Development of nursing diagnoses for pediatric nursing practice

NANDA International 2012 Conference Abstract
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Session 1.3
Education & Implementation Track

Geraldine M. Lyte
Mary DeWys
Susan Mlynarczyk

To propose two child-centered nursing diagnoses pertaining to altered feeding dynamics in childhood, in order to support improved care strategies for this client group. Introduction    This paper will present the development and testing of two new nursing diagnoses, for submission to NANDA-I, which focus on altered feeding dynamics in children leading to obesity or anorexia. Our work forms a collaboration between the US and the UK and aims to help children’s nurses to address the increasing problems that are associated with altered feeding dynamics in childhood.  Review of Literature Childhood obesity and childhood anorexia are major global health concerns in developed countries. In relation to obesity for example, almost 20% of US children were classed as obese in 2008 (Ogden et al. 2010) and almost 17% of English children classed as obese in 2007 (NHS Information Centre 2009). Obesity refers to an excess of body fat to the extent that may have implications for a person's health status - a body mass index (BMI) of 30.0 kg/m 2 or greater with extreme obesity defined as a BMI of 40.0 kg/m 2 or more ( Childhood obesity places children at increased risk of a range of diseases particularly associated with Type 2 diabetes, hypertension and coronary heart disease (Ebbeling et al. 2002) and, subsequent emotional, social and financial costs of treatment. Anorexia, which is characterised by a lack of desire/refusal to eat, although less prevalent, also carries risk of diseases related to malnutrition and similarly carries significant emotional, social and financial costs for the child and family unit (Chatoor 2009). Outcomes to be achieved: Development of Pediatric-Focussed Nursing Diagnoses to Support Altered Feeding Dynamics for Children, Young People and their Families

Results / Findings
The findings will be published in March 2012.

Discussion / Conclusion
This research will offer new diagnostic concepts designed for use by children's nurses to help manage a global childhood health problem.

Phase 1 Two new diagnoses have been developed, applying the Satter Eating Competence Model (Satter 2007) as a conceptual framework and NANDA-I diagnostic submission guidelines.  The two new diagnoses apply to NANDA-I’s current diagnoses of ‘Nutrition Less than (or Greater Than) Body Requirements’.  The newly proposed diagnoses are: ‘Ineffective Eating during Childhood: Less than (or More Than) Body Requirements’. Phase 2 A Delphi Survey Technique is being used to test the validity of the two diagnostic concepts. This type of survey aims for consensus of opinion from a group of experts using a series of questionnaires, to transform individual views into group consensus (Hasson et al. 2000).  Participants are drawn from a US clinic which specialises in childhood nutrition.

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