Nursing Care of Rural Children with Special Health Care Needs (CSHCN)

Abstract

VA National Survey of Children with Special health Care Needs conducted in 2001 estimated that there are 9.4 million children who have special health care needs. This represents an estimated 12.8 percent of the children in the United States. The definition of children with special health care needs (CSCHN) was developed by the federal Maternal Child Health Bureau and states that children with special health care needs are those who have, or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required generally (Van Dyck, P,, Kogan, M., McPherson, M., Wessman, G., & Newacheck, P., 2004).
In providing nursing care, rural nurses can identify and classify CSHCN by the impact on the child’s condition or functional ability. In this classification, nurses can look at whether the special needs a) sometimes affect the child’s functional abilities and activities, b) usually or always affect the CSHCN, or c) never affect functional abilities and activities. Nearly 40% of CSHCN never have their activities affected by their special needs – however, 60% of CSHCN have their functional ability affected and as a result are in need of adaptations and services in their community or by referral to a specialty site.