Journal for Specialists in Pediatric Nursing最新文献

{"title":"Physical activity and fitness: The feasibility and preliminary effectiveness of wearable activity tracker technology incorporating altruistic motivation in youth.","authors":"Angela A Duck,&nbsp;Katherine C Hall,&nbsp;Melissa Klamm,&nbsp;Melissa Temple,&nbsp;Jennifer C Robinson","doi":"10.1111/jspn.12313","DOIUrl":"https://doi.org/10.1111/jspn.12313","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the feasibility and preliminary effectiveness of using wearable activity tracker technology, integrated with altruistic motivation in children to increase physical activity (PA), fitness, and prosocial behavior.</p><p><strong>Design and methods: </strong>A quasiexperimental design was employed in two 4th grade classrooms in a rural southern state. The intervention was a wearable PA tracker and a web-based curriculum with activities to earn power points redeemable to provide life-saving food to undernourished kids internationally. Seventeen children in the intervention group participated in the 10-week PA program and 18 children were in the wait listed control group. Three measures were assessed in both groups at baseline and postintervention: (a) PA measured with accelerometers, (b) fitness levels measured with shuttle run, and (c) prosocial behavior measured with Strengths and Difficulties questionnaire.</p><p><strong>Results: </strong>Of the 35 children enrolled, the majority were nine years old (n = 28), black (n = 31) and female (n = 23). An overall enrollment rate of 88%, attrition rate of 9%, and an accelerometer noncompliance rate of 25% was determined to assess feasibility. There was no statistical significance between the control and intervention group outcome variables. The average minutes of PA in the control group decreased 8 min from baseline to postintervention (p = .05). In the intervention group, PA decreased by 10 min from baseline to postintervention (p = .12). In both the control and intervention groups, prosocial behavior scores decreased (p = .09 control; p = .62 intervention). The fitness scores, VO₂ max, did not significantly change (intervention p = .21; control p = .35).</p><p><strong>Practice implications: </strong>Developing effective interventions that foster PA and dissuade sedentary behaviors are essential to enhancing PA and fitness levels. The recruitment, retention, and accelerometer wear adherence suggest this setting, with this population is feasible. The intervention is deliverable, however, the potential of wearable activity trackers and the effect of prosocial behavior that benefits others in increasing PA and improving cardiorespiratory fitness, should be further researched by building on the successful elements of this study.</p>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 1","pages":"e12313"},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38414972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information","authors":"","doi":"10.1111/jspn.12248","DOIUrl":"https://doi.org/10.1111/jspn.12248","url":null,"abstract":"","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44347335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"This is the worst that has happened to me in 86 years\": A qualitative study of the experiences of grandparents losing a grandchild due to a neurological or oncological disease.","authors":"Maria Flury,&nbsp;Claudia L Orellana-Rios,&nbsp;Eva Bergsträsser,&nbsp;Gerhild Becker","doi":"10.1111/jspn.12311","DOIUrl":"https://doi.org/10.1111/jspn.12311","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric palliative care focuses mainly on the children suffering from a life-limiting disease, but always includes parents and siblings. However, grandparents are also often highly involved in caring for the child and require additional attention. Therefore, the aim of this study was to investigate the experiences of grandparents during the end-of-life care and after the death of a grandchild.</p><p><strong>Design and methods: </strong>A qualitative approach using semi-structured interviews was chosen. Fifteen grandparents of 10 children who had died of neurological or oncological diseases were interviewed. Participants were recruited among the families cared by the pediatric palliative care team of a children's hospital in northern Switzerland. Grandparents were interviewed at least 1 year after the death of the grandchild. The data was analyzed employing reconstructive interview analysis.</p><p><strong>Results: </strong>Regardless of the child's diagnosis and circumstances of death, the participants described how the child's death had a major impact on them and their entire family. Grandparents felt obligated to support the family and constantly be a source of support for the parents. They bore a heavy psychological burden as they cared and mourned not only for their dying grandchild but also for their own daughter or son. Grandparents struggled with their ability to communicate about disease and death. They tried to process and make sense of their loss by remembering the deceased child.</p><p><strong>Practice implications: </strong>These findings emphasize the importance of identifying and understanding grandparents' suffering. Pediatric palliative care teams can achieve this by actively making contact with grandparents, taking their concerns seriously and demonstrating appreciation for their role in supporting the family.</p>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 1","pages":"e12311"},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder perspectives: Communication, care coordination, and transitions in care for children with medical complexity.","authors":"Lori J Williams,&nbsp;Katherine Waller,&nbsp;Rachel P Chenoweth,&nbsp;Anne L Ersig","doi":"10.1111/jspn.12314","DOIUrl":"https://doi.org/10.1111/jspn.12314","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to obtain feedback on communication, care coordination, and transitions in care for hospitalized children with medical complexity (CMC).</p><p><strong>Design and methods: </strong>This descriptive, mixed-methods study used online surveys with forced-choice and open-ended questions to obtain stakeholder feedback. Stakeholders included parents, healthcare providers, and nurses. Participants over 18 years of age were recruited from a Midwest children's hospital inpatient unit dedicated to care of CMC. Quantitative data were analyzed using t-tests and one-way analysis of variance. Qualitative description was used to analyze responses to open-ended questions.</p><p><strong>Results: </strong>Parents' ratings of communication, care coordination, and transitions in care were generally high. Transitions from other facilities to the emergency department and unit received lower ratings. Providers and nurses gave high ratings to overall care, communication among providers and nurses on the patient unit, and experiences with discharge; however, between unit communication and unit-based coordination received lower ratings. Providers and nurses had higher ratings for discharge preparation than parents (p ≤ .001). Three themes were identified in responses to the open-ended questions: establishing balanced and collaborative relationships between the care team and families, taking a proactive approach to care coordination, and the importance of an inclusive, interdisciplinary, and centralized approach to care coordination and communication.</p><p><strong>Practice implications: </strong>Collaboration among all stakeholders is needed to achieve coordinated care, inclusive communication, and transitions with positive outcomes during hospitalization. Parents identified a need for consistent communication from care teams, with the primary inpatient team taking a lead role. Including parents in care coordination and transitions in care is key, as they are the experts in their children's health and well-being.</p>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 1","pages":"e12314"},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38620574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The acuity of pediatric neuroscience nursing using the Inpatient Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO^© ) tool.","authors":"Carole Atkinson,&nbsp;Benjamin Cerrato,&nbsp;Deborah Shiers,&nbsp;Jean A Connor","doi":"10.1111/jspn.12307","DOIUrl":"https://doi.org/10.1111/jspn.12307","url":null,"abstract":"PURPOSE The neuroscience nurse must possess advanced knowledge and skills to care for a wide range of unique congenital and acquired neurological diagnoses. For each of these clinical scenarios, the measurement of complexity and acuity of patient care is key to informing staffing models and patient assignments. The Inpatient Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO© ) acuity tool measures patient acuity in terms of nursing cognitive workload complexity. We describe the implementation and evaluation of the Inpatient CAMEO© in a pediatric neuroscience unit in a large free-standing children's hospital in the northeast United States. DESIGN AND METHODS Using a quality improvement approach, the Inpatient CAMEO© was implemented and evaluated over a 12-month period by a neuroscience clinical lead and unit-based ambassadors. Monthly data reports evaluating unit-level completion and the level of acuity (I-V) were generated for unit leadership. Data were further stratified by type of admission to the neuroscience unit. Five categories of patients included neurology medical, epilepsy, neurosurgical, neurooncology, and other, which is defined as nonneurology patients, admitted to unit. RESULTS The monthly proportion of Inpatient CAMEO© s Classified as III-V ranged from 62.3% to 83.3% with a median of 78.2%. The type of neuroscience admissions varied in level of acuity. Patients identified as neurology (68.7%) and epilepsy (67.5%) had the lowest acuity, patients identified as neurosurgery (82.8%) and other (80.2%) had moderate acuity, and neurooncology (94.5%) had the highest acuity. PRACTICE IMPLICATIONS Using the Inpatient CAMEO© , the acuity of neuroscience pediatric care was demonstrated to be increased and variable across disease categories. Neurooncology patients were identified as having the highest acuity as compared to other pediatric neuroscience admissions.","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 1","pages":"e12307"},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38314727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety, depression, and symptom experience in concussed children and youth.","authors":"Gail Macartney,&nbsp;Michelle Woodfield,&nbsp;Ivan Terekhov,&nbsp;Michael Vassilyadi,&nbsp;Kristian Goulet","doi":"10.1111/jspn.12310","DOIUrl":"https://doi.org/10.1111/jspn.12310","url":null,"abstract":"<p><strong>Purpose: </strong>To describe and explore the relationship between baseline anxiety, depression and symptom experience in children and youth assessed at a concussion clinic.</p><p><strong>Design and methods: </strong>A retrospective chart review of concussed children and youth referred to a pediatric teaching hospital concussion clinic over a 15-month period was completed. Kutcher Adolescent Depression Scale (KAD-6), General Anxiety Disorder Scale (GAD-7), and the Post-Concussion Symptom Inventory (PCSI) scores were extracted.</p><p><strong>Results: </strong>A total of 155 patients were included. The most common symptoms (PCSI) at baseline were headache, fatigue, and feelings of head pressure. Symptoms were rated as mild to moderate in intensity. Overall, mean depression and anxiety scores were low. The mean anxiety scores, as measured by the GAD-7 (n = 108), was 7.4 (range, 0-24). The mean depression score, as measured by the KAD-6 (n = 94), was 4.7 (range, 0-18). A statistically significant, moderate positive correlation between PCSI scores with KAD-6 scores for male (r = .64, p < .001) and female (r = .61, p < .001) participants was identified. Similarly, a statistically significant, moderate positive correlation between PCSI scores with GAD-7 scores for male (r = .68, p < .001) and female (r = .60, p < .001) participants was identified.</p><p><strong>Practice implications: </strong>Concussed children may experience a wide array of symptoms, including emotional challenges such as anxiety and depression. Feelings of anxiety and depression may contribute to overall post concussive symptoms in concussed children. The electronic health record can be leveraged to provide important patient data. Clinicians should systematically assess symptoms at each visit in concussed children and youth so that appropriate interventions can be implemented and monitored.</p>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 1","pages":"e12310"},"PeriodicalIF":1.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38412516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe administration of drug desensitizations in pediatric patients","authors":"Sarah Herr RN, BSN,&nbsp;Ronald Ferdman MD,&nbsp;Melinda Braskett MD","doi":"10.1111/jspn.12322","DOIUrl":"10.1111/jspn.12322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients with certain types of allergic reactions to medication may safely receive the culprit medication through an elaborate allergy procedure called a drug desensitization. Nurses play a key role in this process which is only performed when a certain medication is absolutely indicated as optimal therapy. Nurses are instrumental in the planning stages of drug desensitizations for coordination of interdisciplinary care and anticipation of adverse effects. Thus, it is paramount that nurses performing this procedure understand the mechanism of desensitizations and have access to the resources needed to safely complete these procedures in pediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Excellence in nursing clinical acumen and a detailed order set are essential to patient safety during dug desensitization. With the following methodology and coordination by nursing, we have had great success at Children's Hospital Los Angeles in over one hundred drug desensitizations in pediatric patients which allowed them to received first line therapies. We have created order sets from published references and years of clinical experience. The nursing care of adult patients undergoing drug desensitization procedures is well described in the literature but few resources exist for pediatric nurses. There is paucity of published nursing resources for pediatric drug desensitizations. Repeated PubMed searches for “pediatric drug desensitizations” in 2019-2020, revealed only one recent reference geared toward physicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>With appropriate training, staffing, and coordination, drug desensitizations can be safely performed in pediatric patients with close observation by a multi-disciplinary team. The bedside nurse has a pivotal role as coordinator and clinician for these high-risk resource-intensive procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38763923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of a Brazilian educational comic book for pediatric perioperative care","authors":"Marcela C. M. Z. Vasques,&nbsp;Brenda B. Silva,&nbsp;Marla A. G. de Avila","doi":"10.1111/jspn.12320","DOIUrl":"10.1111/jspn.12320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Educational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>A descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7–12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled “Getting to know the Surgery Center” was created in the form of a 19-page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38711445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and cultural adaptation of the Pediatric Patient-Reported Outcome Measurement Information System-Emotional Distress item banks into Chinese","authors":"Wenjun Gao PhD,&nbsp;Changrong Yuan PhD, FAAN","doi":"10.1111/jspn.12318","DOIUrl":"10.1111/jspn.12318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To develop the Chinese version of the Pediatric Patient-Reported Outcome Measurement Information System (PROMIS)-Emotional Distress item bank version 2.0—both conceptually equivalent to the original and relevant in the Chinese culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>The Pediatric PROMIS-Emotional Distress item bank was translated, following the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology, by a translation team. Eight children aged 8–17 years from the general population were cognitively interviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most items were well understood by children, and some revisions were made after the cognitive interviewing based on the suggestions of the interviewees. The Chinese version of the Pediatric PROMIS-Emotional Distress-v2.0 item bank was conceptually and semantically equivalent to the original.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The Chinese version of the Pediatric PROMIS-Emotional Distress item bank is now available for further studies to develop computer adaptive tests (CATs). Future CAT version measures may become a new standard measure for children in the general population and those living with a chronic condition in China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38671420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological differences between toilet trained and non-toilet trained 4-year-old children","authors":"Michael I. Axelrod PhD,&nbsp;Ray J. Larsen BS,&nbsp;Keith Jorgensen BS,&nbsp;Bobbie Stratman BS","doi":"10.1111/jspn.12319","DOIUrl":"10.1111/jspn.12319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4-year-old well child care visit with their toilet trained peers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Parent reports of internalizing and externalizing behavior using the Child Behavior Checklist (CBCL) were compared across groups, non-toilet trained and toilet trained, for 150 children recruited during their 4-year-old well child health care visit. Independent samples <i>t</i> tests of group means and <i>χ</i>² analyses were performed on all CBCL scales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results found no clinically or statistically significant differences between groups on parents' reports of internalizing and externalizing behavior. The current study provides no evidence that delays in successfully completing toilet training by 4 years of age were related to psychological problems for this sample of children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Nursing professionals in primary care settings are positioned to provide anticipatory guidance to parents of children not yet toilet trained. Findings from the current study offer evidence that delays in toilet training might not be related to psychopathology, and these children are not likely to require intervention outside the pediatric setting and could be effectively managed by primary care health providers employing evidence-based toilet training protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38561377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}