Nurse Faculty Scholars - Pediatrics

Parental Human Papillomavirus Vaccine Survey (PHPVS): Nurse-Led Instrument Development and Psychometric Testing for Use in Research and Primary Care Screening

kdeming — Thu, 11 Jul 2013 14:29:06 +0000

Published Date:

Mon, 2013-04-01 (All day)

Human papillomavirus (HPV) infection is etiologically linked to cancers of the cervix, anus, oropharynx, penis, vagina, and vulva (Parkin & Bray, 2006). The HPV vaccine is a health care breakthrough and an essential element of health promotion in pediatric and adolescent health care for boys and girls (Chaturvedi, 2010). The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommends vaccinating girls and boys from the age of 9 to 26 years (CDC, 2010). To eliminate HPV-related cancers through HPV vaccination, it is essential to recognize the factors involved in parents’ decision whether to permit their children to get the HPV vaccine (Harper et al., 2006). Indeed, the prevalence of HPV infection and cervical cancer rates continue to increase in African American and Latina women (Kobetz et al., 2010). So, the primary author sought to develop a theory-based survey that was short and simple to use with items that could identify intervention points to address HPV vaccination in populations of children and adolescents with low vaccine rates and those experiencing health disparities.

The purpose of this article is to describe the development and results of the psychometric evaluation of the Parental HPV Survey (PHPVS). The PHPVS was developed in 2007 in response to the debut of the HPV vaccine and the controversy that followed. During the spring of 2007, nurses and other health care providers discussed with policy makers and public health officials which parents would or would not vaccinate their child or adolescent with the HPV vaccine. The PHPVS was developed and then psychometrically tested so researchers would have an instrument to use in health promotion research.

The Symptom Cluster Experience Profile Framework

lsharp — Mon, 07 Feb 2011 15:39:26 +0000

Published Date:

Mon, 2010-11-08 (All day)

Purpose/Objectives: To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden.

Data Sources: Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.

Data Synthesis: In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life.

Conclusions: The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur.

Implications for Nursing: The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.

California's Young Hispanic Children With Asthma: Disparities in Health Care Access and Utilization of Health Care Services

lsharp — Mon, 25 Oct 2010 12:49:24 +0000

Published Date:

Fri, 2010-01-01 (All day)

Research is needed to examine what factors determine the health care utilization patterns of Hispanic children with asthma. The purpose of this study was to profile California's Hispanic children with asthma, from 1 to 5 years of age, including their demographics, their health care access, their asthma severity, their disability due to asthma, and their health care utilization patterns. An overall sample of 149 children (N = 149) was used, whose parents reported that they were Hispanic and had a current MD diagnosis of asthma. A secondary analysis of parental reports of their children's asthma was done using the California Health Interview Survey (CHIS), 2001. In the past 12 months, young Hispanic children with asthma had increased emergency department (ED) use due to their asthma (58.5%) as compared to visits to their regular care provider, increased hospitalizations (77.1%), and took daily asthma control medication (53.4%). Most children had mild asthma severity (43.6%) and sometimes had their physical activity limited (26.8%) due to asthma. California's young, Hispanic children with asthma have high utilization of health care services due to asthma.

Children's bicycle helmet use and injuries in Hillsborough County, Florida before and after helmet legislation.

nfs — Wed, 29 Sep 2010 12:48:04 +0000

Published Date:

Sun, 2003-06-01 (All day)

The purpose of this research was to explore the changes in children's bicycle helmet use and motor vehicle bicycle related injuries in Hillsborough County, Florida before and after passage of the Florida's bicycle helmet law for children under the age of 16. The results show a significant increase in bicycle helmet use among children, ages 5-13, in the post-law years compared with the pre-law years. Also, there has been a significant decline in the rates of bicycle related motor vehicle injuries among children in the post-law years compared with the pre-law years. Although there have been complementary educational and outreach activities in the county to support helmet use, it appears that the greatest increase in use occurred after the passage of the helmet law. It is recommended that educational efforts continue to sustain helmet use rates and decreases in injuries.

Pediatric Palliative Care Revisited: A Vision to Add Life

nfs — Tue, 28 Sep 2010 15:02:54 +0000

Published Date:

Sun, 2007-07-01 (All day)

The concept of pediatric palliative care should be analyzed to gain a better understanding of how to address the needs of children living with life-threatening illnesses. According to Walker and Avant, this article identifies uses of the concept, defines its critical attributes, describes a model case, describes additional cases, and identifies antecedents, consequences, and empirical referents. The analysis is useful to researchers and clinicians with a focus on pediatric palliative care. Hypotheses can then accurately reflect relationships among variables in the field, and new tools can be developed to determine the presence of pediatric palliative care.

Continuing bonds: A human response within paediatric palliative care. International Journal of Palliative Nursing

nfs — Mon, 27 Sep 2010 13:43:28 +0000

Published Date:

Tue, 2008-01-01 (All day)

The concept of continuing bonds (CB) is a human response to health and illness within paediatric palliative care. This literature review aims to: define and explain the significance of CB; describe the history of the concept; critically analyze the literature related to CB; and make recommendations for future research. Exploration of CB as a response to life-threatening illness and to losing a child is significant in terms of improving care for children and their families living with life-threatening illness. This paper focuses on children with a life-threatening illness, but CB also needs to be studied with other populations, such as those with life-limiting conditions.

Assessing the Needs of the Pediatric Palliative Care Nurse: History of Palliative Care

nfs — Mon, 27 Sep 2010 13:39:19 +0000

Published Date:

Mon, 2007-01-01 (All day)

The concept of palliative care originally evolved from the hospice philosophy of meeting gaps in care for seriously ill and dying patients. The Latin word palliate means “conceal or alleviate symptoms without curing” (Romesburg, 2007). The earliest recording of the word palliate can be traced to the late 14th century, where it originated in Elizabethan and Indo-European traditions (Morris, 1998). In 1967, Dame Cicely Saunders founded the first modern hospice program in the United Kingdom, which emphasized the importance of compassion and medical science (Georges, Grypdonck, & Dierckx de Casterle, 2002). Florence Wald, Dean of Yale University, invited Saunders to the U.S. to learn about her experiences, and in 1974, she founded the first home hospice program based in New Haven, Connecticut. In 1975, St. Luke’s Hospice in New York was the first hospice in the U.S. incorporated into an existing medical center. In 1982, the first children’s hospice center opened in England (Foster, 2007). Despite growth in hospice initiatives, researchers have only just begun to explore the unique aspects of pediatric palliative care.

Palliative care was first introduced in 1990 by the World Health Organization (WHO) (2004) and is currently defined as “an approach to care which improves quality of life of patients and their families facing life-threatening illness through prevention, assessment, and treatment of pain and other physical, psychological, and spiritual problems.” WHO (2004) further describes palliative care for children as the active total care of the child’s body, mind, and spirit, as well as a means of providing support to the family.

To provide this type of palliative care today, hospitals throughout the U.S. have increased initiatives to meet the unique needs of both adults and children. Although there are some commonalities, pediatric palliative care differs from adult palliative care in several ways that preclude the extension of existing adult services into the pediatric world (Sumner, 2003).

Reliability of the Nursing Child Assessment of Feeding Scale during toddlerhood.

nfs — Tue, 13 Jul 2010 15:44:47 +0000

Published Date:

Sat, 2007-09-01 (All day)

The quality of the maternal-child feeding interaction has been proposed to be an important contributor to a child's being overweight, yet assessment of this proposition has been hindered by a lack of age-appropriate instrumentation. The primary aim of this study was to examine the reliability of the Nursing Child Assessment of Feeding Scale (NCAFS) if extended to use during toddlerhood. A longitudinal design was used to assess NCAFS reliability at 12, 24, and 36 months. The NCAFS was used to code videotaped feeding observations of 116 mother-toddler dyads collected as part of a larger study examining mother-child interactions and adaptations of toddlers. Reliability was explored through the assessment of interrater reliability, internal consistency of the various subscales and the scale as a whole, and stability of the scale measurements over time. At each age, interrater reliability was generally quite good whereas the NCAFS' internal consistency was low. Maternal contributions to feeding interaction quality were stable over time but dyadic and child contributions were not. The lower internal consistency estimates were likely due to relatively low levels of variance among the dyads within each age. Another probable contributor to diminished internal consistency was the attrition of several behavior items due to zero variance. Possible explanations for this restriction of variance and several approaches for improving the NCAFS internal consistency during toddlerhood are considered. With revision, the NCAFS could be useful in assessment of feeding interaction quality during the transition to toddlerhood when issues of control and autonomy become increasingly prominent.

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

nfs — Thu, 15 Apr 2010 19:17:14 +0000

Published Date:

Fri, 2009-08-28 (All day)

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.

The Association of Neighborhood Poverty With Personality Change in Childhood

nfs — Wed, 26 Aug 2009 15:10:09 +0000

Published Date:

Sat, 2008-06-14 (All day)

The child sample of the National Longitudinal Survey of Youth (n.d.) was analyzed to examine the relation of undesirable personality change in early childhood to neighborhood economic deprivation. Participants in the survey who had complete data at Time 1 (3-4 years of age) and Time 2 (5-6 years of age) and who remained in the same neighborhood during both time periods were included in the analyses. The results indicated that neighborhood economic disadvantage was associated with undesirable personality change even after controlling for family-level variables such as maternal education, family income, and cognitive and emotional support in the home environment for children. The association of personality change with neighborhood economic deprivation was not mediated by maternal depression, Head Start participation, cognitive and emotional support in the home, or maternal trust in the neighborhood. The authors discuss recommendations for future investigations. (PsycINFO Database Record (c) 2008 APA, all rights reserved).