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

Background: Anxiety disorders are among the most prevalent mental health conditions in childhood, affecting an estimated 10 % to 20 % of children. Cognitive Behavioral Therapy (CBT) is the most commonly employed treatment for these disorders. This study utilizes a meta-analytic approach to evaluate the effectiveness of CBT interventions in reducing anxiety levels among children diagnosed with anxiety disorders.

Methods: A comprehensive search was conducted in the "PubMed," "Science Direct," "Scopus," and "Web of Science" databases to identify randomized controlled and quasi-experimental studies that investigated the impact of CBT on children's anxiety levels. Studies that met the inclusion criteria were selected for analysis. The methodological quality of the selected studies was assessed using the "Critical Appraisal Checklists" developed by the Joanna Briggs Institute (JBI). Meta-analytic procedures were performed using the Review Manager 5.4.1 software.

Results: Twenty-nine studies published between 2015 and 2024 met the inclusion criteria and were included in the meta-analysis. The results indicate that CBT interventions are significantly effective in reducing anxiety levels in children with anxiety disorders (SMD: -1.51, 95 % CI: -2.07, -0.95, Z = 5.28, p < 0.00001). Among the various types of CBT, cognitive behavioral play therapy emerged as the most effective in reducing anxiety (SMD: -2.41, 95 % CI: -2.95, -1.88, Z = 8.84, p < 0.00001). Additionally, follow-up assessments at 3, 6, and 12 months post-intervention demonstrated that CBT has a sustained effect in lowering children's anxiety levels over time.

Conclusions: This meta-analysis offers a valuable update to the existing literature by reinforcing the efficacy of CBT interventions in treating anxiety disorders in children.

Purpose: This study examined parenting stress and child special healthcare needs to child neurocognitive development (NCD).

Design and methods: This secondary analysis used data from the primary study, a longitudinal cohort study of mother-child dyads. Multivariable regression models examined the associations between parenting stress and child special healthcare needs with NCD. Mothers completed the Children with Special Health Care Needs Screener and the Parenting Stress Index-Short Form. The outcome, child NCD, was evaluated using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) Cognitive and Language Scales. Covariates included maternal and child sociodemographic factors and maternal knowledge of child development, depression, and IQ.

Results: Of the 1040 mother-child dyads in this analysis, 171 (16.4 %) mothers reported that their child had one or more special healthcare needs and reported higher levels of parenting stress (PS) compared to those not experiencing health needs. Models including clinically significant PS along with identified child health needs showed the effect of 0.515 reduction (CI = 0.11, 0.92, p = .013) in Bayley-III Receptive Scaled scores.

Conclusions: Clinically significant parenting stress and the presence of child special healthcare needs were associated with lower child NCD, specifically receptive communication skills.

Practice implications: Healthcare providers, including pediatric nurses, should support NCD in young children by identifying children with special healthcare needs early on, recognizing and providing support to decrease parenting stress, and delivering needed medical and developmental support to young children and their families.

Objective: To better understand critically ill children's lived experiences with family presence in the pediatric intensive care unit (PICU).

Study design: This qualitative, interpretive phenomenological study is grounded in a Childhood Ethics ontology. We recruited children (aged 6-17 years) admitted to one of four participating Canadian PICUs between November 2021-July 2022 using maximum variation sampling. Data generation methods included participant observation and semi-structured interviews. Field-notes and interview transcripts were analyzed following the SAMMSA (Summary &Analysis coding, Micro themes, Meso themes, Syntheses, and Analysis) approach.

Results: Fourteen participants (7 boys; 7 girls) described parental presence in PICU as essential. Parents contributed to their sense of safety, acted as advocates and interlocuters, and were crucial to participants' belief that their voices would be heard and their needs met. Participants valued the ways in which family and visitor presence mitigated the disruptions that being in PICU caused to their social worlds. Age limits restricted sibling and peer interaction and inadvertently restricting parental presence due to sibling childcare needs.

Conclusions and implications: Parental figure presence in PICU is essential for children. Policies that focus on children as patients instead of whole people discredit childrens' concerns and the ways parental figures mitigate the disruptive nature of PICU admissions. Future policy generation must involve children to ensure that their priorities and concerns are meaningfully recognized.

Purpose: This study aims to explore the demographic, clinical, and psychological factors that influence the quality of life in children with chronic illnesses.

Design and methods: A descriptive, cross-sectional study was conducted between February and July 2023. The sample consisted of 120 pediatric patients, aged 7 to 18 years, diagnosed with chronic illnesses and treated in outpatient and inpatient wards. Participants were selected using purposive sampling based on specific inclusion and exclusion criteria. Data were collected using 11 validated questionnaires covering demographic, clinical, and psychological factors, as well as the Pediatric Quality of Life Inventory (PedsQL). Data were analyzed using t-tests, ANOVA, and multivariate linear regression to identify the most influential factors on children's quality of life, with a significance threshold set at p < 0.05.

Results: Gender, age, duration of illness, disease symptoms, and pain level were significantly correlated with children's quality of life (p < 0.05). Another factors like self-efficacy, self-concept, and role function had a strong positive impact (p < 0.01), while coping mechanisms, resilience, self-esteem, and family support showed no significant effect. Duration of illness was the most influential factor (B = 0.969).

Conclusions: Children's quality of life is strongly influenced by factors like gender, age, illness duration, symptoms, self-efficacy, self-concept, and role function, with illness duration having the greatest impact.

Practice implications: Healthcare providers should take a holistic approach, addressing clinical, demographic, and psychosocial factors, with special attention to children with longer illness durations, as this greatly affects their quality of life.

Purpose: The present study aims to investigate the effect of the physical activity program developed according to the PRECEDE-PROCEED Model on children's physical activity level, physical activity self-efficacy, and attitude.

Design and methods: This study was conducted in an experimental design with a pretest-posttest control group. Considering the possibility of data loss during the research, 178 students between the ages of 9 and 11 were included in the study, 89 in the intervention group and 89 in the control group. The exercises were carried out three days a week for 30 min in the school garden and gym, and the training was carried out in the classrooms one day a week.

Results: A significant difference is observed between the mean scores of the children's physical activity questionnaire at the interim follow-up (t = 2.885, p < 0.01) and post-test (t = 12.588, p < 0.01) stages, when comparing the groups of students (p < 0.05). It was determined that the post-test physical activity self-efficacy scale scores for the intervention group were markedly higher than those observed for the control group (t = 11.548, p < 0.01). Significant differences between the two groups in terms of physical activity attitudes were observed at the intermediate follow-up (t = 4.157, p < 0.01) and post-test (t = 9.197, p < 0.01) stages.

Conclusion: According to this study, the physical activity program increased children's physical activity levels as well as their self-efficacy and attitudes towards physical activity.

Practice implications: School health nurses can facilitate student engagement in physical activity by collaborating closely with school administrators and parents.

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.

Background: Children diagnosed with Attention-deficit/hyperactivity disorder (ADHD) have greater difficulty in regulating their own media usage and are inclined to spend more time engaging in video games compared to neurotypical children. This study aimed to investigate the effects of ADHD severity, digital parenting awareness, and accompanying psychiatric symptoms on children's problematic media (PMU) use in children with ADHD.

Methods: The study included 95 ADHD patients aged between 6 and 11 years and 90 age-and gender-matched healthy controls. The Problematic Media Use Measure-Short form (PMUM-SF), Child Behavior Checklist (6-18 years) (CBCL-6/18), Conners Parent Rating Scale-Revised Short (CPRS-RS), and Digital Parental Awareness Scale (DPAS) were administered to all parents.

Results: Daily screen time was 183.56 ± 84.77 min in the ADHD group and 117.47 ± 49.08 min in the control group (p < 0.001), and PMUM-SF scores were higher in children with ADHD (p < 0.001). Comorbid internalizing and externalizing problems were positively associated with PMU. The results of the hierarchical regression analysis showed that ADHD severity, somatic complaints in children, negative media role modeling by mothers, and neglect of children's media use were associated with increased PMU in children (p < 0.001, Adjusted R² = 0.520).

Conclusion: PMU in children with ADHD can be better managed by raising parents' awareness of the adverse effects of digital media within prevention and treatment interventions. Moreover, since comorbid ADHD and somatic symptoms may affect PMU, the severity of somatic complaints should be evaluated within the scope of treatment programs.

Aim: The aim of this study was to determine the psychometric properties of the depression scale in neurological disorders and to determine the characteristics of depression in young people with a diagnosis of epilepsy.

Methods: The population of the study consisted of epileptic youth aged 12-17 years (96 people) who attended the paediatric neurology outpatient clinic of a university hospital during the data collection process and who were able to make self-reports.Validity and reliability analyzes were performed with IBM SPSS 22 and AMOS 22 programs.

Results: The scale; Sensitivity was found to be 81 %, Specificity was 98.1 %, Positive Predictive Values (PPV) was 97.14 %, and Negative Predictive Values (NPV) was 86.88 %. The reliability coefficient (cronbach's alpha) of the scale was 0.924, which indicates a high level of reliability. In confirmatory factor analysis (CFA), CFA factor loading values of the items were found to be valid in the range of 0.575-0.904. The depression rate of young people with epilepsy was 36.5 % and the mean score of depression levels was 25.4 ± 9.0, which is above the average.

Conclusions: The depression scale in neurological disorders adapted to Turkish for young people who were diagnosed with epilepsy was found to be valid and reliabl.

Practical implications: The Turkish version of the Depression Inventory in Neurological Disorders can be used as a valid and reliable measurement tool to assess depression in young people aged 12-17 years diagnosed with epilepsy.

Background: Invasive procedures are commonly used in pediatric healthcare, and storybooks can be used as an adjunct analgesic method.

Objectives: This study was conducted to evaluate the effectiveness of using storybooks as a distraction technique to reduce fear and anxiety in pediatric healthcare. This study was conducted with the aim of revealing the level of effect of storybook use on children's fear and anxiety level in pediatric health services.

Methods: For this meta-analysis study, the studies were obtained by searching PubMed, Web of Scıence, Scopus, EBSCOhost, Google Scholar and YÖK Thesis Center databases in April-June 2024 without any year limitation. After the reviews, 15 studies were included in the study. The data were synthesized by meta-analysis and narrative methods.

Findings: In this meta-analysis, it was found that storybook use in pediatric health services was effective on children's anxiety (SMD: -4.412, 95 % CI: -7.727 to -1.097; Z = -2.608, p = 0.009; I² = 99.890 %) and fear (SMD: -1.13, 95 % CI: -1.71 to -0.54; Z = -3.78, p = 0.000; I² = 83.065 %) levels. In addition, it was determined that the characteristics of the intervention group, age group, the characteristics and content of the storybook, the duration of the intervention and the time of the intervention played a role in the effectiveness of the storybook use intervention in pediatric health services on children's anxiety and fear levels.

Conclusion: The use of story books in children's health services reduces the level of fear and anxiety in children.

Purpose: This study was conducted as a randomized controlled trial to examine the effect of toys made from medical materials on anxiety among hospitalized children.

Design and methods: This study was conducted with pediatric patients aged 4-6 years who were hospitalized in the pediatrics department of a teaching and research hospital in the Southeastern Anatolia Region. The study was completed with 90 children, allocated to the toys made of medical materials group (45) and the control group (45). Children, in the toys made of medical materials group, were given medical materials and asked to make toys. The anxiety levels of children in both the toys made of medical materials and control groups were assessed using the Children's State Anxiety (CSA) scale.

Results: Analysis based on children's self-reports revealed a significant reduction in the post-test anxiety scores of children in the toys made of medical materials group. No significant difference was observed in the anxiety scores of children in the control group. In the comparison between groups based on mothers' reports, it was found that the post-test anxiety scores of children in the toys made of medical materials group were significantly lower than those of children in the control group.

Conclusions: Our study found that toys made from medical materials were effective in reducing children's anxiety.

Practice implications: Healthcare workers can relieve children's anxieties by making toys using medical materials that are easily accessible in the clinic.