International perspectives on the pediatric nurse practitioner role.

INTRODUCTION: Advanced pediatric nurse practitioners (APNPs) working in acute settings are represented in pediatric hospitals, clinics, and wards around the world. They work independently and autonomously. The aim of this study was to compare the role of APNPs in four different countries to gain knowledge on the qualifications and experience of the practitioners and their impact on pediatric patients and families. METHOD: A qualitative design with semistructured keyinformant interviews with four nurses from Sweden, Norway, England, and the United States was conducted. Analyses were performed using thematic analysis. RESULTS: Three themes were identified: 1) Qualification and Competencies, illustrated parallels within the four educations and daily practice. 2) Responsibility and Autonomy, highlighted differences. The informants experienced a mutual understanding of the concepts of advanced practice. Interprofessional collaboration with aphysician was crucial to ensure best practice. 3) Holistic Nurse Perspective highlighted the importance of APNPs having competencies to make holistic and family-centered decisions at a higher level. CONCLUSION: From the perspective of four APNPs, advanced pediatric nursing practice is beneficial to the patient, family, and professionals. The formal education varies in the countries studied, but the basic tenets of practice are the same. Family-centered practice and holism are basic to the APNP role.

Estratégias de enfrentamento dos profissionais de enfermagem frente à morte na oncologia pediátrica: revisão integrativa / Nurses' coping strategies in pediatric oncology: an integrative review / Estrategias de enfrentamiento de los profesionales de enfermería frente a la muerte en la oncología pediátrica: revisión integrativa

Objective: This study's aim has been to identify the coping strategies used by nurses in pediatric oncology in face of the patient's death. Methods: This integrative review was carried out using the following databases: VHL, MEDLINE/PubMed, and Google Scholar, from April 1st to May 3rd, 2017. The following descriptors were used: death, nursing, child, health pediatrics, oncology, cancer, and coping. The final sample consisted of ten scientific papers. Results: The following coping strategies identified: psychological support from other professionals and from the institution; institutional training on death and the dying process; exchange of experiences among professionals; sports practice; and religion and faith. These strategies were carried out according to individual characteristics and the work environment. Conclusion: It was concluded that the strategies lead to supportive attitudes according to the needs of professionals, alleviating their suffering and improving their care process

Objetivo: Identificar as estratégias de enfrentamento utilizadas por profissionais de enfermagem que atuam na oncologia pediátrica diante da morte do paciente. Métodos: Revisão integrativa da literatura realizada nas fontes de informação: BVS, MEDLINE/PubMed e no Google Scholar, no período de 01 de abril a 03 de maio de 2017. Utilizou-se os descritores: death, nursing, child, health pediatrics, oncology, cancer, coping. A amostra final foi constituída por dez artigos científicos. Resultados: Estratégias de enfrentamento identificadas: apoio psicológico de outros profissionais e da instituição; capacitação institucional sobre a morte e o processo de morrer; troca de experiências entre profissionais; prática de esportes; religião e fé. As estratégias ocorrem de acordo com as características individuais e do ambiente de trabalho. Conclusão: Concluiu-se que as estratégias levam a atitudes auxiliadoras nas necessidades do profissional, amenizando seu sofrimento e melhorando seu processo de cuidar

Objetivo: Identificar las estrategias de enfrentamiento utilizadas por profesionales de enfermería que actúan en la oncología pediátrica ante la muerte del paciente. Métodos: Revisión integrativa de la literatura realizada en las siguientes fuentes de información: BVS, MEDLINE/PubMed y en Google Scholar, en el período del 01 de abril al 03 de mayo de 2017. Se utilizaron los descriptores: death, nursing, child, health pediatrics, oncology, cancer, coping. La muestra final fue constituida por diez artículos científicos. Resultados: Estrategias de enfrentamiento identificadas: apoyo psicológico de otros profesionales y de la institución; Capacitación institucional sobre la muerte y el proceso de morir; Intercambio de experiencias entre profesionales; Práctica de deportes; Religión y fe. Las estrategias ocurren de acuerdo con las características individuales y del ambiente de trabajo. Conclusión: Se concluyó que las estrategias llevan a actitudes auxiliares en las necesidades del profesional, amenizando su sufrimiento y mejorando su proceso de cuidar

The Evaluation and Treatment of Tall Stature in Preadolescent Girls: A Case Report.

Families may approach primary care providers for advice and treatment for tall stature (height more than two standard deviations above the mean height for a given age) in pre-pubertal children. The following case report describes an 11-year-old girl who was referred to an endocrinology specialist for familial tall stature. Potential pathological causes for tall stature are reviewed. The assessment, management, and risks and benefits of treatment for this condition are described. Finally, the role of the pediatric nurse practitioner in caring for youth with this chief complaint is discussed.

Mind & body practices in the treatment of adolescent anxiety.

Although anxiety is the most common mental health condition among adolescents in the United States, the current standards of practice for treatment are expensive, may be difficult to obtain, and potentially harmful. Although mind and body practices show great promise in the treatment of adolescent anxiety, financial constraints, lack of education, and structural barriers can hinder the integration of these practices into primary care.

Vitamin D Prescribing Practices in Primary Care Pediatrics: Underpinnings From the Health Belief Model and Use of Web-Based Delphi Technique for Instrument Validity.

Vitamin D deficiency and insufficiency is a pandemic problem in children and adolescents in the United States. The problem may be aggravated by the inconsistent implementation of current clinical practice guidelines for vitamin D management by pediatric primary care providers. This study examines the relationship between primary care providers' prescribing vitamin D to children ages 1 through 18 years and their practice actions and knowledge. A descriptive correlation design was used. Participants were recruited from a purposive sample of pediatricians and pediatric nurse practitioners through an online invitation to participate in a survey. Reliability and validity was established for the survey developed by the principal investigator using a web-based Delphi technique. Results from this study indicate that although most providers are aware that vitamin D insufficiency and deficiency are problems, fewer than half currently recommend 600- to 1,000-IU supplementation to their patients ages 1 through 18 years.

Pediatric nurse practitioners' clinical competencies and knowing patterns in nursing: Focus group interviews.

BACKGROUND: The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). OBJECTIVES: We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. DESIGN: Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. RESULTS: Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. CONCLUSIONS: To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.

Mind Over Gut: Psychosocial Management of Pediatric Functional Abdominal Pain.

INTRODUCTION: Functional abdominal pain (FAP) refers to a common set of symptoms that characterizes abdominal pain for which there is no identifiable organic disease process. FAP is associated with functional disability, but understanding of its pathogenesis is incomplete. The condition appears to stem from an interaction between physical and psychological mechanisms. METHOD: A literature search was conducted to explore the psychosocial management of FAP and the role of nurse practitioners in treatment. RESULTS: A growing body of evidence supports the efficacy of psychosocial interventions, including cognitive behavioral therapy, hypnotherapy, and multidisciplinary treatment programs. There are no randomized controlled trials at the primary care level to guide management. DISCUSSION: Nurse practitioners can provide the supportive and consistent patient-provider relationship that is integral to the management and treatment of FAP. More research is necessary to understand how best to incorporate behavioral interventions into primary care practice.

Complementary and alternative treatments for primary dysmenorrhea in adolescents.

Primary dysmenorrhea is the most common gynecologic complaint among adolescents. Conventional treatments include nonsteroidal anti-inflammatory drugs and hormonal contraceptives, but complementary and alternative medicine is a growing area of interest. As patients seek such treatments, pediatric nurse practitioners should be aware of these options to offer the best advice to patients.

The art of a pediatric exam.

This article discusses incorporating "artistry" into a primary care pediatric exam, a technique that considers a child's cognitive developmental stage, previous medical experiences, and the family's general stressors and fears. Benefits of using the artistic exam technique include decreased fear and anxiety for both the child and parent and fewer unnecessary diagnostic tests. The artistic exam has also been shown to improve adherence to pre- and postcare instructions and improved quality outcomes.