Ethical and leadership aspects of the activities of an advanced practice nurse in pediatric rehabilitation

    Article PDF


    About the Authors

    Anar Nurpeissova – Senior nurse of the Admission Department, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0004-9607-2216

    Aizhan Altynbekova – Senior nurse of the Psychoneurological Department No. 1 "Bobek", NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0007-1821-8891

    Gulnara Zhumabayeva – Nurse of the Admission Department, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0001-7848-9905              

    Diana Kurban – Nurse of the Psychoneurological Department No. 1 "Bobek", NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0006-6222-0350

    Raikhan Tleulinova – Director of Nursing, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0001-1891-7955


    Аbstract

    This review article presents a theoretical analysis of the ethical and leadership aspects of the activities of an Advanced Practice Nurse in pediatric rehabilitation. Modern pediatric rehabilitation is characterized by its long-term, multistage, and multidisciplinary nature, which objectively increases the clinical, organizational, and moral responsibility of Advanced Practice Nurses. The Advanced Practice Nurse is considered as a key coordinator of interprofessional care, an active participant in clinical decision-making, and an advocate for the rights and interests of the child and family. It is substantiated that ethics and leadership constitute the core of the Advanced Practice Nurse’s professional identity and directly influence the quality, safety, and patient-centeredness of rehabilitation care. Special attention is paid to the prospects for the development of the Advanced Practice Nurse’s role in the Republic of Kazakhstan in the context of existing regulatory, educational, and institutional limitations.


    Keywords

    Advanced practice nursing, pediatric rehabilitation, clinical ethics, leadership, family-centered care, child health services, multidisciplinary care.


    References

    1. Cieza, A., Kamenov, K., Sanchez, M. G., Chatterji, S., Balasegaram, M., Lincetto, O., Servili, C., Bermejo, R., & Ross, D. A. (2021). Burden of disability in children and adolescents must be integrated into the global health agenda. BMJ (Clinical research ed.)372, n9. https://doi.org/10.1136/bmj.n9
    2. Requejo, J., Strong, K., Agweyu, A., Billah, S. M., Boschi-Pinto, C., Horiuchi, S., ... & Weigel, R. (2022). Measuring and monitoring child health and wellbeing: recommendations for tracking progress with a core set of indicators in the Sustainable Development Goals era. The Lancet Child & Adolescent Health6(5), 345-352. https://doi.org/10.1016/S2352-4642(22)00039-6
    3. Gholami, B., Bastan, M. M., Gholami, S., Nejati, A., Khosravi, S., Malekpour, M. R., ... & Golestani, A. (2025). Disability-adjusted life years, years lived with disability, and years of life lost of diseases among children and adolescents in national and subnational levels of Iran, 1990–2021: A systematic analysis for the Global Burden of Disease 2021. Plos one20(6). https://doi.org/10.1371/journal.pone.0325085
    4. Guo, H., Zhu, W., & Li, J. (2023). Developing a core competency framework for advanced practice nursing in mainland China: a sequential exploratory study. BMC nursing22(1), 179. https://doi.org/10.1186/s12912-023-01335-4
    5. Chair, S. Y., Wong, F. K. Y., Bryant-Lukosius, D., Liu, T., & Jokiniemi, K. (2023). Construct validity of advanced practice nurse core competence scale: an exploratory factor analysis. BMC nursing22(1), 57. https://doi.org/10.1186/s12912-023-01203-1
    6. Søndergaard, S. F., Andersen, A. B., & Frederiksen, K. (2024). APN nurses' core competencies for general clinical health assessment in primary health care. A scoping review. Scandinavian Journal of Caring Sciences38(2), 258-272. https://doi.org/10.1111/scs.13235
    7. Nursing Council of Hong Kong. (2021). Core-Competencies and Reference Guides. https://www.nchk.org.hk
    8. Hamric, A. B., Hanson, C. M., Tracy, M. F., & O'Grady, E. T. (2013). Advanced practice nursing: An integrative approach. (5th ed.). Elsevier Health Sciences. – 726 р.
    9. Cooke, L., Gemmill, R., & Grant, M. (2008). Advanced practice nurses core competencies: a framework for developing and testing an advanced practice nurse discharge intervention. Clinical Nurse Specialist22(5), 218-225. https://doi.org/10.1097/01.nur.0000325366.15927.2d
    10. Wheeler, K. J., Miller, M., Pulcini, J., Gray, D., Ladd, E., & Rayens, M. K. (2022). Advanced practice nursing roles, regulation, education, and practice: a global study. Annals of global health88(1), 42. https://doi.org/10.5334/aogh.3698
    11. Jokiniemi, K., Tervo‐Heikkinen, T., Peltokoski, J., & Mikkonen, S. (2022). Construct validity of advanced practice role delineation tool: A confirmatory factor analysis. International Journal of Nursing Practice28(5). https://doi.org/10.1111/ijn.13064
    12. Jokiniemi, K., Chair, S. Y., Wong, F. K. Y., & Bryant‐Lukosius, D. (2022). Advanced practice role delineation within Hong Kong: A cross‐sectional study. Nursing & health sciences24(3), 679-689. https://doi.org/10.1111/nhs.12964
    13. International Council of Nurses. Definition of Advanced Practice Nurse / Nurse Practitioner / Clinical Nurse Specialist. https://www.icn.ch
    14. Carnevale, F. A., Teachman, G., & Bogossian, A. (2017). A relational ethics framework for advancing practice with children with complex health care needs and their parents. Comprehensive child and adolescent nursing40(4), 268-284. https://doi.org/10.1080/24694193.2017.1373162
    15. King, G., Graham, F., & Ahkbari Ziegler, S. (2024). Comparing three coaching approaches in pediatric rehabilitation: Contexts, outcomes, and mechanisms. Disability and Rehabilitation46(12), 2708-2719. https://doi.org/10.1080/09638288.2023.2229731
    16. CanChild & IAACD. (2020). Guidelines for Family-Centred Early Intervention in Children with Disabilities. Children with Disabilities. https://www.canchild.ca
    17. Mubarak, M., Ali, A., Davi, P., & Iqbal, H. (2025). Nursing leadership for child rights protection and ethical practice in pediatric care: A systematic review. Academia International Journal for Social Sciences, 4(3), 4827-4836. https://doi.org/10.63056/ACAD.004.03.0759
    18. LeGrow, K., Hubley, P., & McAllister, M. (2010). A conceptual framework for advanced practice nursing in a pediatric tertiary care setting: the SickKids' experience. Nursing Leadership (Toronto, Ont.)23(2), 32-46. https://doi.org/10.12927/cjnl.2013.21831
    19. Hassmiller, S., & Pulcini, J. (Eds.). (2020). Advanced practice nursing leadership: a global perspective(No. 180694). Cham: Springer.
    20. Ylimäki, S., Oikarinen, A., Kääriäinen, M., Holopainen, A., Oikarainen, A., Pölkki, T., ... & Tuomikoski, A. M. (2022). Advanced practice nurses’ experiences of evidence-based practice: a qualitative study. Nordic Journal of Nursing Research42(4), 227-235. https://doi.org/10.1177/20571585221097658
    21. Lee, H., Kim, D.-J., & Han, J.-W. (2024). An exploratory analysis of the roles of nurses on a pediatric rehabilitation unit in South Korea perceived by pediatric rehabilitation professionals. Healthcare, 12(2), 177. https://doi.org/10.3390/healthcare12020177
    22. Grace, P. J., Gaylord, N., & Roosevelt, E. (2022). Ethical Leadership by Advanced Practice Nurses. Nursing Ethics and Professional Responsibility in Advanced Practice, 167.
    23. Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. International journal of nursing studies115. https://doi.org/10.1016/j.ijnurstu.2020.103842
    24. Courtwright, S. E., Turi, E., Barr, E. A., Burns, J. C., Gigli, K. H., Bennett, C. R., ... & Poghosyan, L. (2024). Facilitators and barriers to pediatric nurse practitioner practice in the United States: A systematic review. Journal of Pediatric Health Care38(4), 520-543. https://doi.org/10.1016/j.pedhc.2023.12.003
    25. Sara, M. G., Jocelyn, S., & Sébastien, C. (2025). Advanced practice nursing in the European Union: A scoping review. Nursing Outlook73(6). https://doi.org/10.1016/j.outlook.2025.102588
    26. Starzomski, R., Storch, J. L., & Rodney, P. (2023). Toward a moral horizon: nursing ethics for leadership and practice. (3rd ed., Chapter 7). University of Victoria Libraries. https://doi.org/10.18357/9781550587128

     

    200.png
    © 2026 All Rights Reserved.
    Whatsapp Instagram YouTube Запись на консультацию