Journal of Pediatric Nursing-Nursing Care of Children & Families最新文献_第8页

Understanding vulnerability and diabetes management in families of children with type 1-diabetes - A qualitative study 了解1型糖尿病儿童家庭的易感性和糖尿病管理-一项定性研究。

IF 2.3 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2025-12-22 DOI: 10.1016/j.pedn.2025.12.017

Marie Nedergaard Jeppesen RN, MHH, MSc, PhD-Stud , Jane Clemensen RN, MScN, PhD, Prof. , Malene Søborg Heidemann MD, PhD , Birgitte Hertz MD , Bodil Rasmussen RN, PhD, Prof. , Mette Juel Rothmann RN, PhD, Prof.

Aim & purpose

This study aimed to explore how vulnerability among children with Type 1 Diabetes (T1D) and their families influences diabetes management. Vulnerability was defined broadly, encompassing mental or physical illness, dysfunctional family dynamics, substance abuse, and socio-economic hardship. The research explored how these factors shaped the lived experiences of families managing T1D.

Methods & results

An explorative, qualitative study with eight families followed over 1.5 years through 40 h of field observations and 29 interviews. A phenomenological-hermeneutical analysis grounded in Ricoeur's theory of narrative and interpretation revealed three overarching themes: ‘Like facing a massive wall’, ‘There is not enough room for diabetes’, and ‘Give me the skills so I can become independent’. These themes reflect challenges at the systemic, family, and individual levels. Families encountered significant barriers to accessing support, often feeling overwhelmed and resigned. Diabetes care was frequently not prioritised due to competing life challenges, with children sometimes assuming caregiving roles. Children expressed a strong desire for autonomy in managing their condition, while parents sought better knowledge to support them.

Conclusions

Vulnerability significantly impairs effective diabetes management in children with T1D. The findings highlight the need for healthcare professionals to recognise systemic and familial barriers and to tailor interventions accordingly. Collaborative care approaches, realistic goal-setting, and age-appropriate skill-building programs are essential.

Implications for practice

The study highlights the need for development of inclusive and responsive diabetes care strategies, focusing on the identification of systemic and familial barriers.

目的与目的：本研究旨在探讨1型糖尿病儿童（T1D）及其家庭的易感性对糖尿病管理的影响。脆弱性的定义很宽泛，包括精神或身体疾病、不正常的家庭动态、药物滥用和社会经济困难。该研究探讨了这些因素如何影响管理T1D的家庭的生活经历。方法与结果：通过40小时的实地观察和29次访谈，对8个家庭进行了为期1.5年的探索性定性研究。以利科的叙事和阐释理论为基础的现象学-解释学分析揭示了三个主要主题：“就像面对一堵巨大的墙”，“没有足够的空间容纳糖尿病”，以及“给我技能，这样我就能独立”。这些主题反映了系统、家庭和个人层面的挑战。家庭在获得支持方面遇到了重大障碍，常常感到不知所措，听天由命。由于生活挑战的竞争，糖尿病护理经常不被优先考虑，儿童有时承担照顾的角色。孩子们表达了对自主管理自己病情的强烈愿望，而父母则寻求更好的知识来支持他们。结论：易感性显著影响T1D儿童糖尿病的有效管理。研究结果强调，卫生保健专业人员需要认识到系统性和家族性障碍，并相应地调整干预措施。协作护理方法、现实的目标设定和适合年龄的技能培养计划是必不可少的。实践意义：该研究强调了制定包容性和响应性糖尿病护理策略的必要性，重点是识别系统性和家族性障碍。

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引用次数: 0

The application of virtual and augmented reality in hospitalized pediatric nursing interventions: An integrative literature review 虚拟和增强现实在住院儿科护理干预中的应用：综合文献综述

IF 2.3 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2025-12-19 DOI: 10.1016/j.pedn.2025.12.015

Yujeong Kim , Mingi Chang , Eunhee Nam

Purpose

This integrative review synthesized evidence on nursing interventions using virtual reality (VR) and augmented reality (AR) for hospitalized children, focusing on intervention strategies and components to guide standardized technology-based nursing programs.

Methods

Following Whittemore and Knafl's framework, a comprehensive search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, simulation-related journals, and domestic databases including Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Database Periodical Information Academic (DBpia). Thirteen studies met inclusion criteria: ten randomized controlled trials, two case reports, and one quasi-experimental study. Study quality was appraised using Joanna Briggs Institute (JBI) tools, and data were analyzed by general characteristics, intervention strategies, and components.

Results

Most studies were published after 2020. Participants were mainly children aged 4–12 years. VR interventions predominated (84.6 %), while AR appeared in two studies. Single-session applications (76.9 %) under 10 min were common during injections, dressing changes, or surgery preparation. Longer AR storybooks supported psychological and educational needs. Outcomes included reductions in pain (46.2 %), anxiety (53.8 %), and fear, with interactive content showing stronger effects than passive viewing.

Conclusion

VR and AR are effective non-pharmacological tools to reduce distress in hospitalized children. VR is useful for procedural support, while AR shows potential for extended psychosocial care. Evidence gaps remain regarding chronic conditions, optimal dosage, and child-appropriate devices.

Implications

By matching intervention type, duration, and interactivity to clinical goals and developmental stage, VR and AR can be applied as child-centered nursing strategies to enhance the hospital experience.

目的本综述综合了基于虚拟现实（VR）和增强现实（AR）的住院儿童护理干预证据，重点探讨了干预策略和组成部分，以指导标准化的基于技术的护理方案。方法按照Whittemore和Knafl的框架，综合检索PubMed、chinese journal Index to Nursing and Allied Health Literature （CINAHL）、ProQuest、仿真相关期刊以及研究信息共享服务（RISS）、韩国学信息服务系统（KISS）、数据库期刊信息学术（DBpia）等国内数据库。13项研究符合纳入标准：10项随机对照试验，2项病例报告和1项准实验研究。采用乔安娜布里格斯研究所（Joanna Briggs Institute， JBI）的工具对研究质量进行评价，并对数据进行一般特征、干预策略和成分分析。结果大多数研究发表于2020年以后。参与者主要是4-12岁的儿童。VR干预占主导地位（84.6%），而AR在两项研究中出现。在注射、换药或手术准备期间，10分钟内的单次应用（76.9%）很常见。较长的AR故事书支持心理和教育需求。结果包括疼痛（46.2%）、焦虑（53.8%）和恐惧的减少，互动内容显示出比被动观看更强的效果。结论vr和AR是减轻住院患儿痛苦的有效非药物手段。虚拟现实可用于程序支持，而增强现实显示了扩展心理社会护理的潜力。在慢性病、最佳剂量和适合儿童的器械方面，证据差距仍然存在。通过将干预的类型、持续时间和互动性与临床目标和发育阶段相匹配，VR和AR可以作为以儿童为中心的护理策略来提高医院体验。

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引用次数: 0

Pediatric nurses' perspectives on parents' quality of life in tertiary care for children with disabilities: A qualitative descriptive study 儿科护士对残疾儿童三级护理中父母生活质量的看法：一项定性描述性研究

IF 2.3 4区医学 Q2 NURSING

Journal of Pediatric Nursing-Nursing Care of Children & Families

Pub Date : 2025-12-19 DOI: 10.1016/j.pedn.2025.12.012

Osama Mohamed Elsayed Ramadan , Elham Aldousari , Nadia Bassuoni Elsharkawy , Maha Suwailem S. Alshammari , Enas Mahrous Abdelaziz , Nermen Abdelftah Mohamed

Background

Parents of children with disabilities receiving tertiary care face cumulative demands that threaten their well-being, and pediatric nurses, positioned at the family–hospital interface, witness how organizational routines shape parents' quality of life (QoL).

Purpose

To explore pediatric nurses' perspectives on parental QoL and identify modifiable institutional factors.

Methods

A qualitative descriptive study using reflexive thematic analysis, informed by Family Systems Theory as a sensitizing lens, was conducted with semi-structured interviews of 24 pediatric nurses from four tertiary hospitals in Kafr Elsheikh, Egypt. Rigor was supported through multi-site sampling, an audit trail, and reflexive and collaborative checks.

Results

Four themes characterized nurses' observations of parental QoL: (1) compounding care demands; (2) contracting social worlds; (3) adaptive resilience patterns; and (4) the healthcare system as contextual influence. Parents were portrayed as living with overlapping physical, emotional, financial, and social strain, yet developing advocacy, recalibrated expectations, and meaning-making within hospital ecologies that either buffered or intensified burden. Nurses highlighted modifiable levers, including plain-language family updates, nurse-led coordination with shared care plans, family-supportive spaces, and structured referral to psychosocial and financial supports.