Childhood obesity: nurses' role in addressing the epidemic

Obesity is a significant long-term health problem that is common among children and adolescents in Western countries. Being overweight or obese (extremely overweight) can contribute to type 2 diabetes in childhood and increase the risk of cardiovascular disease in adulthood. Primary prevention of obesity prevents the development of serious secondary complications in adulthood. Nurses can help parents and children by providing nutritional advice and, through weight management programmes, offer strategies for decreasing caloric intake and increasing physical activity. Nurses' actions should always take a whole-family approach because it is challenging for obese children to alter their dietary or physical habits if not supported by their families. Nurses should work with all members of the multidisciplinary team in addressing childhood obesity as it is a major health issue with long-term mobidities.     

Summary of the American Heart Association scientific statement: promoting physical activity in children and youth: a leadership role for schools

Schools have long played an important role in providing students with healthful physical activity. However, the decline in population-level physical activity suggests that schools should play an even greater role in providing and promoting physical activity. Recently, the American Heart Association issued a set of recommendations that, if implemented, would position schools as leaders in helping children and youth become more physically active. This article summarizes an American Heart Association scientific statement on physical activity and the schools that was recently developed by the Association's Council on Nutrition, Physical Activity, and Metabolism in collaboration with the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular Nursing.     

Artificial hydration: the role of the nurse in addressing patient and family needs

When caring for terminally ill patients and their families, nurses are confronted with the subject of terminal dehydration and the question of artificial hydration at the end of life. Terminal dehydration and artificial hydration are still controversial topics of discussion and, to this day, data remain insufficient to reach a final conclusion on the benefits or harm of dehydration in terminally ill patients (Ersek, 2003; Fainsinger, 2008). Nurses, just like physicians, have different attitudes about the usefulness of artificial hydration. Personal and professional experiences, cultural influences, and the place of care, as well as education and available resources, are guiding clinical practice (Morita et al, 2002; Pasman et al, 2004). Since there is no ethically or medically based gold standard, each decision for or against hydration at the end of life needs to be taken on an individual basis. This article reflects on the meaning of dehydration for the patient and their family, and reviews the role of the nurse within the decision-making process. Arguments for or against artificial hydration are illuminated through patient situations which took place in the clinical setting of a hospice. The article further highlights the importance of recognising dehydration in frail and elderly patients, and critically assesses policies that may hinder its optimal palliation in different settings in Switzerland.     

Implementing health promoting nursing: the integration of interpersonal skills and health promotion

Health promoting nursing practice is seen as the way forward for the nursing profession. This paper outlines the meaning of health promotion and distinguishes between a traditional and new paradigm approach. The research examining the extent to which a new paradigm approach is practised demonstrates that, to date, nurses predominantly adopt the traditional approach to health promotion. It is argued that the integration of interpersonal skills and health promotion within nursing curricula is crucial in enabling the transfer of theoretical concepts into practice. The ways in which this integration has been approached within one college of nursing are described. The difficulties encountered in attempting this integration and accomplishing a philosophical shift from a traditional to a new paradigm approach to health promotion are discussed and critiqued. Specifically conflicts that occur at an interpersonal, organizational and societal level are identified and proposed as explanations for the slow implementation of health promoting nursing.     

Health promoting hospitals: the role and function of nursing

Background. In 1986, the World Health Organisation's (WHO) Ottawa Charter for Health Promotion sought to create a framework that conveyed the notion of capacity building, related to specific settings, and a structured process for health promotion action. It provided the platform from which the health promoting hospital movement was later launched. Nearly two decades on, the health promoting hospital (HPH) movement has grown considerably and continues to expand, against the backdrop of having to adapt to the changing needs and demands of clients and the evolving social context of their communities. Many nurses, it is argued here, are often unaware of health promoting hospitals concepts or, when they are, do little to contribute to them. Method. A critical review of the available health promoting hospital and related literature has been conducted for discussion. Findings. The literature revealed that hospitals are being urged to reject practices based purely on health‐limiting and limited biomedical frameworks, in favour of moving towards models based on health promoting hospitals and public health‐orientated hospitals. This requires radical reform that focuses on the social and health policy context of organizations, the socio‐political empowerment of its employers and clients, and the personal/collective positive health and welfare of its employers and clients. Many health service agencies are beginning to emphasize population health within communities as part of a concerted move away from an original primary focus on acute inpatient hospital‐based service provision. Conclusion. Hospitals need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever‐widening community networks of health and social agencies. This requires the commitment of all health care professional groups. Nurses who practice in the hospital setting should be aiming to initiate and promote radical health promotion reform as set out in the health promoting hospital movement. This paper argues that nursing per se could be making much larger inroads and efforts to affect and implement wide‐ranging health promotion activities in hospital organizations. Nurses should view the HPH movement as another opportunity truly to embrace evolving broad‐based health promotion concepts, as a means to forge and own their own health agenda, and also as a means to move beyond the traditional reliance of a limited health education role. Relevance to clinical practice. Hospitals and their employees must be seen to advocate, support and implement wide‐reaching social and community‐based reform, as part of a necessary commitment to ‘seamless’ health care provision. The health promoting hospital movement represents a collective vehicle for enabling such activities. If nurses wish to be at the forefront of current health service strategies they must be seen to embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article.     

Arousing empathy and promoting prosocial behavior toward bereaved peers: Using guided fantasy with elementary school children

The content, structure, and outcome of two classroom presentations devised for fourth- and fifth-grade children are discussed. The focus of the presentations was to convey understanding of the feelings associated with an irrevocable loss, especially a death; to consider what support a classmate might need when experiencing the loss of a brother or sister; and to practice expressing such support by means of writing a letter to a classmate whose sibling has died. At each session the children filled out a questionnaire about feelings associated with the death of a sibling. Answers on the second questionnaire indicated appreciation for the enduring aspect of grief reactions.     

The acquisition of delegation skills: collaboration between education and service.

Many new patient care delivery models are being developed and evaluated. One of the most important skills needed by registered nurses (RNs) to function within these new models is delegation. For many reasons, RNs find it difficult to develop and implement this skill. The authors outline a program that can be used to assist students in the acquisition of delegation behaviors. As a result, students were able to explore and discover their delegation ability while gaining self-confidence in implementing the RN role.     

Parental perceptions of the schools' role in addressing childhood obesity.

As childhood obesity has increased, schools have struggled with their role in this epidemic. Parents with a school-age child in a suburban latchkey program were surveyed regarding their perceptions of childhood obesity, body mass index, and the school's role in prevention and treatment of obesity. More than 80% of participants identified inactivity, poor eating behavior, lack of parental control in what children eat, and eating too much as the main causes of childhood obesity. Parents preferred receiving information about their child's body mass index from the school via a letter from the school nurse. Participants agreed that physical education classes, as well as units on nutrition and weight control, should be present in schools. Parents also supported eliminating junk food machines and offering special low-calorie meals. By supporting these strategies, parents indicated that schools should have a role in childhood obesity. School nurses can advocate for parental preferences in their school district.     

Communication skills intervention: promoting effective communication between nurses and mechanically ventilated patients

Background

Patients in the Intensive Care Unit (ICU) often experience communication difficulties - usually associated with mechanical ventilation - resulting in psychological problems such as anxiety, fear, and depression. Good communication between nurses and patients is critical for success from personalised nursing care of each patient. The purpose of this study is to describe nurses’ experience of a communication skills training intervention.

Methods

A convenience sample of twenty intensive care nurses participated in the study. Data was collected by means of interviews with nurses. Data from the interviews were analysed using qualitative thematic content analysis.

Results

Six themes emerged: (1) acceptance of knowledge and skills developed during workshops; (2) management support; (3) appreciation of augmentative and alternative communication (AAC) devices; (4) change in attitudes; and (5) the need to share knowledge with others and (6) inclusion of communication skills workshop training as an integral part of an orientation programme for all nurses.

Conclusion

The findings of this study indicated that the application of augmentative and alternative communication devices and strategies can improve nurse-patient communication in intensive care units. Therefore, the implementation of communication skills training for intensive care nurses should constantly be encouraged and, indeed, introduced as a key element of ICU care training.

     

Need to know: essential survival skills for the information age

Twenty-five years ago, health care information technology was dramatically different from what it is today. Twenty-five years from now, it promises to be worlds away from what it is today. How good a job has nursing done at keeping up with this exponential change? This article addresses the evolution of technology in health care and nursing's track record of technology expertise. It also discusses the price nursing will pay if it does not keep up with technology and the benefits it can gain if it does.     

行为转变理论在年轻护士沟通技巧培训中的应用

目的 应用行为转变理论（TTM）对5年内规范化培训年轻护士进行沟通技巧培训并评价其效果.方法 采用便利抽样法,对193名5年内规范化培训年轻护士进行问卷调查,了解年轻护士沟通能力及技巧的现状.应用TTM对年轻护士进行沟通能力及技巧的培训,对培训前后年轻护士自我效能感和护士工作满意度情况进行评价.结果 75.65％的年轻护士沟通能力处于中等水平,应用TTM对年轻护士沟通能力和技巧进行培训后,85.49％的年轻护士处于优、良水平;年轻护士的自我效能感得分由（25.84±5.35）分提升到（29.46±5.33）分,差异有统计学意义（t=6.484,P＜0.01）.培训前后护士工作满意度各维度比较差异均有统计学意义（F值分别为8.237,4.594,4.234,5.339;P＜ 0.05）.结论 将TTM用于年轻护士沟通能力培训有助于提升年轻护士自我效能感和工作满意度.     

Preventing youth use of tobacco products: the role of nursing

In the 1997 Youth Risk Behavior Survey (Centers for Disease Control and Prevention [CDC], 1998a), 70.2% of high school students reported cigarette use, 36.4% were current cigarette smokers, and 16.7% reported frequent cigarette use (as measured by more than 20 in the last 30 days). Current tobacco use by all racial and ethnic groups is 42.7% (48.2% male, 36.0% female). Preventing youth tobacco use requires nurses to be active in many different domains. Public health experts agree that tobacco control efforts must target youth, with the goal of preventing tobacco product use and dependence. Nurses need to be actively involved in directing resources and talents toward public awareness and tobacco prevention programs, formulating public policy initiatives to control youth access to tobacco, and initiating cessation programs for youth. Efforts can be targeted at the schools, community, and health care system, as well as the public policy arena and media campaigns.     

Exploring the use of mobile technologies for the acquisition of clinical skills

Mobile learning has the potential to supplement information communication technology (ICT), online learning and the traditional teaching and learning methods to educate practitioners in the clinical practice area. Following the development of several Post Graduate modules of learning for the theory and clinical skills required to undertake the Newborn Infant Physical Examination (NIPE), a small research study was undertaken to combine mobile learning and NIPE. The research study explored the hypothesis that mobile devices could be used in pedagogically effective ways to support and enhance the learning and acquisition of clinical skills in the clinical arena. Participants in the study each received a handheld mobile device (iPod) that had been loaded with several Reusable Learning Objects (RLO) outlining each aspect of the physical examination to be performed. At the end of the module (12 weeks in duration), each participant completed an evaluation questionnaire. Participants confirmed that mobile learning afforded flexibility in time and place of learning and captured their interest in the learning material. This study reports that the use of mobile technology for skill acquisition is creative and innovative, placing learning firmly in the hands of the learner.