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

Purpose: Children with Complex Health Conditions (CCHC) require prolonged, specialized, and multidisciplinary care, often demanding prolonged hospitalizations. In this context, mothers generally assume the role of primary caregivers, facing emotional, physical and social overload. However, their experiences during hospitalization remain little explored. This study aimed to understand the experiences and needs of mothers caring for CCHC during hospitalization.

Design and methods: This qualitative study used an inductive approach based on the Straussian Grounded Theory principles. Data collection took place between September 2024 and March 2025, through individual, in-person, semi-structured interviews, conducted with mothers of CCHC admitted to a Brazilian university hospital. Data analysis followed the constant comparison method, occurring simultaneously with collection, enabling the construction of categories and conceptual refinement.

Results: Sixteen mothers aged between 23 and 46 years (34.75 ± 7.55) were recruited. Data analysis generated the core category "Care experiences: balancing between light and shadow" around which three categories are anchored: 1) Dealing with the complexity of the disease and hospitalization; 2) Barriers to care dynamics during hospitalization; and 3) Enablers of care for children with complex health conditions.

Conclusions: The analysis of maternal experiences highlights the urgent need for care practices based on family-centered care models that recognize mothers as protagonists in the care process.

Practice implications: Findings support the implementation of institutional protocols that ensure effective communication, continuous support and qualification of professionals to promote a welcoming, safe and humanized environment, reducing the emotional and structural vulnerabilities faced by mothers who care for CCHC.

Purpose: This study was conducted to determine pediatric nurses' use of generative artificial intelligence and their level of competency.

Methods: The study was descriptive in nature and conducted online between March 15 and September 30, 2025. The study involved 546 pediatric nurses. Data collection tools included the Data Collection Form and the Artificial Intelligence Use and Competence Scale. In the evaluation of the data, descriptive statistics, Kolmogorov-Smirnov and Shapiro-Wilk tests, Independent Samples t-test, Pearson correlation test, one-way ANOVA, and Tukey post-hoc test were used. The significance level was set at p < 0.05.

Results: Participants were found to have worked as pediatric nurses for 8.75 ± 4.92 years. It was determined that very few nurses had received training related to artificial intelligence (9.3%, n = 51), used generative artificial intelligence applications, and that the majority of those who used them (77.2%, n = 27) did not feel competent while using the applications. The mean scores of pediatric nurses on the Generative Artificial Intelligence Use and Competence Scale were found to be 48.97 ± 10.07 (Minimum = 28.00, Maximum = 76.00).

Conclusion: Pediatric nurses were found to have low levels of Generative Artificial Intelligence Use and Competence. As the number of years working as a pediatric nurse increases, so do the levels of Generative Artificial Intelligence Use and Competence.

Clinical implications: Generative artificial intelligence accelerates pediatric clinical assessment, reduces errors, enhances decision-making accuracy, and increases nurses' direct care time. Strengthening pediatric nurses' competencies in this field will clearly improve the safety, standardization, and overall quality of pediatric care.

Objective: To determine the effects of therapeutic storytelling on intramuscular (IM) injection-related pain, anxiety, and fear in children aged 6-10 years.

Method: A randomized controlled experimental study with a pretest-posttest control group was conducted between February 2025 and October 2025 in the Northwestern region of Turkey. The sample consisted of 44 children who received IM injections in the pediatric emergency department. Data were collected using the Facial Expressions Pain Scale-Revised, the Child Anxiety Scale-State, and the Child Fear Scale. Children in the experimental group were assessed for pain, anxiety, and fear before the procedure, and the therapeutic story was read. Pain, anxiety, and fear levels were reassessed after the procedure. The control group was assessed for pain, anxiety, and fear before and after the procedure without any intervention.

Results: In the post-test measurement, pain scores decreased in the experimental group and increased in the control group. Both the time effect (p = 0.010) and the time × group interaction (p < 0.001) were significant, showing that pain changed differently in the two groups, with decreases seen only in the experimental group. Anxiety (p < 0.001) and fear (p < 0.001) scores also decreased significantly over time, and the significant time × group interactions for both variables (p < 0.001 and p = 0.001, respectively) showed that the decrease was higher in the experimental group compared with the control group. Correlation analyses indicated moderate to strong positive associations among pain, anxiety, and fear both before and after the intervention (p < 0.001).

Conclusion: Therapeutic storytelling is an effective nonpharmacologic method for reducing pain, anxiety, and fear in children receiving IM injections.

Implications for clinical practice: Therapeutic approaches that include atraumatic care should be widely used in pediatric clinics by professional pediatric nursing.

Background: Asthma is one of the most common chronic respiratory diseases among children worldwide. Its recurrent exacerbations and long-term caregiving demands exert significant psychological and physical burdens on both affected children and their caregivers. Family resilience plays a crucial role in alleviating these burdens and promoting adaptive coping; However, existing research has paid limited attention to families affected by childhood asthma, and few studies have explored the specific disease-coping processes of school-age children and their primary caregivers from a dual parent-child perspective.

Objective: To explore the illness-related coping experiences of school-age children with asthma and their primary caregivers within Walsh's family resilience framework.

Methods: A descriptive phenomenological design was adopted. Semi-structured interviews were conducted with 36 participants from 18 families in a children's hospital in China, and the data were analyzed using Colaizzi's seven-step method.

Results: Four overarching themes and fourteen subthemes emerged: (1) Impact of adversity, (2) Internal family support, (3) External family support, (4) Transformation growth. The findings revealed that a stable belief system and sustained emotional support are key factors in facilitating positive family adaptation.

Conclusions: This study highlights the importance of a dyadic management approach involving both children with asthma and their primary caregivers in the process of family resilience.

Implications to practice: Healthcare professionals should assess families' resilience stages and provide targeted support in beliefs, roles, and communication to promote adaptation and growth.

Objective: This study examined the effects of white cover and massage on bilirubin levels and phototherapy duration in newborns.

Methods: Sixty term newborns with hyperbilirubinemia were randomly assigned to intervention (n = 30) or control (n = 30) groups. The intervention group received a reflective white cover around the phototherapy unit and infant massage twice daily; the control group received routine care. Capillary and transcutaneous bilirubin (TcB) levels, phototherapy duration, and urination/defecation frequency and amount were compared between the groups, as were hospital stay.

Results: Baseline characteristics and bilirubin levels were similar between groups (p > 0.05). After the intervention, the intervention group showed a faster decrease in bilirubin, shorter phototherapy, greater weight gain, and more frequent urination and defecation (p < 0.001).

Conclusion: White cover and massage significantly improved bilirubin elimination, reduced phototherapy duration and hospital stay, and supported weight gain in term newborns. Therefore, the use of white cover and massage may be effective and inexpensive adjunctive interventions for term newborns receiving phototherapy.

Implications for practice: The combination of a white cover and massage provides a simple, cost-effective approach to improving phototherapy outcomes and can be readily incorporated into standard newborn care.

Purpose: Adolescents with congenital heart disease (CHD) face multifaceted challenges that may impair development and quality of life, raising concerns about frailty. However, the impact of frailty on their daily functioning remains unclear. This study aimed to understand how adolescents with CHD experience frailty and how their primary caregivers perceive it.

Design and methods: A descriptive phenomenological study was conducted using semi-structured interviews with 20 adolescent-caregiver dyads recruited from two medical centers in Taiwan. Adolescents aged 12-18 years with a CHD diagnosis were classified as prefrail or frail based on Fried's frailty criteria. Data were collected between September and October 2023 and analyzed using Colaizzi's method.

Results: Six key themes emerged: accumulating physical burden with growth, consequences of energy depletion in daily life, facing unavoidable judgment while striving for normalcy, social disconnection shaped by fatigue and peer perception, adaptive strategies for energy conservation, and supportive relationships enabling emotional growth and autonomy.

Conclusions: Frailty in adolescents with CHD affects not only physical health but also identity, autonomy, and social inclusion, highlighting the need for developmentally responsive, relationship-based care.

Implications for practice: Nurses play a key role in early detection and coordinated support, emphasizing the importance of age-appropriate assessments and personalized interventions to promote long-term well-being. These findings underscore the value of frailty-informed care in pediatric cardiology and adolescent health nursing.