Evidence-Based Recommendations for Reducing Pediatric Distress During Vaccination.

Vaccinations are often associated with anxiety, avoidance, and considerable distress for children and parents. These issues can also impair coping during future health care visits. Parents, children, and clinicians can benefit from strategies designed to enhance coping. However, an important barrier to implementation of coping strategy interventions is lack of knowledge among both parents and staff. We produced two sets of tailored handouts designed to enhance education for primary care staff and parents using 41 clinical guidelines, reviews, and randomized controlled trials. Articles were selected from vaccine-specific literature by relevance and practicality for primary care. Handouts provide suggestions for parent and staff interventions before, during, and after vaccinations, focusing on techniques that are effective, cost-efficient, and adaptable. For children of all ages, tailored adult vocabulary and tone can also support coping.

An integrative review of sleep interventions and related clinical implications for obesity treatment in children.

PURPOSE: Evidence has shown correlations between obesity and sleep in children. The purpose of this review was to identify sleep interventions that could be utilized in primary care settings to prevent obesity in children. RESULTS: Three themes emerged: bedtime routines and environment; parental presence and graduated extinction; and health education. Effective strategies to improve sleep in children include consistent bedtime routine and self-soothing. CONCLUSION: Health care professionals can provide innovative and prevention-based sleep education for parents early in a child's development. Education, related to sleep, and appropriate sleep strategies may help prevent obesity and its long-term consequences.

"It was an overwhelming thing": parents' needs after infant diagnosis with congenital adrenal hyperplasia.

This study characterizes the experiences and expressed needs of parents following diagnosis of their newborn with congenital adrenal hyperplasia (CAH). Six parents (four mothers and two fathers) were interviewed about how they learned about CAH and its management, followed by qualitative data analysis. Coding of transcripts revealed several themes, including health communication problems, a lack of medical home and decision support, and a desire for parent-to-parent social support. Findings have implications for how family-centered health care is delivered following an unexpected newborn diagnosis.

Parenting efficacy and its relationship to the prevention of childhood obesity.

Childhood obesity has become a topic of interest for the health sciences research community due to the childhood obesity epidemic. Pediatric nurse practitioners are in the frontline of prevention for children who are obese or at risk of becoming obese. Serving in this role requires the nurses' ability to measure parenting practices, parents' inner beliefs, and parental control over their child's eating practices. Questionnaires and other tools are needed to understand parents' thoughts on how satisfied they are as parents, their locus of control in their parent-child relationship, and how competent they feel in the parenting role. Many parenting scales related to self-efficacy, competence, locus of control, and satisfaction have been developed over the past decades, but little research development has occurred in relation to child's eating behaviors within nursing. This article will review the current parent efficacy literature and examine its relationship to childhood obesity.

Equity and inclusivity in the faculty ranks: Our experience with a clinical track.

BACKGROUND: The evolution of nursing education requires a combination of strong academic faculty and expert clinicians. Different professional growth and development pathways are necessary to build a robust faculty with clinical and research expertise. Some schools have implemented a formal clinical track (CT) to complement the traditional tenure track for the professional advancement of CT. METHODS: The article presents a case example of how one institution maintains and advances a strong CT using the Kotter Change Model and discusses future directions. RESULTS: The school's infrastructure for promotion, which follows a similar structure and guidelines as Tenure Track (TT) Promotion and Tenure Guidelines, has led to an increase in the school's scholarly productivity among CT faculty across ranks. Increasing poster and podium presentations as well as publications to a national and international audience results in greater reach and improved reputation for the school, both nationally and internationally. CONCLUSIONS: While there is still work to be done to advance equity and inclusion for nursing CTs, developing and maintaining a CT with system-level structures holds significant value and provides a clear path to promotion, invests in clinical scholarship, and includes clinical faculty as full citizens in academia.

Parenting efficacy related to childhood obesity: comparison of parent and child perceptions.

The aim of this study was to explore child and parent perceptions of parenting efficacy related to child BMI. This descriptive, cross-sectional study recruited 27 parent-child dyads participating in a healthy eating/activity intervention. Parent and child perceptions of parenting efficacy were measured using a version of the Tool to Measure Parenting Self-Efficacy (TOPSE). Paired sample t test and correlational statistics were used. Parents and children had similar perception of parenting efficacy. Child report of parenting efficacy and child BMI was significant. Exploring perceptions of parenting efficacy will help individualize family-focused intervention programs to prevent obesity in children.

International Family Nursing Association: toolkit of resources for caring for refugee/migrating families.

OBJECTIVE: To report the experience of the International Family Nursing Association (IFNA) Practice Committee on developing a Toolkit of resources to care for refugee/migrating families as a response to the global migration and refugee crisis. METHOD: Qualitative and descriptive study, experience report, which describes the development of a toolkit of resources for caring for refugee/migrating families. RESULTS: The development of this Toolkit of resources to care for refugee/migrating families is supported by current literature related to family-centered evaluation and intervention, culturally sensitive practice based on family strengths; statements of positioning on immigrant and refugee families; and nursing and health organizations that addressed the health of the refugee family. CONCLUSIONS: The dissemination of the resources available in the Toolkit can support nursing practices, drive qualified approaches to assessments and interventions, capable of promoting family resilience as they adapt, providing well-being, and leading to the healing of traumas and adversities experienced by families in the process of migration or refuge.

Association between fasting insulin and C-reactive protein among adults without diabetes using a two-part model: NHANES 2005-2010.

INTRODUCTION: Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment. METHODS: This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model. RESULTS: The final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p < .001) and with higher CRP (ß = 0.03, p < .001). In the adjusted model, including waist circumference as a covariate, higher fasting insulin was not associated with CRP > 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (ß = 0.01, p = .012). CONCLUSION: This study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.

School-age children with diabetes: role of maternal self-efficacy, environment, and management behaviors.

PURPOSE: The purpose of this study was to examine the relationships between maternal environment (child behavior and coping resources), diabetes self-efficacy, diabetes management behaviors, and child glycemic control. METHODS: Study participants were recruited from 3 outpatient clinics in the Midwest and included 41 mothers of children with type 1 diabetes, ages 6 to 10. All participants completed the following measures: Coping Resources Inventory, Behavioral Assessment System for Children-Parent Report, Maternal Self-Efficacy for Diabetes Scale, Diabetes Management Scale-Parent, and 24-hour diabetes behavior recall. Downloaded glucose data and child HgbA1c were obtained by chart review. Stepwise multiple regression was used to determine the influence of maternal environment on maternal diabetes self-efficacy and diabetes management behavior. Pearson product moment correlations were used to determine if relationships existed between maternal self-efficacy, diabetes management behaviors, and child metabolic control. RESULTS: Coping resources contributed significantly to mothers' diabetes self-efficacy. No significant relationship was found between the mothers' environment and diabetes management behavior. Self-efficacy did not predict maternal diabetes management behaviors. The blood glucose testing and maternal recall of diabetes behaviors were correlated to metabolic control. CONCLUSIONS: Mothers with coping resources felt more confident in managing their children's diabetes. Child behavior did not influence a mother's diabetes management behaviors. Mothers who were consistent in their diabetes management behaviors had children in better metabolic control. More information is needed to determine what mothers view as barriers in providing diabetes care for their children.

International Family Nursing Association: toolkit of resources for caring for refugee/migrating families / Asociación Internacional de Enfermería de Familia: herramienta con recursos para atención a familias de migrantes o refugiados / Associação Internacional de Enfermagem da Família: ferramenta com recursos para cuidados a famílias de migrantes ou refugiados

ABSTRACT Objective: To report the experience of the International Family Nursing Association (IFNA) Practice Committee on developing a Toolkit of resources to care for refugee/migrating families as a response to the global migration and refugee crisis. Method: Qualitative and descriptive study, experience report, which describes the development of a toolkit of resources for caring for refugee/migrating families. Results: The development of this Toolkit of resources to care for refugee/migrating families is supported by current literature related to family-centered evaluation and intervention, culturally sensitive practice based on family strengths; statements of positioning on immigrant and refugee families; and nursing and health organizations that addressed the health of the refugee family. Conclusions: The dissemination of the resources available in the Toolkit can support nursing practices, drive qualified approaches to assessments and interventions, capable of promoting family resilience as they adapt, providing well-being, and leading to the healing of traumas and adversities experienced by families in the process of migration or refuge.

RESUMEN Objetivo: Informar la experiencia del Comité de Prácticas de la Asociación Internacional de Enfermería de Familia respecto del desarrollo de una herramienta con recursos para atención de familias de migrantes o refugiados como respuesta a la crisis mundial de ambos grupos. Métodos: Estudio cualitativo y descriptivo. Informe de experiencia describiendo el desarrollo de una herramienta con recursos de atención a familias de migrantes o refugiados. Resultados: El desarrollo de la herramienta se fundamentó en literatura actual relativa a la evaluación e intervención centrada en la familia, práctica culturalmente sensible basada en los puntos fuertes familiares; en declaraciones indicando posición sobre las familias de migrantes o refugiados; y en organizaciones de enfermería y sanitarias que abordaron la salud de las familias refugiadas. Conclusiones: La difusión de los recursos disponibles en la herramienta puede ayudar en las prácticas de enfermería, impulsar el uso de abordajes adecuados en evaluaciones e intervenciones, y promover la resiliencia en las familias mientras enfrentan el período de adaptación, brindando bienestar y apuntando a sanar traumas y adversidades enfrentadas por las familias en su proceso de migración o refugio.

RESUMO Objetivo: Relatar a experiência do Comitê de Práticas da Associação Internacional de Enfermagem da Família em relação ao desenvolvimento de uma ferramenta com recursos para os cuidados a famílias de migrantes ou refugiados como resposta à crise mundial de migrantes e refugiados. Métodos: Estudo qualitativo e descritivo. Relato de experiência que descreveu o desenvolvimento de uma ferramenta com recursos para os cuidados a famílias de migrantes ou refugiados. Resultados: O desenvolvimento dessa ferramenta foi embasado na literatura atual relacionada a avaliação e intervenção centrada na família, uma prática culturalmente sensível baseada nos pontos fortes familiares; em declarações que indicavam o posicionamento sobre as famílias de migrantes ou refugiados; e em organizações de enfermagem e saúde que abordaram a saúde da família refugiada. Conclusões: A disseminação dos recursos disponíveis na ferramenta pode auxiliar nas práticas de enfermagem, estimular o uso de abordagens adequadas em avaliações e intervenções e promover a resiliência das famílias enquanto elas passam pelo período de adaptação, proporcionando, assim, bem-estar e levando à cura de traumas e adversidades enfrentados pelas famílias no processo de migrar ou refugiar-se.

The process of disclosing HIV serostatus between HIV-positive mothers and their HIV-negative children.

The current study explores the impact of HIV disease on mothers as they face the task of balancing their own physical and psychological needs with the needs of their families as well as the additional burden of deciding whether to disclose their HIV status to their children. Qualitative interviews were conducted with 35 women and 19 children 10-18 years of age. Mothers were interviewed about the experience of being an HIV-positive mother and issues regarding disclosure. Children were also interviewed about the experience of having a mother who is HIV-positive and issues regarding disclosure. The decision to disclose was dependent on the child's developmental level, the degree of the mother's illness, and in some cases this decision was taken from mothers when someone else disclosed their HIV status to their children. Positive aspects of disclosure from the mother child dyads included open, honest communication, and closer relationships between mothers and their children. Common negative themes emanating from the data included fear, uncertainty, forced secrecy for fear of being ostracized based on the stigma associated with the disease, behavioral changes in the children, and shifting responsibilities between the mother and the child. Findings of the study suggest that disclosure, and all it entails, remains a vital issue for mothers who are HIV-positive. In addition, the findings reflected that children and their mothers have very different perspectives regarding the process and the effects of disclosure of the mother's HIV status. Clinical implications and recommendations for further research are discussed.