27^th International Conference on Clinical Pediatrics June 10-11, 2019, Golden Tulip Berlin - Hotel Hamburg, Berlin, Germany

May Aasebø Hauken is an Associate Professor at Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Norway

Background: Young adult cancer survivors (YACS) are a small and understudied group, with increased risk of late-effects. Cognitive therapy (CT) is a promising intervention to enhance coping in survivorship, but research into CT interventions and how YACS experience these are lacking. Thus, the objective of this study was to explore YACS’ experiences of CT in a rehabilitation program. Methods: The study applied a phenomenological-hermeneutical approach, including 17 YACS who completed a six-month rehabilitation program, including CT. Semi-structured interviews were conducted and the transcripts were analyzed using Systematic Text Condensation. Results: The analyses revealed two main themes and three corresponding subthemes. The first theme, ‘CT as a tool’, was elaborated by the subthemes ‘education and practicing’, ’follow-up’ and ‘internalization’. The second theme, ‘the perceived usefulness of CT’, was clarified by the three subthemes ‘changed thought patterns’, ‘insight and acceptance’ and ‘handling a new life-situation’. Conclusions: The participants experienced CT as a useful tool in their rehabilitation process, dependent upon education, practicing and follow-up before it could be internalized. Additionally, the YACS expressed that CT changed their thought patterns and helped them achieve insight and acceptance as an important basis to handle their new life-situations. The results cannot be generalized, and further research is warranted.

May Aasebø Hauken is an Associate Professor at Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Norway

Background: Limited research has focused on quality of life (QOL) of children living with parental cancer to discover areas of distress and wellbeing. Aim: Study the children’s HRQOL and how this it’s influenced by anxiety. Method: Survey including 35 children between 8-18 years (mean 13.3) living with parental cancer. . Results: The children reported higher anxiety than the controls. The children’s physiological (p=.03), emotional (p=.04) and school (p=.00) function were significantly impaired, while they scored in line with the controls on self-esteem, family, friends and overall HRQOL. A negative correlation (r= -.707, p<.01) between anxiety and HRQOL was found. Conclusions: A one-dimensional focus on anxiety may not capture these children’s multidimensional challenges. In contrast, a focus on HRQOL may give important knowledge of the children’s challenges, as well as areas where they function well.

Anabela da Graça Amaro Pereira Mendes has completed her PhD in Nursing - Advanced Nursing - by the Portuguese Catholic University in 2014. She is a Professor at the Nursing School of Lisbon in the Department of Adult and Elderly Nursing. She published 9 articles in specialized magazines and 25 papers in events proceedings, has 1 book published. She is the Project Manager of Master's Degree in Nursing - Specialization Person in Critical Situation.

Critical care situations as a significant impact on the family life, so the interaction that family-members and nurses built reveals itself a dynamic and important process for both. Family members are nursing client in the intensive care unit (ICU) due to the emotional vulnerability that they experience. In the clinical interaction, family looks for information to understand the situation while nurses want to know better this family and the process health-disease transition that they are living (1,2). The aim of this research is to identify and analyse the Information Needs and the Information content Shared by nurses and family. The specific objectives are: Identify in the nurses' narrative, the contents that are present in the information transmission; and Identify in the nurses’ description, the nursing contents that are present in the data collection. This project involves a qualitative approach; data collection will be performed with a semi-structured interview and written narratives(3). Participants are going to be selected intentionally. The research population will be the nursing team. Data will be discussed with: 1- “Nursing Interventions Classification (NIC) as a comprehensive standardized nursing terminology that has been used to systematically classify nursing care in clinical settings”,“Nursing Outcomes Classification (NOC) and standardized Nursing Diagnoses (NANDA-I) “ (4) (5); 2- Orem theory of Self-care (6); 3 -“The structure of caring” according to Swanson(7). The expected duration of this study is two years. It will contribute to increase knowledge in nursing practice. The results could affect directly the nursing intervention and indirectly the health care and health systems.

Nurse since 1983. Clinical Exercise in Intensive Care and Cardiology. Lecturer at the Nursing School since 1991. Specialist in Medical-Surgical Nursing (MC) since 1994. Master in Nursing Sciences since 2001. Dissertation with the theme: Empathic understanding and sociomoral development in nurses who care for the AIDS patient. Coordinating Professor since 2006, Nursing area in infectious disease. In 2007, coordination of the Nursing Degree Course (CLE), which he maintains until 2014. During this period he is the director of several CLE units. Co-director of the UC of Ethics and Deontology of CLE. She is a UC regent (which includes ethical issues associated with renal disease and transplantation) of the Master in Nursing MC - Nephrological Nursing; regent of UC of the Master's Degree in Nursing in Person in Critical Situation. She is a Doctorate in Nursing, at the University of Lisbon, awaiting discussion of thesis.

Effective symptom management is considered an essential component of nursing care practice for different clinical conditions, but it is particularly important in chronic diseases (Sidani, 2001), as is the case with HIV infection. Thus, the purpose of this research was to develop a nursing intervention program that demonstrates its effects on symptom management and consequently adherence to antiretroviral therapy in the person with HIV infection. This is a study who the sample was 73 participants with symptoms of anxiety, fatigue, fear, depression and headaches. The majority of participants (95.9%) reported never having failed the therapy, 24.7% took the therapy as they learned, "every time", 57.5% reported adhering to instructions, 91.8% said did not forget, 28.8% reported "never having stopped taking". As for the reason for not taking, at 15% was simply forgetting. Regarding evaluation pre and post intervention of the manual of symptom management strategies use, by the Wilcoxon test, the differences were shown to be statistically significant in the symptoms anxiety, fear and fatigue confirming the theoretical construct that the use of the manual improved these three symptoms. On the other hand, the use of the manual helped to reduce the failures in antiretroviral therapy, with statistically significant differences. The study showed that symptom management is a sensitive indicator of nursing care, where the intervention of the nurse, wherever it takes place, privileges the quality of communication and relation with the sick person and helps to improve the management of its symptoms, as well as adherence to antiretroviral therapy.

Dr Ennies Musvosvi obtained her Bachelor of Science from Jacksonville University-Florida, Masters of Science Nursing from California State University-Chico, California and Doctor of Nursing Practice from Touro University, Nevada. She is currently an Associate Professor in the Department of Nursing at California State University-Chico. Her expertise in Nursing Education is pathophysiology and nursing management of disease processes. Her clinical specialty is Critical Care Nursing. As a tenure track faculty, Dr Musvosvi has presented at local and international levels on various health topics to bring health awareness to both rural and urban communities.

Dr Ennies Musvosvi obtained her Bachelor of Science from Jacksonville University-Florida, Masters of Science Nursing from California State University-Chico, California and Doctor of Nursing Practice from Touro University, Nevada. She is currently an Associate Professor in the Department of Nursing at California State University-Chico. Her expertise in Nursing Education is pathophysiology and nursing management of disease processes. Her clinical specialty is Critical Care Nursing. As a tenure track faculty, Dr Musvosvi has presented at local and international levels on various health topics to bring health awareness to both rural and urban communities.

Chelsea Kadish is a graduate from Tulane University School of Medicine and has completed her pediatric residency at New York University in New York City. She is an attending physician in the department of pediatric emergency medicine at NYU where her research focuses on sepsis identification in the pediatric population.

Study Objective: The primary objective of this study is to evaluate local performance of the two-tiered sepsis screening tool, previously introduced by Balamuth et al, in children diagnosed with sepsis. Secondary objectives included the evaluation of additional clinical data that might improve performance of this screening tool as well as its integration into the workflow of our institution. Methods: We completed a retrospective cohort study of patients <18 years presenting between 1/2017 and 3/2018 with a diagnosis code for sepsis or severe sepsis. Two tiers were established prior to review: Tier one consisted of age-adjusted, vital-signs based SIRS criteria, and tier two consisted of the criteria employed by Balamuth et. al., inclusive of patient historical factors and exam findings. The two-tiered alert was applied retrospectively to all patients at the onset of sepsis, and sensitivity was calculated in this patient cohort. Additional patient characteristics were combined with the screening tool to assess for improved sensitivity (Table1). Results: 63 patients met inclusion criteria for sepsis and 24 of those were identified as severe sepsis. 39 of the 63 cases (sensitivity of 61.9%) were identified by the two-tiered screening tool, while 17 of the 24 cases of severe sepsis (sensitivity 70.8%) were identified. We determined the sensitivity of the two-tier screen with the addition of age-adjusted abnormality of WBC, lactate and postoperative status. Conclusion: Identification of pediatric sepsis remains difficult. The previously developed two-tiered system missed 38% of all sepsis cases and 29% of patients with severe sepsis in our population. Preliminary investigation suggests that altering the second-tier criteria to include postoperative status as well as including an automated alert to clinicians for specific abnormal laboratory data, may enhance sepsis detection. A prospective study evaluating these proposed adjustments to the sepsis screening tool is currently in development. https://d2cax41o7ahm5l.cloudfront.net/cs/upload-images/clinicalpediatrics2019-77546.jpg