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.     

Sibling Incest

Child sexual abuse has gained national attention within the last decade. The most reported and studied form of intrafamilial child sexual abuse is father-daughter incest However, it is believed that sibling incest may be a more widespread form of intrafamilial sexual abuse. Yet, it has received the least amount of documentation and study. The purpose of this article is to describe sibling incest, including family dynamics. Implications for nursing intervention and research are proposed.     

Nursing Diagnoses and Interventions for Post-Acute-Phase Battered Women

PURPOSE. To identify nursing diagnoses and interventions applicable for post-acute-phase battered women.
METHODS. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection.
FINDINGS. Fifty-three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data.
CONCLUSIONS. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.     

Adolescent Perceptions of Relevant Social Problems

PROBLEM: Social problems can be a significant stressor for adolescents. Disturbed youth often experience negative outcomes to social problems, solve problems poorly, and display distortions in reasoning about social problems. METHODS: A series of focus groups was conducted with adolescents (N = 36), and the data was analyzed inductively. Activities to increase the rigor of the study data (establishing credibility, trustworthiness, and transparency) were incorporated into the phenomenological research design. FINDINGS: Five social problem themes with critical attributes were perceived to be relevant to teenagers in today's society. CONCLUSIONS: Adolescents' social problems shift in response to a changing society. Findings from this study can be used to help target assessments and treatment plans when working with disturbed youth.     

Nurse Practitioners' Use of Nursing Diagnoses

"Where are We Now?" is an occasional feature in Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation.     

Trends in umbilical cord care: Scientific evidence for practice

To provide an increasing body of knowledge related to umbilical cord care, a literature review was conducted to study the evolution of umbilical cord care, to evaluate the scientific evidence used to guide practice changes, and to make recommendations for current practice. Historically, there has been a wide range of inconsistent practices related to umbilical cord care that have included a variety of cleansing agents and techniques. The findings of this literature review indicate that the current standard of umbilical cord care may be based on historic practices and traditions rather than scientific investigation and justification. There appears to be little support for continued alcohol use. Yet, insufficient evidence is available to support an immediate change in the standard of care from topical antimicrobial treatment of the umbilical cord to natural healing. Further research is recommended to evaluate natural healing and to establish evidence-based recommendations for practice.