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Annals of Palliative Medicine Feb 2019Palliative care is patient- and family-centered care that enhances quality of life throughout the illness trajectory and can ease the symptoms, discomfort, and stress... (Review)
Review
Palliative care is patient- and family-centered care that enhances quality of life throughout the illness trajectory and can ease the symptoms, discomfort, and stress for children living with life-threatening conditions and their families. This paper aims to increase nurses' and other healthcare providers' awareness of selected recent research initiatives aimed at enhancing life and decreasing suffering for these children and their families. Topics were selected based on identified gaps in the pediatric palliative care literature. Published articles and authors' ongoing research were used to describe selected components of pediatric palliative nursing care including (I) examples of interventions (legacy and animal-assisted interventions); (II) international studies (parent-sibling bereavement, continuing bonds in Ecuador, and circumstances surrounding deaths in Honduras); (III) recruitment methods; (IV) communication among pediatric patients, their parents, and the healthcare team; (V) training in pediatric palliative care; (VI) nursing education; and (VII) nurses' role in supporting the community. Nurses are in ideal roles to provide pediatric palliative care at the bedside, serve as leaders to advance the science of pediatric palliative care, and support the community.
Topics: Adolescent; Bereavement; Child; Education, Nursing; Female; Hospice and Palliative Care Nursing; Human-Animal Bond; Humans; Male; Nurse's Role; Nurse-Patient Relations; Palliative Care; Parents; Pediatric Nursing; Social Support
PubMed: 30180727
DOI: 10.21037/apm.2018.06.01 -
Human Resources For Health Feb 2020Burnout in healthcare providers has impacts at the level of the individual provider, patient, and organization. While there is a substantial body of literature on... (Review)
Review
Burnout in healthcare providers has impacts at the level of the individual provider, patient, and organization. While there is a substantial body of literature on burnout in healthcare providers, burnout in pediatric nurses has received less attention. This subpopulation may be unique from adult care nurses because of the specialized nature of providing care to children who are typically seen as a vulnerable population, the high potential for empathetic engagement, and the inherent complexities in the relationships with families. Thus, the aim of this scoping review was to investigate, among pediatric nurses, (i) the prevalence and/or degree of burnout, (ii) the factors related to burnout, (iii) the outcomes of burnout, and (iv) the interventions that have been applied to prevent and/or mitigate burnout. This scoping review was performed according to the PRISMA Guidelines Scoping Review Extension. CINAHL, EMBASE, MEDLINE, PsycINFO, ASSIA, and The Cochrane Library were searched on 3 November 2018 to identify relevant quantitative, qualitative, and mixed-method studies on pediatric nurse burnout. Our search identified 78 studies for inclusion in the analysis. Across the included studies, burnout was prevalent in pediatric nurses. A number of factors were identified as impacting burnout including nurse demographics, work environment, and work attitudes. Similarly, a number of outcomes of burnout were identified including nurse retention, nurse well-being, patient safety, and patient-family satisfaction. Unfortunately, there was little evidence of effective interventions to address pediatric nurse burnout. Given the prevalence and impact of burnout on a variety of important outcomes, it is imperative that nursing schools, nursing management, healthcare organizations, and nursing professional associations work to develop and test the interventions to address key attitudinal and environmental factors that are most relevant to pediatric nurses.
Topics: Burnout, Professional; Humans; Nursing Staff, Hospital; Pediatric Nursing; Stress, Psychological; Workplace
PubMed: 32046721
DOI: 10.1186/s12960-020-0451-8 -
Revista Brasileira de Enfermagem 2020to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
OBJECTIVES
to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
METHODS
Grounded Theory and the theoretical/philosophical framework of Virginia Henderson were used. The research was conducted in Family Basic Health Units and in Specialized Services in the city of Campina Grande, Paraíba, Brazil. A total of 24 participants composed four sample groups. Data were collected through semi-structured interviews, between April and October 2015, and analyzed by the constant comparison method. The analysis occurred by initial coding, construction of diagrams and memos, axial coding, selective coding and reflection on the paradigm and on the emerging theory.
RESULTS
six categories emerged from the data. Nurses worrying about the care of children with obesity as a neglected area in Primary Health Care was the theoretical model.
FINAL CONSIDERATIONS
the phenomenon is related to the individuality of nursing care and the need for shared responsibilities.
Topics: Adult; Brazil; Female; Grounded Theory; Humans; Interviews as Topic; Male; Middle Aged; Nursing Care; Nursing Theory; Pediatric Nursing; Pediatric Obesity; Qualitative Research
PubMed: 32578728
DOI: 10.1590/0034-7167-2018-0881 -
Revista Brasileira de Enfermagem 2019to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. (Review)
Review
OBJECTIVE
to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer.
METHOD
integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017.
RESULTS
we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care.
FINAL CONSIDERATION
we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.
Topics: Evidence-Based Practice; Humans; Nursing Care; Oncology Nursing; Palliative Care; Pediatric Nursing
PubMed: 31017219
DOI: 10.1590/0034-7167-2018-0121 -
Nursing Children and Young People May 2015It is imperative that nurses caring for children, young people and their families develop and maintain effective, trusting and collaborative therapeutic relationships...
It is imperative that nurses caring for children, young people and their families develop and maintain effective, trusting and collaborative therapeutic relationships that sit within the scope of professional boundaries. This relationship is the nurse's responsibility and should be positive and mutually acceptable to all stakeholders. A unique challenge for children's nurses is to address and prioritise the child's care needs, while meeting the needs of, and empowering, the family. The 6Cs--care, compassion, competence, communication, courage, commitment--should underpin care and enable nurses to overcome challenges such as time pressures, acute situations or disturbed family expectation. Confidentiality and safeguarding should always be observed.
Topics: Adolescent; Adult; Attitude of Health Personnel; Child; Child, Preschool; Clinical Competence; Cooperative Behavior; Education, Nursing, Continuing; Female; Humans; Male; Middle Aged; Nurse's Role; Nurse-Patient Relations; Pediatric Nursing; Professional-Family Relations; Young Adult
PubMed: 25959488
DOI: 10.7748/ncyp.27.4.30.e566 -
Journal of Pediatric Oncology Nursing :... 2017This study assessed the feasibility of studying animal-assisted activities (AAA) in inpatient pediatric oncology and collected preliminary data on potential benefits of...
This study assessed the feasibility of studying animal-assisted activities (AAA) in inpatient pediatric oncology and collected preliminary data on potential benefits of AAA for this population. Patients at a large pediatric hospital were identified using electronic medical records and approached with physician approval. Patients completed surveys before and after a therapy dog visit in their private hospital room. Data on infections were ascertained by electronic medical record review. Provider surveys were placed in provider common areas and distributed through a link in an e-mail. We summarized resultsusing descriptive statistics and estimated mean changes in pre- and postintervention distress and conducted hypothesis tests using the paired t test. The study population (mean age = 12.9 years) consisted of 9 females and 10 males. Following the therapy dog visit, patients had lower distress and significant decreases in worry, tiredness, fear, sadness, and pain. Providers were generally supportive of the intervention. Eight patients developed infections during the 14 days after the dog visit but none could be clearly attributed to the therapy dog visit. The study's primary limitation was that there was no control group. However, results support the feasibility of and need for future studies on AAA in pediatric oncology.
Topics: Adolescent; Animal Assisted Therapy; Animals; Child; Child, Hospitalized; Dogs; Female; Hospitals, Pediatric; Humans; Male; Neoplasms; Patient Satisfaction; Pediatric Nursing; Pilot Projects; Washington
PubMed: 28614971
DOI: 10.1177/1043454217712983 -
Journal of Pediatric Oncology Nursing :... 2015Health care providers recognize that delivery of effective communication with family members of children with life-threatening illnesses is essential to palliative and... (Comparative Study)
Comparative Study
Health care providers recognize that delivery of effective communication with family members of children with life-threatening illnesses is essential to palliative and end-of-life care (PC/EOL). Parents value the presence of nurses during PC/EOL of their dying child. It is vital that nurses, regardless of their years of work experience, are competent and feel comfortable engaging family members of dying children in PC/EOL discussions. This qualitative-descriptive study used focus groups to explore the PC/EOL communication perspectives of 14 novice pediatric oncology nurses (eg, with less than 1 year of experience). Audio-taped focus group discussions were reviewed to develop the following 6 theme categories: (a) Sacred Trust to Care for the Child and Family, (b) An Elephant in the Room, (c) Struggling with Emotional Unknowns, (d) Kaleidoscope of Death: Patterns and Complexity, (e) Training Wheels for Connectedness: Critical Mentors during PC/EOL of Children, and (f) Being Present with an Open Heart: Ways to Maintain Hope and Minimize Emotional Distress. To date, this is the first study to focus on PC/EOL communication perspectives of novice pediatric oncology nurses.
Topics: Adaptation, Psychological; Adolescent; Adult; Attitude of Health Personnel; Attitude to Death; Child; Child, Preschool; Clinical Competence; Communication; Family; Female; Focus Groups; Humans; Male; Middle Aged; Midwestern United States; Nurses; Oncology Nursing; Palliative Care; Pediatric Nursing; Professional-Family Relations; Stress, Psychological; Terminal Care; Young Adult
PubMed: 25556105
DOI: 10.1177/1043454214555196 -
Pediatrics Sep 2020One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program's... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program's effectiveness for reducing outpatient antibiotic prescribing for ARTI visits.
METHODS
In this stepped-wedge clinical trial run from November 2015 to June 2018, we randomly assigned 19 pediatric practices belonging to the Pediatric Research in Office Settings Network or the NorthShore University HealthSystem to 4 wedges. Visits for acute otitis media, bronchitis, pharyngitis, sinusitis, and upper respiratory infection for children 6 months to <11 years old without recent antibiotic use were included. Clinicians received the intervention as 3 program modules containing online tutorials and webinars on evidence-based communication strategies and antibioti c prescribing, booster video vignettes, and individualized antibiotic prescribing feedback reports over 11 months. The primary outcome was overall antibiotic prescribing rates for all ARTI visits. Mixed-effects logistic regression compared prescribing rates during each program module and a postintervention period to a baseline control period. Odds ratios were converted to adjusted rate ratios (aRRs) for interpretability.
RESULTS
Among 72 723 ARTI visits by 29 762 patients, intention-to-treat analyses revealed a 7% decrease in the probability of antibiotic prescribing for ARTI overall between the baseline and postintervention periods (aRR 0.93; 95% confidence interval [CI], 0.90-0.96). Second-line antibiotic prescribing decreased for streptococcal pharyngitis (aRR 0.66; 95% CI, 0.50-0.87) and sinusitis (aRR 0.59; 95% CI, 0.44-0.77) but not for acute otitis media (aRR 0.93; 95% CI, 0.83-1.03). Any antibiotic prescribing decreased for viral ARTIs (aRR 0.60; 95% CI, 0.51-0.70).
CONCLUSIONS
This program reduced antibiotic prescribing during outpatient ARTI visits; broader dissemination may be beneficial.
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Chicago; Child; Child, Preschool; Communication; Confidence Intervals; Education, Distance; Female; Humans; Inappropriate Prescribing; Infant; Intention to Treat Analysis; Logistic Models; Male; Odds Ratio; Otitis Media; Outpatients; Pediatric Nursing; Pediatricians; Pharyngitis; Primary Health Care; Program Development; Quality Improvement; Respiratory Tract Infections; Sinusitis; Streptococcal Infections
PubMed: 32747473
DOI: 10.1542/peds.2020-0038 -
Journal of Pediatric Nursing 2022Trauma is not limited to medical trauma and includes chronic stressors, toxic stress, adverse childhood events, abuse, and now the COVID-19 pandemic. Principles of... (Review)
Review
BACKGROUND
Trauma is not limited to medical trauma and includes chronic stressors, toxic stress, adverse childhood events, abuse, and now the COVID-19 pandemic. Principles of trauma-informed care and resiliency guide pediatric nursing care across the life span from birth to adolescence. Trauma-informed care principles are pertinent to the nursing care needs of healthy and ill children from infancy to adolescence across care settings.
METHODS
The purpose of this integrative literature review (IRL) is to elucidate evidence-based practices for pediatric nurses specific to trauma, trauma-informed principles, and the integration of these principles to care. Using Whittemore and Knafl's (2005) methodology, this IRL presents empirical literature to operationalize trauma-informed care for the pediatric nurse through 1) identification of the problem; 2) literature search; 3) data evaluation; 4) data analysis; 5) result presentation.
FINDINGS
Results are presented in a contemporary framework by the Substance Abuse and Mental Health Services Administration (2018) of trauma-awareness for the pediatric nurse, trauma-informed principles, and the integration of these principles to care. Pediatric nurses are in a unique position to offer trauma-informed care by recognizing and managing trauma to include chronic stressors, toxic stress, adverse childhood experiences, and abuse.
DISCUSSION
Pediatric nurses today are caring for patients in a complex and diverse healthcare climate amid the world's worst public health pandemic in living memory. Awareness of trauma, assessment of trauma in pediatrics, and health and resiliency promotion are critical in moving forward post-pandemic. The overview of trauma-informed care provides a guide for the pediatric nurse.
Topics: Adolescent; COVID-19; Child; Humans; Nurses, Pediatric; Pandemics; Pediatric Nursing; SARS-CoV-2
PubMed: 34798581
DOI: 10.1016/j.pedn.2021.11.003 -
Acta Bio-medica : Atenei Parmensis Jul 2018procedural pain is a significant issue for paediatric patients. In particular, needle pain is amongst the most stressful for children. Studies revealed that a large... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND AND AIM OF THE WORK
procedural pain is a significant issue for paediatric patients. In particular, needle pain is amongst the most stressful for children. Studies revealed that a large number of children do not receive adequate pain prevention during the procedures. Neglecting the prevention of needle pain can cause several psychological effects such as anxiety and phobias, and increase perceptions of pain in the future. We aimed to verify the efficacy of Buzzy System in reducing pain during venipuncture.
METHODS
A randomized control trial was conducted among 72 children aged 3 to 10 years undergoing venipuncture. Children were randomly assigned to The Buzzy with distraction cards group (experimental group) or to "magic gloves" group (control group). Perception of pain was measured through the Visual Analogue Scale (VAS), the Wong-Baker Scale (WBS) and the Numeric Rating Scale (NRS).
RESULTS
Sixty-four children participated in the study, 34 in the experimental group and 30 in the control group. The experimental group showed significantly lower levels of pain (p=.039; 95% CI: -2,11; -0,06) in terms of the mean=3.65±2.011; median=3, compared to the control group (mean: 4.67±2.14, median=4). Caregivers were satisfied with the Buzzy System.
CONCLUSION
The Buzzy System combined to distraction cards showed a greater reduction of perceived pain than "magic glove" technique. This study underlines the importance of active involvement of caregivers during procedural pain in children. Pediatric nurses have an important role in empowering children and caregivers to be interactive during venipunctures.
Topics: Attention; Caregivers; Child; Child, Preschool; Cryotherapy; Female; Humans; Male; Pain Management; Pain Perception; Pain, Procedural; Parents; Pediatric Nursing; Personal Satisfaction; Phlebotomy; Vibration; Visual Analog Scale
PubMed: 30038198
DOI: 10.23750/abm.v89i6-S.7378