Journal of Pediatric Nursing-Nursing Care of Children & Families最新文献

Anti-epileptic drugs (AEDs) are often the first-line treatment implemented to manage epilepsy (Epilepsy Foundation, 2023). While it is unknown the exact mechanism by which different AEDs impact thyroid hormones, studies have shown that patients on AEDs should have thyroid hormone levels monitored due to possible disruption. This is a case report of two pediatric patients who were referred to the endocrinology clinic for different reasons: one for bone health and one for signs of early puberty. Both patients had been on AEDs for several years when an endocrinology evaluation showed an abnormality in their thyroid hormone levels.

Background and purpose: Although the physiological response to enteral nutrition is high in children, it also carries risks and complications. This study was conducted to investigate the effect of abdominal massage on gastrointestinal complications in mechanically ventilated, enterally fed children hospitalized in the pediatric intensive care unit.

Materials and methods: The sample of this controlled experimental study consisted of 38 patients in the experimental group and 38 in the control group, all of whom were receiving enteral nutrition via mechanical ventilation in a pediatric intensive care unit. The experimental group received abdominal massage once daily for three consecutive days.

Results: A significant difference was observed between the groups in terms of abdominal distension, defecation, development of constipation, daily caloric intake, and gastric residual volume. However, no significant difference was found between the groups regarding the occurrence and frequency of vomiting. A significant difference was identified in the experimental group concerning abdominal distension and frequency of defecation, whereas in the control group, significant differences were found in constipation, daily caloric intake, gastric residual volume, and fasting blood glucose measurements.

Conclusion: Abdominal massage applied to patients in the pediatric intensive care unit was found to be potentially effective in reducing abdominal distension, increasing the frequency of defecation, decreasing the incidence of constipation, enhancing daily caloric intake, and lowering gastric residual volume levels.

Implications to practice: Abdominal massage is a safe, noninvasive, cost-free nursing practice that helps prevent or reduce gastrointestinal complications in pediatric intensive care patients.

Objective: The aim of the study was to assess the influence of using tele-nursing application on metabolic control, self-efficacy, quality of life and anxiety in adolescents with Type 1 Diabetes Mellitus (T1DM).

Methods: This is a randomized control intervention study. The study included 67 adolescents aged 12-18 years with T1DM who were monitored at the Pediatric Endocrinology Outpatient Clinic. On enrolment, participant in all conditions received face-to-face training provided by the researchers. Thereafter, for 6 months educative and follow-up telephone calls were conducted in the intervention group to the adolescents and their parents but no intervention was made towards the control group. The study received approval (Decision no: 2020-14) and was registered in the registration number (NCT05211479).

Results: At the 6-month follow-up, the self-efficacy, quality of life, HbA1c, and anxiety levels of the adolescents in the intervention group were found to be better than those in the control group (p <0.05). During the study period, no significant difference was found in HbA1c values, quality of life, self-efficacy, and anxiety levels over time in the control group (p > 0.05).

Conclusion: Diabetes education and follow-up with tele-nursing improved self-efficacy and quality of life, as well as decreased HbA 1c and anxiety among adolescents with T1DM.

Implications for practice: Tele-nursing is an effective and accessible approach for achieving metabolic control, improving self-efficacy and quality of life, and reducing anxiety levels in adolescents with Type 1 Diabetes Mellitus (T1DM). Remote follow-up enables the adolescent to receive continuous support regarding diabetes management without disrupting their daily life.

Background: Nurses in neonatal intensive care units witness the suffering of critically ill infants and the emotional distress of their families, which can lead to psychological strain.

Objective: This study examined individual and organizational factors contributing to secondary traumatic stress among neonatal intensive care unit and explored their experiences of this stress.

Methods: A convergent mixed-methods design was employed. A total of 147 nurses from Level III neonatal intensive care units across South Korea participated, and in-depth interviews were conducted with 13 nurses.

Results: Many nurses reported moderate to severe psychological stress related to repeated exposure to traumatic events. The emotional impact was influenced by both individual sensitivity and the organizational context of care.

Conclusion: Emotional challenges in neonatal intensive care units constitute both a psychological burden and an ethical complexity of nursing. Institutional support is essential to address these challenges, fostering nurses' emotional well-being and professional sustainability.

Implication to practice: Future strategies to reduce secondary traumatic stress should integrate individual-level coping and emotional regulation strategies. In addition, organizational approaches should address unit-specific traumatic events and promote trauma-informed work environments in neonatal intensive care units.

Aim: This study investigated nurses' self-efficacy in caring for children with epilepsy and the factors influencing it.

Method: This descriptive-cross-sectional and correlational study was conducted with 135 nurses working in pediatric clinics at a university's medical faculty hospital. Data were collected between using a socio-demographic data collection form, the scale of self-efficacy in nursing care of children with epilepsy, the self-efficacy-sufficiency scale. Descriptive statistics and multiple linear regression analysis were used to analyze the data.

Results: Three models were created to analyze the relationships between the study variables and nurses' self-efficacy. The effect on nurses' self-efficacy levels in the care of children with epilepsy was explained by their descriptive characteristics at a rate of 27.8% in the first model, by the Self-Efficacy-Sufficiency Scale at a rate of 18.5% in the second model, and by their descriptive characteristics and self-efficacy at a rate of 35.5% in the third model. Age, number of children, having receivede ducation on children with epilepsy at school, and the total self-efficacy scale score were found to be relevant factors in predicting the self-efficacy of nurses in the care of children with epilepsy (p < 0.05).

Conclusion: It was determined that nurses' self-efficacy in caring for children with epilepsy was above average and that factors affected this level of self-efficacy.

Implications for practice: Nurses' high self-efficacy in caring for children with epilepsy increases the quality of care they provide. It is recommended that detailed evidence-based and case-based courses on childhood epilepsy management be offered both in in-service training and nursing curricula.

Purpose: This study aimed to examine the preliminary results of a health literacy education program on the health literacy of parents of children with disabilities in special education and rehabilitation centers.

Study design and methods: The study employed a single-group pre- and posttest research design. It was conducted with parents of children receiving services at four special education and rehabilitation centers affiliated with a district national education directorate. First, the questionnaires were administered, and the data were collected. Then, a 6-week health literacy training program was conducted. After the program, the data were collected again and analyzed using the paired-sample t-test and the McNemar's test.

Results: The pretest mean health literacy score was 30.19 ± 8.08, which increased to 36.63 ± 8.42 at posttest (p < .001). Following the educational program, 44 participants demonstrated enhancement in their health literacy levels and transitioned from the inadequate or problematic category to the adequate category in their post-assessment results (p < .001).

Conclusion: The study successfully achieved this objective, thereby demonstrating a positive impact of the training program on the health literacy of parents of disabled children.

Practice implications: The significance of this study lies in addressing the research gap concerning parents of children with disabilities in special education. The program had a positive impact on the health literacy of participating families.

Background: The rising prevalence of Autism Spectrum Disorder (ASD) places increasing demands on family caregivers. While the barriers to self-care are well-documented, the motivations that drive caregivers to prioritize their own health remain underexplored. This gap is particularly evident in culturally distinct settings like Saudi Arabia, where societal norms and religious beliefs shape caregiving dynamics.

Aim: This study aimed to explore the motivations for self-care among Saudi mothers of children with ASD.

Methods: A descriptive phenomenological design, grounded in Husserl's philosophy, was employed to investigate the lived experiences of 12 Saudi mothers. Participants were recruited via criterion-based purposive sampling. Data were collected via semi-structured, in-depth interviews conducted and analyzed using Colaizzi's method to distill thematic insights. Rigor was ensured through bracketing, interpretive member checking, and investigator triangulation.

Results: Four key categories emerged: (1) Personal Values and Beliefs, highlighting intrinsic maternal duty and spirituality as a primary sustainer; (2) Social Support, emphasizing family and professional encouragement; (3) Barriers to Self-Care, identifying time constraints and guilt rooted in cultural expectations; and (4) Perceived Impact on Caregiving, linking self-care to enhanced resilience and child well-being. Spirituality and collectivist support systems uniquely influenced motivations, while cultural norms posed distinct challenges.

Conclusion: Motivation for self-care among Saudi mothers is not driven by a desire for personal indulgence, but by a pragmatic and spiritual imperative to maintain caregiving capacity. Findings advocate for culturally tailored interventions, such as "Self-Care Prescriptions," that leverage spirituality and family networks to overcome barriers and enhance caregiver well-being.

Background: Comprehensive continuous assessment and effective pain management for pediatric pain are important.

Purpose: To assess the differences between oncology and non-oncology nurse knowledge and attitudes toward pediatric pain.

Method: A descriptive cross-sectional study was conducted in three public hospitals and included nurses who provided oncology and/or non-oncology care in pediatric departments. The sample included 207 nurses.

Results: More than half of nurses (n = 142, 68.6%) had not attended any workshop related to pediatric pain management. Both oncology and non-oncology nurses exhibited low mean of knowledge and attitude toward pediatric pain assessment and management, however, oncology nurses scored significantly higher (t = 12.13, p < .001). Among oncology nurses, higher PNKAS scores were associated with younger age (ꞵ = -0.575, p = .003), longer nursing experience (ꞵ = 0.642, p = .016), having children (ꞵ = 0.402, p = .010), and reliance on child status (ꞵ = 0.206, p = .044) and parent verbalization (ꞵ = 0.236, p = .027).

Conclusion: Targeted educational interventions, particularly for non-oncology nurses focusing on child-centric assessment and supported by mentorship and clear clinical policies, are essential to bridge this knowledge-attitude gap and improve pediatric pain outcomes.

Implications to practice: This study underscores the critical need to implement standardized, mandatory pain management education for all pediatric nurses, with a focus on training in non-verbal pain assessment techniques. Findings emphasize that all nurses need to apply culturally sensitive approaches to overcome sociocultural barriers to effective pain relief.

Background: Childhood type 1 diabetes poses substantial challenges for disease management and psychosocial well-being. Caregivers play a central role in diabetes care, and their psychological distress and caregiving burden may negatively influence children's mental health and illness-related outcomes. This study aimed to examine the associations between caregivers' psychological well-being and caregiving burden and the mental health and illness attitudes of children with type 1 diabetes.

Methods: This cross-sectional study included 129 child-caregiver dyads (caregivers were all mothers) of children aged 10-18 years with type 1 diabetes who were followed at a pediatric endocrinology outpatient clinic in Turkey. Data were collected using validated questionnaires and analyzed using structural equation modeling.

Results: Caregivers' depression, anxiety, stress, and caregiving burden were significantly associated with children's emotional, behavioral, and social difficulties (r = 0.51-0.77, p < 0.001). Structural equation modeling supported a sequential pathway in which caregiving burden predicted parental psychological distress, which in turn influenced children's illness attitudes and psychosocial outcomes (β = 0.52-0.66, p < 0.001).

Conclusion: Caregiver mental health plays a critical role in children's illness perception and psychosocial adjustment. Supporting caregivers may indirectly improve coping and psychosocial well-being in children with type 1 diabetes.

Practice implications: Pediatric and family nurses should incorporate caregiver psychological assessment and support into diabetes management. Family-centered interventions addressing caregiver distress and burden may enhance children's coping capacity, illness attitudes, and psychosocial well-being.