Day 1 :
Keynote Forum
Satoko Tsuru
University of Tokyo, Japan
Keynote: Logical design of the nursing observation for the quality improvement of the pediatric team medicine
Time : 10:35-11:15
Biography:
Abstract:
Keynote Forum
Christine Guarnieri
NYU Winthrop Hospital, USA
Keynote: Navigating colorectal and pancreatic cancer patients in a multidisciplinary cancer center
Time : 11:35-12:15
Biography:
Abstract:
- Pediatric Healthcare | Pediatric Oncology | Pediatric Cardiology | Child Right & Child Safety | Pediatric Bioethics | Pediatric Psychology | Pediatric Gynecology | Pediatric Vaccines | Pediatric Infection & Allergy | Nursing Education & their Innovations | Adult Health Nursing | Surgical Nursing | Healthcare Management | Clinical Nursing | Cardiovascular Nursing | Disaster Nursing
Chair
Vedrana Vejzovic
Malmo University, Sweden
Co-Chair
Huda Al-Alwaisi
Sultan Qaboos University Hospital, Oman
Session Introduction
Christiana Nicolaou
Cyprus University of Technology, Cyprus
Title: Health related quality of life in mothers with children with cancer: A systematic review
Biography:
Christiana Nicolaou joined the Department of Nursing, School of Health Sciences, Cyprus University of Technology in 2007 as Senior Lecturer. Currently, she is an Assistant Professor in Pediatric Nursing (since 2011), elected member of the CUT Senate and elected member of the Council of the Department of Nursing (CUT). She worked as Staff Nurse in Pediatric Unit and Neonatal Intensive Care Unit (Archbishop Makarios Hospital, Nicosia, 1987 - 1994) and in a Gynecological and Midwifery Clinic, Nicosia (1986-1987). She has received her Diploma in General Nursing from School of Nursing, Cyprus (1985), a BSc (Honors) in Professional Studies (Nurse Education) from Anglia Polytechnic University, UK (1997), a Certificate in Teaching and Learning Methodology (Pedagogical Institute of Cyprus, 2001) and her PhD in Epidemiology and Biostatistics from the Cyprus University of Technology (2015). Her area of clinical practice and research is pediatric nursing care and social epidemiology.
Abstract:
Background: Studies among parents of children with cancer have focused on anxiety, depression, or post-traumatic stress, and less so on overall measures, such as health-related quality of life (HRQoL).
Methods: Literature review in Scopus and CINAHL with terms: mothers or carers etc., and child* or adolesc* etc., and cancer or oncolog* etc., and quality of life or HRQoL etc., in 65 combinations. Selection criteria: mothers (or predominately in mixed samples), children aged<18 in active treatment (no palliative), quantitative, some measure of quality of life, comparative (e.g. population norms, or control group) or correlational, or baseline in interventions, English language, prior 2015.
Results: Of 237 studies reviewed in full-text among 2184, 10 fulfilled all criteria: 6 mothers only, 4 mixed with separate results for mothers, and additional 10 with sample of predominately mothers. With the exception of a series of studies from Canada (N>400), most studies had small sample sizes (N<150). European studies originated from limited number of settings. There were single-sample correlational studies (e.g. coping, anxiety, depression, sleep quality), internal comparisons (e.g. single- vs two-parent families, time since diagnosis, or same group longitudinal, etc.,) or external (i.e. mothers of healthy children, or other diagnosis, or population norms). SF-36 was commonly used. In studies with external comparison, quality of life was significantly reduced amongst mothers (or parents) of children with cancer. Despite cross-national heterogeneity, in studies that the SF-36 commonly effect sizes were in the range of 0.5-1 SD for mental health and ~0.5 SD for physical health dimension.
Conclusions: Physical health as well as mental health aspects of the quality of life appears affected in this vulnerable group, highlighting the need to monitor and incorporate QoL as an outcome measure in assessing the effectiveness of psychosocial intervention programs
Abed N Azab
Ben-Gurion University of the Negev, Israel
Title: Effects of analgesics administration, surgical techniques and parental anxiety on hospital length of stay among post-tonsillectomy children
Biography:
Abed N Azab has completed his Bachelor in Nursing degree and PhD in Pharmacology in Ben-Gurion University of the Negev (Israel). His PhD thesis was focused on the study of anti-inflammatory drugs. As a Post-Doctoral Fellow in Wayne State University (Michigan), he investigated the therapeutic mechanisms of mood-stabilizing drugs. Currently, he is an Assistant Professor in the Faculty of Health Sciences in Ben-Gurion University. The major research projects in his lab are: Studying the role of inflammation in the pathophysiology and treatment of mood disorders; searching for novel therapeutic strategies for mood disorders and; issues in pharmacology that are related to nursing practice.
Abstract:
Background: Tonsillectomy is a surgical procedure in which the tonsils are partially or totally removed. Hospital length of stay (HLOS) is an important predictor of resource utilization.
Objective: The present study examined the associations between parental anxiety, surgical technique and analgesic regiment - and HLOS among post-tonsillectomy children.
Materials & Methods: Parents of children planned for tonsillectomy who met the inclusion criteria and signed an informed consent to participate in the study were included. Before surgery, parents completed anonymous questionnaires for demographics and for assessing anxiety. After surgery, medical files were utilized to ascertain the surgical technique used and the analgesics type, quantity and timing of administration. HLOS data was obtained from hospital computerized records. Statistical analyses were performed to evaluate the effect of parental anxiety level, surgical technique, analgesics quantity and scheduling on HLOS.
Results: The study sample included 95 parents. The average age of children was 5.51 years, 65% males. The primary indication for tonsillectomy was obstructive sleep apnea. Partial removal of the tonsils was performed in 66% of cases (85% were done using mono- and bi-polar electrocautery method). Participating parents had low trait anxiety and moderate state anxiety levels. Analgesics were mostly managed according to the child's pain ("as needed" dosing) and not according to a scheduled regiment. Parental anxiety and surgical technique did not significantly affect HLOS. In contrast, analgesic regiment significantly influenced HLOS: children who received scheduled analgesics had a significantly longer HLOS.
Conclusions: Our results suggest that type of analgesic regiment but not parental anxiety or type of surgical technique significantly affected HLOS. Nevertheless, parents had low to moderate anxiety levels, underscoring the need for anxiety-relieving interventions for parents of tonsillectomy-operated children especially on the day of operation.
Nancy Adrianna Garofalo
NorthShore University HealthSystem, USA
Title: OPT-MOM: Oro-pharyngeal therapy with mother’s own milk to protect extremely premature infants against infectious morbidities
Biography:
Nancy A is a Neonatal Nurse Practitioner at the NorthShore University HealthSystem and a Senior Clinician Researcher at the Pritzker School of Medicine, University of Chicago. She received a BSN from Loyola University, an MS in Nursing Administration from Aurora University, an MSN in the Neonatal Nurse Practitioner specialty and also a PhD from Rush University, Chicago IL. Her dissertation introduced the concept of oropharyngeal administration of colostrum into the medical literature, and she is currently leading a multi-center RCT to investigate the immune effects and clinical outcomes of extremely premature infants who receive the OPT-MOM intervention.
Abstract:
Extremely premature infants are born before the last trimester of pregnancy and experience an abrupt cessation of amniotic fluid exposure. Their oropharynx is no longer bathed with protective biofactors, which stimulate the immune system and promote intestinal maturation. Many of these biofactors are highly concentrated in the milk (especially colostrum) expressed by women who deliver extremely premature infants; which suggest an important biological function for facilitating extra-uterine transition. Unfortunately, clinical instability precludes enteral feeding for extremely premature infants in the first days of life. The post-birth fasting leads to intestinal atrophy and abnormal intestinal microbiota which contribute to the pathogenesis of infection. Once started, enteral feeds of mother’s milk are administered via a nasogastric tube, which bypasses the infant’s oropharynx. Oropharyngeal exposure to protective (milk) biofactors does not occur until the infant begins per oral feeds; typically at 32 weeks corrected gestational age. Thus, post-birth oropharyngeal exposure to protective biofactors is delayed for up to 10 weeks for the smallest extremely premature infants; born as early as 22/23 weeks gestation. This deficit has never been addressed in neonatology and may be contributing substantially to prematurity-associated infectious morbidities, including late-onset sepsis and necrotizing enterocolitis. Oropharyngeal therapy with mother’s own milk (OPT-MOM) can serve as an easy, inexpensive oral immune therapy to mimic the protective effects of amniotic fluid exposure for extremely premature infants until per oral feedings can be safely introduced. Current evidence will be presented. Clinical implications and future directions for multidisciplinary research will be discussed.
Fatima Alzahra Abdul Rahman M
International University of Africa, Sudan
Title: Effect of innovative participatory health education program to augment knowledge, attitude and practices of mothers of children with sickle cell anemia
Biography:
Fatima Alzahra Abdul Rahman M has recently had her PhD in Pediatric and Child Health Nursing. Her expertise is in teaching and passion is in improving the health and wellbeing of children specially sicklers. She is a member in Sudan Sickle Cell Anemia center and has attended many training workshops on care and management of sickle cell anemia and integrating palliative care with SCA for nurses and community. She had teaching experience in education institutes and hospitals.
Abstract:
Statement of the Problem: Sickle cell anemia (SCA) is one of the commonest devastating neglected disorders in Sudan particularly in western region in North Darfur State. Most SCA patients are from IDP camps, nomadic tribes with low socioeconomic status and have no real background about the disease. No dedicated center for SCA to provide care for those patients who pose a real financial, physical, psychological burden for affected children and their families.
Purpose: The purpose of this study is to evaluate the effect of an innovative participatory health education program about SCA to augment knowledge, attitude, and practices of mothers of the affected children.
Methodology: A quasi experimental pretest-posttest design was conducted in El Fasher City and three (IDPs) camps. 127 mothers were consecutively selected from El Fasher Hospital general pediatric referral clinic over four months period. Fifteen mother and community outreach members from the same community were trained as peer educators to conduct the health education on SCA for the participants through home visits and community outreach group sessions using simple educational materials prepared for the study. Semi-structured questionnaire used before and after the intervention and six months following the program intervention to assess the knowledge, attitude, and care practices of participants. Data were analyzed by SPSS version 20.
Findings: A statistically significant improvement was found in knowledge, attitude and care practices of caregivers about the disease after the program intervention. Before the intervention, the mean hospitalization rate was 2.3 times in 6 months, where after 6 month from the intervention reduced to 1.8 times.
Recommendations: The use of peer educators from the local community could be an effective approach for increasing knowledge, improving attitudes and practice of care towards SCA.
Ioanna Menikou
Cyprus University of Technology, Cyprus
Title: The effectiveness of non-directive play therapy (NDPT) on children with a medical condition: A scoping review
Biography:
Ioanna Menikou is a PhD candidate at Cyprus University of Technology, School of Nursing. She has completed a two-year Postgraduate course on Thearpeutic Play Skills from The Academy of Play and Child Psychotherapy in collaboration with Leeds Beckett University and accredited by Play Therapy UK and Play Thearpy International.
Abstract:
NDPT is a psychotherapy approach used in children. It is based on the fact that play is the natural means that children use to explore and understand the world, express their thoughts and feelings, and learn self-mastery. NDPT has been developed by Virginia Axline, who was influenced by the person-centered, non-directive approach of Carl Rogers. In our knowledge, this is the first review in the field of NDPT on children with a medical condition.The aim of the review was to identify research evidence on NDPT as an intervention on children with any medical condition. The systematic literature search of databases such as CINAHL Plus, AMED, EMBASE, Ovid MEDLINE, ProQuest Central, PsycInfo, and SCOPUS revealded six studies meeting the eligibility criteria. Despite the fact that there is enough evidence on the effectiveness of NDPT on children with mental, behavioral, or academic problems, there is a paucity of evidence examining the effectiveness of NDPT on children in the medical context. However, a thematic analysis demonstrated a positive effect of NDPT on children with a medical condition on four aspects: overall adjustment, illness-related adjustment, anxiety levels, and play behaviors. The findings of the review can be used to inform programs, procedures, and clinical practice development in pediatric population in order to provide integrated and child-centered care with an age-appropriate intervention to children. Research implications are also discussed.
Roghayeh Esmaeili
Shahid Beheshti University of Medical Sciences, Iran
Title: Dignity in elderly people: A concept analysis
Biography:
Roghayeh Esmaeili has completed her PhD in Nursing Field from School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. She has published more than 30 papers in reputed journals and has been intresting in elderly people.
Abstract:
Purpose: Nurses need to have knowledge about the concept of the elderly’s dignity in order to be able to perform proper supportive interventions. The exact definition of dignity, its components, and its characteristics are not yet a unique understandable concept for nurses. The purpose of the present study was to analyze the concept of dignity in the Iranian elderly in order to achieve a correct definition and understanding of this concept.
Method: This qualitative study of concept development used the hybrid model in three phases: theoretical phase, fieldwork phase and incorporation.
Results: The elderly’s dignity is a complex and dynamic mental state which results in the enhancement of inner feelings. It is affected by personal, family, and social factors. This concept is formed in relationship with others and guarantees the person’s health. The practical definition of the elderly’s dignity is related to the domains of dignity in this population, i.e. relative dignity, which originate from the culture and are subject to change. The characteristics of the elderly’s dignity include respect, integrity, independence and authority, privacy, unique support and participation in the self-care. For this characteristics to emerge, the predisposing factors and antecedents depend on the the person, family, and society.
Conclusions: Developing a clear image of dignity in health care services leads to better understanding of the concept among the practitioners on one hand and also improves the role of moralities in provision of the services.
- Workshop
Session Introduction
Judith Cullinane, Maria Lombardi
Floating Hospital for Children - Tufts Medical Center, USA
Title: Pediatric Complex Care: Establishing a “HUB†for High Quality Care
Biography:
Judith Cullinane completed her graduate degree from Graceland University, Independence, MO, USA and is currently a PhD candidate at Simmons College, Boston, MA, USA. She is the Executive Director of nursing research, innovation, professional development and quality at Tufts Medical Center and The Floating Hospital for Children. Her research includes studying bisphenol A in neonates, teaching baccalaureate nursing students root cause analysis and pain management in neonates. She also participated in the writing of the Nurse of the Future Core Competencies and the Nurse of the Future Competency Toolkit in collaboration with the MA Action Coalition.
Abstract:
Children with complex healthcare disorders are a vulnerable patient population and require highly organized care delivery. This patient population often experiences limited or inefficient care that results in high cost healthcare. Complex care programs offer the ability to organize patient care interventions, activities and necessities, helping to improve care delivery and patient outcomes throughout the continuum. The purpose of this presentation is to describe the implementation of a pediatric inpatient complex care team that led to the inception of a pediatric hospital base complex care program at an academic medical center in Boston, Massachusetts, USA. The quadruple aim framework and the chronic case model were used in conjunction to develop, implement and establish a pediatric interprofessional complex program using a six phase process over a one-year period of time. Overall impact of the program demonstrated that care coordination reduced the inpatient length of stay by 15% and prevented adverse drug events by early detection of medication reconciliation discrepancies in 73% of the patients. Social services were also consulted earlier in the hospital stay in 68% of the cases assisting in identifying and addressing psycho-socio economic constraints. The innovation led to the establishment of an interprofessional pediatric hospital complex care program using a hub concept inclusive of patients and families. Developing a comprehensive complex care program to better provide effective care coordination is essential to maximize the quality of care, provide the best experience for patients, families and providers, and improve the cost-efficiency of the health care system.