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

{"title":"Predictive effect of having a child with primary immunodeficiency on resilience, self-efficacy and spiritual well-being of Turkish parents","authors":"Hatice Dönmez ,&nbsp;Tuba Arpaci ,&nbsp;Şükrü Nail Güner","doi":"10.1016/j.pedn.2025.12.027","DOIUrl":"10.1016/j.pedn.2025.12.027","url":null,"abstract":"<div><h3>Background</h3><div>The study aimed to examine the predictive effect of having a child with primary immunodeficiency (PID) on the psychological resilience, general self-efficacy, and spiritual well-being of parents.</div></div><div><h3>Methods</h3><div>A cross-sectional, correlational, and comparative study was conducted with parents of children with PID (<em>N</em> = 88) and healthy controls (<em>n</em> = 168) in Türkiye from June 2024 to February 2025. Study data were collected through the Connor-Davidson Resilience Scale Short Form, the General Self-Efficacy Scale, and the Spiritual Well-being Scale.</div></div><div><h3>Results</h3><div>The mean general self-efficacy of parents of children with PID was significantly lower than that of parents of healthy controls (<em>p</em> <em>&lt;</em> 0.05). However, no significant difference was found between the groups in psychological resilience or spiritual well-being <em>(p</em> <em>&gt;</em> 0.05). There were significant positive relationships among psychological resilience, general self-efficacy, and spiritual well-being among parents of children with PID (<em>p</em> <em>&lt;</em> 0.05). The disease has no statistically significant effect on spiritual well-being in parents (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The mean general self-efficacy of parents of children with PID was lower than that of parents of healthy controls. Although no difference in psychological resilience was detected between the groups in the descriptive comparison, the multivariate analysis indicated that having a child with PID is a negative factor affecting parents' resilience. Having a child with PID also had a statistically significant effect on the general self-efficacy of parents.</div></div><div><h3>Practice implications</h3><div>The findings will guide the planning of family-centred nursing interventions to enhance the psychological resilience, general self-efficacy, and spiritual well-being of parents of children with PID.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 112-117"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with metabolic syndrome risk in Indonesian adolescents and young adults: A cross-sectional study","authors":"Oliva Suyen Ningsih ,&nbsp;Ferry Efendi ,&nbsp;Yulis Setiya Dewi ,&nbsp;Fadhaa Aditya Kautsar Murti ,&nbsp;Chong Mei Chan","doi":"10.1016/j.pedn.2026.01.017","DOIUrl":"10.1016/j.pedn.2026.01.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence and factors associated with metabolic syndrome (MetS) in adolescents and young adults in Indonesia.</div></div><div><h3>Design and methods</h3><div>Data were obtained from the Indonesian Health Survey 2023, conducted across 38 provinces using a cross-sectional design and stratified sampling. This study analyzed 2992 adolescents and young adults aged 16–24 with complete data on all variables. Data analysis used binary logistic regression and is presented as unadjusted odds ratio (OR) and adjusted odds ratio (AOR), with each variable and its 95% confidence interval (CI) shown.</div></div><div><h3>Results</h3><div>The prevalence of MetS among adolescents and young adults in Indonesia is 13.36%, as reported in a study of 2992 individuals in this age group. In the adjusted analysis, high-risk consumption behavior categorized as frequent (AOR 9.88, 95% CI 2.57–37.88, <em>P</em>-value 0.001) and a body mass index (BMI) classified as obese (AOR 15.60, 95% CI 11.30–21.53, <em>P</em>-value 0.000) were significantly associated with higher odds of MetS in this population.</div></div><div><h3>Conclusion</h3><div>High-risk consumption behavior and obesity are the main risk factors significantly associated with MetS in adolescents and young adults in Indonesia.</div></div><div><h3>Practical implications</h3><div>Health services for adolescents and young adults should include education on the prevention of MetS, focusing on obesity prevention, maintaining a balanced diet, and reducing high-risk consumption behaviors. Furthermore, early detection of MetS in this population should be a top priority in health services.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 227-235"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From adherence to sustainability: Why parental well-being matters in autism interventions","authors":"Ajeng Ayu Widiastuti ,&nbsp;Mozes Kurniawan ,&nbsp;Lanny Wijayaningsih ,&nbsp;Maria Melita Rahardjo ,&nbsp;Eunike Milasari Listyaningrum ,&nbsp;Trivena Dyah Wijayanti","doi":"10.1016/j.pedn.2026.01.043","DOIUrl":"10.1016/j.pedn.2026.01.043","url":null,"abstract":"","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 400-401"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of telenursing-based family empowerment program on self-efficacy and treatment adherence in children with cystic fibrosis “telenursing and CF”","authors":"Fatemeh Rameh ,&nbsp;Azam Shirinabadi Farahani ,&nbsp;Manijeh Nourian ,&nbsp;Seyyed Ahmad Tabatabayi ,&nbsp;Malihe Nasiri","doi":"10.1016/j.pedn.2025.12.028","DOIUrl":"10.1016/j.pedn.2025.12.028","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the impact of a telenursing-based family empowerment program on <!--> <!-->self-efficacy and treatment adherence in children with cystic fibrosis (CF).</div></div><div><h3>Design and methods</h3><div>This is a clinical trial study conducted on CF patients between 9 and 17 who were randomly assigned to two groups: an intervention group (received twelve-week telenursing training via the SendBig website and Skype messenger) or a control group (routine care). The child and caregiver demographic information questionnaire, Pediatric Rating of Chronic Illness Self-Efficacy, and Adherence to Treatment Questionnaire were evaluated before, immediately, and one month after the intervention. The results were analyzed using SPSS V26, considering a significant level.</div></div><div><h3>Results</h3><div>A total of 50 patients were recruited for this study (25 in each group). The results showed a significant difference in the mean total scores of self-efficacy and treatment adherence between the two groups, immediately and one month after the intervention (<em>P</em>-value &lt; 0.001). In addition, intra-group comparisons showed that the impact of time was significant in the intervention group (P-value &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Considering the improvement of self-efficacy and treatment adherence in the intervention group, it is recommended to use a telenursing-based family empowerment program for children with CF.</div></div><div><h3>Implications to practice</h3><div>The findings support the integration of telenursing-based family empowerment programs into routine nursing practice to promote long-term disease management and family-centered care.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 66-71"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experiences of adolescents with thalassemia major: A phenomenological study/ lived experiences in tm adolescents","authors":"Münevver Erkul ,&nbsp;Zeynep Öztürk","doi":"10.1016/j.pedn.2026.01.009","DOIUrl":"10.1016/j.pedn.2026.01.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored the lived experiences and coping processes of adolescents diagnosed with Thalassemia Major (TM) to inform the development of patient-centered and individualized care strategies.</div></div><div><h3>Methods</h3><div>A qualitative phenomenological design was employed. Between April and June 2024, purposive sampling was used to recruit ten adolescents (12–18 years) from the Thalassemia Unit of a public hospital in Antalya, Türkiye. Semi-structured interviews were conducted until data saturation was achieved. Ethical approval was obtained (TBAEK-199). Sociodemographic data were summarized using SPSS 22.0 as frequencies and percentages. Interview transcripts were analyzed using Colaizzi's seven-step method. Trustworthiness was ensured through independent double-coding, audit trail maintenance, and member checking.</div></div><div><h3>Results</h3><div>Six main themes emerged: (1) Acceptance and normalization (integrating illness into daily life; reframing TM as manageable); (2) Impact on schooling (absences due to transfusions or surgeries; academic and emotional strain; facilitative role of teacher support); (3) Peer and societal responses (misinformation, stigma, strategic disclosure, and peer support); (4) Family support and sibling dynamics (parental support enhancing adherence; protective bonds and ambivalence); (5) Treatment adherence and transplant pathway (burden of chronic transfusion and chelation; hope and hesitation regarding hematopoietic stem cell transplantation; donor availability and risk perception); and (6) Psychological processes and coping (anxiety, fear of death, body-image concerns, and active coping strategies such as social support, humor, positive reappraisal, and medication adherence).</div></div><div><h3>Conclusion</h3><div>Adolescents with TM experience multidimensional challenges affecting their educational, social, psychological, and treatment-related lives. A holistic and developmentally sensitive approach is essential to support long-term adaptation and well-being.</div></div><div><h3>Implications for practice</h3><div>Healthcare professionals should integrate routine psychosocial screening and counseling into standard care, strengthen family-centered practices to support treatment adherence, and collaborate with schools to promote flexible attendance policies. Awareness initiatives targeting peers and educators may reduce stigma, while structured, age-appropriate counseling can support informed decision-making regarding long-term treatment and transplantation options.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 118-125"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of education program provided for healthcare professionals on their levels of knowledge and awareness about child abuse and neglect","authors":"Tuba Geçdi ,&nbsp;Derya Tanrıverdi","doi":"10.1016/j.pedn.2026.01.022","DOIUrl":"10.1016/j.pedn.2026.01.022","url":null,"abstract":"<div><h3>Background</h3><div>Child abuse and neglect harm children's development and can lead to long-term mental health issues. Challenges such as underreporting and diagnostic difficulties make early detection harder. Healthcare professionals are essential in recognizing and reporting such cases, but lack of awareness is a major barrier.</div></div><div><h3>Purpose</h3><div>This study examined the impact of a structured training program on healthcare professionals' knowledge and awareness of child abuse and neglect.</div></div><div><h3>Methods</h3><div>A quasi-experimental pretest-posttest control group design was used. Ninety-five healthcare professionals from a city and a university hospital were included. Participants were assigned to experimental and control groups. Data were collected via a Personal Information Form and the Scale for Recognizing the Symptoms and Risks of Child Abuse and Neglect. The experimental group received five weekly 30-min face-to-face training sessions.</div></div><div><h3>Results</h3><div>Both groups initially had moderate knowledge and awareness. Pretest scores showed no significant differences (<em>p</em> &gt; 0.05). Post-test results showed a statistically significant improvement in the experimental group's total knowledge and awareness scores related to the signs and risks of child abuse and neglect (<em>p</em> &lt; 0.001). No significant change was observed in the control group (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Structured training programs enhance healthcare professionals' knowledge and awareness of child abuse and neglect. Regular implementation and updates of such programs in healthcare institutions are recommended.</div></div><div><h3>Implications to practice</h3><div>This study demonstrates that structured training programmes increase healthcare professionals' knowledge and awareness of child abuse and neglect. Integrating evidence-based and regular programmes into in-service training can strengthen child protection practices by supporting early identification, appropriate reporting and effective intervention.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 330-337"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality for pediatric procedural pain: An umbrella review and re-analysis of meta-analytic evidence","authors":"Çiğdem GÖK ,&nbsp;Pelin KARATAŞ","doi":"10.1016/j.pedn.2026.01.026","DOIUrl":"10.1016/j.pedn.2026.01.026","url":null,"abstract":"<div><h3>Background</h3><div>Needle-related medical procedures are among the most common sources of pain, fear, and anxiety in children. Negative procedural experiences may lead to behavioral distress, avoidance of future care, and reduced treatment compliance. Virtual reality (VR) has recently emerged as a promising non-pharmacological intervention that provides multisensory distraction, thereby reducing the perception of pain. However, inconsistencies across existing meta-analyses limit the generalizability of current evidence.</div></div><div><h3>Aim</h3><div>This umbrella review aimed to synthesize and re-analyze existing meta-analytic evidence on the effectiveness of VR in reducing pain and anxiety during needle-related procedures in children and adolescents.</div></div><div><h3>Methods</h3><div>A systematic search was performed across PubMed, Cochrane Database of Systematic Reviews, and Web of Science up to September 2025. Only meta-analyses of randomized controlled trials (RCTs) examining VR interventions for pediatric procedural pain were included. Two independent reviewers conducted study selection and data extraction. Methodological quality was assessed using AMSTAR 2 criteria. Heterogeneity (I²), standardized mean differences (SMD), and publication bias (Egger / Begg tests) were recorded.</div></div><div><h3>Results</h3><div>Six meta-analyses (<em>n</em> = 1450 children) met the inclusion criteria. VR interventions demonstrated significant reductions in pain across self-, parent-, and observer-reported measures (SMD range: −0.5 to −3.5). The strongest effects were observed for self-reported pain, indicating high clinical relevance. Despite high heterogeneity (I² = 81–100%), all analyses showed consistent effect directions favoring VR. Methodological quality was moderate to moderate-high, with limited protocol registration and publication bias analysis. Evidence overlap between studies was substantial (CCA = 15.8%).</div></div><div><h3>Conclusion</h3><div>VR significantly reduces needle-related pain in pediatric patients and demonstrates moderate-to-high reliability across studies. Despite methodological heterogeneity, findings strongly support integrating VR as a complementary tool in pediatric pain management.</div></div><div><h3>Implications for practice</h3><div>Nurses and clinicians can incorporate immersive VR interventions into routine pediatric care to minimize pain and anxiety during short invasive procedures, improving patient comfort and cooperation.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 297-305"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journeying through the landscape of home-based pediatric cancer care: Needs and expectations from the perspectives of children and parents","authors":"Hazal Ozdemir Koyu PhD, RN,&nbsp;Ebru Kilicarslan PhD, RN","doi":"10.1016/j.pedn.2025.12.029","DOIUrl":"10.1016/j.pedn.2025.12.029","url":null,"abstract":"<div><h3>Purpose</h3><div>Children with cancer and their parents face multidimensional demands in home-based pediatric cancer care, spanning informational, practical, and psychosocial domains, often requiring acute decision-making at home. However, qualitative evidence integrating both children's and parents' perspectives remains limited. This study aimed to explore and understand the needs, expectations, and experiences of children with cancer and their parents during home-based care.</div></div><div><h3>Methods</h3><div>A qualitative dyadic child–parent study was conducted in a pediatric oncology ward of a university hospital. Purposeful sampling continued until thematic saturation. Data were collected using a researcher-developed Characteristics Information Form and semi-structured interviews informed by Empowerment Theory. Reflexive thematic analysis guided by theoretical frameworks was used. Ethical approval was obtained, and trustworthiness was ensured through strategies addressing credibility, dependability, transferability, and confirmability.</div></div><div><h3>Results</h3><div>Eighteen children and eighteen parents participated. Two overarching themes emerged: (1) Navigating Challenges in Home-Based Pediatric Cancer Care, encompassing physical, informational, clinical, emotional, and psychosocial difficulties; and (2) The Lighthouse of Empowerment: Guiding Support, highlighting the need for tailored, structured support mechanisms, including home-care education, symptom management guidance, coordinated communication pathways, digital tools, psychological support modules, and clear emergency roadmaps.</div></div><div><h3>Conclusion</h3><div>The study reveals complex challenges and empowerment needs of children with cancer and their parents during home-based care. Findings emphasize the importance of family-centered and child-focused, empowerment-oriented, and technology-supported approaches to enhance home-care competence and psychosocial well-being.</div></div><div><h3>Implications for practice</h3><div>Pediatric oncology nurses can enhance home-based care by providing structured education, individualized symptom guidance, empowerment-focused interventions, digital tools, clear communication, and emergency planning, thereby improving family confidence, continuity of care, and psychosocial outcomes.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 11-19"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of tele-nursing application on metabolic control, self-efficacy, quality of life and anxiety level in adolescents with Type 1 diabetes: A randomized controlled trial","authors":"Emel Avçin PhD, RN (Corresponding Author, Assistant Professor) ,&nbsp;Ayfer Açıkgöz PhD, RN (Co-Author, Professor)","doi":"10.1016/j.pedn.2026.01.042","DOIUrl":"10.1016/j.pedn.2026.01.042","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>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 (<span><span>NCT05211479</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>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 (<em>p</em> &lt;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 (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Implications for practice</h3><div>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.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 433-442"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Type 1 diabetes in adolescents: Effectiveness of the remote personalized system of instruction model","authors":"Nebahat Bora Güneş ,&nbsp;Melike Taşdelen Baş ,&nbsp;Semra Çetinkaya ,&nbsp;Nurdan Yıldırım","doi":"10.1016/j.pedn.2026.01.012","DOIUrl":"10.1016/j.pedn.2026.01.012","url":null,"abstract":"<div><h3>Background and aim</h3><div>Type 1 Diabetes Mellitus (T1DM) is a common chronic condition in childhood and requires appropriate education and self-management skills. Structured education is key to improving glycemic stability and empowering adolescents. The Personalized System of Instruction (PSI), though effective in other fields, is underused in diabetes education. This study evaluated the impact of PSI-based structured ongoing education program among adolescents living with T1DM and with glycemic instability.</div></div><div><h3>Methods</h3><div>A randomized controlled trial with a pre-test/post-test comparison group design was conducted. Participants were adolescents aged 12–18 years with glycemic instability (glycated hemoglobin [HbA1c] ≥7%) and at least one weekly hypo‐hyperglycemic episode. Stratified randomization ensured group balance. The study included 60 adolescents with T1DM, evenly split between intervention and control groups. Validated instruments were used to assess cognitive knowledge, self-efficacy, glycemic episode frequency, and HbA1c levels. The intervention group received structured education based on the PSI model, while the comparison group received standard diabetes education.</div></div><div><h3>Results</h3><div>The intervention group showed significantly greater improvements than the comparison group in all outcomes. From the 3rd month, cognitive knowledge and self-efficacy increased, while HbA1c levels and glycemic episode frequency declined. Group-time interaction was significant, with sustained improvement in the PSI group up to 6 months. η² values indicated moderate to large effect sizes.</div></div><div><h3>Conclusion</h3><div>The PSI model is an effective strategy to enhance diabetes self-management and glycemic stability in adolescents with T1DM. Its structured, learner-centered design offers a promising alternative to traditional education methods in this population.</div></div><div><h3>Implications to practice</h3><div>The findings suggest that the PSI framework can be effectively integrated into pediatric nursing practice to support individualized, learner-centered diabetes self-management education for adolescents with T1DM, enhance skill acquisition and self-efficacy, and facilitate ongoing educational support within both in-person and digital care settings.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 181-189"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}