How Does Creative Arts Therapy Reduce Distress for Children With Cancer? A Metasynthesis of Extant Qualitative Literature [Formula: see text].

Introduction: As more children survive cancer, attention must be paid to their quality of life (QOL). Integrative therapies are an ideal modality for nurses to advocate for reducing distress and improving QOL for children with cancer. Creative arts therapy is a type of integrative health that may improve QOL in this population. Therefore, the research question was asked, "For children with cancer, what opportunities exist for creative arts therapy to reduce distress?" Method: A metasynthesis of the extant qualitative research was conducted to answer the research question. Seven qualitative studies were identified, which included 162 participants. New themes were identified through rigorous analyzation by the study team of each study as individual data. Results: Four derived analytic themes emerged through the analysis: (a) connection is established through creative expression, (b) coping is facilitated by creative arts, (c) communication is enabled by creative arts interventions, and (d) continuance (the concept of time) is experienced through creative arts. Examples of each theme with subthemes are delineated, including expressive quotes. Summary: Through this qualitative synthesis of studies with creative arts therapy, evocative opportunities to reduce the distress associated with the disease experience are revealed. Nurses are called now to promote creative arts therapy to improve the symptoms in children with cancer.

Creative Arts Therapy in the Context of Children With Cancer: A Concept Analysis.

Aim: To report an analysis of the concept of creative arts therapy (CAT) in the context of pediatric cancer. Background: Literature supports the intuitive conclusion that creative interventions improve a patient's journey through the cancer trajectory. However, a new definition is needed to encompass CAT and creative expression interventions in order to better understand the concept of creativity in health care, specifically in pediatric oncology. Design: Concept analysis. Data Sources: The scientific databases CINAHL, PsycInfo (Ovid), AMED (Allied and Complementary Medicine), and PubMed were queried for English language research articles published between 2008 and 2018 using the search terms: creative arts therapy and cancer. Method: The Walker and Avant method of concept analysis was implemented. Results: CAT is a broad concept bringing creative arts in a therapeutic manner to children with cancer. Attributes include expression of feelings; creating art, music, or movement; and improvement of symptoms. CAT is frequently measured using quality of life and symptom assessment scales. Antecedents include the diagnosis of cancer, the distress caused by cancer, and a child's willingness to participate in creative activity. Consequences include improved quality of life, improved sense of well-being, decreased psychosocial symptoms, and less cancer pain. Conclusion: The literature supports CAT as a concept that may decrease distress for children with cancer.

The DNP/MPH Dual Degree: An Innovative Graduate Education Program for Advanced Public Health Nursing.

Strong professional priorities, evolving Affordable Care Act requirements, and a significantly limited public health nursing workforce prompted the University of Colorado College of Nursing to collaborate with the School of Public Health to implement one of the first Doctor of Nursing Practice/Master of Public Health dual degree programs in the nation. Federal grant funding supported the development, implementation, and evaluation of this unique post-baccalaureate dual degree program, for which there were no roadmaps, models, or best practices to follow. Several key issues emerged that serve as lessons learned in creating a new, novel higher education pathway for Advanced Public Health Nursing. This paper highlights two of those: (1) marketing, admission, and matriculation across two programs, and (2) enhancing curricula through distance coursework and interprofessional education. When collaboration with a school of public health is possible, the Doctor of Nursing Practice/Master of Public Health dual degree is an efficient way to prepare public health nurses' with the highest level of public health knowledge, practice, and leadership expertise.

Advancing the Development of the Guidelines for the Nursing of Children, Adolescents, and Families: 2014 Revision: Process, Development, and Dissemination.

This article details the process used to develop the revision of the original Guidelines that resulted in the development of the 2014 Health Care Quality and Outcomes Guidelines for Nursing of Children, Adolescents, and Families. Members of the 2014 Guidelines Revision Task Force conducted an extensive process of revision, which included the input and approval of 16 pediatric and child health nursing and affiliated organizational endorsements. The revised Guidelines were presented to and endorsed by the American Academy of Nursing Board. These Guidelines are designed for use by pediatric and child health nurses who work in a range of health care and community-based settings. The Guidelines are proposed to be used as a framework for nurse-directed services and intervention development and testing, as a model for undergraduate and graduate pediatric and child health nursing program curriculum development, and as the theoretical basis for nursing investigations on the care of children, adolescents, and families.

Snoring, Trouble Breathing, Un-Refreshed (STBUR) Screening Questionnaire to Reduce Perioperative Respiratory Adverse Events in Pediatric Surgical Patients: A Quality Improvement Project.

Children who present for surgery with undiagnosed sleep-disordered breathing are particularly vulnerable to perioperative respiratory adverse events (PRA Es). Preoperative screening can identify children at increased risk who would benefit from evidence-based perioperative management, reducing serious preventable harm or death. The purpose of this quality improvement study was 2-fold: (1) increase identification of pediatric surgical patients who may be at increased risk of PRAE through the introduction of a validated pediatric screening questionnaire (Snoring, Trouble Breathing, Un-Refreshed [STBUR]), and (2) reduce preventable harm by introducing evidence-based perioperative management guidelines. A pre-post intervention design was conducted in 6,216 patients aged 1 to 18 years. The STBUR questionnaire embedded in the electronic medical record was the primary intervention. Data for the primary outcome measure and 3 secondary process measures were analyzed using Yatesχ2 and Fisher exact test to compare proportional change. After STBUR implementation, PRAE risk identification increased from 10.5% to 15% (χ2 (1, N = 12,975) = 57.19, z = -7.59, P < .001, odds ratio =1.49). Results of the secondary process measures were mixed. The STBUR screening questions embedded in the medical record significantly improved identification of patients at risk, allowing modification of perioperative management toward safer practices.

Increasing patient attendance in a pediatric obesity clinic: a quality improvement project.

Research supports intensive lifestyle interventions (>25 contact hours/six months) to treat childhood obesity. Success requires retention in program. This quality improvement project's purpose was to increase attendance of follow-up patients in a childhood obesity clinic by 10%. A pretest posttest design was used. Three months of baseline data were collected, followed by 52 weeks of intervention data. Data were analyzed using descriptive statistics and Fisher's exact test. Follow-up patient attendance improved significantly from 69% to 81% (z=1.76, p=.039 (95% CI=0.2822, 1.0021)). Simple and inexpensive interventions can significantly increase attendance of obese children in follow-up.

Obesogenic environment: a concept analysis and pediatric perspective.

PURPOSE: A concept analysis was undertaken to examine the attributes, characteristics, and uses of the concept of obesogenic environment within a pediatric context. CONCLUSIONS: Utilizing a modified version of Walker and Avant's method, the attributes and characteristics of obesogenic environment were identified as it pertains to children. Based on the review of the literature and previous definitions applied to adults, a definition of the concept of obesogenic environment within a pediatric context was developed; examples of sample cases illustrate the concept further. PRACTICE IMPLICATIONS: Defining the concept of obesogenic environment has utility for nursing theory development, practice, research, and education.

Childcare health and health consultation curriculum: trends and future directions in nursing education.

PURPOSE: The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. DESIGN AND METHODS: A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. RESULTS: Fifty-nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. PRACTICE IMPLICATIONS: Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.

Report of the American Academy of Nursing Child-Family Expert Panel: identification of quality and outcome indicators for maternal child nursing.

Core values and assumptions regarding child health care are identified. Concepts that are generalized across settings are defined. The dimensions of care involve the child, the family, the system, and the community. The Child-Family Expert Panel will continue to work within specialties on standards, processes, and outcomes.