Journal of Pediatric Nursing-Nursing Care of Children & Families最新文献_第10页

Effect of game-based asthma management interventions on pediatric asthma control, knowledge, attitudes, hospitalizations, and emergency visits: A systematic review and meta-analysis. 基于游戏的哮喘管理干预对小儿哮喘控制、知识、态度、住院和急诊就诊的影响：系统回顾与荟萃分析。

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-12-31 DOI: 10.1016/j.pedn.2024.12.009

Aylin Akca Sumengen, Damla Ozcevik Subasi, Remziye Semerci, Gokce Naz Cakir

Purpose: Many studies have used game-based interventions to educate children about asthma. The study aims to determine the effectiveness of these games in improving asthma control and related outcomes in children.

Methods: Seven databases were searched: PubMed, Cochrane Library, Scopus, CINAHL, Embase, Web of Science, and PsycINFO'. All research papers published until June 2023 were included. MeSH terms and keywords were used in the literature search. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments was used to assess the risk of bias.

Results: This systematic review and meta-analysis included nine studies with a total sample size of 694 children. The effect size for hospitalization rates was not statistically significant (p > 0.05), although the association was significant (p = 0.004). Conversely, a statistically significant reduction in emergency visits was observed (p < 0.05), with an effect size estimate of 0.376. The analysis also revealed a significant improvement in asthma knowledge (p < 0.05), with an effect size estimate of 0.677 (95 % CI: 0.240 to 1.114, p = 0.002), and an increase in asthma control (p < 0.05), although the association was not statistically significant (p = 0.120) with an effect size estimate of 0.169 (95 % CI: -0.044 to 0.381). Conversely, no statistically significant effect was observed for asthma attitude (p > 0.05).

Conclusion: Game-based interventions have shown promise in improving asthma management in children by enhancing knowledge and control and reducing emergency visits. This approach is increasingly recommended in clinical settings, though there is notable heterogeneity in study design and participant demographics.

目的：许多研究使用基于游戏的干预措施来教育儿童哮喘。该研究旨在确定这些游戏在改善儿童哮喘控制和相关结果方面的有效性。方法：检索PubMed、Cochrane Library、Scopus、CINAHL、Embase、Web of Science、PsycINFO’等7个数据库。包括2023年6月之前发表的所有研究论文。文献检索采用MeSH术语和关键词。采用乔安娜布里格斯研究所统计评估和回顾工具的元分析来评估偏倚风险。结果：本系统综述和荟萃分析包括9项研究，总样本量为694名儿童。住院率的效应量无统计学意义（p < 0.05），但相关性显著（p = 0.004）。相反，观察到急诊次数有统计学意义的减少（p 0.05）。结论：基于游戏的干预措施通过提高知识和控制以及减少急诊就诊，在改善儿童哮喘管理方面显示出希望。尽管在研究设计和参与者人口统计方面存在显著的异质性，但这种方法在临床环境中越来越多地被推荐。

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引用次数: 0

The relationship between digital addiction and social anxiety, trait anger and anger expression style in adolescents. 青少年数字成瘾与社交焦虑、特质性愤怒及愤怒表达方式的关系

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-12-03 DOI: 10.1016/j.pedn.2024.11.024

Arzu Koçak Uyaroğlu, Esra Ünal, Alime Selçuk Tosun

Objective: This study aimed to investigate the relationship between adolescents' digital addiction levels and their social anxiety, trait anger and anger expression styles.

Method: The study was devised as a descriptive and correlational research study. The sample consisted of 958 adolescents in Konya, Turkey. The data were collected via Personal Information Form, Digital Addiction Scale for Children, Social Anxiety Scale for Adolescents, and Trait Anger and Anger Expression Style Scale.

Results: The total mean score of digital addiction in adolescents was found as 56.74 ± 19.02. A significant relationship was found between digital addiction, and trait anger, anger out, anger in, anger control and social anxiety levels (p < 0.01). Grade, mother's educational and employment status, trait anger, anger out, anger in, anger control, and social anxiety explain 69.3 % of the variation on digital addiction levels.

Conclusion: As digital addiction levels increase, social anxiety, trait anger, anger in, and anger out levels also increase. However, the level of anger control decreases as digital addiction levels rise. These variables are predictors of digital addiction levels.

Implications for nursing practice: To protect and improve adolescent health concerning biopsychosocial aspects, comprehensive educational programs and seminars about digital addiction should be organized for families and adolescents by nurses in collaboration with educational institutions. To assist adolescents in managing negative emotions such as social anxiety and anger more effectively, nurses should encourage the engagement in a variety of activities and hobbies in educational and extracurricular social settings in addition to developing and implementing relevant psychoeducational programs.

目的：探讨青少年数字成瘾水平与社交焦虑、特质愤怒和愤怒表达方式的关系。方法：采用描述性、相关性研究方法。该样本由土耳其科尼亚的958名青少年组成。数据通过《个人信息表》、《儿童数字成瘾量表》、《青少年社交焦虑量表》和《特质愤怒与愤怒表达方式量表》收集。结果：青少年数字成瘾总分平均为56.74±19.02分。数字成瘾与特质性愤怒、愤怒输出、愤怒输入、愤怒控制和社交焦虑水平之间存在显著关系(p结论：随着数字成瘾水平的增加，社交焦虑、特质性愤怒、愤怒输入和愤怒输出水平也会增加。然而，随着数字成瘾程度的上升，愤怒控制水平会下降。这些变量是数字成瘾程度的预测指标。对护理实践的启示：为了保护和改善青少年在生物心理社会方面的健康，护士应该与教育机构合作，为家庭和青少年组织有关数字成瘾的综合教育计划和研讨会。为了帮助青少年更有效地管理负面情绪，如社交焦虑和愤怒，护士除了制定和实施相关的心理教育计划外，还应鼓励青少年在教育和课外社会环境中参与各种活动和爱好。

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引用次数: 0

A comparison of watching cartoons versus playing games as a distraction method on pain and fear of pain during peripheral intravenous cannula placement in children aged 6–9 years: A randomized experimental study 6-9岁儿童外周静脉置管时，观看卡通片与玩游戏分散注意力对疼痛和疼痛恐惧的影响：一项随机实验研究

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-30 DOI: 10.1016/j.pedn.2024.11.023

Derya Akdeniz Uysal RN, MScN, PhD , Ozlem Guzel Polat RN, MScN, Ph.D. , Guzide Ugucu Res. Asst., RN, MScN, Ph.D. , Atiye Karakul RN, MScN , Ayşe Zişan Olcay RN, MScN , Ozlem Tuzun RN , Rana Yigit R.N., MSc.N., Ph.D.

Purpose

This study aimed to compare the effects of watching cartoons and playing games as a distraction method during peripheral intravenous cannula insertion on pain and fear of pain in children aged 6–9 years.

Design & methods

This RCT with a parallel-group randomized experimental design was conducted between May and July 2024 in the pediatric unit of a university hospital with a tertiary referral centre. Sixty-eight children aged 6–9 years were assigned to two different groups using block randomization method (Cartoon Group = CG; n = 34, Gaming Group = GG; n = 34). The Wong-Bakers FACES® Pain Rating Scale and Children's Fear Scale were used for data collection. The children's pain and fear of pain were evaluated 2 min before, during and 2 min after the procedure.

Results

The mean age of the children (N = 64) was 7.41 ± 1.71 years (min-max = 6–9). Pain scores of GG (n = 32) were higher than CG (n = 32) (MD = 1.46; SE = 0.35; p < 0.001; %95 CI = 0.76–2.15). During the procedure, fear of pain scores of GG were higher than CG (MD = 0.78; SE = 0.32; p = 0.018; %95 CI = 0.13–1.42).

Conclusion

This study revealed that watching cartoons reduced the pain score by approximately 1.5 units and the fear of pain score by approximately 1 unit compared to playing online games during peripheral intravenous cannula placement in children aged 6–9 years.

Practice implication

In children aged 6–9 years planned to undergo peripheral intravenous cannula placement, watching a cartoon, one of the distraction techniques, can be recommended to effectively reduce pain and fear of pain. Tablets that allow watching cartoons and films, which are widely used and accessible in the clinical field, can facilitate the use of distraction techniques.

目的比较6-9岁儿童外周静脉置管过程中观看动画片和玩游戏作为分散注意力的方法对疼痛和疼痛恐惧的影响。设计,方法采用平行组随机实验设计的随机对照试验，于2024年5月至7月在某三级转诊中心的大学附属医院儿科进行。68名6-9岁的儿童采用分组随机法分为两个不同的组(卡通组= CG；n = 34, Gaming Group = GG；n = 34)。使用Wong-Bakers FACES®疼痛评定量表和儿童恐惧量表进行数据收集。分别于术前、术中及术后2分钟对患儿的疼痛及疼痛恐惧程度进行评估。结果患儿平均年龄（N = 64）为7.41±1.71岁（最小-最大= 6-9岁）。GG组（n = 32）疼痛评分高于CG组（n = 32） (MD = 1.46；se = 0.35；p & lt;0.001;%95 ci = 0.76-2.15)。手术过程中，GG组疼痛恐惧评分高于CG组(MD = 0.78；se = 0.32；p = 0.018；%95 ci = 0.13-1.42)。结论6-9岁儿童外周静脉置管期间，与玩网络游戏相比，观看动画片可使疼痛评分降低约1.5个单位，疼痛恐惧评分降低约1个单位。实践意义对于6-9岁拟行外周静脉置管的患儿，可推荐观看动画片作为分散注意力的方法之一，有效减轻疼痛和对疼痛的恐惧。可以观看卡通和电影的平板电脑在临床领域被广泛使用，可以方便地使用分散注意力的技术。

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引用次数: 0

Comparison of nutritional screening tools in pediatric oncology patients receiving chemotherapy treatment 儿科肿瘤化疗患者营养筛查工具的比较

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-29 DOI: 10.1016/j.pedn.2024.11.009

Buket Meral , Melda Kangalgil , Erol Erduran

Background

Malnutrition in pediatric oncology patients is a complex and multifactorial process, and the most appropriate screening tool to determine the risk of malnutrition is not clear. The study aimed to compare the Screening Tool for Risk on Nutritional Status and Growth (StrongKids), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), which are commonly used in the general pediatric population, with the Nutrition Screening Tool for Childhood Cancer (SCAN), which was specifically validated for pediatric cancer, in determining the risk of malnutrition.

Methods

This cross-sectional study included 92 children aged 2–18 years who were admitted to the hematology-oncology unit and were receiving chemotherapy. The prevalence of nutritional risk was determined using the SCAN, StrongKids, PYMS, STAMP, and anthropometric assessments were performed. Sensitivity and specificity values, and the degree of agreement between screening tools were calculated.

Result

The SCAN identified nutritional risk in 69.6 % of the children. According to StrongKids, PYMS and STAMP, the high nutritional risk in children was 43.5 %, 56.5 % and 64.1 %, respectively. The sensitivity of STAMP (81.2 %) was higher than that of StrongKids (60.9 %) and PYMS (79.7 %). The specificity of StrongKids, PYMS and STAMP was 96.4 %, 96.4 %, and 75.0 %, respectively. There was substantial agreement between SCAN and PYMS.

Conclusion

PYMS has the best specificity and sensitivity in identifying patients at risk of malnutrition as determined by SCAN.

Implications for practice

In addition to anthropometric measurements, population-specific or highly sensitive nutritional screening tools should be used to determine the risk of malnutrition.

儿童肿瘤患者的营养不良是一个复杂的多因素过程，目前尚不清楚确定营养不良风险的最合适的筛查工具。本研究旨在比较一般儿科人群常用的营养状况和生长风险筛查工具（StrongKids）、儿科约克希尔营养不良评分（PYMS）、儿科营养不良评估筛查工具（STAMP）与儿童癌症营养筛查工具（SCAN）在确定营养不良风险方面的差异，SCAN专门针对儿童癌症进行了验证。方法本横断面研究纳入92名2-18岁的儿童，他们在血液肿瘤科接受化疗。使用SCAN、StrongKids、PYMS、STAMP来确定营养风险的流行程度，并进行人体测量评估。计算敏感性和特异性值，以及筛选工具之间的一致程度。结果69.6%的儿童存在营养风险。根据StrongKids、PYMS和STAMP的数据，儿童的高营养风险分别为43.5%、56.5%和64.1%。STAMP的敏感性为81.2%，高于StrongKids（60.9%）和PYMS（79.7%）。StrongKids、PYMS和STAMP的特异性分别为96.4%、96.4%和75.0%。SCAN和PYMS之间有实质性的一致。结论pyms对SCAN诊断的营养不良风险患者具有最佳的特异性和敏感性。实践意义除人体测量外，还应使用特定人群或高度敏感的营养筛查工具来确定营养不良的风险。

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引用次数: 0

“She deserves the best. So how can I feed her the best?” Complementary food introduction practices among young mothers with a history of child maltreatment “她应该得到最好的。那么我怎样才能喂她吃得最好呢？”在有虐待儿童史的年轻母亲中引入辅食的做法

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-29 DOI: 10.1016/j.pedn.2024.11.022

Amara Channell Doig PhD MPH , Leena Moses MSPH , Michelle Jasczynski PhD, EdM , Francia Ximena Marin Gutierrez MSW , Kayla Bae BS , Stefany Zeyala BS , Chloe Bernardi MSW, LCSW-C , Elizabeth M. Aparicio PhD, MSW, LCSW-C

Purpose

To explore the practices, experiences, and needs of young mothers with a history of maltreatment who are introducing their children to complementary foods.

Design and methods

In-depth interviews (n = 9) were conducted with young mothers (19–23 yrs) who had childhood histories of abuse and neglect (maltreatment). Interviews were transcribed verbatim and analyzed using a five-step thematic analysis approach.

Results

Thematic analysis resulted in three themes: (1) Practices and sources of information, (2) Providing the best, and (3) Feeding challenges. Participants' primary sources of nutrition information were family or foster parents and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) educators. Participants expressed wanting to give their children healthy food and to change the cycle by not repeating some of their own childhood food experiences. Finally, participants sometimes struggled with food affordability.

Conclusions

The study highlights the need for additional support for young maltreated mothers, including access to healthy foods and education about infant feeding.

Practice implications

Young maltreated mothers are in need of trauma-informed and strengths-based complementary feeding information and support with basic needs. Universal trauma-informed care has the potential to prevent re-traumatization and improve patient care and nutrition education.

目的探讨有虐待史的年轻母亲在给孩子喂食辅食时的做法、经验和需求。设计与方法对19-23岁有童年虐待史的年轻母亲进行深度访谈（n = 9）。访谈被逐字记录下来，并使用五步专题分析方法进行分析。结果专题分析得出三个主题：(1)实践和信息来源；(2)提供最佳方案；(3)喂养挑战。参与者营养信息的主要来源是家庭或养父母以及妇女、婴儿和儿童特殊补充营养计划（WIC）的教育者。参与者表示，他们希望给自己的孩子提供健康的食物，并通过不再重复自己童年的一些食物经历来改变这种循环。最后，参与者有时难以负担食物。该研究强调需要为受虐待的年轻母亲提供额外支持，包括获得健康食品和婴儿喂养教育。实践意义受虐待的年轻母亲需要创伤信息和基于力量的补充喂养信息，以及满足基本需求的支持。普遍的创伤知情护理有可能防止再次创伤，改善患者护理和营养教育。

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引用次数: 0

A qualitative study on the experiences of caregivers of children undergoing surgery for congenital heart diseases 先天性心脏病患儿手术护理人员经验的定性研究

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-28 DOI: 10.1016/j.pedn.2024.11.016

Eda Ayten Kankaya , Nazife Gamze Özer Özlü , Nihal Müezzinler Evsine

Objective

This study explores the experiences of caregivers of pediatric cardiac surgery patients, aiming to deepen understanding of their role and improve the caregiving process.

Methods

A qualitative, phenomenological approach was employed using individual, semi-structured interviews with a heterogeneous sample of caregivers (both mothers and fathers) of children who had undergone surgery for congenital heart disease. Interviews were conducted face-to-face from June 2023 to May 2024, following Creswell's interview techniques. Data collection and analysis were performed simultaneously using MAXQDA software.

Results

Participants included caregivers of children aged 2 months to 17 years, with caregivers themselves aged 25 to 50 years. Most children had undergone surgery for congenital heart valve disease, with surgeries ranging from one to three. Three main themes and nine sub-themes were identified: (1) “Comprehensive health journey” described caregivers' experiences from diagnosis through treatment and their interactions with healthcare professionals; (2) “Challenges” encompassed social isolation, financial strain, work-life balance issues, and the impact on the education process; and (3) “Uncertainty” captured caregivers' anxiety about the future and concerns regarding home care.

Conclusion

The findings offer valuable insights into the challenges and needs of caregivers in the pediatric cardiac surgery context, highlighting areas where support services and interventions could be beneficial.

Implications to practice

The study emphasizes the importance of healthcare professionals providing caregivers with clear information and empathetic support, which can enhance both caregiver well-being and patient outcomes.

目的探讨小儿心脏手术患者护理人员的护理经验，加深对护理人员角色的认识，改进护理过程。方法采用定性、现象学的方法，对接受先天性心脏病手术的儿童的照顾者（包括母亲和父亲）的异质性样本进行了半结构化的个人访谈。访谈于2023年6月至2024年5月进行，遵循Creswell的访谈技巧。使用MAXQDA软件同时进行数据采集和分析。结果研究对象包括2个月至17岁儿童的照顾者和25至50岁儿童的照顾者。大多数儿童都接受过先天性心脏瓣膜疾病的手术，手术次数从一到三次不等。研究确定了3个主题和9个副主题：(1)“全面健康之旅”描述了护理人员从诊断到治疗的经历以及他们与医护人员的互动；(2) “挑战”包括社会孤立、财政紧张、工作与生活平衡问题以及对教育进程的影响；(3)“不确定性”反映了照顾者对未来的焦虑和对家庭护理的担忧。结论研究结果为儿科心脏外科护理人员的挑战和需求提供了有价值的见解，突出了支持服务和干预可能有益的领域。该研究强调了医疗保健专业人员为护理人员提供清晰的信息和共情支持的重要性，这可以提高护理人员的幸福感和患者的治疗效果。

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引用次数: 0

Performance analysis and science mapping of family resilience research in the context of children and adolescents: A bibliometric study 儿童和青少年家庭弹性研究的绩效分析和科学制图：文献计量学研究

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-28 DOI: 10.1016/j.pedn.2024.11.014

Haktan Demircioğlu PhD , Emin Demir PhD

Problem

The present study explores research on family resilience in the context of children and adolescents, as well as studies covering all family members, and examines the conceptual, intellectual, and social structures of the research through bibliometric analysis.

Materials and methods

We carried out the search procedure on the abstracts of papers indexed to Social Science Citation Index (SSCI), Science Citation Index Expanded (SCI-E), Emerging Sources Citation Index (ESCI), and Arts & Humanities Citation Index (AHCI) within the Web of Science (WoS) database.

Results

We could access 407 papers since 1994 pertaining to the topic of family resilience in the context of children and adolescents. These records are distributed across 245 sources, and we calculated the annual growth rate of the research to be 14.49. The United States of America seems to lead the research field, followed by China and Canada. Moreover, we present findings regarding the conceptual, intellectual, and social structures of the selected research.

Conclusion

We conclude that family resilience is an important issue in the context of children and adolescents. In this sense, our findings would provide a foundation for further investigation into family resilience in the mentioned context. Finally, we anticipate that our results will contribute to evidence-based policies concerning family resilience in the context of children and adolescents.

Practical implications

The study offers a comprehensive view of family resilience in the context of children and adolescents, particularly in the domain of health. Furthermore, it provides insights into bibliometric analysis.

本研究探讨了儿童和青少年背景下的家庭弹性研究，以及涵盖所有家庭成员的研究，并通过文献计量学分析检验了研究的概念结构、智力结构和社会结构。材料和方法我们对被社会科学引文索引（SSCI）、科学引文索引扩展版（SCI-E）、新兴资源引文索引（ESCI）和艺术&；Web of Science （WoS）数据库中的人文引文索引（AHCI）。结果自1994年以来，我们检索到407篇有关儿童和青少年家庭弹性的论文。这些记录分布在245个来源，我们计算出研究的年增长率为14.49%。美国似乎在研究领域处于领先地位，其次是中国和加拿大。此外，我们提出了关于所选研究的概念、智力和社会结构的发现。结论家庭弹性在儿童青少年中是一个重要的问题。从这个意义上说，我们的研究结果将为进一步研究上述背景下的家庭弹性提供基础。最后，我们预计我们的研究结果将有助于在儿童和青少年的背景下制定以证据为基础的家庭弹性政策。实际意义本研究对儿童和青少年的家庭复原力，特别是在健康领域提供了一个全面的观点。此外，它还提供了对文献计量学分析的见解。

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引用次数: 0

Identification of risk factors for emergence delirium in children undergoing magnetic resonance imaging 识别接受磁共振成像检查的儿童出现谵妄的风险因素

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-27 DOI: 10.1016/j.pedn.2024.11.011

Lydia Merkel BSN, RN, CPN , Mary Drouillard BSN, RN, CCRN, CPN, CRN , Shirley Wiggins PhD, RN , Leeza Struwe PhD, MSN, RN , Kaeli Samson MA, MPH

Purpose

Emergence delirium (ED) remains an ongoing concern for children undergoing sedation/anesthesia. The purpose of this study was to identify risk factors for ED in a population of children from two to seven years of age undergoing sedation/anesthesia for magnetic resonance imaging.

Design and methods

This was a descriptive, observational study taking place in a free-standing midwestern pediatric hospital. The Child Induction Behavioral assessment (CIBA) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) were used to assess child/parent anxiety. The presence of ED was documented using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Associations between ED demographic and clinical characteristics were assessed using Chi-square and Wilcoxon Rank Sum tests.

Results

Of the 136 children who underwent sedation/anesthesia for MRI, 23 (16.9 %) experienced ED. Although not significant, children who received the pre-medication midazolam experienced an increased incidence of ED (25.6 %) compared to those who did not (13.4 %, p = 0.09). Children who experienced ED took a significantly shorter time to arouse from sedation/anesthesia (median = 8 min) compared to those who did not experience ED (median = 15 min, p < 0.0001).

Conclusions

A shorter post-procedural arousal time was a significant risk factor associated with ED in this sample of children undergoing MRI.

Implications

It is unclear which pre-procedural factors predict children who will experience ED. There is a need for interdisciplinary research to identify interventions to decrease the incidence of pediatric ED. More research is needed to support the development of interventions to best support the safety of the child experiencing ED.

目的谵妄（ED）仍然是接受镇静/麻醉的儿童一直担心的问题。本研究旨在确定接受磁共振成像镇静/麻醉的 2 到 7 岁儿童中发生 ED 的风险因素。儿童诱导行为评估（CIBA）和阿姆斯特丹术前焦虑和信息量表（APAIS）用于评估儿童/家长的焦虑。使用小儿麻醉后谵妄（PAED）量表记录是否存在 ED。结果在接受核磁共振成像镇静/麻醉的 136 名儿童中，有 23 名（16.9%）经历过 ED。与未使用咪达唑仑的患儿（13.4%，P = 0.09）相比，使用咪达唑仑前药物的患儿发生 ED 的几率（25.6%）有所增加，但影响不大。在接受磁共振成像检查的儿童样本中，较短的术后唤醒时间是与 ED 相关的重要风险因素。有必要进行跨学科研究，以确定减少儿科 ED 发生率的干预措施。需要开展更多的研究来支持干预措施的开发，从而为经历 ED 的儿童的安全提供最佳支持。

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引用次数: 0

Identifying missed care in pediatric nursing: A scoping review 识别儿科护理中的遗漏护理：范围审查

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-26 DOI: 10.1016/j.pedn.2024.11.017

Marina Maffeo RN, MSN , Eustachio Parente RN, MSN , Daniele Ciofi RN, MSN, PhD

Problem

Missed nursing care (MNC) refers to required patient care that is omitted or delayed. Commonly missed elements include ambulation, turning, feeding, patient education, discharge planning, emotional support, hygiene, documentation, and patient surveillance. Key reasons for MNC are insufficient staffing, poor resource utilization, time constraints, lack of teamwork, ineffective delegation, habitual practices, and denial. MNC links inadequate work environments and staffing to poor clinical outcomes, especially affecting efficiency in pediatric settings.

Objective

To describe missed nursing care in pediatrics and to identify the most frequently missed categories of nursing care and summarize the reasons for this.

Eligibility criteria

Any quantitative study which reported on any combination of categories, reason and factors associated with missed nursing care within pediatric settings and which was published in English, full-text available and studies that collected variables on the structure and process of missed nursing care in pediatrics.

Sample

The following databases were searched: PubMed, Embase, CINAHL and Scopus with no time limits.

Results

Missed nursing care (MNC) is influenced by workload, work environment, and staffing levels. A higher patient-to-nurse ratios significantly increase MNC. Better work environments correlate with fewer missed care activities, but frequent interruptions and unexpected patient volume spikes remain major issues. Commonly missed activities include oral care, routine bathing, and adherence to infection protocols.

Conclusion

Addressing MNC requires strategic staffing, improved work environments, targeted interventions, and continuous education to enhance care quality. The studies collectively highlight the complexity of missed nursing care and its dependence on various factors including workload, work environment, and nurse characteristics.

Implication

Developing and validating pediatric-specific assessment tools and studying factors like workload, staff training, and work environment are crucial for addressing MNC in these settings. More research is needed to understand MNC in pediatric settings, focusing on specific challenges and needs.

问题遗漏的护理（MNC）是指遗漏或延迟的所需病人护理。常见的遗漏内容包括下地活动、翻身、喂食、病人教育、出院计划、情感支持、卫生、文件记录和病人监护。造成 MNC 的主要原因是人员配备不足、资源利用率低、时间限制、缺乏团队合作、授权不力、习惯性做法和否认。MNC 将不足的工作环境和人员配备与不良的临床结果联系在一起，尤其影响儿科的工作效率。目标描述儿科护理的遗漏情况，确定最常遗漏的护理类别，并总结遗漏的原因：结果护理遗漏（MNC）受工作量、工作环境和人员配备水平的影响。病人与护士的比例越高，护理误时率越高。工作环境越好，遗漏的护理活动就越少，但频繁的中断和意外的患者数量激增仍是主要问题。常见的遗漏活动包括口腔护理、常规沐浴和遵守感染规程。这些研究共同凸显了护理遗漏的复杂性及其对工作量、工作环境和护士特点等各种因素的依赖性。需要开展更多研究，以了解儿科环境中的 MNC，重点关注具体挑战和需求。

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引用次数: 0

Can an increase in nursing care complexity raise the risk of intra-hospital and intensive care unit transfers in children? A retrospective observational study 护理复杂性的增加会提高儿童院内转院和重症监护室转院的风险吗？回顾性观察研究

IF 2.1 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2024-11-26 DOI: 10.1016/j.pedn.2024.11.015

Manuele Cesare RN, PhD , Antonello Cocchieri RN, PhD

Introduction

Intra-hospital patient transfers (IPTs) and transfers to intensive care units (ICUs) are high-risk events in pediatric care. Nursing care complexity, reflected by nursing diagnoses (NDs) and nursing actions (NAs), may influence the frequency of these transfers. This study explores the association between nursing care complexity and IPTs, including ICU transfers, in hospitalized children.

Materials and methods

A retrospective observational study was conducted at a tertiary care university hospital in Italy. Data from 1013 children aged 2 to 12 years were collected from electronic health records. Sociodemographic, clinical, and nursing data, including NDs and NAs, were analyzed. Latent Class Analysis classified nursing care complexity, while backward elimination regression and binary logistic regression identified predictors of IPTs and ICU transfers.

Results

Significant positive correlations were found between IPTs and both NDs (r_s = 0.326, p < 0.001) and NAs (r_s = 0.428, p < 0.001). Key predictors of IPTs included Diagnosis Related Groups (DRG) weight, total comorbidities, surgical DRG, the number of medications used, and high nursing care complexity. ICU-transferred patients had significantly higher nursing care complexity (6.54 vs. 3.46 NDs, p < 0.001; 31 vs. 16 NAs, p < 0.001). High nursing care complexity increased the likelihood of ICU transfer by 18 times (OR = 18.413, p < 0.001).

Conclusion

Nursing care complexity strongly influences IPTs and ICU transfers. Close monitoring of patients with high nursing care complexity is essential to anticipate transfers and reduce clinical risks.

导言院内病人转院（IPT）和转入重症监护病房（ICU）是儿科护理中的高风险事件。护理诊断（ND）和护理操作（NA）所反映的护理复杂性可能会影响这些转院的频率。本研究探讨了住院儿童的护理复杂性与包括 ICU 转院在内的 IPT 之间的关系。研究人员从电子健康记录中收集了 1013 名 2 至 12 岁儿童的数据。研究分析了社会人口学、临床和护理数据，包括 NDs 和 NAs。结果发现，IPTs 与 NDs（rs = 0.326，p < 0.001）和 NAs（rs = 0.428，p < 0.001）之间存在显著的正相关。IPTs的主要预测因素包括诊断相关组（DRG）权重、合并症总数、手术DRG、用药数量和护理复杂性高。ICU 转运患者的护理复杂度明显更高（6.54 对 3.46 NDs，p < 0.001；31 对 16 NAs，p < 0.001）。护理复杂度高的患者转入 ICU 的可能性增加了 18 倍（OR = 18.413，p < 0.001）。对护理复杂度高的患者进行密切监测对于预测转院和降低临床风险至关重要。

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引用次数: 0