Subject(s)
Antipsychotic Agents/therapeutic use , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Attention Deficit and Disruptive Behavior Disorders/nursing , Nurse Practitioners , Adolescent , Antipsychotic Agents/adverse effects , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Combined Modality Therapy , Double-Blind Method , Evidence-Based Medicine , Female , Humans , Male , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Beliefs have been found to have an effect on how people deal with illness. Therefore, knowing healthcare practitioners' beliefs about specific high frequency illnesses are vital when caring for vulnerable populations such as school-age children with chronic illnesses or disorders. AIM: To psychometrically test the Iceland Health Care Practitioner Illness Beliefs Questionnaire for healthcare professionals who are working with families of school-age children with asthma and attention deficit/hyperactivity disorder. DESIGN: The Iceland Health Care Practitioner Illness Beliefs Questionnaire is a 7-item Likert-type instrument with four additional open-ended questions that was developed from the Iceland Family Illness Belief Questionnaire. The questionnaire is designed to measure a provider's beliefs about their understanding of the meaning of the illness situation for families. The questionnaire was administered to 162 school nurses in Iceland and the state of Minnesota. METHOD: Two condition-specific versions of the Iceland Health Care Practitioner Illness Beliefs Questionnaire were developed in this study: one to measure beliefs about families of children with asthma and one to measure beliefs about families of children with attention deficit hyperactivity disorder. Higher scores on the questionnaire indicate that healthcare professionals are more confident in their illness beliefs. After initial development, the questionnaire was translated into English. Participants completed the questionnaire using an online survey platform and parallel study procedures in both countries. RESULTS: Based on exploratory factor analysis using principal component analysis, the Iceland Health Care Practitioner Illness Beliefs Questionnaire was found to have a one-factor solution with good construct validity (Cronbach's α = 0.91). Confirmatory factor analysis supported the one-factor solution (Cronbach's α = 0.91). CONCLUSION: This instrument is a promising tool for measuring illness beliefs among healthcare practitioners in clinical and research settings.
Subject(s)
Asthma/psychology , Attention Deficit and Disruptive Behavior Disorders/psychology , Attitude to Health , Chronic Disease/nursing , Chronic Disease/psychology , Health Personnel/psychology , Health Personnel/statistics & numerical data , Adolescent , Adult , Aged , Asthma/nursing , Attention Deficit and Disruptive Behavior Disorders/nursing , Child , Female , Humans , Iceland , Male , Middle Aged , Minnesota , Psychometrics , Reproducibility of Results , School Nursing , Students , Surveys and Questionnaires , Translations , Young AdultABSTRACT
BACKGROUND: Self-help parenting interventions have been shown to be effective in the management of children with attention-deficit/hyperactivity disorder (ADHD) and may be useful when there are barriers to face-to-face therapist-led parent trainings. Previous studies indicate that behavioral interventions might be a useful adjunct to medication in children with residual ADHD symptoms, and regarding comorbid oppositional symptoms and multiple domains of functional impairment. In the present study, we examined whether a telephone-assisted self-help (TASH) parenting behavioral intervention (written materials plus telephone counseling) enhanced the effects of methylphenidate treatment in children with ADHD. METHODS: In this randomized controlled trial, parents of 103 school-aged children with ADHD and residual functional impairment despite methylphenidate treatment were randomly assigned to either the enhancement group, which received the TASH intervention as adjunct to routine clinical care (including continued medication), or to the active control group, which received routine clinical care only (including continued medication). Parent-completed outcome measures at baseline and at 12 months (postassessment) included functional impairment, ADHD symptoms, oppositional defiant disorder (ODD) symptoms, parenting behavior, and parental satisfaction with the intervention (ClinicalTrials.gov: NCT01660425; URL: https://clinicaltrials.gov/ct2/show/NCT01660425). RESULTS: Intention-to-treat analyses of covariance (ANCOVAs), which controlled for baseline data, revealed significant and moderate intervention effects for ODD symptoms and negative parenting behavior at the postassessment, whereas per-protocol analyses additionally showed significant and moderate effects on functional impairment (primary outcome). Parents expressed high satisfaction with the program. CONCLUSIONS: The TASH program enhances effects of methylphenidate treatment in families who complete the intervention. The discontinuation rate of about 30% and comparison between completing and discontinuing families suggest that the program may be more suitable for families with a higher educational level and fewer additional stresses.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/therapy , Behavior Therapy/methods , Central Nervous System Stimulants/pharmacology , Methylphenidate/pharmacology , Outcome Assessment, Health Care , Parenting , Telephone , Adult , Attention Deficit Disorder with Hyperactivity/therapy , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Attention Deficit and Disruptive Behavior Disorders/nursing , Child , Female , Humans , MaleSubject(s)
Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/therapy , Breathing Exercises/nursing , Impulsive Behavior/therapy , Students/psychology , Adolescent , Attention Deficit and Disruptive Behavior Disorders/psychology , Breathing Exercises/psychology , Combined Modality Therapy , Education , Health Education/methods , Humans , Impulsive Behavior/nursing , Impulsive Behavior/psychologyABSTRACT
The following case study is presented to highlight the importance of consistency in identifying and treating oppositional defiant disorder in a pediatric patient with a life-threatening medical illness. A pediatric transplant patient's oppositional behaviors are described, as well as the educational behavioral training program provided to the patient's caregivers and medical staff. As a result of the training, the patient engaged in less oppositional behavior, was more cooperative and pleasant with staff, and was more compliant with her treatment. Subjective reports from caregivers indicated that the training with its emphasis on consistency effectively reduced the patient's symptoms and enhanced the caregivers' ability to care for the patient.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/psychology , Child, Hospitalized/psychology , Multiple Organ Failure/nursing , Patient Compliance , Child , Female , HumansSubject(s)
Attention Deficit and Disruptive Behavior Disorders/drug therapy , Disruptive, Impulse Control, and Conduct Disorders/drug therapy , Mood Disorders/drug therapy , Psychotropic Drugs/administration & dosage , School Nursing/methods , Attention Deficit and Disruptive Behavior Disorders/nursing , Child , Disruptive, Impulse Control, and Conduct Disorders/nursing , Humans , Male , Mood Disorders/nursingABSTRACT
The purpose of this qualitative descriptive study was to describe techniques nurses use to successfully manage disruptive behavior (DB) of colleagues. DB is any inappropriate behavior, confrontation, or conflict, ranging from verbal abuse to physical and sexual harassment. Nine RNs who had successfully managed DB in a nurse colleague participated in individual interviews. All participants felt it was important to confront in private unless patient safety was at risk. Participants' described a deliberate approach that included delaying confrontation, approaching the colleague calmly, and acknowledging the colleague's point of view. Responses to the confrontation were positive. Participants also reported that the ability to confront DB improved their practice.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/nursing , Interprofessional Relations , Nursing, Team , Workplace , Assertiveness , Communication , Conflict, Psychological , Dissent and Disputes , Female , Humans , Inservice Training , Interview, Psychological , Negotiating , Patient Safety , Privacy , Sexual Harassment , Students, Nursing/psychology , Violence/prevention & control , Violence/psychologyABSTRACT
BACKGROUND: People with learning disabilities can disrupt mealtimes with non-cooperative, aggressive and self-injurious behaviours that challenge other people to tolerate and manage them. These behaviours appear to arise because the proximity of other people, and the heightened activity and noise of a dining room, causes anxiety and agitation. AIM: To examine how delivering calming background music via headphones affected anxiety-driven behaviours that disrupted mealtimes. METHOD: A sample of 30 adults with mild, moderate or severe learning disabilities were videotaped during mealtimes on two consecutive days. On the first day, half the group ate without any calming music while the other half sat opposite them wearing earphones and listening to calming music. On the second day, the non-music and music groups swapped around. RESULTS: Of the participants who tolerated the earphones, only three showed disruptive behaviour; all three had been sitting at the table waiting for their food. With so few examples, meaningful inferential analysis was not possible. However, there were signs that calming music had a positive effect on disruptive mealtime behaviours. It eliminated physical harm, complaining and verbal repetition in one person, and stopped another from shouting/swearing. It also reduced the incidence of shouting/swearing, restlessness and vocalising. CONCLUSION: Calming music and reduced waiting at tables for food may reduce disruptive behaviours.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/therapy , Behavior Therapy/methods , Feeding Behavior/psychology , Learning Disabilities/therapy , Music Therapy/methods , Adult , Aged , Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/psychology , Female , Humans , Learning Disabilities/nursing , Learning Disabilities/psychology , Male , Middle AgedABSTRACT
BACKGROUND: Despite a U.S. prevalence of 9%, less than 25% of depressed adolescents receive treatment because of time constraints in clinical practice and lack of mental health providers available to deliver it. OBJECTIVE: To assess the feasibility and effects of a brief manualized seven-session cognitive-behavioral skills building intervention entitled COPE (Creating Opportunities for Personal Empowerment) delivered to 15 depressed adolescents in routine 30-minute mental health medication management outpatient visits. STUDY DESIGN: A preexperimental one group pre- and posttest design was used. RESULTS: Adolescents reported significant decreases in depression, anxiety, anger, and destructive behavior as well as increases in self-concept and personal beliefs about managing negative emotions. Evaluations indicated that COPE was a positive experience for teens and parents. CONCLUSION: COPE is a promising brief cognitive-behavior therapy-based intervention that can be delivered within 30-minute individual outpatient visits. With this intervention, advanced practice nurses can work with practice time limitations and still provide evidence-based treatment for depressed teens.
Subject(s)
Ambulatory Care , Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/nursing , Depressive Disorder, Major/psychology , Psychotherapy, Brief/methods , Adolescent , Advanced Practice Nursing , Anger , Antidepressive Agents/therapeutic use , Anxiety Disorders/nursing , Anxiety Disorders/psychology , Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/psychology , Combined Modality Therapy , Delivery of Health Care , Evidence-Based Nursing , Feasibility Studies , Humans , Internal-External Control , Manuals as Topic , Personality Inventory , Self Concept , Treatment OutcomeSubject(s)
Adaptation, Psychological , Attention Deficit Disorder with Hyperactivity/nursing , Attention Deficit Disorder with Hyperactivity/psychology , Mother-Child Relations , Mothers/psychology , Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child, Preschool , Defense Mechanisms , Family Conflict/psychology , Germany , Humans , Infant , Interview, Psychological , Male , Parenting/psychology , Self-Help Groups , Sibling Relations , Social Stigma , Social SupportSubject(s)
Aggression/drug effects , Antipsychotic Agents/adverse effects , Attention Deficit and Disruptive Behavior Disorders/nursing , Cooperative Behavior , Drug Monitoring/nursing , Interdisciplinary Communication , Nurse Clinicians , Nursing Assessment/methods , Risperidone/adverse effects , Antipsychotic Agents/therapeutic use , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Child , Humans , Male , Patient Education as Topic , Quebec , Risperidone/therapeutic useABSTRACT
El TDAH se caracteriza por una serie de comportamientos que interfieren en el óptimo desarrollo evolutivo del niño, tanto a nivel cognitivo como de relación con la familia e integración con el resto de compañeros de su edad. Su prevalencia se estima en torno al 7%. El 80% de esos niños seguirá teniendo problemas en la adolescencia y entre el 30-65% en la edad adulta. Para diagnosticarlos se requiere, además de la exploración, entrevista/s con el profesorado, la familia y el propio niño, y una evaluación de los diversos informes (tests) elaborados por cada una de las partes implicadas. En los casos difíciles se recomienda el abordaje conjunto de pediatra, neurólogo, psiquiatra infantil y psicólogo clínico o neuropsicólogo, y psicopedagogo. Ha demostrado mayor efectividad el tratamiento multimodal: combina el farmacológico, psicológico y psicopedagógico, y en él es fundamental el rol de la familia y profesorado. La Cartera de Servicios de Atención Primaria contempla revisiones periódicas, enmarcadas dentro de los Programas de Atención al Niño Sano, a todos los niños y adolescentes. En esas revisiones la actuación de enfermería es muy relevante al desarrollar una valoración exhaustiva que permita colaborar en la detección precoz y seguimiento de esta patología. El presente artículo pretende facilitar esa actividad a todas las enfermeras del ámbito de Atención Primaria, principalmente a las de pediatría(AU)
Attention deficit hyperactivity disorder (ADHD) is characterized by a series of behaviors which interfere with the optimal evolutionary development of a child, at the cognitive level as well as in his/her relations with his/her family and integration with other children in his/her age group. An estimated 7% of children have this disorder. 80% of these children will continue to have problems during adolescence while 30 to 65% show symptoms as adults. Correct diagnosis requires, besides an exploration, an interview/s with teachers, family and the child and an evaluation of diverse tests designed for each of the implicated parties. For difficult cases, it is recommended there be a combined evaluation by pediatric, neurologist, child psychiatrist, clinical psychologist or neuropsychologist, and psycho-pedagogue. A multi-modal treatment has proven more effective; this combines pharmacological, psychological and psycho-pedagogical aspects and in this approach, the role of family and educators is fundamental. Primary Health Care Services Protocol contemplates periodical revisions, included in the Program to Attend to Healthy Children, which covers all children and teenagers. The role of nurses in these revisions is quite relevant to develop an exhaustive evaluation which enables collaboration in precocious detection and follow-up for this pathology. This article hopes to facilitate this activity to all nurses involved in Primary Health Care, especially in pediatrics(AU)
Subject(s)
Humans , Male , Female , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/nursing , Parent-Child Relations , Community Health Nursing/methods , Community Health Nursing/statistics & numerical data , Community Health Nursing/trends , Community Health Services/methods , Primary Health Care , Parents , Combined Modality Therapy/methods , Combined Modality Therapy/trends , Attention Deficit and Disruptive Behavior Disorders/epidemiology , Combined Modality TherapySubject(s)
Sleep Wake Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/etiology , Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/therapy , Behavior Therapy , Child , Child, Preschool , Diagnosis, Differential , Humans , Infant , Nursing Assessment , Risk Factors , Sleep Wake Disorders/etiology , Sleep Wake Disorders/therapyABSTRACT
The following article provides the authors' definition of complex care patients. It is based on what they have learned about these special patients from the literature and from their personal clinical experiences. When I received this article for review, I decided to do a literature search on the term complex care patient and had a difficult time finding relevant articles. I asked a wonderful librarian from the Boston Children's Hospital, Alison Clapp, to help me with the search, and she had to maneuver through a maze of clinical subheadings. She described the search as "a difficult one." It is ironic that the search for information pertaining to these patients mirrors the complexity of care that they require from us. Are complex care patients the same as complex patients? The insertion of the word care may make a difference: You decide. There are complex patients who challenge us technically and intellectually, and then there are those who require even more from us--they challenge us technically, intellectually, physically, emotionally, and spiritually. The term complex care patient encompasses all these care dimensions. I think it is an excellent choice of words to make us consider what we are increasingly expected to do--and how we cannot do it alone.--Maura MacPhee, RN, PhD, Clinical Practice Column Editor.
Subject(s)
Chronic Disease/nursing , Patient Care Planning/organization & administration , Pediatric Nursing/organization & administration , Adolescent , Attention Deficit and Disruptive Behavior Disorders/etiology , Attention Deficit and Disruptive Behavior Disorders/nursing , Chronic Disease/epidemiology , Chronic Disease/psychology , Communication , Comorbidity , Continuity of Patient Care , Decision Trees , Family/psychology , Humans , Length of Stay , Male , Neurodegenerative Diseases/complications , Neurodegenerative Diseases/nursing , Nurse's Role , Nursing Assessment , Nursing Process , Organizational Innovation , Organizational Objectives , Patient Readmission , Planning Techniques , Social SupportSubject(s)
Attention Deficit and Disruptive Behavior Disorders/nursing , Child Advocacy , Nurse Practitioners , Nurse's Role , Pediatric Nursing/methods , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Humans , Mass Screening , Patient Care Team , Referral and ConsultationSubject(s)
Attention Deficit Disorder with Hyperactivity/nursing , Adolescent , Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/nursing , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child Behavior Disorders/classification , Child Behavior Disorders/diagnosis , Child Behavior Disorders/nursing , Diagnosis, Differential , Humans , Interview, Psychological , Male , Nursing Diagnosis/methods , Personality Assessment , Practice Guidelines as Topic , Surveys and Questionnaires , Video RecordingABSTRACT
A 32-bed Behavior Management Unit was opened in a long-term care facility to care for dementia patients who exhibit aggressive, agitated, or disruptive (AAD) behaviors. The purpose of the study was to evaluate the effectiveness of the Behavior Management Program (BMP) in decreasing such behaviors. The sample consisted of all patients (N = 32) who resided in the unit for at least 3 months. The Nursing Home Behavior Problem Scale (NHBPS) was used to collect data. Hypothesis 1, predicting participation in the BMP would decrease the total number of AAD behaviors was supported, with a significant decrease from the baseline to 6-month measurements. Hypothesis 2, predicting participation in the BMP would decrease the frequency of occurrence of specific AAD behaviors was supported, with 7 behaviors being significantly reduced by 6 months. Nurses in long-term care often treat patients with AAD behavior. Because staff members on general long-term care units and even in dementia units may not be experts in caring for patients with AAD behaviors, the implications of this study might be helpful. The interventions that were effective in reducing AAD behaviors included verbal distraction, time-outs, activity diversion, getting to know the patient well, and managing the environment.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/prevention & control , Behavior Therapy , Dementia/psychology , Adult , Aged , Aggression , Alzheimer Disease/psychology , Attention Deficit and Disruptive Behavior Disorders/nursing , Dementia/nursing , Female , Humans , Male , Middle Aged , Psychomotor Agitation , Skilled Nursing FacilitiesABSTRACT
This study is the first part of a larger research project concerned with disruptive behaviour and the use of physical restraints on elderly nursing home residents. This paper is focused on the types and prevalence of disruptive behaviour among elderly residents, nurses' experiences and the types of nursing interventions employed. Data was collected from nurses of varying qualifications (n = 173) in seven Swiss nursing homes by using a questionnaire. The most frequent behavioural problems reported by nurses were mobility, incontinence, getting dressed, verbal communication, passivity, withdrawal and continual requests. Nurses found physical aggression, continual shouting and verbal abuse the most difficult to manage with. The results also indicated that experiences varied between nurses. In particular, nursing staff always considered disruptive behaviour more disruptive against other residents rather then against themselves. The most frequently used interventions against disruptive behaviour were considering residents' wants and needs, getting close, adjustment to residents' background and organisation of activities. Physical and chemical restraints were also used.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/nursing , Geriatric Nursing/methods , Nursing Homes , Restraint, Physical , Adult , Aged , Attention Deficit and Disruptive Behavior Disorders/prevention & control , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , SwitzerlandABSTRACT
Nurses may find themselves in a home situation where a child demonstrates characteristics of a child with ODD. While the nurse is not in the home to provide therapy for the child, it may be evident that the parents need help in determining an appropriate plan of action. While it is not the role of the nurse to diagnose the child, the nurse who is aware of the symptoms of ODD may play a very significant role in assisting the parents in dealing therapeutically with the child.
