A review of paediatric palliative care nursing education in Latin America.

Around the world, children suffering from catastrophic illnesses need quality palliative nursing care. However, unstable economic, social, and political structures in developing nations have delayed the advancement of paediatric palliative care programs in some regions. This systematic literature review primarily focuses on paediatric palliative care in Latin American countries. The aim is to identify existing support structures and possible barriers to paediatric palliative care nursing education. This review provides the background for a proposed collaborative paediatric palliative care nursing education initiative between a children's research hospital in the United States and a Chilean partner site.

Conjoint analysis: using a market-based research model for healthcare decision making.

BACKGROUND: Conjoint analysis is a market-based research model that has been used by businesses for more than 35 years to predict consumer preferences in product design and purchasing. Researchers in medicine, healthcare economics, and health policy have discovered the value of this methodology in determining treatment preferences, resource allocation, and willingness to pay. OBJECTIVES: To describe the conjoint analysis methodology and explore value-added applications in nursing research. METHODS: Conjoint analysis methodology is described, using examples from the healthcare and business literature, and personal experience with the method. IMPLICATIONS: Nurses are called upon to increase interdisciplinary research, provide an evidence base for nursing practice, create patient-centered treatments, and revise nursing education. Other disciplines have met challenges like these using conjoint analysis and discrete choice modeling.

Access to breast cancer screening services for women with disabilities.

OBJECTIVE: To identify barriers to breast cancer screening services encountered by women with physical disabilities. DESIGN: Phenomenologic design using a semi-structured interview guide to explore the experiences of women with disabilities seeking breast cancer screening services. SETTING: Face-to face interviews conducted in the homes of women from the urban and rural mid-south. PATIENTS/PARTICIPANTS: A purposive sample of women with motor or sensory disabilities, age 21 to 65, was recruited for this study based on community type and type and severity of disability. Community collaborators working with people with disabilities identified eligible participants. RESULTS: Although the study focused on breast cancer screening services, women also described financial, architectural, environmental, and attitudinal barriers that affected all of their health care services. Women described poor transportation, heavy doors, and inaccessible exam tables and bathrooms. They felt devalued by their providers and believed that their symptoms were often overlooked. Women with disabilities want to be partners in their own health care. CONCLUSIONS: Women with physical disabilities face both financial and nonfinancial barriers to access that may result in delayed detection and increased risk of poorer outcomes from breast cancer. Providers require education about working with women with disabilities.

The impact of managed behavioral health care on youth in the juvenile justice system.

The purpose of this study was to describe how managed behavioral health care affects youth in the juvenile justice system with behavioral health disorders. A multiple case study consisting of 30 semistructured interviews of officials in the local, state, and federal juvenile justice system was performed. The study found that agreement exists among officials that managed behavioral health care acts as a barrier to behavioral health care for juvenile justice youth. A major conclusion of the study was that the relinquishment of youth custody to the state for the purpose of accessing behavioral services must cease.

Recovery of injured children: parent perspectives on family needs.

OBJECTIVE: To study the broader impact of emotional and financial burdens of injury in children on their families, along with solutions to these problems. DESIGN: Focus groups were conducted to reveal the needs of parents and children after injury. Audiotaped semistructured interviews were conducted by a team of qualitative researchers. SETTING: Tertiary care children's hospital. PARTICIPANTS: Mothers of children who had sustained traumatic injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary of reported themes of experience and suggested interventions. Data were analyzed by using content analysis software. RESULTS: Overall satisfaction with care was high. Parents expressed concerns with communication, access to care, and the transition both within the phases of medical care and from medical care into the community. Consistent financial and social stressors were voiced, along with the need for peer support during all phases of care. CONCLUSIONS: Parents provided valuable insight into their needs after their child's injury. Attention to constructive communication, clarification of the system of care, continued family-centered care, and development of peer support programs may meet the needs of caregivers and therefore facilitate improvement in pediatric injury recovery.