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.     

壳聚糖/聚乙二醇琥珀酸酯薄膜的制备及其与肌成纤维细胞的相容性

目的：制备防粘连壳聚糖/聚乙二醇琥珀酸酯薄膜并观察其与肌成纤维细胞的相容性。方法：实验于2006-05/11在南方医科大学附属珠江医院中心实验室完成。实验材料：在透析后的壳聚糖与聚乙二醇琥珀酸酯或聚乙二醇共混后置入冻干机冻干制得壳聚糖/聚乙二醇琥珀酸酯薄膜或壳聚糖/聚乙二醇膜，并将新生2～5d的SD大鼠骨骼肌成纤维细胞种植于膜片上。实验评估：①MTT法测定肌成纤维细胞接种在不同膜片上的吸光度值，计算相对贴附率。相对贴附率=不同膜的A490nm/培养板的A490nm×100%。②MTT法测定肌成纤维细胞在不同膜片上的生长1，5d后的吸光度值。③相差显微镜下观察肌成纤维细胞的生长形貌。结果：①肌成纤维细胞在不同膜片上的贴附率：肌成纤维细胞在壳聚糖/聚乙二醇琥珀酸酯薄膜上能良好黏附、增殖，而在壳聚糖/聚乙二醇膜、壳聚糖膜上黏附性差。联合培养12h，5d后MTT法结果显示，壳聚糖/聚乙二醇琥珀酸酯组的A值分别为0.074±0.009，0.141±0.031，分别为壳聚糖组的6.17倍和6.13倍（P〈0.05）。②肌成纤维细胞的生长特性：肌成纤维细胞在壳聚糖/聚乙二醇琥珀酸酯膜上的活性最高，增殖能力最强，增长速度最快，其次为壳聚糖/聚乙二醇膜，但两者差异无显著性意义（P〉0.05），而细胞在壳聚糖膜上的增殖能力较低，膜上细胞数目较少，与其他组比较差异有显著性意义（P〈0.05）。③肌成纤维细胞与不同膜片联合培养1，5d时的生长形貌：壳聚糖膜上细胞未贴壁生长，为透明的圆球形，呈游离状态，未能很好舒展，且有些皱缩，生长活力也不旺盛;细胞与壳聚糖/聚乙二醇膜、壳聚糖/聚乙二醇琥珀酸酯膜片联合培养的生长情况要明显好于壳聚糖膜，细胞相互融合成片，多呈长梭形，细胞间隙狭窄，紧密排列成束，成指纹状结构且聚集生长的趋势也更明显。结论：将接支琥珀酰基的聚乙二醇与壳聚糖共混组成的网状系统改进了膜片的力学性能，提高了膜片的柔韧性，使其成膜性更好;壳聚糖/聚乙二醇琥珀酸酯薄膜具有良好的生物相容性，肌成纤维细胞在壳聚糖/聚乙二醇琥珀酸酯薄膜上的黏附及生长情况明显好于壳聚糖薄膜。     

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.     

Ethical Decision-Making in Paradoxical Intervention A Model for Practice

The ethical frameworks of situation ethics and bioethical decision-making are used to analyze decision-making in treatment choices of the clinical nurse specialist in the role of psychotherapist. Paradoxical intervention is the treatment choice considered. The ethical issues regarding the use of paradoxical techniques are reviewed and the decision model is applied to therapy with a mother and son to illustrate the process of ethical decision-making.     

Patterns of Depressive Symptoms in Children

PROBLEM: Depressive symptoms in children have been linked to recurrent problems with depression, school problems, and risky health behaviors. Adolescent girls report depressive symptoms three to four times more frequently than adolescent boys. Few studies, however, have examined gender-related depressive symptoms in younger, school-aged children. METHODS: In the present study, gender differences in depressive symptoms in children ages 10-12 years were explored using the Children's Depression Inventory (CDI) with a convenience sample of 122 suburban middle-class public school fifth and sixth graders. FINDINGS: A distinct pattern of depressive symptom expression was found with girls reporting more internalizing and more negative self-esteem, and boys reporting more externalizing and more school problems. CONCLUSION: These findings suggest that despite similarities on a total depressive symptom score, there are distinct gender differences in depressive symptom expression that are identifiable before adolescence and may be associated with normative development.     

Exploring the Grief of Adolescents After the Death of a Parent

This study explored the grief of 26 adolescents after the death of a parent during the subjects' adolescent years. Data collection involved a one-time semi-structured interview. In addition, the adolescents were asked to write and draw about death. The study identified variables and themes that appeared to have possible significance for how adolescents coped. The study conclusions were that adolescents do grieve differently from children and differently from adults; younger adolescents even grieve differently from older adolescents. No discernible differences in grieving were ascertained on the basis of sex, type of death, or prior loss experiences. The one adolescent who was perceived as grieving in an adaptive manner had the advantage of open communication with family members, had closure with the parent now dead, had seen the parent when dead, and had been involved with the rituals surrounding the death. Implications for future research and recommendations for adults involved with adolescents are included.     

Planning a Continuum of Care in Child Psychiatric Nursing A Collaborative Effort

A guide for providing a continuum of care for children in need of psychiatric services from the least restrictive services (outpatient care), to a moderately restrictive setting (partial hospitalization), to the most restrictive setting (inpatient care) is described. Movement along the continuum is facilitated by the nurse case manager. Concepts from three theoretical frameworks are integrated to define goals, criteria, and expected outcomes for each level of care along the continuum. They are Neuman's (1982) systems model for nursing practice and education, Caplan's (1961) model for primary prevention of mental disorders in children, and Frances, Clarken and Perry's (1984) differential therapeutics. The continuum provides a guide for nurses and other health care providers to achieve high quality care as economically as possible. It also enhances self-care and self-responsibility for families of disturbed children by offering a sequential graded system of care along the health-illness continuum.