Using mHealth Applications to Promote Self-Managed Health Behaviors Among Teens.

THEORETICAL PRINCIPLES: As technology use increasingly expands, the opportunity to capitalize on it for healthcare education, monitoring, and assessment has grown rapidly, especially among adolescent patients. As apps are developed, consideration should be given to self-management theory concepts. PHENOMENA ADDRESSED: The proliferation of mobile health (mHealth) applications allows adolescents to access healthcare information in new, innovative ways. Many health applications focus on health promotion, fitness, and nutrition and others help persons with chronic disease. This article offers a compelling case for incorporating mHealth into teen healthcare by reviewing current data on teens' technology use, showing how mHealth aligns with self-management theory concepts, and offering a case scenario on mHealth-enhanced self-management care. RESEARCH LINKAGES: The ability to combine accurate and immediate healthcare information with continual social support could radically improve teen's self-management behaviors, especially when mHealth apps use connectivity, a feedback loop, and concepts known to enhance self-management behaviors.

Impact of a multimedia teaching tool on parental anxiety and knowledge during the informed consent process.

PURPOSE: Before performing a surgical procedure, informed consent (IC) is obtained. Parents may exhibit anxiety and/or a desire for more knowledge during the IC process for their child. The purpose of this study was to measure the impact of a multimedia intervention (MMI) versus conventional discussion on parental understanding and anxiety during the IC process for infants undergoing surgery for hypertrophic pyloric stenosis. METHODS: A time-interrupted series design was employed over a 9-month period. In the first phase, conventional discussion for IC was performed. In the second phase, a MMI was utilized. In both phases, anxiety scores and post-consent knowledge tests were collected. RESULTS: 31 participants were included in the study, 17 in the conventional consent and 14 in the MMI phase. Parental anxiety around the IC discussion was measured. There was a significant decrease in anxiety noted with use of the MMI (p = 0.046) but no significant difference in knowledge (p = 0.84). CONCLUSION: The MMI significantly reduced parental anxiety during the IC process. Providers may consider applying this type of MMI to other surgical procedures. Securing IC in a manner that improves knowledge and decreases anxiety may improve long-term understanding and parental satisfaction with the health care process.

Better Together: A Win-Win Pediatric Academic Partnership.

As healthcare facilities and academic nursing programs are challenged to be efficient and effective in light of an ever-changing healthcare system, recent literature has focused on the value of creating academic practice partnerships. Using the American Association of Colleges of Nursing (AACN) and American Organization of Nurse Executives (AONE) Academic Practice Partnership Guiding Principles, a children's hospital and state university are working collaboratively to improve evidence-based practice and research, create innovative educational opportunities for undergraduate and advanced practice students, promote academic progression that enables nurses to advance their education, improve access to health care services for underserved families, and implement initiatives that improve patient- and family-centered care. This article will describe the initiatives, processes, and outcomes of this fruitful partnership. The examples we provide using the Academic Practice Partnership Guiding Principles can be adapted in other healthcare facilities and nursing programs.

Validation of the parenting sense of competence scale in fathers: Thai version.

The role of the parent is a significant family factor that can impact the child cognitively, emotionally, and socially. Strengthening parents' competence improves their performance as parents. This study is the development and validation of the Thai Parenting Sense of Competence scale (Thai PSOC scale) for assessing the parenting competence of Thai fathers. The Thai PSOC scale was revised from the PSOC scale developed by Gibaud-Wallston and Wandersman (1978). The scale consists of 17 items with 2 subscales: skill/knowledge (8 items) and valuing/comfort (9 items). The scale was tested with 195 Thai fathers-to-be/ fathers. The results showed high internal consistency: 0.78 for the total scale and 0.73 and 0.80 for the skill/knowledge and valuing/comfort subscales, respectively. Confirmatory factor analysis (CFA) led to a revision of the Thai PSOC scale with better goodness of fit indices for the sample. In the revised scale with Item 17 was omitted, several goodness of fit indices improved significantly with a more acceptable, good fit (Chi(2)/df = 1.63; RMSEA = 0.06; GFI = 0.91; AGFI = 0.88; NFI = 0.80; TLI = 0.90; CFI = 0.91). With revision, the Thai PSOC scale is a potential instrument to measure parenting competence in Thai fathers.

Predictors of family management behavior for children with thalassemia.

Children with thalassemia can thrive with quality care by their families. The purpose of this study was to examine predictors of family care behavior by family caregivers of children with thalassemia. Eighty-eight family caregivers for children with thalassemia aged 1-16 years were recruited by purposive sampling from in-patient and out-patient clinics in an eastern regional hospital in Thailand. Research instruments were 5 self-administered questionnaires: 1) demographics of family caregivers, 2) perceived family management, 3) medical adherence, 4) health literacy, and 5) family management behavior. Data were analyzed by percentages, means, standard deviations, Pearson's product moment correlation and multiple regression. The strongest predictor for family management behavior was perceived family management (B = 0.550, p < 0.001), it accounted for 26.3% of the variance. Health literacy (B = 0.337, p = 0.024) accounted for 4.5% of the variance. When these two dependent measures were combined, they accounted for 30.8% of the variance (R2 = 0.308, F = 18.933, p < 0.001). Within the three subscales of family management behavior (medical, role, and psychosocial management), medical adherence, health literacy and perceived family management, together accounted for 22.6% of the variance for medical management. Perceived family management and health literacy together accounted for 30.3% of the variance in role management. Perceived family management accounted for 20.9% of the variance in psychosocial management. These findings suggest a tailored intervention program should emphasize promoting family management and increasing health literacy to improve the quality of family management behavior for children with thalassemia.

Developmental evaluation of preschool children: a service-learning experience for nursing students.

Service-learning is a practice that is beneficial for both students and community participants. This article presents the service-learning experience of senior-level undergraduate nursing students at a southeastern U.S. university. Nursing students were taught how to administer the Denver II Developmental Screening Test (DDST-II), and they then evaluated high-risk preschool children during a clinical nursing experience. A total of 1,030 children were screened between 2008 and 2012. Early detection of developmental delays promotes earlier intervention for concerns, and the implementation of this service-learning project using a valid and sensitive screening tool aids in the cost-effective identification of preschool children who are at risk for developmental delays. Student evaluations of the experience were positive, and examples of the knowledge acquired are provided.

Prevalence and Impact of Adverse Childhood Experiences in an Interdisciplinary, School-Based Pediatric Clinic.

INTRODUCTION: This study's purpose was to ascertain the prevalence of adverse childhood experiences (ACEs) in a pediatric population and their connection to other health history information. METHOD: Using health history data, a retrospective, descriptive study was undertaken with 1,028 children seen at a school-based, interprofessional clinic over 1 academic year. RESULTS: Nearly 58% of children had at least one ACE, and 9.5% had four or more, similar to the prevalence of ACEs in adults reported in the original study by Felitti et al. (1998). With increasing ACEs, children had higher rates of intrauterine drug exposure, intensive care on delivery, homelessness, substance abuse, behavioral problems, mental illness, learning difficulties, and weight issues. DISCUSSION: Because ACEs are prevalent among children, pediatric providers should use trauma-informed care principles and teach and model a loving and supportive adult presence in children's lives.

Cooperative m-learning with nurse practitioner students.

New technologies give nurse academicians the opportunity to incorporate innovative teaching-learning strategies into the nursing curricula. Mobile technology for learning, or m-learning, has considerable potential for the nursing classroom but lacks sufficient empirical evidence to support its use. Based on Mayer's multimedia learning theory, the effect of using cooperative and interactive m-learning techniques in enhancing classroom and clinical learning was explored. The relationship between m-learning and students' learning styles was determined through a multimethod educational research study involving nurse practitioner students at two mid-Atlantic universities. During the 16-month period, nurse practitioner students and their faculty used personal digital assistants (PDAs) to participate in various m-learning activities. Findings from focus group and survey responses concluded that PDAs, specifically the Pocket PC, are useful reference tools in the clinical setting and that all students, regardless of learning style, benefited from using PDAs. It was also demonstrated that connecting students with classmates and other nurse practitioner students at distant universities created a cooperative learning community providing additional support and knowledge acquisition. The authors concluded that in order to successfully prepare nurse practitioner graduates with the skills necessary to function in the present and future health care system, nurse practitioner faculty must be creative and innovative, incorporating various revolutionary technologies into their nurse practitioner curricula.

Picky eating: a toddler's continuing approach to mealtime.

Research indicates that three primary components play a role in the picky eating phenomenon: development, personal preferences, and the family. Picky eating is an aspect of child development. Children will develop their own preferences when given the appropriate tools to do so. Parents are their children's greatest role models. An understanding of these concepts can help guide the primary care provider in making appropriate recommendations to parents to improve their toddlers' eating behaviors.

A national survey of the primary and acute care pediatric nurse practitioner educational preparation.

INTRODUCTION: The past decade has been marked by a gradual expansion of the traditional primary care role of the pediatric nurse practitioner (PNP) into practice arenas that call for more acute and critical care of children. The purpose of the study was to explore the educational programming needs of dual (combined) track PNP programs that prepare graduates to provide care to children and adolescents across the continuum of health and illness. METHOD: A two-phase, exploratory, mixed method design was utilized. An electronic survey was completed by 65% of PNP program directors in the country. Semi-structured telephone interviews were conducted with hospital-based PNPs who were practicing in roles that met a range of health care needs across the primary and acute care continuum. RESULTS: Primary care and acute care programs have more common than unique elements, and the vast majority of clinical competencies are common to both types of program. Only three competencies appear to be unique to acute care programs. DISCUSSION: The Association of Faculties of Pediatric Nurse Practitioner Programs should utilize existing evidence and develop guidelines for dual PNP programs that focus on the provision of care to children across a wide continuum of health and illness.