Caracterización de adolescentes ingresadas en el servicio de Ginecología ( 2011- 2013) / Characterization of teenager admitted at Gynecological Service ( 2011- 2013)

Introducción: la adolescencia es un momento vital en la vida de los seres humanos. Se reconoce su importancia demográfica, cultural, psicosocial y económica. Es necesario prestarle atención por ser una etapa de enfrentamiento a nuevas situaciones, capaces de afectar definitivamente la vida del individuo. Dentro de los múltiples factores que amenazan la vida de los adolescentes se encuentran las conductas sexuales de riesgo, las que constituyen el principal peligro, para su salud sexual y reproductiva. Objetivo: caracterizar las adolescentes ingresadas en el Servicio de Ginecología del Hospital América Arias. Métodos: estudio descriptivo y transversal, con una muestra constituida por 346 adolescentes ingresadas en el Servicio de Ginecología del Hospital Docente Ginecoobstétrico América Arias, en el período comprendido desde enero de 2011 hasta diciembre de 2013. Resultados: la mayor cantidad de ingresos ocurrió en el año 2013; prevaleció la edad de inicio de las relaciones sexuales en la adolescencia precoz, el embarazo y el aborto. El dolor pelviano y la fiebre fueron las causas más frecuentes de ingreso en el servicio de ginecología. La enfermedad inflamatoria pélvica y las complicaciones de la interrupción de embarazo ocuparon los sitios cimeros como diagnóstico al egreso. Predominó el tratamiento médico y no hubo complicaciones en la muestra estudiada. Conclusiones: la adolescencia es una etapa de la vida difícil. Constituye un reto para la Salud Pública Cubana tratar de influir en todos los aspectos posibles para evitar o lograr una disminución en la morbilidad de este grupo de edad.(AU)

Introduction: Adolescence is a vital phase in human beings life. Its demographic, cultural, psychosocial and economic importance is recognized requiring to be carefully attended since this is a stage of confrontation to new situations which may affect an individual's life. Among the many factors that threaten the lives of adolescents are risky sexual behaviors, which are the main danger for sexual and reproductive health. Objective: Characterize teenagers who are admitted to Gynecology Service at America Arias Hospital. Methods: A descriptive study was conducted in a sample consisting of 346 adolescents admitted at America Arias University Hospital of Gynecology and Obstetrics from January 2011 to December 2013. Results: Most hospital admission occurred in 2013. Early initiation of sex, pregnancy and abortion prevailed in adolescence. Pelvic pain and fever were the most frequent causes of admission in the service. Pelvic inflammatory disease and complications of pregnancy termination occupied the top rankings as diagnosis at hospital discharge. Medical treatment predominated and there were no complications in the studied sample. Conclusions: Adolescence is a very difficult period of life. It is a challenge for the Cuban public health trying to influence every possible way to avoid or achieve a decrease in the morbidity of this age(AU)

Empowering Our Youth: Initiating Sexual Health Education on the Inpatient Unit for the Chronically Ill Pediatric Patient.

Chronicaly ill pre-teens and adolescents often spend months as inpatients while undergoing treatment. This population includes but is not limited to oncology, transplant, physically disabled, and medically fragile pediatric patients. Sexual health education is often considered less important than the complex disease states and medical issues faced by pediatric inpatients. Many clinicians fail to realize the value of providing this guidance as a necessary part of the physical and psychosocial health of these young patients. Chronically ill youth lack normal social interactions while hospitalized and may have body image issues related to physical disabilities. A need for sexual health education stems from the high sexually transmitted disease prevalence in this population. Lack of formal provider education on sexual health, provider discomfort in discussing sexual health topics, and overlooking the importance of adolescent sexual health have delayed integration of sexual education into inpatient teaching, discharge planning, and outpatient follow up. With few guidelines and minimal published research on this topic, clinicians and parents often have no experience, education, or guidance to provide this specific knowledge effectively. The goal of this discussion of sexual health education for chronically ill adolescents is to highlight the need for additional research, improved training for healthcare providers, and development of evidence-based guidelines in the inpatient and outpatient settings.

Using the hospital as a venue for reproductive health interventions: a survey of hospitalized adolescents.

BACKGROUND AND OBJECTIVES: Less than one-half of sexually active adolescents have received counseling regarding contraception and sexually transmitted disease (STD) from their health care provider. We hypothesized that hospitalized adolescents would be interested in receiving reproductive health education and/or STD testing. In addition, we assessed the opinion of female adolescents on initiation of contraception during hospitalization. METHODS: A convenience sample of 13- to 18-year-old male and female adolescent patients hospitalized at a tertiary pediatric hospital were approached for inclusion. Consenting patients completed a self-administered anonymous questionnaire. RESULTS: Questionnaires from 49 female adolescents and from 51 male adolescents were collected. Based on their answers, 37% of female adolescents and 44% of male adolescents want to learn more about contraception and/or abstinence in the hospital independent of sexual activity. Thirty percent of respondents reported a desire for STD testing in the hospital. Fifty-seven percent of female subjects answered that adolescents should be offered contraception while in the hospital. CONCLUSIONS: Among hospitalized adolescents in this study, there was an interest in reproductive health education and contraception even among those with a primary care provider and without sexual experience. Thus, hospital-based pediatricians can play a pivotal role in expanding critical sexual health services by discussing and offering sexual health care to hospitalized adolescents. We recommend that hospitals make a brochure available to all admitted adolescents, with opportunity for follow-up discussions with their hospitalist.

Classe hospitalar: uma estratégia para a promoção da saúde da criança / Hospital school a strategy for promoting a child´s health

A saúde é determinada por condições sociais, econômicas, educacionais, políticas e ambientais extrapolando, portanto, a dimensão exclusivamente biológica. Sua promoção definida como o processo de capacitação da comunidade para atuar na melhoria da sua qualidade de vida e saúde, depende da colaboração de diversos setores, da participação popular e da utilização de diferentes instrumentos, tais como: educação, informação e legislação. A abordagem educativa deve estar presente em todas as ações para promover a saúde e prevenir as doenças. Dentre as diretrizes da Promoção da Saúde está a criação de ambientes favoráveis à saúde. A Classe Hospitalar é um espaço dentro dos hospitais reservado ao desenvolvimento de atividades pedagógico-educacionais em ambiente favorável à promoção do bem estar das crianças. Possibilita a construção de conhecimentos, a capacitação e o ensino de algumas habilidades e contribui para o desenvolvimento infantil. Ameniza o sofrimento da criança, tranquilizando os pais durante a hospitalização. É uma importante aliada no processo de Humanização Hospitalar. Um trabalho pedagógicoeducacional, utilizando como apoio um Manual de Saúde Ocular, dois filmes e jogos de multimídia, foi realizado em uma classe hospitalar de um Hospital Público com a finalidade de analisar as suas contribuições para promover a educação e promoção da saúde entre crianças internadas. A partir do uso desse material instrucional, verificaram os seus efeitos na redução de sentimentosnegativos, tanto das crianças quanto de seus pais, inerentes à hospitalização. Entrevistas com os pais e educadores bem como observação dos alunos em sala de aula permitiram avaliar os benefícios das atividades. O material educativo mostrou-se eficiente tanto para a educação continuada dos educadores, quanto para a intermediação da informação entre o professor e o aluno, melhorando a construção de conhecimentos relativos à saúde e a doença...

Health is determined by social, economical, educational, political and environmental conditions, therefore, beyond its solely biological dimension. Its promotion defined as the process of the community empowerment to act for the improvement of their quality of life and health depends on the collaboration of several sectors, population participation and the use of different resources, such as: education, information and legislation. The educational approach should be present in all actions to promote health and prevent diseases. The creation of health favorable environments is among the guidelines for the Promotion of Health. The Hospital School is a room inside hospitals maintained for the development of educational-pedagogic activities in an environment that favors the promotion of childrens well-being. It makes the construction of knowledge, the skills building, and the teaching of some abilities possible, and it also contributes to the child development. It softens childs suffering, easing parents during hospitalization. Its an important ally in the process of Hospital Humanization. An educational-pedagogic work was carried out by using an Eye Health Manual, two movies and multimedia games as aids in a hospital classroom of a public Hospital aiming at analyzing their contribution in promoting education and health among hospitalized children. From the use of these instructional materials, the effects in the reduction of both childrens and parents´ negative feelings inherent in hospitalization were verified, The interviews with parents and educators as well as the observation of the pupils in the classroom allowed us to assess the benefits of these activities. The educational material showed to be efficient both for the continuing formation of the educators and for the mediation of the information between teacher and pupil improving the construction of knowledge related to health and disease...

Evaluation of a PNP care coordinator model for hospitalized children, adolescents, and young adults with cystic fibrosis.

PURPOSE: The purpose of this study was to evaluate a new model for delivery of care to hospitalized children, adolescents, and young adults with cystic fibrosis (CF) admitted to the adolescent unit at Golisano's Children's Hospital at Strong. SPECIFIC AIM/HYPOTHESIS: The specific aim of this study was to test the hypothesis that children, adolescents, and young adults with CF who were hospitalized under the new model for care delivery would have better experiences and clinical outcomes than they had during previous hospitalizations prior to the implementation of the new model. METHODS: A pre-post design included all children, adolescents, and young adults with CF admitted to the hospital for treatment of a pulmonary exacerbation during the six-month study period. Each patient's experience was compared with his or her most recent previous hospitalization. Outcomes measured included timeliness of inpatient consultations, change in forced experitory volume in first second (FEV1), weight gain, length of hospital stay (LOS), and patient/parent and nursing/medical staff satisfaction. RESULTS: A total of 21 patients completed the study. Compared to the patient's previous admission, there was a significant reduction in the time to complete consultations by ancillary services. The differences between predicted LOS and actual LOS was reduced by 2.47 days (p = .06). Actual LOS was decreased by 1.35 days. Parent/patient satisfaction with new model remained high and health care provider satisfaction was overwhelmingly positive. CONCLUSIONS: An inpatient Pediatric Nurse Practitioner Care Coordinator (PNP-CC) for CF patients admitted to the hospital can reduce the time for ancillary service consultations, reduce LOS, and improve patient and health care provider satisfaction. This model also can be applied to the treatment of hospitalized children with other chronic illnesses.

[Expected benefits of a nursing consultation on the compliance of the adolescent renal transplantation patient]. / Bénéfices escomptés d'une consultation infirmière sur la compliance thérapeutique de l'adolescent transplante rénal.

Benefits expected from a nurse consultation on the therapeutic compliance of the student with a kidney transplant The therapeutic non-observance of chronic ill teenagers in general, and of teenagers who had a kidney transplant in particular, is a genuine problem of public health. At the children Hospital of Toulouse, from March 2002 to March 2003, a nurse consultation coupled with the medical consultation, was set up for the follow-up of these teenagers. The object of this research in nurse care was to appraise, at the end of a year's operation, the results of this consultation on the therapeutic observance of these teenagers and its operation within the institution. At the dawn of a deep upheaval for the profession, this study enabled us to valorise the nurse expertise combined with the medical activity for the actual benefit of children. The nurse consultation, in the heart of the news for some time, has remained in the heart of our concern for over half a century.

Practices for preparing children for clinical examinations and procedures in Swedish pediatric wards.

This study sought to elucidate Swedish pediatric wards concerning the practice of informing children and their parents about clinical examinations and procedures. A semi-structured questionnaire was distributed to all 36 pediatric departments in Sweden, comprising of 83 wards. Fifty-eight (70%) of the wards responded. The results showed that 55 (95%) of the wards provided regular planned information programs. Twenty-seven (47%) of the wards had formulated quality goals for their information program, but in only nine (16%) of the wards were the goals quality assured. Although the results showed that most pediatric wards in Sweden inform children about hospitalization, formulated quality goals remain uncommon. In some wards, economic cutbacks had led to reduction of information for preparation. Despite obstacles, nurses try to give priority to the giving of information. Further studies should focus on children's and parents' experience and satisfaction.

A health website for children.

Knowledge about the special needs of children and adolescents in hospital has advanced in the past 40 years. There is now general acknowledgement that they should have services tailored to their emotional and developmental needs, and should be cared for by specially trained practitioners. However, admission to hospital is a stressful experience even for those going into the most child-friendly environments. Preparation can do much to relieve anxiety, and a new website has been set up to give children the information they need about their health and what to expect in hospital.

Effects of coping instruction in reducing young adolescents' pain after major spinal surgery.

BACKGROUND: Enduring pain following major orthopaedic surgery is a major challenge for adolescents. PURPOSE: To evaluate the effects of coping instruction and concrete-objective information on adolescents' postoperative pain and focus on potential applications of these interventions for orthopaedic nursing practice. DESIGN/METHOD: A randomized controlled trial of 66 young adolescents (age 11-14) undergoing major spinal surgery for idiopathic scoliosis. RESULTS: The intervention that focused only on coping instruction was the most effective intervention on postoperative Day 2. On postoperative Day 4, adolescents receiving coping instruction (coping alone or coping plus information) reported less pain than those not receiving coping instruction. DISCUSSION: Interventions that direct adolescent patients' attention to learning coping strategies they can use during recovery to lessen pain may be more efficacious than others following major spinal surgery.

Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses.

AIM: This study was designed to investigate the teenage sexual health service provided by gynaecology nurses at Queen's Medical Centre, Nottingham, United Kingdom (UK), by assessing their knowledge, activities and perceptions in relation to teenage sexual health. BACKGROUND: Part of a gynaecology nurse's work is caring for teenagers with sexual health problems, including unwanted pregnancies and sexually transmitted infections (STIs). Given the current national focus in the UK on improving teenage sexual health, there is clearly a role for gynaecology nurses to play, but this is rarely referred to in published literature and appears to be poorly defined. METHOD: A cross sectional survey of all gynaecology nurses at Queen's Medical Centre was carried out, followed by semi-structured interviews with a small random subsample. FINDINGS: Results indicated that, although 65% of nurses had worked on the gynaecology unit for more than 5 years, there was poor knowledge, an inconsistent pattern of nursing interventions and negative perceptions of the service offered. A majority of the nurses (87%) had not received any specific training in how to nurse teenagers with sexual health problems and 65% considered that the quality of sexual health service offered to teenagers was poor. Unexpected findings included poor general knowledge of local teenage sexual health services, the emotional effect on some nurses caring for young teenagers undergoing medical terminations of pregnancy (ToP), and the complete lack of training and protocols for taking a sexual history. CONCLUSIONS: The nurses felt that the teenage sexual health service provided could be improved by better staff training, better information for teenagers and better organization. Recommendations have been made as a result of the study but the staff will need management support to ensure that changes are effective. Generalizations cannot be drawn from a study in one hospital but the results could reflect the low profile given to the teenage sexual health aspect of gynaecology nurses' work in the UK.

School reintegration: a rehabilitation goal for spinal cord injured adolescents.

This article describes how the Education for All Handicapped Children Act of 1975, Public Law 94-142, assists in achieving the rehabilitation goal of school reintegration for spinal cord injured (SCI) adolescents. It also describes how subordinate goals are achieved during the inpatient rehabilitation phase. Comments from a survey of 13 SCI adolescents who returned to school demonstrate the need to prepare SCI adolescents for the services to which they are entitled, to acquaint them with ways of resolving possible problems they may encounter, and, when they return for follow-up care, to encourage them to continue in school.

Does partial hospitalization for children with emotional disorders mean partial education?

In this keynote address, Dr. Zimet discusses two issues. She reviews the accomplishments and future efforts of the Child and Adolescent Special Interest Group in AAPH. And she presents research findings that attempt to answer the question posed in the title.