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1.
J Obstet Gynecol Neonatal Nurs ; 49(2): 200-211, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32035974

RESUMO

OBJECTIVE: To develop and assess the reliability and validity of a new instrument used during the third trimester of pregnancy to measure women's confidence in their ability to achieve physiologic birth, the Preparation for Labor and Birth (P-LAB) instrument. DESIGN: Two-phase instrument development study that consisted of item generation and a prospective field test. SETTING: Field testing occurred in five midwestern U.S. prenatal clinics. PARTICIPANTS: Participants in the field test were 203 nulliparous and parous pregnant women who intended to give birth vaginally. METHODS: Psychometric testing consisted of test-retest reliability testing and assessments of content validity, face validity, and construct validity. We measured construct validity using exploratory factor analysis and correlation with the Sense of Coherence Scale. RESULTS: The 22-item P-LAB showed good content validity, good internal consistency, and stability over time. All items had content validity index scores greater than or equal to 0.8, and the total instrument content validity index was 0.95. We identified four factors related to women's confidence in their ability to achieve physiologic birth: Planned Use of Pain Medication, Relationship With Care Provider and Supportive Birth Environment, Beliefs About Labor, and Labor Support (social and professional). Cronbach's alpha coefficient for the four extracted factors were .93, .76, .73 and .74, respectively. Intraclass correlation [95% confidence interval] for the total questionnaire was .92 [.88, .94]. We found no linear association between total P-LAB scores and sense of coherence. CONCLUSION: Our findings demonstrate acceptable initial psychometric properties for the P-LAB instrument. Additional testing is required to evaluate the instrument's construct, convergent, and divergent validity.

2.
J Pediatr Health Care ; 34(2): 90-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31548138

RESUMO

INTRODUCTION: Family-centered communication at transitions of care can decrease readmissions and costs for children with medical complexity (CMC). The purpose of this quality improvement project was to improve the communication of postdischarge goals for CMC in a pediatric specialty setting. METHODS: We used process improvement strategies to implement a Post-Hospitalization Action Grid (PHAG) and a standardized discharge handoff process. Families of hospitalized CMC at high risk for readmission received the pilot intervention over 3 months. Indicators of successful implementation included rates of use of the PHAG, perceptions of integrated care, and usability of the tool. RESULTS: The PHAG was implemented with 11 of 40 eligible CMC families. Most staff agreed that the new process could improve the communication of postdischarge goals; however, perceptions of integrated care in the organization changed only minimally. DISCUSSION: The PHAG facilitates family engagement in discharge transitions but requires organizational investment of resources to implement.

3.
Child Care Health Dev ; 46(1): 121-131, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31782818

RESUMO

BACKGROUND: There has been a recent, rapid increase in the number of studies of children with medical complexity (CMC) and their families. There is a need for attention to gaps and patterns in this emerging field of study. OBJECTIVES: The purpose of this scoping review was to identify patterns and gaps in the evidence related to classification systems, data, and outcomes in studies of CMC. DATA SOURCES: We searched peer-reviewed journals for reports of quantitative studies focused on CMC outcomes published between 2008 and 2018. On the basis of a structured screening process, we selected 63 reports that met our inclusion criteria. STUDY APPRAISAL AND SYNTHESIS: We used the methodological framework for scoping studies described by Arskey and O'Malley to map relevant literature in the field and the ECHO model to categorize studies according to three health outcome domains (economic, clinical, and humanistic). RESULTS: The terminology used to describe and classify CMC differed across studies depending on outcome domain. Two thirds of the reports focused on economic outcomes; fewer than a quarter included child or family quality of life as an outcome. A majority of studies used a single source of data, with robust analyses of administrative, payer, and publicly available data. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Research on CMC and their families would benefit from standardization of terms and classification systems, the use of measurement strategies that map humanistic outcomes as trajectories, and more attention to outcomes identified as most meaningful to CMC and their families.

4.
J Fam Nurs ; 26(1): 5-14, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31878822

RESUMO

Systems thinking is essential for advanced family nursing practice, yet this skill is complex and not innate. The Family Nursing Assessment and Intervention Map (FN-AIM) was developed to support student development of systems thinking competencies for Family Systems Nursing practice (see Marigold Family Case Study). The FN-AIM is a pedagogical tool grounded in a family systems framework for nursing with a focus on core family processes as a foundation for interventions. The FN-AIM was implemented as an educational tool to support student skill development as part of a graduate family nursing course in the United States. Through a self-assessment of competence in family nursing practice, 30 students demonstrated an enhanced ability to articulate the distinction between family as context and family as system approaches to family nursing after using the FN-AIM mapping approach. The FN-AIM may be a useful strategy for supporting systems thinking in preparation for clinical skills development in graduate nursing students.

5.
J Sch Nurs ; 35(2): 96-106, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29161978

RESUMO

The purpose of this study was to explore school nurse perceptions of the nurse-family relationship in the care of elementary students with asthma and attention-deficit hyperactivity disorder (ADHD). A cross-sectional survey design was used to collect data from 97 school nurses in Minnesota. The Family Nursing Practice Scale measured nurses' perceptions of their family nursing practice. Bivariate analyses were conducted to compare scores by factors at the community, school, nurse, and child levels. Results suggest that school nurses have positive appraisals of their family nursing practice, though scores were generally lower in the context of ADHD compared to asthma. Participants with a graduate degree reported greater skill in working with families, whereas novice nurses reported less confidence working with families and less comfort initiating family involvement in care. Results suggest that interventions at the nurse and school levels may support enhanced family nursing practice by nurses caring for students with chronic conditions.


Assuntos
Asma/enfermagem , Transtorno do Deficit de Atenção com Hiperatividade/enfermagem , Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros/psicologia , Relações Profissional-Família , Serviços de Enfermagem Escolar , Adulto , Criança , Doença Crônica , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Minnesota , Competência Profissional/estatística & dados numéricos , Adulto Jovem
6.
J Pediatr Health Care ; 32(1): 63-75, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28870494

RESUMO

The purpose of this study was to explore health-related quality of life (HRQL) and family impact in the context of an advanced practice registered nurse-delivered telehealth care coordination intervention for children with medical complexity (CMC). This was a secondary outcomes analysis of a randomized controlled trial with 163 families of CMC in an existing medical home. HRQL and family impact were measured using the PedsQL measurement model. Bivariate and analysis of covariance analyses were conducted to explore associations at baseline and the intervention effect over 2 years. Significant predictors of Year 2 child HRQL were baseline HRQL and the presence of both neurologic impairment and technology dependence. There was no significant intervention effect on child HRQL or family impact after 24 months. Care coordination interventions for CMC may need to incorporate family system interventions for optimal outcomes in a range of quality of life domains.


Assuntos
Prática Avançada de Enfermagem , Doença Crônica/psicologia , Doença Crônica/terapia , Continuidade da Assistência ao Paciente/normas , Assistência Centrada no Paciente/normas , Qualidade da Assistência à Saúde/normas , Qualidade de Vida , Telemedicina , Adolescente , Prática Avançada de Enfermagem/normas , Cuidadores , Criança , Pré-Escolar , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Telemedicina/normas
7.
J Fam Nurs ; 23(1): 73-89, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28795934

RESUMO

This discussion article presents communities of practice (CoPs) and bridging social capital as conceptual frameworks to demonstrate how social media can be leveraged for family nursing knowledge, scholarship, and practice. CoPs require a shared domain of interest, exchange of resources, and dedication to expanding group knowledge. Used strategically and with a professional presence, mainstream social media channels such as Twitter, Facebook, and YouTube can support the family nurse in developing and contributing to CoPs related to family nursing. This article presents four strategies-curate, connect, collaborate, and contribute-for establishing and growing a social media presence that fits one's professional goals and time availability. Family nurses who leverage social media using these strategies can strengthen existing CoPs and at the same time bridge networks to reach new audiences, such as family advocacy groups, policy makers, educators, practitioners, and a wide array of other extended networks.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Enfermagem Familiar/organização & administração , Promoção da Saúde/métodos , Disseminação de Informação/métodos , Mídias Sociais , Humanos , Planejamento Social
8.
J Pediatr Health Care ; 31(4): 452-458, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28017489

RESUMO

INTRODUCTION: The purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration. METHOD: This was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups. The focus of the analysis was planned and unplanned clinical and therapy visits by CMC over a 30-month data collection period. Nonparametric tests were used to compare visit counts among and within the three groups. RESULTS: The number of unplanned visits decreased over time across all groups, with the greatest decrease in the video telehealth intervention group. Planned visits were higher in the video telehealth group across all time periods. DISCUSSION: Advanced practice registered nurse-delivered telehealth care coordination may support a shift from unplanned to planned health care service use among CMC.


Assuntos
Prática Avançada de Enfermagem , Doença Crônica/terapia , Continuidade da Assistência ao Paciente/organização & administração , Visita a Consultório Médico/economia , Qualidade da Assistência à Saúde/organização & administração , Telemedicina , Adolescente , Criança , Pré-Escolar , Doença Crônica/economia , Pesquisa em Enfermagem Clínica , Continuidade da Assistência ao Paciente/economia , Continuidade da Assistência ao Paciente/normas , Feminino , Custos de Cuidados de Saúde , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Profissionais de Enfermagem Pediátrica , Avaliação de Programas e Projetos de Saúde , Qualidade da Assistência à Saúde/economia , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos
9.
10.
Telemed J E Health ; 22(4): 295-301, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26484851

RESUMO

INTRODUCTION: Obtaining complete and timely subject data is key to the success of clinical trials, particularly for studies requiring data collected from subjects at home or other remote sites. A multifaceted strategy for data collection in a randomized controlled trial (RCT) focused on care coordination for children with medical complexity is described. The influences of data collection mode, incentives, and study group membership on subject response patterns are analyzed. Data collection included monthly healthcare service utilization (HCSU) calendars and annual surveys focused on care coordination outcomes. MATERIALS AND METHODS: One hundred sixty-three families were enrolled in the 30-month TeleFamilies RCT. Subjects were 2-15 years of age at enrollment. HCSU data were collected by parent/guardian self-report using mail, e-mail, telephone, or texting. Surveys were collected by mail. Incentives were provided for completed surveys after 8 months to improve collection returns. Outcome measures were the number of HCSU calendars and surveys returned, the return interval, data collection mode, and incentive impact. RESULTS: Return rates of 90% for HCSU calendars and 82% for annual surveys were achieved. Mean return intervals were 72 and 65 days for HCSU and surveys, respectively. Survey response increased from 55% to 95% after introduction of a gift card and added research staff. CONCLUSIONS: High return rates for HCSU calendars and health-related surveys are attainable but required a flexible and personnel-intensive approach to collection methods. Family preference for data collection approach should be obtained at enrollment, should be modified as needed, and requires flexible options, training, intensive staff/family interaction, and patience.


Assuntos
Continuidade da Assistência ao Paciente/estatística & dados numéricos , Coleta de Dados/métodos , Crianças com Deficiência , Serviços de Saúde/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Telemedicina/métodos , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Hospitais Pediátricos , Humanos , Masculino , Monitorização Ambulatorial , Inquéritos e Questionários
11.
J Pediatr Health Care ; 29(4): 352-63, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25747391

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the effect of advanced practice registered nurse (APRN) telehealth care coordination for children with medical complexity (CMC) on family caregiver perceptions of health care. METHOD: Families with CMC ages 2 to 15 years (N = 148) were enrolled in a three-armed, 30-month randomized controlled trial to test the effects of adding an APRN telehealth care coordination intervention to an existing specialized medical home for CMC. Satisfaction with health care was measured using items from the Consumer Assessment of Healthcare Providers and Systems survey at baseline and after 1 and 2 years. RESULTS: The intervention was associated with higher ratings on measures of the child's provider, provider communication, overall health care, and care coordination adequacy, compared with control subjects. Higher levels of condition complexity were associated with higher ratings of overall health care in some analyses. DISCUSSION: APRN telehealth care coordination for CMC was effective in improving ratings of caregiver experiences with health care and providers. Additional research with CMC is needed to determine which children benefit most from high-intensity care coordination.


Assuntos
Prática Avançada de Enfermagem , Cuidadores , Doença Crônica/psicologia , Continuidade da Assistência ao Paciente/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Satisfação do Paciente/estatística & dados numéricos , Enfermagem Pediátrica/tendências , Percepção Social , Telemedicina , Adolescente , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Criança , Pré-Escolar , Serviços de Saúde Comunitária , Comportamento Cooperativo , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Qualidade da Assistência à Saúde , Qualidade de Vida
12.
Online J Issues Nurs ; 20(3): 3, 2015 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-26882512

RESUMO

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge. The TeleFamilies Model of Pediatric Care Coordination uses an advanced practice registered nurse care (APRN) coordinator embedded within an established HCH. The PRoSPer Model of Pediatric Care Coordination uses a registered nurse/social worker care coordinator team embedded within a specialty care system. We describe key findings from implementation of these models, and conclude with lessons learned. Replication of the models is encouraged to increase the evidence base for care coordination for the growing population of children with medical complexities.


Assuntos
Serviços de Saúde da Criança/tendências , Continuidade da Assistência ao Paciente , Crianças com Deficiência , Assistência Centrada no Paciente/métodos , Adolescente , Prática Avançada de Enfermagem , Criança , Reforma dos Serviços de Saúde/métodos , Necessidades e Demandas de Serviços de Saúde , Humanos , Minnesota , Avaliação de Processos e Resultados em Cuidados de Saúde , Pais , Assistência Centrada no Paciente/tendências , Relações Profissional-Paciente
13.
J Adv Nurs ; 71(3): 535-46, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25223389

RESUMO

AIM: To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model. BACKGROUND: Little is known about how school nurses coordinate care for youth with asthma in different countries. DESIGN: A qualitative descriptive study design using focus group data. METHODS: Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. FINDINGS: Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma. CONCLUSIONS: Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations.


Assuntos
Asma/enfermagem , Serviços de Enfermagem Escolar/organização & administração , Adolescente , Criança , Comunicação , Assistência à Saúde , Escolaridade , Grupos Focais , Saúde Global , Prioridades em Saúde , Humanos , Islândia , Cooperação Internacional , Relações Interprofissionais , Minnesota , Educação de Pacientes como Assunto , Prática Profissional , Medição de Risco
14.
J Pediatr Health Care ; 28(4): 305-12, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23988611

RESUMO

Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity.


Assuntos
Prática Avançada de Enfermagem , Continuidade da Assistência ao Paciente , Recursos Humanos de Enfermagem , Criança , Humanos
15.
ISRN Nurs ; 2013: 793936, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23533804

RESUMO

Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems.

16.
J Pediatr Health Care ; 27(4): 293-303, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22560803

RESUMO

Efficiency and effectiveness of care coordination depends on a match between the needs of the population and the skills, scope of practice, and intensity of services provided by the care coordinator. Existing literature that addresses the relevance of the advanced practice nurse (APN) role as a fit for coordination of care for children with special health care needs (SHCN) is limited. The objective of this article is to describe the value of the APN's enhanced scope of knowledge and practice for relationship-based care coordination in health care homes that serve children with complex SHCN. The TeleFamilies project is provided as an example of the integration of an APN care coordinator in a health care home for children with SHCN.


Assuntos
Prática Avançada de Enfermagem , Necessidades e Demandas de Serviços de Saúde , Relações Enfermeiro-Paciente , Criança , Continuidade da Assistência ao Paciente , Humanos , Recursos Humanos
17.
J Adv Nurs ; 69(5): 1161-71, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-22897444

RESUMO

AIM: This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. BACKGROUND: Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing care to adolescents with asthma in school settings. Understanding universal barriers to asthma management in schools is important for developing interventions that are effective in multiple societal contexts. DESIGN: Exploratory, descriptive study. METHODS: Parallel studies were conducted from September 2008-January 2009, through six focus groups among school nurses (n = 32, in Reykjavik n = 17 and St. Paul n = 15) who were managing asthma in adolescents. Focus groups were audio-recorded and transcribed verbatim in English or Icelandic. The Icelandic transcripts were translated into English. Descriptive content analytic techniques were used to systematically identify and categorize types of barriers to asthma care. RESULTS: School nurses in both countries identified common barriers, such as time constraints, communication challenges and school staff barriers. The primary difference was that St. Paul school nurses identified more socio-economic and health access barriers than school nurses in Reykjavik. CONCLUSION: Greater cultural and linguistic diversity and socio-economic differences in the student population in St. Paul and lack of universal healthcare coverage in the US contributed to school nurses' need to focus more on asthma management than school nurses in Reykjavik, who were able to focus more on asthma prevention and education.


Assuntos
Asma/terapia , Serviços de Enfermagem Escolar , Adolescente , Criança , Feminino , Grupos Focais , Humanos , Islândia , Masculino , Minnesota
18.
Comput Inform Nurs ; 30(12): 649-54, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22948406

RESUMO

Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special healthcare needs. The purpose of this article is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special healthcare needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special healthcare needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse's ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data.


Assuntos
Prática Avançada de Enfermagem/organização & administração , Registros Eletrônicos de Saúde , Uso Significativo , Informática em Enfermagem , Enfermagem Pediátrica/organização & administração , Telemedicina/organização & administração , Criança , Humanos , Modelos de Enfermagem , Modelos Organizacionais , Pesquisa em Avaliação de Enfermagem , Pesquisa Metodológica em Enfermagem , Inovação Organizacional
19.
J Pediatr Health Care ; 26(5): 320-31, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22920774

RESUMO

Non-synostotic deformational plagiocephaly (DP) is a common condition that affects as many as one in five infants in the first 2 months of life. The purpose of this article, the second in a two-part series, is to present a synthesis of the evidence related to management of deformational plagiocephaly and an evidence-based clinical decision tool for multidisciplinary management of DP. We systematically reviewed and graded the literature on management of DP from 2000 to 2011 based on level of evidence and quality. The evidence suggests that although many cases of DP will improve over time, conservative management strategies such as repositioning, physical therapy, and cranial molding devices can safely and effectively minimize the degree of skull asymmetry when implemented in the first year of life. Outcomes are best when the timing of diagnosis and severity of asymmetry guide decision making related to interventions and referrals for DP. Prevention and management of early signs of DP are best achieved in a primary care setting, with multidisciplinary management based on the needs of the child and the goals of the family.


Assuntos
Modalidades de Fisioterapia , Plagiocefalia não Sinostótica/terapia , Torcicolo/terapia , Medicina Baseada em Evidências , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Comunicação Interdisciplinar , Masculino , Pais , Equipe de Assistência ao Paciente , Educação de Pacientes como Assunto , Plagiocefalia não Sinostótica/diagnóstico , Atenção Primária à Saúde , Sono , Decúbito Dorsal , Fatores de Tempo , Torcicolo/diagnóstico , Resultado do Tratamento
20.
J Pediatr Health Care ; 26(4): 242-50; quiz 251-3, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22726709

RESUMO

Non-synostotic deformational plagiocephaly (DP) is head asymmetry that results from external forces that mold the skull in the first year of life. Primary care providers are most likely to encounter DP when infants present for well-child care, and for this reason it is important that providers be competent in assessing, diagnosing, and participating in the prevention and management of DP. The purpose of this two-part series on DP is to present an overview of assessment, diagnosis, and evidence-based management of DP for health care providers. In Part I we provide a brief background of DP and associated problems with torticollis and infant development, and we present strategies for visual and anthropometric assessment of the infant with suspected DP. We also provide tools for differentiating DP from craniosynostosis and for classifying the type and severity of lateral and posterior DP. Part II (to be published in a future issue of the Journal of Pediatric Health Care) provides a synthesis of current evidence and a clinical decision tool for evidence-based management of DP.


Assuntos
Assimetria Facial/diagnóstico , Plagiocefalia não Sinostótica/diagnóstico , Decúbito Dorsal , Torcicolo/diagnóstico , Diagnóstico Diferencial , Medicina Baseada em Evidências , Assimetria Facial/etiologia , Assimetria Facial/terapia , Feminino , Dispositivos de Proteção da Cabeça , Humanos , Lactente , Recém-Nascido , Masculino , Desenvolvimento Maxilofacial , Plagiocefalia não Sinostótica/etiologia , Plagiocefalia não Sinostótica/terapia , Fatores de Risco , Índice de Gravidade de Doença , Sono , Torcicolo/complicações , Torcicolo/terapia
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