral beliefs, normative beliefs, and level of knowledge had a significant positive effect on mothers' intention to vaccinate their daughters. High levels of religiosity were found to negatively affect mothers' intention to vaccinate their daughters. The TRA combined with level of knowledge and level of religiosity succeeds in predicting mothers' behavioral intentions regarding vaccinating daughters. This indicates the significance of nurses' roles in imparting information and increasing awareness among mothers.

Nurse Researchers in Children's Hospitals - Corrected Proof

2009-09-16

Little is known about the role of nurse researchers (NRs) and the structure of nursing research programs in children's hospitals in the United States. This descriptive study obtained survey data from 33 NRs. Data suggest that the NR role is emerging and has both commonalities and unique components when compared with the previous studies of NRs in adult hospitals. Most participants have been in their position for less than 4 years. Conducting research, having staff development related to research, and facilitating evidence-based practice or research were common responsibilities. The structure of nursing research programs impacts both the NRs and the program outcomes.

Expressive Arts in Pediatric Orientation Groups - Corrected Proof

Robert Basso — 2009-09-07

Children admitted to a pediatric unit experience separation or loss from everyday supports while undergoing medical tests or procedures in an environment that children characterize as distressing. A Canadian multidisciplinary hospital team conducted a pilot project that provided children experiencing unplanned admissions to come together to explore, discuss, enact, and make sense of the stress in the hospital environment. The children participated in postadmission orientation groups engaging in improvised skits in which they shared experiences, listened to each other's feelings, and began to problem solve. Primary care staff provided scaled responses and clinical judgements before and after the groups. Staff report that children's fears, anger, and withdrawal improved after the shared group activities.

The Effect of an Educational Session on Pediatric Nurses' Perspectives Toward Providing Spiritual Care - Corrected Proof

Eileen R. O'Shea, Meredith Wallace, Mary Quinn Griffin, Joyce J. Fitzpatrick — 2009-09-07

This study evaluated the effect of a spiritual education session on pediatric nurses' perspectives toward providing spiritual care. A one-group pretest and posttest design was used to evaluate the effectiveness of the educational session. Participants consisted of 41 pediatric and neonatal nurses that worked in a large university-affiliated children's hospital. Findings confirmed that the spiritual education session had a positive effect on nurses' perspectives toward providing spiritual care. In addition, a positive correlation was identified between the pediatric nurses' perception of their own spirituality and their perspective toward providing care.

Adolescents as Health Agents and Consumers: Results of A Pilot Study of the Health and Health-Related Behaviors of Adolescents Living in a High-Poverty Urban Neighborhood - Corrected Proof

Robert Atkins, Myra Bluebond-Langner, Nichole Read, Jerri Pittsley, Daniel Hart — 2009-08-31

Although there is a considerable literature on how adolescents make decisions which lead to risky behaviors (e.g., unprotected sex, drug use) and adversely affect the health and well-being of youth, little is known about the routine behaviors youth engage in which influence their health (e.g., having permanent teeth extracted, discontinuing antibiotics prematurely, delaying or going without treatment of subacute illnesses and minor injuries) and concomitantly the factors which influence these behaviors. In an effort to begin to fill this gap, we have undertaken a study of routine health behaviors and the factors which bear on them in adolescents from a high-poverty urban neighborhood. In this article, we present the results of the pilot phase of the study in which we documented the behavior of 10 adolescents from Camden, New Jersey, the fifth poorest city in the United States, and explored with them their perceptions of the decisions they made and the factors that gave rise to them. We found that participants had an insufficient understanding of their health problems and consequences of their health actions, problems in understanding and being understood by health care professionals, and reluctance to involve parents in routine health care decisions. The implications of these findings are discussed in relation to improving the health of vulnerable youth.

Content Validation of the Infant Malnutrition and Feeding Checklist for Congenital Heart Disease: A Tool to Identify Risk of Malnutrition and Feeding Difficulties in Infants with Congenital Heart Disease - Corrected Proof

2009-08-24

Infants with congenital heart disease (CHD) have a high prevalence of feeding difficulties and malnutrition. Early intervention decreases morbidity and long-term developmental deficits. The purpose of this study was to develop and establish the content validity of a screening checklist to identify infants with CHD at risk of feeding difficulties or inadequate nutritional intake for timely referral to a feeding specialist or dietitian. The Delphi method was used, and expert participants reached consensus on 24 risk indicators. This study is the first step in establishing the validity and reliability of a screening tool for early intervention of feeding difficulties and inadequate nutritional intake in infants with CHD.

Adherence to Antiretroviral Therapy in Pediatric Patients With Human Immunodeficiency Virus (HIV-1) - Corrected Proof

Gail Burack, Sunanda Gaur, Roseann Marone, Anna Petrova — 2009-08-24

The evaluation of HIV treatment adherence is essential to manage the development of resistant mutations, treatment failure, and disease progression in patients with HIV-1 infection; however, none of the commonly used measures of treatment adherence have been found to be accurate. The objective of this study was to evaluate three treatment adherence measures (caregiver reports, pharmacy refill, and appointment maintenance data) in association with viral load suppression in pediatric patients with HIV-1 infection. Although viral suppression was not found to be significantly associated with adherence defined by any single measure, treatment adherence could be predicted if all three measures were in agreement.

Health Care Transitions Among Youth With Disabilities or Special Health Care Needs: An Ecological Approach - Corrected Proof

Grace Wang, Barbara Burns McGrath, Carolyn Watts — 2009-08-24

This literature review of 46 articles uses the ecological model as a framework for organizing concepts and themes related to health care transition among youth with disabilities or special health care needs (SHCN). Transition involves interactions in immediate and distal environmental systems. Important interactions in immediate environments include those with family members, health care providers, and peers. Activities in distal systems include policies at the governmental and health system levels. The ecological model can help researchers and practitioners to design experimental interventions in multiple settings that ensure smooth transitions and support the well-being of youth with disabilities or SHCN.

Siblings' Perceptions of the Costs and Rewards of Diabetes and its Treatment - Corrected Proof

Judith W. Herrman — 2009-08-21

This qualitative descriptive study explored the perceptions of siblings about the costs and rewards of diabetes and its management for the child with Type 1 diabetes, the sibling, and the family. Twenty children were interviewed using a semistructured interview guide. Children attending a day camp for children with diabetes and their siblings made up the sample. Iterative and thematic analysis yielded three cost themes and two reward themes. The perspectives of siblings about diabetes may aid in the development of family-focused teaching programs with the goal to assist family adaptation to Type 1 diabetes.

Obesity in Hong Kong Chinese Preschool Children: Where Are All the Nurses? - Corrected Proof

Christine M.S. Chan, Toity Deave, Trisha Greenhalgh — 2009-08-12

We report an ethnographic study of 10 preschool children aged 2–6 years recruited from kindergartens in Hong Kong, 6 of whom were overweight or obese. Each was followed for 12–18 months. We confirmed previously described risk factors and showed how these interacted to produce obesity in some but not all at-risk children. Despite much rhetoric in the literature about holistic care of the preschool child, we were struck by the lack of coordinated professional input to the needs of children at risk of obesity and by the absence of nursing input in particular. We argue that a “whole-systems” nursing role, based in the community and with remit that includes clinical care, education, and policy, is urgently needed, as well as review examples of such roles from other countries.

Individual Nurse and Organizational Context Considerations for Better Knowledge Use in Pain Care - Corrected Proof

Margot A. Latimer, Judith A. Ritchie, Celeste C. Johnston — 2009-08-10

Nurses are involved in many of the painful procedures performed on hospitalized children. In collaboration with physicians, nurses have an exceptional responsibility to have knowledge to manage the pain; however, the evidence indicates this is not being done. Issues may be twofold: (a) opportunities to improve knowledge of better pain care practices and/or (b) ability to use knowledge. Empirical evidence is available that if used by health care providers can reduce pain in hospitalized children. Theory-guided interventions are necessary to focus resources designated for learning and knowledge translation initiatives in the area of pain care. This article presents the Knowledge Use in Pain Care (KUPC) conceptual model that blends concepts from the fields of knowledge utilization and work life context, which are believed to influence the translation of knowledge to practice. The four main components in the KUPC model include those related to the organization, the individual nurse, the individual patient, and the sociopolitical context. The KUPC model was conceptualized to account for the complex circumstances surrounding nurse's knowledge uptake and use in the context of pain care. The model provides a framework for health care administrators, clinical leaders, and researchers to consider as they decide how to intervene to increase knowledge use to reduce painful experiences of children in the hospital.

Optimizing the Health of Infants and Children: Their Oral Health Counts! - Corrected Proof

Kathleen Peterson-Sweeney, Joanne Stevens — 2009-07-16

Tooth decay and poor oral health are the most common chronic health conditions in children in the United States today. This article discusses the significance of dental caries in children, the importance of oral health promotion, barriers to providing and obtaining oral health care, and current recommendations for practice. This article also recommends strategies for the promotion of optimal oral health in children and adolescents through screening, triaging, education, and tracking.

Bisphenol A Exposure: Human Risk and Health Policy - Corrected Proof

Cheryl Erler, Julie Novak — 2009-07-10

Bisphenol A (BPA) is a chemical used extensively to manufacture commonly used plastics and epoxy resin liners for food and beverage cans. BPA, with properties similar to diethylstilbestrol, has been shown to exert endocrine-disrupting effects and result in behavioral changes, altered growth, and early secondary sexual maturation. In 2008, legislation was introduced at the state and federal level to ban the use of BPA in children's products. The purpose of this article is to provide the reader with the weight of evidence, current federal regulatory stance, and proposed legislation regarding the safe use of BPA.

Family Functioning and Children's Response to Primary Care Treatment for Overweight: A Preliminary Study - Corrected Proof

2009-07-06

Objective: The aim of this study was to assess the relation between family functioning and children's response to treatment for overweight in a primary care setting.Methods: Sixty predominantly African American (72%) parents of children who are overweight were recruited from a pediatric outpatient clinic to provide information about family functioning. Children's success in treatment was tracked through medical chart review.Results: Parents' baseline self-report of family adaptability was associated with child body mass index z-scores (zBMI) at 3-month follow-up, although this association was no longer significant once baseline child zBMI was taken into account.Conclusions: Families with greater ability to adopt/implement changes may have children who do better in weight loss treatment. This preliminary study provides a model for integrating family systems ideas into pediatric overweight research and offers heuristic value as well as directions for future research in primary care settings.

African American Parents'/Guardians' Health Literacy and Self-Efficacy and Their Child's Level of Asthma Control - Corrected Proof

2009-07-06

Nearly 1of 10 American children has asthma. Asthma is addressed in Healthy People 2010 as a public health problem. This study examined the relationship between parents'/guardians' health literacy levels and their perceived self-efficacy to manage their child's asthma. A four-page asthma questionnaire was developed to assess the self-efficacy of parents/guardians of African American children with asthma. There was a statistically significant relationship among the parents'/guardians health literacy levels and their perceived efficacy expectations to manage their child's asthma. There is evidence that high parental/guardian self-efficacy and successful asthma management contribute to a child with well-controlled asthma. It is necessary for patient educators to capitalize on physician/nurse visits and use the time for asthma education, particularly to increase the efficacy expectations of parents/guardians with limited health literacy skills.

Predictors of Exclusive Breast-Feeding in Early Infancy: A Survey Report from Phnom Penh, Cambodia - Corrected Proof

2009-07-03

Background: Exclusive breast-feeding (EBF) is recommended in the first 6 months of an infant's life. This study aims to investigate the present status of infant feeding practices and identify factors that affect EBF practices during the first 6 months following infant birth in Phnom Penh, Cambodia.Methods: A cross-sectional survey with a semistructured questionnaire was given to 312 mothers with children aged 6 to 24 months who visited the immunization clinic in the National Maternal and Child Health Centre in Phnom Penh, Cambodia, from December 2005 to February 2006.Results: Eighty-three percent of mothers fed breast milk exclusively in the first month, whereas only 51.3% continued EBF in the first 6 months. Within 30 minutes after delivery, 39% of mothers began breast-feeding. Results from logistic regression analysis indicate that the lack of a maternal antenatal EBF plan (odds ratio [OR] = 10.01, 95% confidence interval [CI] = 3.68–27.24, p < .001), working mothers (OR = 4.71, 95% CI = 2.77–8.01, p < .001), and lack of paternal attendance at breast-feeding classes (OR = 1.93, 95% CI = 1.13–3.28, p < .05) have independently positive associations with cessation of EBF during the first 6 months of infant life.Conclusion: The findings have helped to identify some important factors affecting EBF practices in the study area in Cambodia. The findings revealed that it is important to educate pregnant mothers, probably through exposure to trained midwives and media, so they may recognize the significance of EBF and will develop intention and plan to feed their babies, keeping in mind the benefits it may yield. Paternal involvement in breast-feeding classes may increase their awareness and consequently complement EBF practices. Finally, development of conducive working environments and policies for working mothers should be carefully explored because it could have positive influence in better care and promotion of EBF.

The Lived Experience of Foster Parents of Children With Special Needs Living in Rural Areas - Corrected Proof

Lori S. Lauver — 2009-07-03

The experience of 10 foster families living in rural communities in the Northeastern United States was explored through phenomenological inquiry. Through an unstructured interview approach, parents were asked to describe what it was like to parent foster children with specialized health care needs. Recorded interviews were transcribed verbatim and analyzed using van Manen's method. Data analysis revealed that parents fostering children in rural communities have concerns related to accessing medical care and decision making. They expressed feelings of being overwhelmed and unprepared, isolated, and stigmatized.

Korean Immigrant Discipline and Children's Social Competence and Behavior Problems - Corrected Proof

Eunjung Kim, Yuqing Guo, Chinkang Koh, Kevin C. Cain — 2009-07-03

The goal of this correlational study was to explore the relationship between Korean immigrant discipline (e.g., positive, appropriate, and harsh discipline) and children's social competence and behavior problems. Self-report data were collected from 58 mothers and 20 fathers of children aged from 3 to 8 years. Only paternal harsh discipline was positively correlated with children's behavior problems. Among specific discipline strategies, maternal physical affection, correcting misbehaviors, and reasoning were positively correlated with children's social competence. Paternal physical punishment (e.g., spanking, hitting, and raising arms) was positively correlated with children's behavior problems. Immigrant fathers need to learn alternative ways of managing children's misbehaviors.

Food Security and Dietary Intake in Midwest Migrant Farmworker Children - Corrected Proof

Jill F. Kilanowski, Laura C. Moore — 2009-06-25

This article is a descriptive cross-sectional study with Latino migrant farmworker (MFW) families in Ohio. A demographic questionnaire, the U.S. Household Food Security Survey (USHFSS), and the Food Frequency Questionnaire were self-administered. Participants (N = 50) were primarily mothers of children with ages 2 to 13 years. USHFSS was 30% high, 18% marginal, 44% low, and 8% very low. Only 22% of the children met the minimum MyPyramid daily recommended food-group servings for age and gender. Knowledge gained from these data will influence development of culturally appropriate nutrition interventions to help Latino MFW families achieve healthier nutrition and weight in their children.

Evaluation of the Cadi ThermoSENSOR Wireless Skin-Contact Thermometer Against Ear and Axillary Temperatures in Children - Corrected Proof

Kim-Gau Ng, Sook-Thow Wong, Soh-Min Lim, Zenton Goh — 2009-04-20

The Cadi ThermoSENSOR skin-contact thermometer measures body temperature continuously and transmits readings wirelessly to a central server. This study evaluated the ThermoSENSOR against ear temperatures (ETs) measured by a Braun ThermoScan ear thermometer and axillary temperatures (ATs) measured by a Terumo digital clinical thermometer. The test participants consisted of 109 children aged 6 months to 16 years from a pediatric ward. The sensor was attached to the lower abdomen at least 15 minutes before the first measurement. ET, AT, and ThermoSENSOR temperatures (TTs) were recorded up to three times at the usual measurement times. The TTs differed from ETs by −0.23°C ± 0.47°C (mean ± standard deviation, n = 271) and from ATs by +0.21°C ± 0.46°C (n = 270). The ETs differed from ATs by +0.43°C ± 0.42°C (n = 315). These results suggest that the TTs were comparable to the ETs and ATs.

Family-Centered Pediatric Nursing Care: State of the Science - Corrected Proof

Tondi M. Harrison — 2009-04-13

The purposes of this article were to summarize the development of family-centered pediatric care, review the current state of nursing research in this area, and recommend directions for future study. A literature review of 30 nursing research studies between 1995 and 2006 was conducted. Results revealed that evidence of consistent provision of family-centered pediatric care is lacking. Many areas of research remain undeveloped, but there is a solid foundation for moving forward in conducting research focused on assisting nurses in implementing this basic philosophy of practice in all settings and situations in which children receive health care.

Using Focus Groups to Understand Mother–Child Communication About Sex - Corrected Proof

Mary F. Cox, Kathleen Scharer, Beverly Baliko, Amy Clark — 2009-04-10

The purpose of this descriptive focus group study was to examine communication themes regarding sex and sexual risk behavior in low-income mothers of adolescent children. Focus group questions were guided by Jaccard's communication constructs. Data analysis provided three overriding themes in all five construct areas: mothers are often uncomfortable discussing sex with their male children, mothers feel strongly that their own values and beliefs must guide discussion, and mothers believe their children need developmentally appropriate information. This information may be useful in assisting pediatric nurses in discussing adolescent sex and sexual risk behavior with families.

It's a Small, Small World: Data Collection Strategies for Research With Children and Adolescents - Corrected Proof

Becky J. Christian, Patricia F. Pearce, Anthony J. Roberson, Erin Rothwell — 2009-04-10

This article describes methodological processes focusing on developmentally appropriate, creative data collection strategies for use with children and adolescents, illustrated from data-based research. The research reported includes adolescents' understanding of physical activity and engagement in designing a computerized questionnaire, adolescent decision making and consent to psychiatric treatment, social skills focus groups for children with behavioral disorders, and development of a longitudinal intervention study to improve the physiological–functional–psychosocial status of children with cystic fibrosis from qualitative stories of children and adolescents with cystic fibrosis. Use of developmentally appropriate strategies is critical for successful research, contributing to our understanding of the world of children and adolescents.

Interruptions and Pediatric Patient Safety - Corrected Proof

2009-04-09

This study explored interruptions in pediatric nurses' work and the systems issues related to interruptions in nursing work environments. A total of 5,325 interruptions were observed in this study, providing information on sources, types, and causes of interruptions. The nursing work being performed when interrupted and the outcomes of these interruptions are described.

Pain Assessment in Cognitively Impaired, Functionally Impaired Children: Pilot Study Results - Corrected Proof

Angela McJunkins, Angela Green, K.J.S. Anand — 2009-04-09

Pain assessment in cognitively impaired children (CIC) is difficult despite their repeated exposure to painful procedures. We compared four different methods of pain assessment in 11 children undergoing skin-breaking, acute, painful procedures. Assessments using all four methods were performed simultaneously by the bedside nurse (Modified Objective Pain Scale [MOPS], Children's Hospital of Eastern Ontario Pain Scale [CHEOPS], and Non-Communicating Child's Pain Checklist-Postoperative Version [NCCPC-PV]) and the parent (Visual Analog Scale [VAS]) before and immediately after the procedure. All pain scores increased during the painful procedure, but the greatest increases occurred using the NCCPC-PV. Moderate or severe pain was identified in 45% of CIC using CHEOPS or NCCPC-PV, but only 18% of CIC using MOPS and VAS. No significant differences occurred between age groups or between the scores assigned by parents and the bedside nurse. We propose that pain assessment methods specifically designed and validated for CIC (such as NCCPC-PV) provide a more accurate diagnosis of moderate or severe pain during painful procedures in these children.

Parental Handling of Fear in Children With Cancer; Caring in the Best Interests of the Child - Corrected Proof

Agneta Anderzén-Carlsson, Mona Kihlgren, Mia Svantesson, Venke Sorlie — 2009-04-09

The aim of this study was to gain a deeper understanding of how parents of children with cancer handle the fear in their children. Fifteen parents of 11 children participated in focus-group interviews. Data were analyzed by a phenomenological hermeneutical method. The results suggest that the parents' handling was equivalent with caring in the best interests of the child. This included striving for the security and well-being of the child up to a certain point where the parents instead used their authority to maintain the child's physical health rather than trying to prevent or relieve the child's fear.

“And Then You'll See Her in the Grocery Store”: The Working Relationships of Public Health Nurses and High-Priority Families in Northern Canadian Communities - Corrected Proof

Nancy J. Moules, Martha L.P. MacLeod, Lorraine M. Thirsk, Neil Hanlon — 2009-04-09

The aim of the study is to examine and articulate the nature of working relationships of public health nurses and high-priority families in small communities in northern Canada. Public health nurses working in northern, rural, and remote communities face unique and varied challenges. Reportedly, the hardest part of their job is working with families who have been deemed high priority or high risk. Working with these families in these contexts relies on relationships of reciprocity, trust, and communication. This qualitative research was guided by an interpretive hermeneutic inquiry; 32 families, 25 public health nurses, and three lay home visitors were interviewed from July 2005 through July 2006. Analysis was completed individually and through teamwork of the researchers. Findings suggest that the working relationship of public health nurses and high-priority families in northern communities is complex and multifaceted. Nurses carefully negotiate the process of engaging and entering relationships, maintaining the relationships, and negotiating boundaries. The analysis offers insight into the everyday practices and problems that public health nurses and families encounter in providing care to a vulnerable, isolated, and often marginalized population while navigating the complexity of living and working in the same small communities.

Grandparent's Health and Functioning After a Grandchild's Death - Corrected Proof

2009-04-09

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent, resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild's death on the grandparent–parent relationship, and the influence of race and ethnicity on grandparent grieving are discussed. Despite approximately 40,000 child and infant deaths each year, knowledge about grandparent health and functioning after the death of a grandchild is limited.

The Relationship Between Home Nursing Coverage, Sleep, and Daytime Functioning in Parents of Ventilator-Assisted Children - Corrected Proof

Lisa J. Meltzer, Deborah S. Boroughs, John J. Downes — 2009-04-06

This descriptive study examined the relationship between home-care nursing support, sleep, and daytime functioning in familial caregivers of ventilator-assisted children. Thirty-six primary caregivers (27 mothers, 7 fathers, 1 foster mother, and 1 grandmother) of ventilator-assisted children completed measures of home nursing support, sleep, depression, fatigue, and daytime sleepiness. Daytime nursing coverage was not related to caregiver sleep or daytime functioning, but caregivers with less nighttime nursing coverage had significantly shorter sleep onset latency than caregivers with some night nursing (16–48 hours/week). Caregivers with regular night nursing (>48 hours/week) had a total sleep time of almost 1 hour more than caregivers without regular night nursing (≤48 hours/week). Caregivers with clinically significant symptoms of depression and sleepiness received significantly fewer hours of night nursing per week than caregivers without significant symptoms of depression or sleepiness. Home nursing support, in particular night nursing, is important for the health and well-being of familial caregivers of ventilator-assisted children.

Assessing Linguistic and Cultural Equivalency of Two Chinese-Version Sexual Health Instruments Among Chinese Immigrant Youth - Corrected Proof

Angela Chia-Chen Chen, Dianne Morrison-Beedy, Chong-suk Han — 2009-04-03

This study aimed to evaluate the linguistic and cultural equivalency of two Chinese-version instruments measuring sexual knowledge, attitudes, and behaviors among 10 bilingual and 2 monolingual Chinese immigrant youth aged 13–19 years. We used a rigorous design to translate, back-translate, and pilot test the instruments. Kappa coefficient, percentage agreement, and qualitative feedback from participants were used to examine reliability and validity of the instruments. Telephone interviews revealed that answer discrepancies in different language versions were due to external factors rather than lack of linguistic and cultural equivalency. This study offers preliminary evidence supporting the cultural and linguistic equivalence of two Chinese-version sexual scales.

Caregiving Demands in Parents of Children With Cancer: Psychometric Validation of the Care of My Child With Cancer Questionnaire - Corrected Proof

2009-04-02

A comprehensive evaluation of the psychometric properties of Care of My Child With Cancer (CMCC) was performed in a sample of 411 parents of children undergoing treatment of cancer at five Canadian pediatric oncology centers. Psychometric tests used to assess data quality, targeting, reliability, and construct validity demonstrated that the CMCC is a scientific sound measure. The CMCC will be helpful for assessing increasing parental responsibility for caregiving tasks associated with cancer care.