title: New challenges, new answers: pediatric nurse practitioners and the care of adolescents.
abstract: BACKGROUND
  Since the 1950s, patterns of morbidity and mortality among adolescents have shifted to social and environmental causes. This study examines pediatric nurse practitioners' (PNPs') self-assessed competencies in addressing the common health concerns of adolescents.
  
  
  METHODS
  The analysis used a sample of 257 PNPs drawn from a larger national data set of 637 nurses randomly sampled from 3 nursing organizations. Factors associated with self-perceived knowledge or skill and interest in training for 28 common health concerns of adolescents were analyzed using Chi square, t test, and Pearson's correlation. Barriers and attractions to working with adolescents were also investigated.
  
  
  RESULTS
  The greatest deficits in self-perceived knowledge or skill, as well as low interest in training and low perceived relevance to practice, were around issues of gangs, gay/lesbian/bisexual/transgender youth, HIV/AIDS, and counseling about a positive pregnancy test. Also, PNPs identified the lack of resources appropriate for adolescent referrals as the greatest barrier to working with this population.
  
  
  CONCLUSIONS
  PNPs assessed their lowest competencies in some of the areas that present the greatest threats to adolescents' health and well-being. These deficits suggest needed curricular shifts in entry-level and advanced-level preparation of PNPs, as well as new priorities for continuing education.
authors.affiliation: St Paul Public Schools, Minn., USA.
authors.forename: P
authors.initials: P
authors.lastname: Nerdahl
authors.forename: D
authors.initials: D
authors.lastname: Berglund
authors.forename: L H
authors.initials: LH
authors.lastname: Bearinger
authors.forename: E
authors.initials: E
authors.lastname: Saewyc
authors.forename: M
authors.initials: M
authors.lastname: Ireland
authors.forename: T
authors.initials: T
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009722:Nurse Practitioners / Q000193:education / Q000523:psychology* / Q000592:standards*; D015403:Nursing Evaluation Research; D010371:Pediatric Nursing / Q000193:education / Q000592:standards*; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014481:United States