Barriers and facilitators to children's use of speech-generating devices: a descriptive qualitative study of mothers' perspectives.

Purpose: The purpose of this study was to identify barriers and facilitators to children's use of speech-generating devices (SGD).

Design And Methods: Interviews with 14 mothers were analyzed with content analysis to identify barriers and facilitators to SGD use.

Results: This study identified a number of specific barriers and facilitators to successful and sustained SGD use by children with complex communication disorders.

Comparing bedside methods of determining placement of gastric tubes in children.

Purpose: The purpose of this study was to compare the accuracy and predictive validity of pH, bilirubin, and CO2 in identifying gastric tube placement errors in children.

Design And Methods: After the tube was inserted into 276 children, the CO2 monitor reading was obtained. Fluid was then aspirated to test pH and bilirubin.

Comparing methods of determining insertion length for placing gastric tubes in children 1 month to 17 years of age.

Purpose: The purpose was to compare three methods of predicting the gastric tube insertion length in children 1 month to 17 years of age: age-related, height-based (ARHB); nose-ear-xiphoid (NEX); and nose-ear-mid-umbilicus (NEMU).

Design And Methods: The design was a randomized controlled trial. Children were randomly assigned to the ARHB, NEX, or NEMU groups.

Predicting the insertion length for gastric tube placement in neonates.

Objective: To compare error rates of three existing methods of predicting the gastric tube insertion length in a group of neonates <1 month corrected age: age-related, height-based (ARHB); direct distance nose-ear-xiphoid (NEX); and direct distance nose-ear-mid-umbilicus (NEMU).

Design: Randomized controlled trial.

Setting: Five neonatal care units in a large midwestern city.

Accurate localization of the position of the tip of a naso/orogastric tube in children; where is the location of the gastro-esophageal junction?

Background: Abdominal radiographs are used to determine the location of the tip of a newly placed nasogastric tube. The precise location of the gastroesophageal junction has not been well described in the radiology literature.

Objective: To improve interpretation of radiographs taken to evaluate the location of the tip of a nasogastric tube.

A literature review of the safety and efficacy of using propofol for sedation in endoscopy.

A 2007 survey of members of the Society of Gastroenterology Nurses and Associates identified a need for more evidence regarding sedation medications including propofol. Therefore, the Cochrane Database of Systematic Reviews, Cochrane Database of Randomized Clinical Trials, MEDLINE, CINAHL, EMBASE, and the National Guideline Clearinghouse (http://www.guideline.

Out of the abyss of colic: a view through the fathers' eyes.

Purpose: To elucidate the experience of fathers living with a colicky infant.

Study Design And Methods: Interpretive phenomenology using in-depth interviews with 10 fathers of colicky infants. Reiterative interview reading, repeated meaning unit sorting, going back to the literature, and discussions gave way to emerging themes.

The use of carbon dioxide monitoring to determine orogastric tube placement in premature infants: a pilot study.

Enteral nutrition, frequently given through gastric tubes inserted through the nose or mouth, is an important part of supportive care for children unable to maintain adequate nutrition orally. To provide safe enteral nutrition, however, correct tube position must be achieved. Capnography, a noninvasive monitoring technique designed to measure expired carbon dioxide (CO2) levels, has been used previously to identify respiratory placement of nasogastric tubes in adults; however, its use in children is understudied.

Predicting internal distance to the stomach for positioning nasogastric and orogastric feeding tubes in children.

Aim: This paper is a report of a study to examine how well direct morphological distances commonly used for nasogastric or orogastric tube insertion and other methods perform as predictors of the internal distance to the targeted position for the tube pores in the stomach.

Background: Previous studies with very small samples have indicated that commonly used distances give malplacements, either above the oesophagogastric junction or below the body of the stomach, perhaps as much as 33% of the time.

Methods: We compared the predicted distances to the endoscopic and manometric distances to the oesophagogastric junction and to the body of the stomach in a prospective study of 494 children, 2 weeks to 19 years (231 months) of age.

Examination of the effect of Dr. Brown's Natural Flow Baby Bottles on infant colic.

Thirty-six parents of colicky infants participated in this randomized, placebo-controlled clinical trial conducted via the Internet. Parents recorded a baseline state-of-arousal diary for 3 days using their usual feeding methods, and then they used six study-provided bottles for 2 weeks while recording a second state-of-arousal diary. Infants being fed with placebo bottles significantly spent more time crying (rho=.

Important facts about intestinal feeding tube placement.

Enteral feeding is desirable when the gastrointestinal tract is functional because it allows better use of nutrients, is safer, and is more cost-effective than parenteral nutrition. Feeding through a gastric tube, however, is often not feasible in severely ill adults and children because of gastric paresis leading to recurrent episodes of gastroesophageal reflux with the risk of subsequent aspiration. Feeding into the small intestine (duodenum or jejunum) through a nasointestinal tube, therefore, is preferred.

Gastric tube placement in young children.

In this study, the internal position of a nasogastric/orogastric tube was determined in 72 children, prior to an abdominal radiograph, by measuring CO2 and pH and bilirubin of tube aspirate. Fifteen of the 72 tubes (20.8%) were incorrectly placed on radiograph.

Living with a colicky infant.

Infant colic is prolonged hard crying for no apparent reason in an otherwise healthy infant. The purpose of this study was to describe the parents' experiences of caring for their infants with colic. This qualitative study employed a multiple case study design using a descriptive approach through indepth interviews.

What is known about methods of correctly placing gastric tubes in adults and children.

An abdominal radiograph is considered the "gold standard" for determining the position of flexible small-bore nasogastric/orogastric tubes. However, placement must be checked frequently while a tube is in place, and the summative radiation risk of multiple radiographs, as well as their expense, make the development of adequate bedside placement-locating methods imperative. Several methods of detecting tube placement have been investigated in adults, including: aspirating gastric contents and measuring the pH, bilirubin, pepsin, and trypsin levels; examining the visual characteristics of aspirate; placing the proximal end of the tube under water and observing for bubbles in synchrony with expirations; measuring the carbon dioxide level at the proximal end of the nasogastric/orogastric tube; auscultation for a gurgling sound over the epigastrium or left upper quadrant of the abdomen; and measuring the length from the nose/mouth to the proximal end of the tube.

Predicting the insertion distance for placing gastric tubes.

Approximately 1 million enteral tubes are placed through the nose or mouth in adults and children in the United States annually. Previous studies found gastric tube placement errors to be common. A primary issue in ensuring safe and effective gastric feeding by tube is achieving optimal tube position on insertion.

Feasibility of using kangaroo (skin-to-skin) care with colicky infants.

Infant colic affects about 20% of all infants and the cause remains elusive. Healthcare providers typically view infant colic as a minor inconvenience that is harmless to the thriving infant and will go away with time; however, parents view caring for a colicky infant as a crisis situation. The purpose of this feasibility study conducted via the internet was to examine the feasibility of implementing kangaroo care at the beginning of colicky episodes.

Ethical and legal issues of conducting nursing research via the Internet.

In February 2001, President Clinton's Information Technology Advisory Commission reported that information technology has the potential to advance biomedical research. As nursing research via the Internet expands, important ethical and legal issues need to be addressed. The purpose of this article is to report one researcher's journey in attempting to conduct ethical and legal nursing research via the Internet.

Development and psychometric testing of the infant colic scale.

Novice researchers, when confronted with a clinical problem they want to study, are admonished by more experienced researchers to search the literature for an instrument that already has established reliability and validity, fits the problem of study, or that can be easily adapted. Sometimes, however, there is no such instrument available so the researcher has to develop a new instrument. The purpose of this article is to describe the steps required to develop and psychometrically test a new instrument.

What is known about infant colic?

The ancient Greeks were the first to mention infant colic in recorded history; yet in 2002, the cause of infant colic is still unknown. Review of the infant colic literature suggests there are at least five possible explanations-cow's milk/soy protein allergy or intolerance; immature gastrointestinal system; immature central nervous system; difficult infant temperament; and parent-infant interaction problems consisting of either the transfer of parental anxiety to the infant or the inability of the infant to give clear cues about needs to the caregiver. It is likely the cause of infant colic is multifactorial because it has proven to be so elusive.

Introduction to qualitative research.

The purpose of this article is to introduce practicing nurses to qualitative research. Qualitative research terms are defined, philosophy of science is briefly discussed, and several types of qualitative research studies are described. A hermeneutic phenomenological study of infant colic is described as an example of qualitative research useful in gastroenterology nursing.