The Need for Operational Definitions for Defining Characteristics

Although much attention has focused on the validation of denning characteristics for nursing diagnoses, equal attention has not been devoted to the development of operational definitions for defining characteristics. Operational definitions, however, provide a reference for determining whether defining characteristics are present in patients who participate in clinical validation studies. Validation of nursing diagnoses emerges from occurrence of the diagnostic label in clinical practice. Operational definitions provide the bridge between incidental observation and scientific validation of nursing diagnoses.     

Group Play Therapy Using an Interaction Model with Delayed Regressed Behaviors in Children

This article gives an overview of individual play therapy and relates the concepts of individual play therapy to group play therapy. A new model of group play therapy, an interactional model, is introduced. The article provides basic guidelines for beginning play therapists. An actual group is described and specific interventions for problems are suggested.     

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.     

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.     

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.