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.     

Validation of the Defining Characteristics of Altered Sexuality Patterns

Human sexuality is a complex and multifaceted phenomenon that encompasses physical, psychological, and social components. The nursing diagnosis altered sexuality patterns labels the human response to alterations in sexuality that occur as the result of various health problems. This validation of the defining characteristics of the diagnosis was based on a substantive theory derived from a qualitative grounded theory study. In the original study, data from 11 adult insulin-dependent diabetics living in a rural area of the Midwest were analyzed and relevant experiences conceptualized through the core concept of transforming and the supporting concepts of valuing self and meeting intimacy needs. The theory was then used as a framework to formulate specific defining characteristics for the nursing diagnosis. A single diagnosis of altered sexuality has emerged that encompasses the perception of change in sexuality as well as the change itself.     

Relational Aggression, Gender, and the Developmental Process

TOPIC: Defining and exploring the concept of relational aggression, or the purposeful intent to inflict harm on another through a social relationship. PURPOSE: This study aims to describe the concept of relational aggression as it has been shaped through recent research, to contrast relational aggression with other types of aggression, and to explore the influence of gender and the formation of a self-concept in the development of relational aggression. SOURCES: A review of the literature from 1969 to 2005 from selected nursing, child development, women's studies, and psychology publications. CONCLUSIONS: Some degree of relational aggression seems to be a normal response to conflict for many girls, from preschool through adolescence; however, more research needs to be conducted to determine at what level, or what subtypes, of relational aggression are predictive of future deviant behavior.     

Imipenem-resistant Pseudomonas aeruginosa infection at a medical-surgical intensive care unit: Risk factors and mortality

Objectives

The aim of this study was to evaluate the risk factors and attributable mortality associated with imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in a medical-surgical intensive care unit (ICU).

Methods

A retrospective case-control study was carried out at a 16-bed medical-surgical ICU in a 780-bed, university-affiliated hospital. All patients admitted from January 1, 2003, to December 31, 2004, who had nosocomial infection caused by IRPA, were included in the study.

Results

Imipenem-resistant P. aeruginosa was recovered from 63 patients during the study period. One hundred eighty-two controls were matched with cases by period of admission, age, and time at risk. Urinary tract (34.9%) and respiratory tract (22.2%) were the main sources of IRPA isolation. In multivariate analysis, a previous stay in the ICU (odds ratio, 3.54; 95% confidence interval [CI], 1.29-9.73; P = .03) was the only independent risk factor for IRPA infection. The in-hospital mortality rate among case patients was 49% (31 of 63) compared with 33% (61 of 182) for control patients (odds ratio, 1.92; 95% CI, 1.07-3.44; P = .02). Thus, we had an attributable mortality of 16% (95% CI, 9.74%-22.3%; P = .03).

Conclusions

Our study suggests that IRPA infections are strongly related to previous ICU stay, and that IRPA infections significantly increase mortality in those critical patients.     

Effects of Communication Skills Training on Parents and Young Adolescents From Extreme Family Types

PROBLEM What were the effects of a communication skills training intervention among a sample of young adolescents and parents who scored in the “extreme” range of the Circumplex Model of Family Systems? METHODS Thirty‐seven young adolescents and a parent (intervention group) participated in communication skills training 2 hours/week for 6 weeks. Their responses on measures of satisfaction with the family system and perceptions of communication were compared with those of 47 young adolescents and a parent who scored in the extreme range but did not participate in the training (control group). FINDINGS Fathers and young adolescents demonstrated no change as a result of the program. Mothers who participated in skills training perceived communication with their young adolescent as more open than control mothers, but became increasingly dissatisfied with the family system. CONCLUSION This universal, community‐based, family‐focused intervention may not be indicated for extreme families.