Thesis (Ph. D.)--Virginia Commonwealth University, 2007. / Prepared for: Dept. of Health Administration. Bibliography: leaves 175-186.

Now in its Second Edition, this text focuses exclusively on the management of hospitalized pediatric patients from admission to discharge. It is an excellent resource for residency programs, hospitalist fellowships, and continuing education for physicians whose practice includes the management of hospitalized newborns and children. Because pediatric hospital care is provided by a wide variety of healthcare professionals and in many different hospital settings, this text provides a framework for unified management and effective and efficient care. This edition includes new sections on emergency medicine and psychiatric hospitalization and expanded coverage of management of children with complex and chronic conditions.

Vara förälder till ett barn som är inneliggande på ett sjukhus är komplicerat, svårt och upplevs olika av föräldrar. Isolering kan orsaka stress och leda till kontroll-, informations- och kommunikationsbehov. Syftet med studien var att beskriva föräldrars upplevelser av att vistas i isoleringsrum vid vård av sina barn på sjukhus. Studien har en deskriptiv kvalitativ design. Resultatet visade att föräldrarna kände sig besvärliga och var rädda för att störa när de behövde be om hjälp. Vikten av att personalen såg föräldrarna framkom och brister fanns gällande information och kommunikation. Information kring avlastning, planering och sysselsättning saknades. Isoleringsrummen beskrevs som sterila och saknade värme och hemtrevnad. Sysselsättning bidrog till att underlätta isoleringen men föräldrarna tyckte ändå det var svårt att underhålla barnen. Föräldrarna kände sig instängda då de inte kunde lämna rummet vilket bidrog till oro och tankar kring barnets hälsa. Avlastningen som föräldrarna fick varierade och stöd var betydelsefullt. Vidare forskning om avlastningens betydelse samt hur personalen kan förändra föräldrars upplevelse av att känna sig besvärliga skulle kunna vara till nytta för föräldrar, barn och personal och frambringa nya rutiner. / To be a parent of a child who is being cared for in hospital is complicated and difficult and affects each parent differently. Isolation can cause stress to the parents and lead to a further need for control, information and communication. The purpose of this study was to describe how parents experienced staying in a hospital isolation room with their children when the children were being cared for in hospital. The study has a descriptive qualitative design. The study showed that the parents felt awkward and worried about asking for help when they needed it. The parents placed an importance on being seen by the staff and there was a lack of information and communication. There was no information available about how to receive help, the planning process and also how to keep oneself occupied. The isolation rooms were described as sterile, cold and lacking a homely feel. Having something to do made the isolation easier to cope with however the parents still found it difficult to keep the children entertained. The parents felt trapped when they were not able to leave the room which resulted in a constant focus on the health of the child and this in turn led to an increased anxiety level. The level of help given to the parents varied and support was considered important. Further research into the importance of help available for parents, as well as how staff members could change the awkwardness parents feel, would be useful for parents, children and staff members, and may encourage new routines.

Los hospitales actualmente según la OMS están destinados a ser lugares de sanación tanto en el aspecto físico como emocional de los pacientes, pero en el Perú la inversión en salud pública se encuentra muy por debajo de la recomendada y la preocupación por mejorar estos espacios para los pacientes con cáncer es nula, sobre todo cuando se habla de niños el tema es aún más delicado. Por lo tanto, este proyecto aborda la importancia de que los niños tengan acceso a establecimientos de salud que cuenten con espacios eficientes que logren producir efectos positivos sobre el estado de ánimo, cambiando la percepción del espacio de los niños; con el fin de crear un espacio amigable y cálido, el cual les de confort y seguridad. Se propone utilizar la hipótesis del diseño basado en la evidencia como marco para el diseño, que aportan los beneficios de: iluminación y ventilación natural, presencia de áreas verdes, ambientes para la integración y el encuentro entre los pacientes infantiles y familiares. No obstante, sin perder la correcta y eficaz funcionalidad de un hospital debido a su alto nivel de complejidad. / The hospitals currently according to the OMS are destined to be places of healing both in the physical and emotional aspect of the patients, but in Peru the investment in public health is well below the recommended and the concern to improve these spaces for patients Cancer patients are null, especially when talking about children the subject is even more sensitive. Therefore, this project addresses the importance of children having access to health facilities that have efficient spaces that achieve positive effects on mood, changing the perception of children's space; in order to create a friendly and warm space, which gives them comfort and safety. It is proposed to use the evidence-based design hypothesis as a framework for design, which provide the benefits of: natural lighting and ventilation, presence of green areas, environments for integration and the encounter between children and family patients. However, without losing the correct and effective functionality of a hospital due to its high level of complexity. / Trabajo de Suficiencia Profesional

No description available.

High levels of emotional work, staffing shortages, high turnover rates, low workforce engagement levels, and complex healthcare reforms are common problems in healthcare settings. Healthcare leaders are increasingly aware of the vital impact an engaged workforce can have on patient outcomes and an organization's ability to survive despite current challenges in the healthcare setting. It is important for leaders to understand what factors may influence the ability to engage with their organization, such as emotional labor. The purpose of this correlational quantitative study was to test whether emotional labor is related to employee engagement within a large Midwestern pediatric hospital. The theoretical frameworks that helped guide the development of this study were Herzberg's motivation-hygiene theory, Kahn's engagement theory, intergroup emotions theory, and Diefendorff and Richard's model of emotional display rules. Three measures (a demographic questionnaire, the revised Emotional Labour Survey, and the Job Engagement Scale) were used to address the relationship between the variables (the subscales of emotional labor and employee engagement). Data analysis involved simple bivariate correlations and curvilinear regressions. Results indicated that the subscales of faking emotions and hiding feelings negatively correlated with employee engagement. Five of the 6 subscales also had a significant curvilinear relationship with employee engagement. Gender did not play a moderating role in this study. Social change implications and recommendations include the potential for improvements in the need to identify and develop training and self-care strategies necessary for staff to endure the emotional fallout associated with the high emotional demands of their job.

Este estudo investigou as motivações de alunos da Universidade Federal do Rio de Janeiro (UFRJ) para participar de um projeto de Extensão Universitária em um hospital pediátrico, assim como as contribuições percebidas pelos estudantes em relação às suas trajetórias pessoais e profissionais relacionadas à participação no projeto. O Projeto de Extensão Universitária Alunos Contadores de Histórias é desenvolvido no Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG) há quatro anos e visa à melhoria do cuidado junto à clientela, através da oferta de uma atividade lúdica, a contação de histórias, que representa algo de positivo num momento de muitas perdas e sofrimento. A cada semestre é realizada uma seleção e, após a capacitação, os alunos passam a contar histórias para as crianças, os adolescentes e seus familiares, nos diversos setores assistenciais da instituição durante duas horas por semana, por no mínimo seis meses. Foi realizado um estudo exploratório usando os métodos quantitativo e qualitativo. Os dados utilizados foram provenientes da análise de registros existentes em documentos do projeto e de dois grupos focais realizados com alunos. A análise dos dados apontou que os alunos participantes buscam o projeto no intuito de poder realizar uma atividade solidária, junto às crianças. Suas percepções sobre a experiência e suas contribuições, de uma maneira geral, são muito positivas, e revelam amadurecimento e redimensionamento de valores com ampliação da visão social, através de uma atividade a qual referem ser prazerosa. As principais dificuldades observadas foram a falta de flexibilização curricular e o desconhecimento das propostas da Extensão Universitária por grande parte do corpo discente e também dos docentes e técnico administrativos dos diversos cursos. O projeto está sintonizado com as propostas da Política Nacional de Extensão Universitária e o presente estudo espera contribuir para o aprimoramento das atividades de Extensão Universitária em ambientes institucionais análogos. / This study investigated the motivation of students of the Federal University of Rio de Janeiro to take part of a University Extension Project at a children hospital and also their perceptions of the contribution of their engagement in this project for their personal and professional lives. The project: Story Tellers Students is developed at Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG) since 2008 and aims at the improvement of the care of the patients through the offer of a playful activity, the story telling, which may represent something positive in a period of much losses and suffering. Participants enrollment starts at the beginning of each semester and, after being trained, the students spend two hours weekly, for at least six month telling stories to children, teenagers and their families in the several care sectors of the institution. An exploratory study was performed, using quantitative and qualitative methodology. The data used where collected from records of pre-existent documents, and from data collected through two focal groups realized with students. The analysis revealed that the participant students looked for the project to develop a solidarity action next to children. The perception about the experiences they had and about the contribution of this participation for their lives is, for most of them, very positive, they gained maturity and they were able to reshape their personal values with a consequent enlargement of their social vision, through the development of a pleasant activity. The main difficulties observed where the little flexibility of the curriculum and the lack of awareness of the objectives of the University Extension as a whole by most students and also from the teachers and other co workers of the most courses. The project is aligned with the proposals of the National University Extension Policy and the study hopes to contribute to the improving of the activities of University Extension in similar institutions.

Este estudo investigou as motivações de alunos da Universidade Federal do Rio de Janeiro (UFRJ) para participar de um projeto de Extensão Universitária em um hospital pediátrico, assim como as contribuições percebidas pelos estudantes em relação às suas trajetórias pessoais e profissionais relacionadas à participação no projeto. O Projeto de Extensão Universitária Alunos Contadores de Histórias é desenvolvido no Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG) há quatro anos e visa à melhoria do cuidado junto à clientela, através da oferta de uma atividade lúdica, a contação de histórias, que representa algo de positivo num momento de muitas perdas e sofrimento. A cada semestre é realizada uma seleção e, após a capacitação, os alunos passam a contar histórias para as crianças, os adolescentes e seus familiares, nos diversos setores assistenciais da instituição durante duas horas por semana, por no mínimo seis meses. Foi realizado um estudo exploratório usando os métodos quantitativo e qualitativo. Os dados utilizados foram provenientes da análise de registros existentes em documentos do projeto e de dois grupos focais realizados com alunos. A análise dos dados apontou que os alunos participantes buscam o projeto no intuito de poder realizar uma atividade solidária, junto às crianças. Suas percepções sobre a experiência e suas contribuições, de uma maneira geral, são muito positivas, e revelam amadurecimento e redimensionamento de valores com ampliação da visão social, através de uma atividade a qual referem ser prazerosa. As principais dificuldades observadas foram a falta de flexibilização curricular e o desconhecimento das propostas da Extensão Universitária por grande parte do corpo discente e também dos docentes e técnico administrativos dos diversos cursos. O projeto está sintonizado com as propostas da Política Nacional de Extensão Universitária e o presente estudo espera contribuir para o aprimoramento das atividades de Extensão Universitária em ambientes institucionais análogos. / This study investigated the motivation of students of the Federal University of Rio de Janeiro to take part of a University Extension Project at a children hospital and also their perceptions of the contribution of their engagement in this project for their personal and professional lives. The project: Story Tellers Students is developed at Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG) since 2008 and aims at the improvement of the care of the patients through the offer of a playful activity, the story telling, which may represent something positive in a period of much losses and suffering. Participants enrollment starts at the beginning of each semester and, after being trained, the students spend two hours weekly, for at least six month telling stories to children, teenagers and their families in the several care sectors of the institution. An exploratory study was performed, using quantitative and qualitative methodology. The data used where collected from records of pre-existent documents, and from data collected through two focal groups realized with students. The analysis revealed that the participant students looked for the project to develop a solidarity action next to children. The perception about the experiences they had and about the contribution of this participation for their lives is, for most of them, very positive, they gained maturity and they were able to reshape their personal values with a consequent enlargement of their social vision, through the development of a pleasant activity. The main difficulties observed where the little flexibility of the curriculum and the lack of awareness of the objectives of the University Extension as a whole by most students and also from the teachers and other co workers of the most courses. The project is aligned with the proposals of the National University Extension Policy and the study hopes to contribute to the improving of the activities of University Extension in similar institutions.

Missed nursing care, according to Kalisch and Williams, is nursing care that is not completed to the highest quality of care, leading to an increase in hospital costs and poor patient outcomes. Missed nursing care can occur with any patient population; however, a survey by Kasich called the MISSCARE Survey has only been used in the adult and neonatal populations. Pediatric patients are a diverse and complex subset of the population, differing greatly from the adult and neonatal populations, thus identifying a need for a focused pediatric survey to effectively study missed nursing care in the pediatric setting. The purpose of this research, therefore, was to create and validate a pediatric nursing care survey A convenience sample of 10 pediatric experts completed the Expert Panel Survey to determine a content validity ratio (CVR) and content validity index (CVI) of a modified, MISSCARE Survey (Kalisch & Williams, 2009). Items determined to be essential by ninety percent or more of the participants (CVR> 0.78), were included in the MISSCARE-Pediatric Survey. Results showed that the CVI of the MISSCARE-Pediatric Survey determined by the Expert Panel was 0.9, meaning the items are essential to the pediatric population (Gilbert & Prion, 2016a). The created MISSCARE-Pediatric Survey includes 18 questions in section A (Types of Missed Nursing Care), 28 questions in section B (Reasons for Missed Nursing Care), and 9 questions in Demographics. Future research will determine content reliability of the MISSCARE-Pediatric Survey.

Mental health is a growing concern for adolescents. Billions of dollars are spent annually on mental services for youth. Many adolescents experience abuse, suicidal ideations, psychotic disorders, substance abuse, and other challenges. Recurring inpatient psychiatric hospitalizations are increasing among adolescents. The recurring admissions impact adolescents significantly socially, psychologically, and financially. Social workers are a vital part of this treatment process from admission to discharge. The research question asked what were the issues and challenges social workers encounter when conducting discharge planning with adolescents receiving recurring inpatient psychiatric treatment. The purpose for this doctoral project was to carefully examine the discharge planning process while identifying ways social workers can positively impact the process. Key concepts for this project were adolescent, inpatient hospitalization, recurring hospitalization, and discharge planning. Systems theory was used to inform the project. This action research study allowed social workers to share their experiences and perspectives about the role of social workers in discharge planning. Seven participants were identified using purposive sampling. One focus group provided data for project. Data analysis consisted of in vivo and process coding. Four participant-inspired themes identified related to issues and challenges in discharge planning include (a) adequate resources, (b) insurance restrictions, (c) rapport with adolescents, and (d) parental participation. Social work practice and positive social change implications include establishing follow-up protocol for all adolescent discharges from inpatient settings and increasing the use of encouragement and engagement strategies for rapport building with adolescents.