Diane Magyary

Prevention of Parenting Alterations for Women with Low Social Support

Parenting is a demanding role. Traditionally societies provide mechanisms for supporting major caregivers. For most parents the partner relationship is a source of refueling energy. In addition, often the extended family members provide support for the parent(s). In a prior research study dealing with early intervention where the family demonstrated double vulnerability, defined by pregnancy complications and social problems, we found the mothers most resistant to help were women who both had a lot of situational problems and few if any friends or family supporting them (Barnard et al. 1985). This finding prompted us to think about parents who did not have the supportive mechanisms cultures generally provide.

Local Toxicity Patterns Associated with lntravesical bacillus Calmette‐Guérin: A Southwest Oncology Group Study

Background: While the efficacy of bacillus Calmette‐Cuérin (BCG) immunotherapy has been demonstrated, the relative benefit, given a seemingly high incidence and severity of toxicities, remains an issue. Adequate understanding and management of toxicities can maximize the safety of the treatment and enable the administration of required doses of BCC intravesical therapy.

A DECISION TREE AND CLINICAL PATHS FOR THE ASSESSMENT AND MANAGEMENT OF CHILDREN WITH ADHD

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder. Children with ADHD are disproportionately represented in pediatric populations characterized by school failure, criminal behavior, and substance abuse. Many children who present with ADHD symptomatology do not receive systematic assessments nor comprehensive treatment that is well coordinated across home and school environments. And yet, evidence suggests that early detection and appropriate treatment can alter the probability of a negative developmental trajectory. The Decision Tree and Clinical Paths for Assessment and Management of ADHD identify the critical components of care through a stepwise decision-making process involving the assessment, diagnosis, treatment, and outcome evaluation of children who present with ADHD symptomatology. Preliminary field testing supports the clinical utility and validity of the ADHD Decision Tree/Paths. In addition, cross-validation comparisons indicate consistency between the ADHD Decision Tree/Paths and recently released ADHD clinical guidelines issued by several national professional organizations.

Helping parents with preterm infants: Field test of a protocol

1 Supported by Maternal and Child Health Training, Grant No. MCH‐009035, Bureau of Health Care and Delivery Assistance, Health Resources and Service Administration, Public Health Service, Department of Health and Human Services.

Early Social Interactions: Preterm Infant-Parent Dyads

Preterm infant-parent dyads are disproportionately represented in samples of infants who have failed to thrive and of children who nave been neglected and/or abused. This finding suggests that the effect of prematurity on the interactive process between an infant and parent places the dyad at risk for developing relationship problems. The specifics as to why a premature birth has the potential disruptive effect on a dyadic relationship is examined in this article. The early origins of social interactions for preterm dyads are analyzed with respect to a) important theoretical concepts about dyadic interactive processes, b) characteristics that the preterm infant and parent each bring to bear on the interactive process, and c) early first-year interactive patterns manifested by preterm dyads as compared to full-term dyads. Finally, the implications for nursing research and clinical practice are discussed.

A Nursing assessment standard for early intervention: Family coping

Professional standards of practice provide a basis for valid and reliable assessments and quality assurance. The purpose of this case study research was to evaluate a nursing standard, Family Coping, in two families with an infant with cerebral palsy. An assessment protocol was developed from the Family Coping standard and provided the basis for a comprehensive assessment. The case study provided the format and methodologies for implementing the assessment protocol. Patterns of family coping were derived from data collection that occurred at different times and through the use of multiple methods and respondents. The findings of this study confirmed the value of multiple sources of evidence for deriving a diagnosis from which a plan of treatment could be developed. The Family Coping standard proved to be useful for nursing practice by providing a theoretically and empirically based standard for guiding the assessment of family coping.

A leadership training model to enhance private and public service partnerships for children with special healthcare needs

Healthcare in this nation and the nature of the workforce are experiencing the most dramatic transformation in history. With healthcare reform, health professionals are increasingly being called upon to be leaders in creating a wide variety of community partnerships to influence and document accessible, high-quality, cost-effective service systems. In particular, community partnerships between private and public sectors of society need to be coordinated to achieve optimal health for children with special healthcare needs, and their families and communities. Healthy People 2010 objectives encourage new partnership development between the private–public sectors of healthcare in collaboration with families and communities. The reformulation of healthcare and the workforce likewise calls for a revision of professional education to produce leaders who have the competency to create and engage in partnerships on behalf of children with special healthcare needs. In this article, a nursing training grants model of leadership is discussed that encompasses the full spectrum of private-public partnerships using the Maternal Child Healthcare Service Pyramid model, with particular emphasis on the interface among 4 service levels: (1) direct healthcare services, (2) enabling/advocacy services, (3) population-based services, and (4) infrastructure-building services. An additional leadership dimension, cultural competency, is identified as an essential aspect of leaders who engage in partnership building with diverse communities. Finally, the training grants formative and summative evaluation process is discussed, and illustrated by presenting data that illustrate culturally competent leadership.