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

Objectivec: This is a cross-sectional and descriptive study to determine the levels of artificial intelligence anxiety and readiness of neonatal nurses.

Design and methods: The study included 107 neonatal nurses, with data collected between May and August 2023. Data were obtained using sociodemographic information, the Artificial Intelligence Anxiety Scale (AIAS) and the Medical Artificial Intelligence Readiness Scale (MAIRS). For the analyses, Kolmogorov-Smirnov test results were examined for normality assumptions of numerical variables and nonparametric statistical methods were used. The relationships between two independent numerical variables were analysed using Spearman's Rho Correlation coefficient, and the differences between two independent groups were analysed using Mann-Whitney U Analysis.

Results: There was a statistically significant moderate negative correlation between participants' AIAS scores and MAIRS scores (r = -0.549). AIAS scores differed statistically significantly by age, education level, experience in neonatal care, knowledge about artificial intelligence, favouring the existence of AI-based technologies in neonatal clinics, and anxiety about artificial intelligence (p < 0.05). MAIRS scores differed statistically significantly (p < 0.05) by education level, having knowledge about artificial intelligence, favouring the existence of AI-based technologies in neonatal clinics, and anxiety about artificial intelligence.

Conclusion: Neonatal nurses' perceptions and attitudes towards AI technologies need to be better understood. Continuous training and support for neonatal nurses about AI technologies is important. This can enable them to effectively use AI technologies and contribute to improving the quality of patient care.

Background: High rates of medication non-adherence (52-73 %) in pediatric hematopoietic stem cell transplant (HCT), due to complex regimens and forgetfulness, increase life-threatening risks.

Purpose: This mixed methods study aimed to develop and evaluate the usability of the BMT4me© mobile health application to enhance adherence to immunosuppressants in children undergoing HCT.

Design and methods: A mixed methods, cross-sectional, iterative approach, with caregiver-child dyads and healthcare providers, was used to create the BMT4me© app prototype. This iterative approach involved continuously refining the app based on feedback from stakeholders at each phase. The process was user-centered, engaging patients, caregivers and healthcare providers in each stage. In phase 1, caregiver/child dyads (ages 8-17, n = 14) provided feedback on wireframes via qualitative interviews, which informed prototype development. Phase 2 involved focus groups with healthcare providers including physicians (n = 3), nurses (n = 15), and advanced practice nurses (n = 3) who evaluated the prototype's usability and provided feedback via reaction cards and the System Usability Scale (SUS). The System Usability Scale (SUS) measured usability, and thematic analysis identified key themes regarding engagement, ease of use, safety, and helpfulness. Quantitative data were analyzed using descriptive statistics, while qualitative data were thematically analyzed with NVivo software.

Results: The mean SUS score from healthcare providers was 84.2, notably higher than the average expected score of 68, indicating successful usability of the BMT4me app. Thematic analysis highlighted themes of engagement, ease of use, and safety among providers, and ease of use and helpfulness among children and caregivers. This feedback refined the app to better serve families, patients, and providers.

Practice implications: The BMT4me© app shows promise in improving medication adherence in pediatric HCT patients. Integrating such mHealth applications into clinical practice will support adherence and improve outcomes in patients with high-risk, complex regimens. This app will guide practical implications and effectiveness of digital health tools.

Conclusions: A user-centered design approach, involving multiple stakeholders, was essential in developing BMT4me app. Feedback facilitated enhancements in app features and functionality. Pilot feasibility testing with caregivers is ongoing. Future research will assess the efficacy of digital interventions on clinical outcomes in children with complex treatment regimens.

Purpose: The aim of the study was to examine the effect of Turkish adolescents' social appearance anxiety on their perception of their appearance-related social media consciousness.

Design and methods: This cross-sectional and descriptive study involved 364 adolescents aged 15-18 years. The study used a demographic information form, the Social Appearance Anxiety Scale (SAAS) and the Appearance-Related Social Media Consciousness Scale (ASMC). The data were analysed using descriptive analyses, independent groups t-test, one-way ANOVA test, Tukey post hoc test, point bi-serial and Pearson correlation analysis.

Results: It was found that adolescents' social appearance anxiety predicts their perceptions of their appearance-related social media consciousness, and as adolescents' social appearance anxiety levels increase, there may be a 54.4 % increase in their appearance-related social media consciousness.

Conclusions: The results of the study show that social appearance anxiety in adolescents also leads to negative perceptions of their appearance-related social media consciousness.

Implications to practice: By liaising with psychiatric nurses, school teachers and school psychological counsellors, paediatric nurses can educate adolescents about the potential risks of excessive social media use, social appearance anxiety and perception of appearance on social media, and help them to be aware and act consciously. School-based interventions can be implemented to educate adolescents, especially girls, about healthy use of social media.

Purpose: The purpose of this study was to evaluate the quality, content, and reliability of YouTube videos that address ostomy bag change techniques in children. As digital platforms are increasingly used for health-related information, especially for those caring for pediatric ostomy patients, this study aims to identify the strengths and limitations of available online resources.

Design: A descriptive, retrospective, and cross-sectional research design was used to evaluate YouTube videos focused on pediatric ostomy bag change techniques.

Subjects and setting: The study included a total of 33 YouTube videos identified through searches conducted between May 3 and May 30, 2024. Videos included infants, children, and adolescents and were selected based on their relevance to pediatric double pouch ostomy care.

Methods: Videos were scored using the modified DISCERN score and the Global Quality Scale (GQS) to assess video quality and reliability. A checklist based on established ostomy care guidelines was used for content analysis and identification of common procedural errors. The view rates, video/likes ratio, and popularity of the videos were calculated as the video power index. Data were analyzed using SPSS 27 and statistical significance was determined with a p-value of less than 0.05.

Results: The analysis showed that 54.5 % of the videos were uploaded by independent publishers and 45.5 % by healthcare institutions. Videos aimed at caregivers were the most common (66.7 %). The mean number of views was 24,026.57, with a mean modified DISCERN score of 2.53 and a GQS score of 2.80. There was also a positive correlation between video length and quality scores. Significant differences in video quality were found between those published by healthcare organizations and independent publishers, with healthcare organization videos generally scoring higher. The most common errors in the videos included inadequate stoma coverage and improper disposal procedures.

Conclusions: The study shows that there is significant variability in the quality and reliability of YouTube videos on how to change an ostomy pouch in children. Compared to videos produced by independent publishers, videos produced by healthcare institutions had higher quality and reliability. The findings underscore the need for improved educational resources and quality control in digital platforms in order to better support the caregivers of pediatric ostomy patients.

Aim: This study aimed to analyze the accuracy, quality, and reliability of the content of YouTube videos on safe sleep for infants in relation to the safe sleep recommendations from the American Academy of Pediatrics (AAP).

Methods: The research was conducted by searching the video-sharing platform YouTube for the keywords "safe sleep." The videos were subjected to a review and evaluation process conducted by two independent reviewers. The modified DISCERN and Global Quality Scale (GQS) were employed to assess the quality and reliability of the videos. The content of the videos was evaluated using an eight-item checklist prepared by the researchers in accordance with the recommendations of the AAP. The Kruskal-Wallis-H, Mann-Whitney U, and Pearson correlation analyses were employed for the purpose of data analysis. All statistical data were deemed significant at the 0.05 level.

Results: The 100 most relevant videos were viewed, and 85 videos that met the inclusion criteria were subjected to analysis. The mean values for the quality and reliability of the videos are 2.98 for the modified DISCERN score and 3.26 for the GQS. The mean value for the total checklist score was 4.78 out of 8. As indicated by the checklist developed in this study for the assessment of safe sleep video content, four of the eight items were present in over 80 % of the videos. The remaining four items were present in less than 42 % of the videos. A strong correlation was observed between the total score on the checklist and the modified DISCERN score (r = 0.915, p < 0.001) and the GQS (r = 0.918, p < 0.001).

Conclusion: The evidence presented in this study indicates that improvements are needed in the quality and reliability of content on safe sleep practices for infants on YouTube.

Aim: To determine the effects of communication behaviors observed during discussion of home management of hospitalized children with long-term ventilator dependence on post-discharge quality of life and clinical outcomes.

Design: A descriptive, quantitative study of family caregiver and nurse communication.

Methods: Conversations between 100 family caregivers and 48 nurses were recorded and transcribed. Transcripts were coded for key communication behaviors: ask, listen, explain, negotiate roles, verify understanding and advocate. Quality of life measures and clinical outcomes were collected one week and one month post-discharge. Analysis included descriptive statistics and linear mixed-effects models.

Results: Each communication behavior was associated with quality of life outcomes. Family caregivers demonstrated more listening behaviors when there was poorer child quality of life (β = -1.52) and advocated more with increased child fatigue (β = 1.55). When family caregivers negotiated care roles with nurses, there was less child anxiety and more mobility (β = -2.15, β = -1.54). Less child fatigue and more mobility were evidenced when nurses advocated (β = -1.49, β = 0.92). Better child quality of life was predicted by nurses asking family caregivers more questions (β = 1.03), while poorer child quality of life was evident when nurses negotiated care roles (β = -2.22). Overall, when family caregivers demonstrated a need or willingness to negotiate care roles with nurses, more respiratory infections were found post-discharge at one week (β = 1.23) and one month (β = 1.59).

Conclusion: Family caregiver and nurse communication can impact outcomes for hospitalized children with long-term ventilator dependence. Family caregivers advocate and negotiate roles to ensure support and appropriate care for themselves and their child.

Purpose: The purpose of this study was to assess physical activity (PA) levels in children and adolescents with Down syndrome (DS) using a commercially available activity tracker (Fitbit) and a parental proxy questionnaire.

Design and methods: This cross-sectional study included two groups of individuals with DS (school-age children and adolescents) and one parent per child/adolescent. The school-age children and adolescents with DS wore the Fitbit for seven consecutive days. Parents completed the parental proxy questionnaire on the seventh day. Weekday and weekend PA levels for the two groups of individuals with DS were compared. In addition, PA levels obtained with the Fitbit were compared to parental responses.

Results: Complete data sets were available for 32 child-parent dyads. Sedentary time was higher for the adolescent group (p = .022), while light PA time was lower (p = .020). All measured PA patterns, excluding sedentary behavior, decreased on weekends in both groups: steps (p = .002), light PA time (p = .028), and moderate-to-vigorous PA time (p = .004). Parental proxy questionnaires underestimated actual PA levels.

Conclusions: PA was lower in the adolescent group and during the weekend for both groups.

Practice implications: Findings from this study suggest a need for tailored programs designed to increase weekend PA levels in school-age children and adolescents with DS in pediatric nursing research. The use of commercial activity trackers, such as the Fitbit, which are user-friendly and relatively affordable, is effective for pediatric nurses to monitor PA levels of children and adolescents with DS in clinical settings.

Purpose: This study aimed to investigate the opinions and experiences of parents whose children are hospitalized in a pediatric surgery clinic in Turkey regarding care practices.

Design and methods: Sixteen in-depth interviews with parents whose children were hospitalized in a pediatric surgery clinic were conducted and analyzed between October and December 2023, by grounded theory methodology. The COREQ guidelines guided the reporting of this study.

Results: A core category was identified, 'Preoperative information helps my child and I experience less anxiety and fear' demonstrating that parents are aware of their situation. Analyzing resulted in an interpretive theory of two interrelated categories: 'Quality Nursing Care' and 'Patient and Parent Satisfaction'.

Conclusion: Children and parents who received accurate, sufficient, and timely information experienced less anxiety and fear in the preoperative. Quality nursing care significantly affects the well-being of parents and pediatric patients. As a result of all these, high patient and parent satisfaction is an important care outcome.

Practice implications: Reducing the anxiety and fears of pediatric patients and parents in the preoperative is an important goal. Quality nursing care is one of the most important perceived factors in achieving this goal. Providing in-service training on this subject can increase awareness, especially for nurses new to the pediatric surgery clinic.

Purpose: This study aimed to examine the effect of mechanical vibration and the ShotBlocker® device on pain level, crying time, and procedure time during a heel lance in healthy term neonates.

Design and methods: A total of 105 healthy-term neonates were randomized into three groups: control (n = 36), mechanical vibration (n = 33), and ShotBlocker® (n = 36). The control group underwent a routine heel lance procedure. The neonates in the mechanical vibration group received mechanical vibration to the extremity for 30 s before the heel was lanced. For the ShotBlocker® group, a ShotBlocker® was placed on the area where the heel lance procedure would occur and the heel was lanced. The heel lance procedure was videotaped, and the neonates' pain scores at 1 min before, 2 min after, and 5 min after the procedure, crying time, and procedure duration were recorded and were evaluated by two independent raters. Data were evaluated using the chi-square test and analysis of variance. The analysis of variance, Bonferroni, Dunnett T3 analysis, and effect size were used in the analyses of repeated measures. The study was approved by an ethics committee. Informed consent was obtained from parents.

Results: The pain level of the neonates in the mechanical vibration group was lower than those of the control and ShotBlocker® group during and at 2 min and 5 min after the procedure (F = 12.063, p = 0.000; F = 4.580, p = 0.012; and F = 6.145, p = 0.003, respectively). The duration of neonate crying time in the mechanical vibration group was lower than in the control and ShotBlocker® groups (F = 4.598, p = 0.012). The heel lance duration was similar in the groups (F = 1.369, p = 0.259).

Conclusion: Mechanical vibration is an effective method to reduce the pain level and crying time associated with heel lance procedures in neonates.

Practice implications: This study provides evidence to nurses that the ShotBlocker is not an effective method for reducing pain associated with the heel lance procedure but that mechanical vibration is an effective method.

Clinical trials registration: The study was registered at Clinical-Trials.gov (NCT06380556).

Purpose: This study was carried out to adapt the child forensic attitude scale into Turkish and evaluate its validity and reliability.

Methods: This methodological, descriptive, and correlational study was conducted with a total of 363 professionals, including 40 physicians, 87 nurses, 79 lawyers, 81 law enforcement officers, 20 psychologists, and 56 social service experts, between January 2023 and February 2023. The study data were collected online using a "Personal Information Form" and the "Child Forensic Attitude Scale". Explanatory and confirmatory factor analysis, Cronbach's alpha, item-total score analysis were used for the evaluation of the data.

Results: It was determined that the scale consisted of 28 items and three sub-dimensions, namely fear of not identifying abuse, fear of overcalling abuse, skepticism, which explained 44.11 % of the total variance. In confirmatory factor analysis, all fit indices were greater than 0.85. Cronbach's alpha coefficient was determined as 0.80 for the total scale.

Conclusions: According to the results of the analyses and evaluations in this study, the child forensic attitude scale is a valid and reliable measurement tool for the Turkish sample.

Practice implications: Child sexual abuse is a serious problem globally and the fields of justice, security, health, social services need to collaborate to protect and guarantee victims' rights. Professionals working in this field have difficulties in evaluating children who have been abused. For this reason, it is very important to evaluate the attitudes of professionals, especially pediatric nurses, in this process and will guide the shaping of the initiatives to be taken.