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Health supervision and management considerations for individuals with CHARGE syndrome are often complex, and a comprehensive approach is essential. The Atlantic Canadian CHARGE syndrome team developed a checklist organized by body system and age to aid healthcare providers in their approach to the ongoing care of these individuals. The checklist was evaluated qualitatively using a modified Delphi method with widespread consultation from expert healthcare practitioners, parents, and individuals with CHARGE syndrome. These are the first comprehensive guidelines across the lifespan of CHARGE syndrome that suggest a consistent approach to medical surveillance, investigations, and management for the physician and the multi-disciplinary team caring for these individuals. We anticipate that these guidelines will provide improvements in care by preventing missed diagnoses, allowing for anticipatory counseling, and facilitating early referral for interventions and treatments. (C) 2017 Wiley Periodicals, Inc.

Purpose To utilize a Wilsonian method of concept analysis to define and describe the concept of adherence. Data Sources Published research articles, nursing literature, published books, and national and international advisory reports. Data Synthesis The concept of adherence was analyzed using the Wilson method. Results, applications, and practice implications in regards to the concept of adherence were then derived from the analysis. Conclusions Adherence is a complex, multifaceted concept that can greatly impact patient behaviors and nursing practice. Further clarification of adherence is needed to help delineate this concept from other related terms. Implications Healthcare providers should have an understanding of the concept of adherence in the context of patient care in order to guide patient self-care behaviors.