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This article reviews the current state of the knowledge in the management of children and adolescents with sickle cell disease (SCD). A thorough review of the literature concerning physiological issues including the clinical manifestations of SCD as well as current treatment modalities is included. Therapeutic management of health and illness for a child with SCD is discussed in relation to primary, secondary, and tertiary prevention. Recommendations for nursing practice and research are made.

The presence of a history of poor parental upbringing, poverty, and substance abuse within a family stresses its capacity to cope with the needs of a child with congenital anomalies. Nursing has a key role to play in providing specific information, practical assistance, and support in these circumstances. A case study of a child in such a family is presented in this article, and the multiple nursing interventions provided to facilitate the family's coping skills are discussed.

Infants discharged from neonatal intensive care units (NICUs) often face a long journey of chronic illness, family stresses, and financial burdens. Health care professionals involved in acute care need to be aware of the far-reaching repercussions of neonatal illness. This report presents a case study of a low-income, single mother from a rural community and her son, a neonatal intensive care unit (NICU) graduate post-extracorporeal membrane oxygenation (ECMO) and post-necrotizing enterocolitis (NEC) discharged with a gastronomy tube (g-tube) and failure to thrive (FTT), from his birth to 10 months of age. Family-focused interventions aimed at improving growth and developmental delays and providing family support will be discussed.

The purposes of this study were to pilot test the instrument and methods for a major study of caregivers of children who are technology dependent and to test constructs proposed for the major study in a discrete sample. The major study will be implemented in 13 cities in the United States. The pilot was conducted in three small- to moderate-size metropolitan areas in the Southeast and Midwest. Seventy-three primary caregivers provided data during a structured telephone interviews. The children represented four groups of children dependent on technology as defined by the Office of Technology Assessment (OTA) (1987). The findings supported the methodology and the viability of the instrument. Analysis suggests that caring for a child who is technology dependent affects family functioning and increases family stress levels in some families. The financial burden is also significant. It is suggested that nurses can be a critical source of support and information to these families.

This study introduces the basic concepts of observational research by defining the terms and discussing some of the critical issues specific to observational research. Observational methods signify a systematic approach to quantifying behavior. A discussion of the major concerns in observational research is presented. These concerns include defining the coding categories; identifying the unit of measurement, the method of recording the observation, and deciding on a sampling strategy; training of observers; and interrater and intrarater reliability.

The purpose of this study was to prospectively study inpatients admitted for failure to thrive during their first year of life. Twelve infants with failure to thrive were studied and compared with 17 healthy controls. Mothers and infants with nonorganic failure to thrive scored lower on the Nursing Child Assessment Feeding Scale, reported more change in their lives, and less social support. The need for further research is discussed and suggestions for beginning level interventions are made.

This article examines parent-infant interaction (PII) during feeding when the infant has congenital heart disease (CHD) using the Nursing Child Assessment Feeding Scale (NCAFS) and compares the NCAFS scores of the infants with CHD with those of healthy controls. Twenty mother-infant dyads, 10 with CHD and 10 controls, were studied. Infants with CHD scored significantly lower than controls on both infant subscales, Responsiveness to Caregiver and Clarity of Cues, of the NCAFS. Mothers of CHD infants scored significantly lower on the Social Emotional Growth Fostering subscale. These findings suggest specific behavioral differences in infants with CHD during feeding and support the need for more information about feeding interactions in infants with CHD.