Attention-Deficit/Hyperactivity Disorder: A Neurodevelopmental Approach

TOPIC. Attention-deficitlhyperactivity disorder is frequently overdiagnosed when a complete evaluation by a knowledgeable clinician is not undertaken. Because of the recent negative media campaign regarding psychos t im ulan t medication, it becomes more imperative that a thorough and accurate evaluation be completed before starting children and adolescents on psychostimulant medications.
PURPOSE. To describe the neurodevelopmental perspective in the assessment and treatment of ADHD.
SOURCES. Published literature and clinical experience.
CONCLUSION. It is useful in practice to conceptualize the dmelopmental path of children with ADHD not as disordered but as delayed, and to build on each child's strengths. The neurodmeloprnental approach provides the child psychiatric nurse a child-focused framework for assessment and development of individualized interventions.     

Post-Traumatic Stress Disorder in Children: Controversies and Unresolved Issues

TOPIC: Questions regarding how severely traumatized children may meet diagnostic criteria for an accurate diagnosis of posttraumatic stress disorder (PTSD), the comorbidity of PTSD with many other psychiatric illnesses, and the possibility that PTSD is not a valid diagnostic formulation as it has been applied to children and adolescents demonstrate that the currently held concept of PTSD may not be operationally sound. PURPOSE: To explore recent empirical studies to demonstrate the current state of controversy and postulate future direction of the conceptual framework. SOURCES: Selected published literature. CONCLUSIONS: PTSD in children and adolescents, as it is popularly understood as a conceptual framework, is found to be undergoing a conceptual metamorphosis.     

Adjustment Difficulties of Adolescents With Sickle Cell Disease

TOPIC: The psychosocialfactors that affect adolescents with sickle cell disease (SCD). PURPOSE: To explore whether specific psychosocial factors can provide clues to the future adjustment of this population. SOURCES: Ovid Web, Medline, Psychinfo, and CINAHL databases for the years 1997 to 2001. CONCLUSIONS: Promoting effective psychosocial functioning is as important as managing the medical aspects of SCD, yet this is an area of care that is commonly overlooked. Nurses, therefore, have an opportunity to have a significant impact on the lives of adolescents with SCD if they intervene in ways to promote both biological and psychosocial adjustment.     

Modification of the Diagnostic Content Validity Model

Diagnostic content validation of nursing diagnoses is a recommended means to confirm the defining characteristics necessary to establish a specific nursing diagnosis. The diagnostic content validity model has been used in numerous studies to develop lists of major and minor defining characteristics recommended by experts as being present in patients with specific diagnoses. The authors provide an overview of the diagnostic content validity model, review the meaning and purposes of content validity, discuss problems with information processing, and suggest revisions to the diagnostic content validity model. Incorporation of these changes may improve the usability of nursing diagnoses in clinical practice, education, and research.