Journal for Specialists in Pediatric Nursing最新文献

{"title":"The health literacy disparity in adolescents with sickle cell disease","authors":"Elizabeth Perry Caldwell PhD, RN, CNE, Erin Killingsworth PhD, RN, CNE","doi":"10.1111/jspn.12353","DOIUrl":"10.1111/jspn.12353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This is a cross-sectional, descriptive, exploratory study. One hundred and thirty-four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples <i>t</i> tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant relationship between health literacy, age (<i>r</i> = .286, <i>p</i> < .01) and grade level (<i>r</i> = .317, <i>p </i>= .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (<i>r</i> = .235; <i>p </i>< .05) and parental education <i>(r</i> = .263; <i>p</i> < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (<i>t</i> = 4.772; <i>p</i> < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>There are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is need","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39260284","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":"Effects of therapeutic clowning on pain and anxiety during venous blood sampling in Turkey: Randomised controlled trial","authors":"Fatma Kurudirek PhD,&nbsp;Duygu Arikan PhD,&nbsp;Arzu Sarialioğlu PhD","doi":"10.1111/jspn.12352","DOIUrl":"10.1111/jspn.12352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The research aim was to investigate the effects of therapeutic clowning on pain and fear during the process of venous blood sampling in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This study was conducted in a randomised controlled trial from January to March 2020. The study population consisted of children from 7 to 12 years of age who came to the research centre for blood sampling. The research sample consisted of 166 children (83 in the intervention group and 83 in the control group) who met the research criteria and came to the research centre on a specific date through probable sampling. For the data collection, a questionnaire form, the Visual Analogue Scale and the Children's Fear Scale were used. Therapeutic clowning was used in this process for the intervention group. There was no intervention for children who were in the control group. The calculation of percentage distribution and means, <i>χ</i>² test, analysis of variance analysis in repeated measures and least significant difference and independent <i>t</i>-test were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of the research indicated that children in the intervention group had significantly lower pain and fear than children in the control group (<i>p</i> &lt; .001). Therapeutic clowning seems to effectively reduce pain and fear during venous blood sampling for children from 7 to 12 years of age. Our results support using therapeutic clowns which is an inexpensive, safe, and effective method for lowering children's pain and fear during venous blood sampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The use of therapeutic clowns could become the standard of care in blood sampling for children from 7 to 12 years of age in hospitals. Therapeutic clowning, which is an easy-to-use, low-cost and practical method to provide better communication and cooperation with the family and the child, can be used as a complementary therapy in all nursing areas, especially in the field of paediatrics. Nurses could be encouraged to be trained on the use of therapeutic humour based upon a standardised approach and offered guidance on how to apply entertaining methods such as clowns. Therapeutic clowning can be examined in other applications in nursing care in light of these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39077612","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":"Beyond “Watching the Sweets”: An interpretive description of adolescent's understandings and insights into preventing prediabetes and type 2 diabetes","authors":"Shelley Spurr RN, PhD,&nbsp;Jill Bally RN, PhD,&nbsp;Solomon K. Mcharo RN, PhDc,&nbsp;Shannon Hyslop RN, MNc","doi":"10.1111/jspn.12351","DOIUrl":"10.1111/jspn.12351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to explore adolescents' experiences and knowledge of type 2 diabetes (T2D) and identify appropriate T2D education and prevention interventions for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This interpretive description study was conducted at two urban high schools in midwestern Canada. Participants had been previously screened and considered at high risk for T2D, prediabetes, or as having T2D. Individual, semistructured interviews were conducted with twelve adolescents between the age of 14–19 years meeting these criteria. Thematic analysis was completed using interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Themes and subthemes identified included (1) <i>Type 2 Diabetes: More Than Too Many Sweets</i> (Mostly Diet but Insulin Does Play a Role, and A Serious but Common Disease); (2) <i>Who Holds the Power?</i> (Personal Responsibility for Health, Family as Role Models, and Community Connections); and (3) <i>Bringing Home the Message</i> (Our Considerations for Schools, I need the Expert's Support, and Using Technology to Get the Points Across).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Findings from this study provide target areas for education and prevention interventions and approaches for working with adolescents surrounding prediabetes and T2D that may be effective.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38987770","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":"Comparison of electromagnetic guided imagery to standard confirmatory methods for ascertaining nasogastric tube placement in children","authors":"Beth Wathen MSN, RN, PNP, CCRN-K,&nbsp;Heidi L. McNeely MSN, RN, PCNS-BC,&nbsp;Christine Peyton MSN, CPNP-AC,&nbsp;Zhaoxing Pan PhD,&nbsp;Robin Thomas BSN, RN, CCRN,&nbsp;Cayla Callahan BSN, RN, CCRN,&nbsp;Sara Fidanza MSN, RN, CNS-BC, CPNP-PC,&nbsp;James Brown BSN, RN, CPN,&nbsp;Madalynn Neu PhD, RN, FAAN","doi":"10.1111/jspn.12338","DOIUrl":"10.1111/jspn.12338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Evaluate the accuracy of an electromagnetic device (EMD) guided nasogastric tube (NGT) placement compared with standard confirmation methods. A secondary aim was to determine if EMD guided NGT placement would avert potential pulmonary misplacements of the tube.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Pediatric Intensive Care Unit (PICU) patients were enrolled if they had an NGT order during the study period of April 2014 through December 2016. Patients were included if they were one through 18 years of age. An EMD trained nurse inserted the NGT using EMD guidance. An insertion questionnaire, confirming if the nurse determined the NGT to be gastric per EMD, was completed immediately after NGT placement and before confirmation via either pH testing or radiographic imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-five patients were enrolled in the study. Nurses reported, based on EMD, that 86.7% (<i>n</i> = 39) of placements were gastric. Overall agreement between EMD guided tube placement and pH testing was 58% (<i>n</i> = 26). The marginal distribution was significantly different between the two methods (<i>p</i> = .0029). When compared to radiographic confirmation, sensitivity of the pH method was 32% (95% confidence interval [CI]: 17%–51%) compared with 85% (95% CI 69%–95%) for the EMD method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EMD guidance was superior to pH testing when compared with radiographic confirmation of nasogastric tube placement in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>EMD guided NGT placement is a potentially viable method for confirming nasogastric tube placement in children when done by appropriately trained clinicians. More research on EMD guided NGT placement in children is needed before any practice recommendation can be made.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38970191","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":"Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study","authors":"Henrik Hjelmgren MSN,&nbsp;Anna Nilsson MD,&nbsp;Ida H. Myrberg BSc,&nbsp;Nina Andersson PhD,&nbsp;Britt-Marie Ygge,&nbsp;Björn Nordlund PhD","doi":"10.1111/jspn.12337","DOIUrl":"10.1111/jspn.12337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, <i>p</i> = .001, adj-OR 2.88 (CI 1.79–4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (<i>n</i> = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50–0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38–0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76–1.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. Altogether, this study also indicates that implementing more venous blood sampling and improve the cases of capillary sampling could reduce the number of preanalytical errors in pediatric hospitals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38957800","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 Children's Action-Reaction Assessment Tool (CARAT) as an observational technique for assessing symptom management: An initial validation study with children aged 3–7 years undergoing needle procedures","authors":"Katarina Karlsson PhD, RN,&nbsp;Ensa Johnson PhD,&nbsp;Stefan Nilsson PhD","doi":"10.1111/jspn.12334","DOIUrl":"10.1111/jspn.12334","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child's pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children's Action–Reaction Assessment Tool (CARAT) is built on action–reaction strategies. This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3- to 7-year-old children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The completed CARAT indicated the use of action–reaction strategies. Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action–reaction strategies in conjunction with needle procedures in children aged 3–7 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25579531","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":"Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013","authors":"Jessica Keim-Malpass PhD, RN,&nbsp;Melanie J. Cozad PhD,&nbsp;Radion Svynarenko PhD,&nbsp;Jennifer W. Mack MD, MPH,&nbsp;Lisa C. Lindley PhD, RN, FPCN, FAAN","doi":"10.1111/jspn.12333","DOIUrl":"10.1111/jspn.12333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Pediatric hospice is a comprehensive model of care for medically complex children at end of life. The Affordable Care Act changed regulatory requirements for pediatric Medicaid enrollees to allow for enrollment into hospice services while still receiving life-prolonging therapy. There are gaps in understanding factors associated with pediatric concurrent hospice care use. The objectives were to examine the prevalence of concurrent hospice care overtime and investigated the relationship between medical complexity and concurrent hospice care among Medicaid children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>We used national Medicaid data and included children less than 21 years with an admission to hospice care. Medical complexity was defined with four criteria (i.e., chronic conditions, functional limitations, high health care use and substantial needs). Using multivariate logistic regression, we evaluated the influence of medical complexity on concurrent hospice care use, while controlling for demographic, hospice, and community characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four percent of the study sample used concurrent hospice care. Medical complexity was unrelated to concurrent hospice care. However, the four individual criteria were associated. A complex chronic condition was negatively related to concurrent hospice care, whereas technology dependence, multiple complex chronic conditions, and mental/behavioral disorders were positively associated to concurrent care use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>These findings suggest that concurrent hospice care may be important for a subset of medically complex children with functional limitations, high health utilization, and substantial needs at end of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25555045","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":"State of the science: A scoping review and gap analysis of adolescent insulin pump self-management","authors":"Eileen R. Faulds PhD, RN, FNP-BC, CDE,&nbsp;Lindsey Karnes MS, RN, APRN-CNP,&nbsp;Vanessa D. Colicchio RN, BSN,&nbsp;Lisa K. Militello PhD, MPH, RN,&nbsp;Michelle Litchman PhD, RN, FNP-BC, FAANP","doi":"10.1111/jspn.12331","DOIUrl":"10.1111/jspn.12331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Adolescent diabetes outcomes remain poor despite increased use of diabetes technologies such as insulin pump therapy. Meaningful research examining adolescent insulin pump self-management has been done, however, a summary of these self-management findings has not been published. The aim of this literature review is to map, evaluate, and summarize existing adolescent insulin pump self-management research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A scoping review of three databases was conducted to comprehensively report and synthesize relevant literature published before September 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1295 titles identified, 18 articles met the inclusion criteria and were included in this scoping review. Key insulin pump self-management behaviors were featured in the literature, most notably self-monitoring of blood glucose (SMBG) and bolus frequency. Several factors were found to influence pump self-management including psychological factors, parental support and self-management transition, insulin pump education and knowledge acquisition, and environmental factors. We uncovered five gaps in the literature including: an unclear delineation of adolescent age; limited minority representation; variability in the definitions and reporting of self-management behaviors; the role of data sharing and remote monitoring was not addressed; and there remains limited inquiry into diabetes burden and distress associated with insulin pump self-management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>There exists a consensus that well-established behaviors, such as bolus and SMBG frequency, influence glycemic outcomes for adolescent insulin pump users, however, full insulin pump utilization and self-management is poorly understood. Diabetes clinicians should work to support adolescent insulin pump self-management practices by reinforcing bedrock behaviors while fostering supportive factors found to influence pump self-management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25538152","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":"Nursing care for pediatric patients with autism spectrum disorders: A cross-sectional survey of perceptions and strategies","authors":"Wanda J. Mahoney PhD,&nbsp;Minerva Villacrusis MOT,&nbsp;Margaret Sompolski MOT,&nbsp;Brittany Iwanski MOT,&nbsp;Alyssa Charman MOT,&nbsp;Colleen Hammond BSN,&nbsp;Gifty Abraham OTD","doi":"10.1111/jspn.12332","DOIUrl":"10.1111/jspn.12332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study is to describe nursing staff perspectives about caring for children with autism spectrum disorders (ASD) in the hospital, strategies they use to support care, and relationships between these factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>A descriptive, cross-sectional survey design with nursing staff at a large pediatric hospital system in the United States was employed. The researcher-designed, pilot-tested survey assessed participant demographics, knowledge about ASD, perceived effectiveness caring for children with ASD, previous training, and current strategy use. Data analysis involved descriptive statistics, correlations, and group comparisons based on interaction frequency with the population and previous training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants involved 90 pediatric hospital nursing staff members providing direct care. Respondents demonstrated 90% accurate knowledge of the characteristics of ASD. Self-reported effectiveness in caring for children with ASD did not correlate with knowledge and significantly correlated with an increased number of strategies. Nursing staff with frequent interaction with people with ASD or those with previous training reported significantly more strategies to care for children with ASD. Only 35% of participants reported that they have adequate strategies to care for children with ASD in the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Having more strategies was the factor associated with higher self-efficacy, so training for nursing staff should focus on increasing the number of strategies to use with children with ASD in the hospital and provide mechanisms to collaborate with other professionals to individualize strategies to meet each child's needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25537188","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":"Use of a Pediatric Obesity Fall-risk Scale (POFS) in 301 hospitalized obese children and adolescents","authors":"Sofia Tamini,&nbsp;Sabrina Cicolini,&nbsp;Anna Porcu,&nbsp;Angela Seddone,&nbsp;Nancy Ryan-Wenger,&nbsp;Alessandro Sartorio","doi":"10.1111/jspn.12335","DOIUrl":"10.1111/jspn.12335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Falls are a significant safety risk in hospitalized patients, but little evidence regarding their significance in obese children are available to date. Aim of the study was to determine whether the Pediatric Obesity Fall-risk Scale (POFS) is able to discriminate between hospitalized obese pediatric patients at high or low risk of falling, to evaluate its sensitivity and specificity and to analyze if the risk factors considered were actually related to the falling event.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>The sample consisted of 301 children and adolescents hospitalized for a body weight reduction program. In this 12-month study, 14.6% of patients experienced a fall during hospitalization, the fall rate per 1000 patient days being 5.33 for the first and 4.36 for the second 6-month of the year. The components of the POFS included chronological age, history of falls, body mass index standard deviation score (BMI-SDS), and the ability to maintain equilibrium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No differences were observed between fallers and nonfallers as far as BMI and BMI-SDS are concerned. Compared with patients who did not fall, those who fell were significantly younger and shorter and their weights were lower. The POFS identified 85 patients with high and 216 with low falling risk, the two subgroups being comparable for BMI and BMI-SDS. Compared with patients with low fall-risk, those with high fall-risk were significantly younger and shorter and their weights were lower. The sensitivity of the POFS was 61.4%, while the specificity was 77.4%. The positive predictive value of the POFS was 31.8%, while the negative predictive value was 92.1%. The analyses of each POFS component did not show significant differences between fallers and non-fallers in terms of BMI-SDS and equilibrium test. Compared with patients who did not fall, those who fell were significantly younger, experienced a fall during the 3 months prior the admission in hospital and their total POFS score was higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>Preventing falls in hospitalized obese pediatric patients is challenging due to the markedly increased risk of this population and specific fall-risk assessment tools are required to early identify patients who needs more care, attention, and specific nursing/medical interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":"26 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jspn.12335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25538150","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}