Febrile seizures are a common childhood problem occurring in two to five percent of children in Western Europe and the United States with a higher incidence reported in underdeveloped countries. Peak incidence occurs between 14-18 months of age. The author's experience when working with the Inuit population in the Eastern Arctic province of Nunavut suggests a high incidence of febrile seizures in young children although the statistics are not available regarding the incidence and prevalence. Community health nurses working in remote health centres are challenged by the uncertainty of which intervention is the most efficacious when treating these children during or following febrile seizures. This uncertainty results in inconsistent interventions, which creates stress and anxiety in both the community health nurses and parents. Despite their frightening presentation febrile seizures usually present as single benign incidents however, once they occur, recurrence may be as high as 50 percent. Due to a lack of treatment guidelines on the prevention of febrile seizures in remote Nunavut communities interventions are often inconsistent. A systematic review of the literature and guidelines were conducted to respond to the questions of whether increased dosages or prolonged use of pharmacological agents as compared to non-pharmacological interventions are more effective in preventing febrile seizures. Using the Stetler Model of research utilization as a framework to promote change recommendations for guidelines were developed. --P.ii.
Childhood obesity rates are rising at an alarming rate. Obesity has a negative impact on health and well being as well as social development. Obese children have a higher incidence of morbidity and mortality. Current clinical practice guidelines recommend practitioners use a family centered approach to managing childhood obesity. The purpose of this project is to examine the use of a family centered care (FCC) approach in managing childhood obesity in the primary health care setting and determine how best to incorporate it into managing childhood obesity in nurse practitioner (NP) practice. The principles of FCC are reviewed. NP use of existing nursing models such as the McGill model of nursing for guidance in incorporating family centered care into practice is examined and discussed. The research obtained during the literature review indicates using a FCC approach to disease management is effective and can be achieved in the primary health care setting. As a result of the findings, a five step approach to assessing and managing childhood obesity is recommended for NPs practicing in the primary health care setting. --Leaf ii.
