Journal of Pediatric Surgical Nursing

Anencephaly is a congenital defect in which the neural tube fails to fully close during the fourth week of embryonic development (Obeidi, Russell, Higgins, & O'Donoghue, 2010). The Medical Task Force on Anencephaly (1990) defined it as a condition with the following four characteristics: (a) A large portion of the skull is absent, (b) the scalp is absent over the skull defect, (c) the exposed tissue is hemorrhagic and fibrotic, and (d) the cerebral hemispheres are indistinguishable. Approximately one in every 4,647 births is affected by anencephaly, with an estimated 847 anencephalic infants born each year (Centers for Disease Control and Prevention, 2020). It is estimated that around 65% of anencephalic fetuses will die in utero, whereas those that survive to birth typically die within a few hours or days of life (Medical Task Force on Anencephaly, 1990). Anencephalic infants who do survive beyond birth often exhibit irregular breathing, requiring the use of mechanical ventilation to be kept alive. For decades, anencephalic infants have been the topic of a highly controversial and heated debate with regard to their status and potential as organ donors. Currently, anencephalic infants are not used as organ donors because they do not meet the criteria for brain death. To some, this seems like the elimination of a vital pool of organ donors, whereas others view this as preservation of the sanctity and dignity of human life. This highly disputed issue of anencephaly and how it relates to both brain death and organ donation is the topic of this discussion.

Historical and modern-day use of maggots for debridement is described. Included are benefits of maggot therapy based on the evidence. This article also includes method for procurement.

The aim of this study was to test Katharine Kolcaba's theory of comfort by evaluating the effectiveness of integrative comfort care interventions on discomfort experienced by children (aged 5–10 years) during the postoperative period. An experimental approach, pretest-and-posttest control group design, was used for evaluating the effectiveness of integrative comfort care interventions on discomfort experienced by children. Sample was composed of 200 children, selected using purposive sampling technique with random assignment to experimental and control groups. Kolcaba's Comfort Theory was used to assess the child's condition and then plan and deliver integrative comfort care interventions. The steps that followed for data collection, planning, and implementing effective care were based on the presuppositions of the theory. The tools used for data collection were demographics, a Comfort Behaviors Checklist, and the Comfort Daisies tool. Comfort care interventions were delivered through nursing process approach. These interventions were addressed across physical, psychological, social, spiritual, and environmental aspects. After the application of theory, the analysis revealed improvement in the comfort level of the subjects. Mann–Whitney U test was used to find out the significant difference in posttest postoperative discomfort scores among subjects in the experimental and control groups. Findings were significant at <.001. The findings revealed that subjects who received integrative comfort care interventions using the comfort theory experienced more comfort as compared with the subjects in the control group.