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Depression, once thought rare in children, is now more widely recognized and believed to arise from negative views of self, world, and future, according to Beck's cognitive theory of depression. The Cognitive Triad Inventory for children measures the three negative views, and although reported as psychometrically adequate, this study extended previous analyses with confirmatory factor analysis in a sample of 122 school-aged children. Internal consistency was .82 (total scale) but ranged from .54 to .76 for subscales reflecting the views of self, world, and future. Confirmatory factor analysis revealed factors reflecting three aspects of the self rather than the three negative views. The findings suggest that Beck's theory about the negative cognitive triad may be less suitable for children than adults.

To examine the frequency, time of gestation, and reasons for antenatal hospitalizations in women with medically high-risk pregnancies.This secondary analysis reports all antenatal hospitalizations from a clinical trial testing transitional care to women with high-risk pregnancies. Data were collected from 1992 to 1996. Pregnant women with pregestational (n = 16) or gestational diabetes (n = 21), hypertension (n = 29), and diagnosed (n = 47) or at high risk for preterm labor (n = 37) were included. Diagnoses for each hospitalization and lengths of stay were collected from chart review and validated by attending physicians. Gestation was determined via ultrasonography. The sample (N = 150) consisted of predominantly African-American women, never married, between the ages of 15 and 40 with Medicaid insurance.Eighty-three percent (n = 125) of the women had one or more antenatal hospitalization with a mean length of stay of 123 hours. All women with diabetes were hospitalized at least once. Women with pregestational diabetes had the greatest number of hospitalizations whereas those with gestational diabetes had the least. Major reasons for hospitalizations were preterm labor, glucose control, premature cervical dilation, and preeclampsia.Some hospitalizations could potentially be avoided or reduced through expanded patient education, improved screening, and more aggressive monitoring for early signs and symptoms of impending complications.

Eighteen very-low-birth-weight (VLBW) infants who met study criteria were observed during routinely scheduled feedings, twice in one day, once with a nasogastric (NG) tube and once without, in random order. Breathing and sucking measurements were compared with and without NG tube placement. During the prefeed period, minute ventilation and tidal volume were significantly lower with an NG tube than without the tube. During the continuous sucking (CS) period after commencement of oral feeding, minute ventilation, tidal volume, pulse rate, and oxygen saturation were also lower with the tube. During both CS and subsequent intermittent sucking periods, infants sucked less forcefully and took less formula with the tube. Based on these findings, if VLBW infants have an NG tube in place, clinicians are urged to monitor for breathing compromise, oxygen desaturation, and bradycardia during oral feeding.

The purposes of this study were to investigate the effects of maternal employment, maternal employment attitude/behavior consistency, and degree of choice and satisfaction with the employment decision on family functioning and preterm infant development and to describe changes in family functioning over time. Data were collected in the family’s home (N = 79) when the infant was 3, 9, and 18 months old. Parents in nonemployed-mother families were more satisfied with their families at 18 months than parents in employed-mother families. Decreases in family cohesion and/or adaptability from 9 to 18 months were seen for fathers in employed-mother families, for mothers in nonemployed-mother families, and for mothers in families where the mother’s employment attitudes and behaviors were consistent. Degree of choice was positively related to the child’s mental development, mother’s perception of family cohesion, and mother’s and father’s satisfaction with family.

The purpose of this study was to determine the amount of vibration transmitted to the surface of an incubator mattress. Empty incubators with metal (n = 12) and non-metal (n = 12) bases were monitored for vibration levels when the incubators were turned "off" and when they were turned "on." High levels of low-frequency vibration were detected in both types of incubators in both conditions. The metal incubators transmitted significantly less vibration to the mattress than did the non-metal incubators at several frequencies in the "off," the "on," and the "adjusted" conditions. These results suggest that infants experience significant whole-body vibration while lying in incubators.

Because of increased survival rates for children with critical illnesses and injuries coupled with early discharge programs, medically fragile children are increasingly likely to receive care in the home. The purpose of this exploratory study was to provide an initial description of the typical decisions and problems families experienced on a day-to-day basis, family coping strategies (F-COPES), and family resources (Family Strengths Scale). A convenience sample of 10 families, recruited from a pediatric rehabilitation hospital, participated in a one-hour, in-home interview. Respondents included the child's mother (n = 4), mother and father (n = 2), grandmother (n = 2), grand aunt and uncle (n = 1), and legal guardian (n = 1). Family members were likely to consult health care professionals for treatment-related issues but not for child care issues such as toileting. Coping strategies used most often included Mobilizing Family and Acquiring Social Support. Comments indicated a need for additional financial resources and alternative child care services.

Neonatal and pediatric critical care units are growing in size and complexity. Each unit is staffed by a highly specialized group of nurses. Although the units share many commonalities, the relationship between nurses in the neonatal and pediatric critical care units often is characterized by rivalry and antagonism rather than by cooperation. The purpose of this report is to identify similarities and differences between the two units and to describe the benefits of collaboration between units.

Single-item indicators that ask respondents for their global rating of a specific concept are congruent with nursing’s emphasis on wholism and individualism. They allow the subject to take personally salient features of the situation into account when providing a response. The psychometric performance of single-item indicators in published research and in a sample data set using measures of the mother’s choice and satisfaction with her employment decision support the validity and reliability of the measures, suggesting that these indicators deserve more attention in nursing research. Recommendations for the use of single-item indicators are provided.

To compare tympanic membrane temperature with pulmonary artery (PA) and rectal temperature (calibrated glass mercury) to determine consistency among measures.Convenience, within-subject, quasi-experimental.Midwestern university-affiliated tertiary medical center.128 adult (18 years or older) patients admitted to the surgical intensive care unit with an age range of 18 to 90 years (mean 57 years).Tympanic, PA, and rectal temperature.Rectal and tympanic membrane temperatures were measured in 60 patients. PA and tympanic membrane temperatures were measured in 68 patients.Rectal and tympanic membrane temperatures were moderately correlated (r = 0.525). Mean rectal was slightly higher than mean tympanic membrane temperature (mean difference 0.19 degrees C). PA and tympanic membrane temperatures were highly correlated (r = 0.909). Mean tympanic membrane temperature was slightly higher than mean PA temperature (mean difference 0.42 degrees C). For PA temperatures, 57 (84%) of the differences were between 0 and +1 degree Celsius, whereas for rectal temperature, 23 (37%) were between 0 and +1 degree Celsius and 28 (47%) were between 0 and -1 degree Celsius.Tympanic temperature measurements would be an appropriate substitute for PA temperature if the PA catheter has been removed or the PA thermistor is nonfunctional. In addition, this study suggests that to effectively track temperature in a particular patient, the site for temperature measurement must be consistent.

To describe child behaviors and level of family functioning after discharge from the pediatric ICU (PICU) and to begin to explore the relationship of family reactions and the child's severity of illness to child and family outcomes after discharge.Exploratory, repeated measures: Time 1 (T1) at 24 hours after admission; Time 2 (T2) at 2 to 4 weeks after hospital discharge.Nine mothers and fathers of children who were 5 years of age or younger, hospitalized in a PICU for at least 1 day, expected to survive.Parental Concern Scale and Parental Stressor Scale: PICU at T1; Posthospitalization Behavior Questionnaire at T2; Feetham Family Functioning Survey and FACES III, at both T1 and T2; and Pediatric Risk of Mortality to measure illness severity.Mothers' cohesion scores decreased significantly from T1 to T2. Scores from the Pediatric Risk of Mortality were not related to family measures. Mothers' family cohesion and satisfaction with family after discharge were negatively related to time the child was intubated. Few family measures were related to the Parental Concern Scale and Parental Stressor Scale: PICU subscales.PICU admission of a child is a stressful event for parents, independent of the child's illness severity. Mothers' perceptions of family may be negatively affected.

To explore the relationships between parents' reactions to the pediatric intensive care unit admission of a child and characteristics of the child's illness.A convenience sample, consisting of 16 mothers and 13 fathers of 16 children aged 5 years and younger, was used. The Pediatric Risk of Mortality scale was used to measure severity of illness. Parental reactions were measured at about 24 hours after the child's admission with the Parental Stressor Scale: PICU and the Parental Concerns Scale.Mothers' concerns and stressors were not related to the child's Pediatric Risk of Mortality score. However, fathers reported greater concern about the child's experience and about parenting as the child's Pediatric Risk of Mortality score increased.Parents' reactions to their child's critical illness and admission to the pediatric intensive care unit were not related to characteristics of the child's condition in this small sample. Future research needs are suggested.

The purpose of this study was to investigate the effects of maternal employment status and the mother’s degree of choice and satisfaction regarding her employment status on family functioning and, on the preterm infant’s development at three months chronologic age. Families with preterm infants (N = 110) were categorized as employed, nonemployed, and on leave of absence based on the mother’s employment status at three months postpartum. There were no significant differences across employment groups on family functioning and child development. The infant’s motor development was positively correlated with number of hours employed per week and degree of choice for the employed, mother families, but negatively correlated with choice for the nonemployed mother families. These results suggest that maternal employment may not be detrimental for infants born prior to term. Indeed, it may be beneficial, especially if the mother has a choice in the matter.

Psychometric properties of the Moos (1979) Family Environment Scale (FES) were studied in a sample of 73 two-parent and 19 single-parent families. Mothers and fathers completed the FES questionnaire while the child in the family closest to 11 years old was administered the FES in an interview. Moos reported initial internal consistency estimates (Kuder-Richardson 20s) between .64 and .79. In this study, KR20s ranged from .24 to .75 for the entire sample, and differences among mothers, fathers, and children in the KR20s calculated for each group were found. Although Moos hypothesized three dimensions into which the 10 subscales fall, confirmatory factor analysis using LISREL VI did not support this assertion.