Childhood Primary Care Services in Wyoming

Provision of childhood primary care services and differences between types of providers (family practice physicians, pediatricians, nurse practitioners, and physicians' assistants) were explored in this study. A mail survey was conducted in Wyoming using a questionnaire based on the recommendations from the U. S. Preventive Service Task Force. Sixty-one percent of the providers returned questionnaires. While some areas of assessment, screening, and treatment/counseling services were provided at high levels, many were not. Gaps exist particularly in the areas of behavioral and lifestyle assessment and treatment/counseling. Only small differences existed between types of providers. However, nurse practitioners and pediatricians were more likely to report that they followed recommendations, while physicians' assistants were least likely to report that they followed recommendations.     

Validation of the Defining Characteristics of the Nursing Diagnosis Ineffective Airway Clearance

The investigators designed this validation study to determine the defining characteristics of the nursing diagnosis ineffective airway clearance. Using Fehring's Diagnostic Content Validity Model, 546 nurses who care for respiratory clients validated one major and 19 minor defining characteristics. Nine characteristics previously described in the literature were eliminated. Clarification of the defining characteristics of this diagnosis improves communication in practice, education and research.     

Book Review

Performance Breakthroughs for Adolescents With Learning Disabilities or ADD. G. Markel & J. Greenbaum.     

A School-based Primary Prevention Group for Children with Alterations in Health Status

The implementation of primary prevention measures for the positive mental health of children has been identified by psychiatric nursing leaders as a priority for child psychiatric nurses. Promoting positive mental health behaviors in school-aged children is facilitated by establishing a helping relationship within the context of small-group activity situated in the child's natural school setting. The authors describe the theory and process of establishing a time-limited, closed group in a school setting, for 10 children who were experiencing some alteration in health status.     

Child Psychiatric Nursing and the Family

Within the growing body of nursing literature, a relatively new method of inquiry, critical theory, has emerged. Critical theory is used as a framework toward understanding the social realities in which child psychiatric nurses must act when negotiating with family systems. Nursing's predominant view of the family, structural-functionalism, is examined by the use of the dialectic and Habermasian critique.     

The concept of interpersonal pattern in Peplau's Theory of Nursing

Interpersonal pattern, defined as the category in which separate interpersonal acts are linked by similar, defining characteristics, is a critical, data-rich concept that is used in the therapeutic nurse-client relationship. If this concept is studied within the framework of aesthetic knowing in nursing, the processes of deliberate involvement that form the crux of the nurse-client relationship become illuminated. An illustrative case study brings this concept to life by demonstrating the use of interpersonal pattern as the focus of intervention with a frail, elderly woman. In this case study, the nurse practices aesthetic knowing to assess and respond to the woman, and ultimately assist in her forward movement towards optimum function and health. Linkages of this type of intervention to all of nursing practice are made by integrating the use of interpersonal pattern with aesthetic knowing in nursing.