Psychometric evaluation of the child PTSD symptom scale in Spanish and English.

Given the consistent growth of the Latino population in the United States, there is a critical need for validated Spanish measures to assess posttraumatic stress disorder (PTSD) symptoms in children. The current study examines the psychometric properties of the Child PTSD Symptom Scale (CPSS). We examined 259 children (8-17 years) who had experienced a recent traumatic event. Study measures were completed in Spanish (n = 106; boys = 58, girls = 48) or in English (n = 153; boys = 96, girls = 57). In addition to internal consistency, confirmatory factor analyses were conducted by testing four models to examine construct validity: (1) PTS single-factor, (2) DSM-IV three-factor, (3) Numbing four-factor, and (4) Dysphoria four-factor models. Findings demonstrated good internal consistency for both the English and Spanish versions of the CPSS. The English version revealed superior fit to the data for several models of PTS symptoms structure compared to the Spanish version. The current study demonstrated construct validity for the English CPSS, but not for the Spanish CPSS. Future studies will examine additional alternative models as well as convergent and discriminant validity of the Spanish CPSS.

Mood and health-related quality of life among pediatric patients with heart failure.

Adult patients with heart failure (HF) commonly experience depression, with morbid and mortal consequences. However, mood disorders in pediatric patients with HF are poorly understood. This study examined mood and health-related quality of life (HRQOL) in children with HF and compared them cross-sectionally with those of healthy control subjects and heart transplant (Htx) recipients with good heart function. The 62 participants in this study were divided into three groups: HF subjects (n = 15), Htx subjects (n = 23), and healthy control subjects (n = 24). The HF subjects all had chronic HF with a left ventricular ejection fraction lower than 35 %. All the participants completed the Mini-Mental State Examination (MMSE), the Childhood Depression Inventory (CDI), and the Pediatric Quality-of-Life Inventory Cardiac Module (PedsQL CM). Overall, the MMSE scores and CDI subscale scores were similar for all the groups. The HF and Htx participants scored similarly on the PedsQL CM subscales for HRQOL, treatment anxiety, perceived physical appearance, cognitive function, and communication. However, the HF group had a significantly lower HRQOL related to heart problems and treatment than the Htx group. The prevalence of depression among children with HF is not as high as reported in the adult HF literature. However, certain aspects of HRQOL experienced by pediatric HF patients still suffer, especially those related to heart problems and treatment. Health-related QOL tended to be better for the Htx participants than for the HF participants. Exploring developmental and psychosocial outcomes is critical for patients with HF, especially because it has an impact on vital developmental, academic, and social outcomes.

Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care.

OBJECTIVES: To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV). BACKGROUND: Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges. WORKING HYPOTHESIS: Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience. STUDY DESIGN: An exploratory online survey was used to evaluate emergency case-based pediatric scenarios. Demographic and professional experiences were profiled. PATIENT-SUBJECT SELECTION: Seventy-nine nurses had an average of 6.73 (SD = 1.41) years in pediatric nursing. Over 70% received their HMV training in their agency, 41% had less than 4 years of experience, and 30.4% had encountered at least one emergency situation at home. METHODOLOGY: The online survey was distributed by managers of 22 home health agencies to nurses providing pediatric HMV care. RESULTS: Nurses scored an average of 4.87 out of 10 possible points. There were no significant differences between nurses with <4 years of experience versus those with more experience on ventilator alarms knowledge or total knowledge. Ninety-seven percent of the nurses favored more training in HMV from a variety of settings (e.g., agency, on-line training). CONCLUSIONS: Nurses did not perform well in case-based ventilator alarm scenarios. Length of nursing experience did not differentiate greater knowledge. It is clear that nurses require and want more training in emergency-based HMV. Recommendations for an enhanced curriculum are suggested.