To explore the lived experience of pediatric nurses caring for child maltreatment victims when the suspected offender is present at the bedside, a context that presents unique ethical and emotional challenges.
Design and method
A hermeneutic phenomenological approach was used to explore the lived experience. Fourteen pediatric nurses participated in in-depth interviews. Data were analyzed using van Manen's thematic analysis.
Results
Four themes, comprising 11 subthemes, were identified: 1) Nurses care for sick people, 2) Adjusting mental and physical strategies, 3) Navigating attention and role conflict, and 4) Enduring emotional impact.
Conclusions
This study reveals the emotional toll pediatric nurses face during maltreatment investigations. Despite their commitment to caring for all patients and the use of adaptation strategies, nurses often experience psychological harm. Maltreatment investigations disrupt traditional models of family-centered care and can contribute to compassion fatigue, burnout, and professional isolation.
Practice implications
Findings highlight the need for organizational support, clearer role expectations, education, and nurses' psychological safety. Interventions that support nurses' emotional well-being and professional identity are essential to sustaining compassionate, ethical care in complex pediatric settings.
{"title":"Pediatric nurses' experiences caring for children and suspected offenders during maltreatment investigations: A hermeneutic phenomenological study","authors":"Brady Franklin PhD, RN, FNP-BC, CPN , Rachel Johnson-Koenke PhD, MSW, LCSW , Elias Provencio-Vasquez PhD, RN, FAAN, FAANP , Kathleen Ellis PhD, CCRN, CNE , Jacqueline Jones PhD, RN, FAAN, FRCNA","doi":"10.1016/j.pedn.2025.11.027","DOIUrl":"10.1016/j.pedn.2025.11.027","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the lived experience of pediatric nurses caring for child maltreatment victims when the suspected offender is present at the bedside, a context that presents unique ethical and emotional challenges.</div></div><div><h3>Design and method</h3><div>A hermeneutic phenomenological approach was used to explore the lived experience. Fourteen pediatric nurses participated in in-depth interviews. Data were analyzed using van Manen's thematic analysis.</div></div><div><h3>Results</h3><div>Four themes, comprising 11 subthemes, were identified: 1) Nurses care for sick people, 2) Adjusting mental and physical strategies, 3) Navigating attention and role conflict, and 4) Enduring emotional impact.</div></div><div><h3>Conclusions</h3><div>This study reveals the emotional toll pediatric nurses face during maltreatment investigations. Despite their commitment to caring for all patients and the use of adaptation strategies, nurses often experience psychological harm. Maltreatment investigations disrupt traditional models of family-centered care and can contribute to compassion fatigue, burnout, and professional isolation.</div></div><div><h3>Practice implications</h3><div>Findings highlight the need for organizational support, clearer role expectations, education, and nurses' psychological safety. Interventions that support nurses' emotional well-being and professional identity are essential to sustaining compassionate, ethical care in complex pediatric settings.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 348-354"},"PeriodicalIF":2.3,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615127","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}
The purpose of this article is to highlight the importance of pediatric nursing as a valued specialty within the healthcare ecosystem and to explore diverse pathways for career progression throughout pediatric nursing with hopes of inspiring future leaders to achieve further influence of the pediatric specialty within the healthcare ecosystem.
Results
The Institute of Pediatric Nursing (IPN) is a committee of the Pediatric Nursing Certification Board (PNCB) comprised of nationally recruited thought leaders cultivated to create resources and strategies to support the pediatric nursing profession. The IPN explored ways to communicate the value of pediatrics as a specialty, develop future leaders at the bedside and beyond, and involve educators in promoting advanced development and longevity for careers in pediatric nursing. Through group discussion and resource sharing, an IPN workgroup consisting of a diverse, accomplished pediatric nursing leaders explored and developed 22 potential professional pathways for pediatric nurses to pursue advanced roles both at and beyond bedside nursing care.
Conclusion
Pediatrics is an essential specialty within the nursing profession in which caring nurse experts are equipped to skillfully respond to complex physical, developmental, emotional, behavioral, and mental health needs of children from birth through early adulthood in a framework of family-centered, evidence-based, holistic care. Far beyond bedside care delivery, pediatric nurses increasingly work at the forefront of child health as indispensable resources in modern contexts to meet rapidly evolving health needs of individual children, their families, and their communities.
{"title":"Beyond the bedside: Building career pathways to strengthen pediatric nursing","authors":"Jessica L. Peck DNP, APRN, CPNP-PC, CNE, CNL, FAANP, FAAN , Tomika S. Harris DNP, APRN, CPNP-PC , Kathleen Schoemer MSN, RN, CPNP-PC","doi":"10.1016/j.pedn.2025.11.024","DOIUrl":"10.1016/j.pedn.2025.11.024","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this article is to highlight the importance of pediatric nursing as a valued specialty within the healthcare ecosystem and to explore diverse pathways for career progression throughout pediatric nursing with hopes of inspiring future leaders to achieve further influence of the pediatric specialty within the healthcare ecosystem.</div></div><div><h3>Results</h3><div>The Institute of Pediatric Nursing (IPN) is a committee of the Pediatric Nursing Certification Board (PNCB) comprised of nationally recruited thought leaders cultivated to create resources and strategies to support the pediatric nursing profession. The IPN explored ways to communicate the value of pediatrics as a specialty, develop future leaders at the bedside and beyond, and involve educators in promoting advanced development and longevity for careers in pediatric nursing. Through group discussion and resource sharing, an IPN workgroup consisting of a diverse, accomplished pediatric nursing leaders explored and developed 22 potential professional pathways for pediatric nurses to pursue advanced roles both at and beyond bedside nursing care.</div></div><div><h3>Conclusion</h3><div>Pediatrics is an essential specialty within the nursing profession in which caring nurse experts are equipped to skillfully respond to complex physical, developmental, emotional, behavioral, and mental health needs of children from birth through early adulthood in a framework of family-centered, evidence-based, holistic care. Far beyond bedside care delivery, pediatric nurses increasingly work at the forefront of child health as indispensable resources in modern contexts to meet rapidly evolving health needs of individual children, their families, and their communities.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 331-341"},"PeriodicalIF":2.3,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607021","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}
Pub Date : 2025-11-24DOI: 10.1016/j.pedn.2025.11.022
Nurgül Özırmak , Emriye Hilal Yayan
Objective
The Palm Stimulator provides tactile stimulation through the palm of the hand. This study aimed to assess the efficacy of the Palm Stimulator in reducing pain levels during intravenous blood draws in children aged 8–12 years. Additionally, the effect of the Palm Stimulator depending on the application site, i.e. the hand from which blood is being drawn or the contralateral hand, was evaluated.
Method
The study was conducted using a randomised controlled experimental design. Between May and July 2024, 168 children who came to the paediatric blood draw unit were randomised into three groups. Data were collected using the Child Information Form, Children's Fear Scale, Faces Pain Scale-Revised and Visual Analogue Scale.
Results
In both intervention groups, pain scores assessed by the child, parent, and observer (researcher) were found to be considerably lower than in the control group (p < 0.05). No significant difference was found in terms of pain levels between same-hand and contralateral-hand application (p > 0.05).
Conclusion
The Palm Stimulator was found to effectively reduce pain during an intravenous blood draw, regardless of where it was applied. These findings support the use of the Palm Stimulator as a flexible and effective non-pharmacological intervention in paediatric clinics.
{"title":"The difference between site of application and pain relief efficacy of the palm stimulator: A randomised controlled trial of intravenous blood drawn in children","authors":"Nurgül Özırmak , Emriye Hilal Yayan","doi":"10.1016/j.pedn.2025.11.022","DOIUrl":"10.1016/j.pedn.2025.11.022","url":null,"abstract":"<div><h3>Objective</h3><div>The Palm Stimulator provides tactile stimulation through the palm of the hand. This study aimed to assess the efficacy of the Palm Stimulator in reducing pain levels during intravenous blood draws in children aged 8–12 years. Additionally, the effect of the Palm Stimulator depending on the application site, i.e. the hand from which blood is being drawn or the contralateral hand, was evaluated.</div></div><div><h3>Method</h3><div>The study was conducted using a randomised controlled experimental design. Between May and July 2024, 168 children who came to the paediatric blood draw unit were randomised into three groups. Data were collected using the Child Information Form, Children's Fear Scale, Faces Pain Scale-Revised and Visual Analogue Scale.</div></div><div><h3>Results</h3><div>In both intervention groups, pain scores assessed by the child, parent, and observer (researcher) were found to be considerably lower than in the control group (<em>p</em> < 0.05). No significant difference was found in terms of pain levels between same-hand and contralateral-hand application (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>The Palm Stimulator was found to effectively reduce pain during an intravenous blood draw, regardless of where it was applied. These findings support the use of the Palm Stimulator as a flexible and effective non-pharmacological intervention in paediatric clinics.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 315-323"},"PeriodicalIF":2.3,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607006","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}
Pub Date : 2025-11-24DOI: 10.1016/j.pedn.2025.11.028
Pablo Buck Sainz-Rozas , Laia García Fernández , Marina Duque Domínguez
Purpose
To evaluate the effectiveness of a structured handover tool implemented in paediatric inpatient care. Poor communication during clinical handovers can compromise patient safety. The Situation, Background, Assessment, Recommendation tool adapted for Paediatric Inpatient Care (SBAR-HP) was designed to standardise and improve this process by addressing common barriers such as omission of critical information and lack of structure.
Methods
A pre–post quasi-experimental study was conducted at Vall d'Hebron Barcelona Hospital Campus using the Handoff CEX Scale to assess quality, adherence, and satisfaction before and after implementing the SBAR-HP. Descriptive analyses and the Wilcoxon test were used to evaluate pre–post changes, alongside a logistic regression model.
Results
A total of 110 nurses participated before the implementation and 81 afterwards. Of the total participants, 92.7 % were women, with a mean age of 31.1 years (SD = 9.1). Handover quality improved significantly following the introduction of SBAR-HP: the setting dimension rose from 3.8 to 5.3 (p < 0.00001), organisation from 5.9 to 6.7 (p = 0.00354), and overall quality from 51.5 to 69 (p < 0.00001). A total of 70.3 % rated their adherence as ≥7/9, and 71.6 % positively assessed its applicability. A positive correlation was observed between self-assessed performance and handover quality, supporting the tool's effectiveness in structuring the process.
Conclusion
The SBAR-HP is an effective tool for structuring nursing handovers, fostering clear and safe communication in paediatric settings. Its adoption may enhance both patient safety and staff satisfaction.
Implications for practice
Implementing the SBAR-HP tool in paediatric settings may enhance handover quality, promote safer communication among nurses, and foster a culture of structured clinical exchange.
{"title":"Standardisation and structuring of nursing handover in paediatric inpatient care: A quasi-experimental study","authors":"Pablo Buck Sainz-Rozas , Laia García Fernández , Marina Duque Domínguez","doi":"10.1016/j.pedn.2025.11.028","DOIUrl":"10.1016/j.pedn.2025.11.028","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness of a structured handover tool implemented in paediatric inpatient care. Poor communication during clinical handovers can compromise patient safety. The Situation, Background, Assessment, Recommendation tool adapted for Paediatric Inpatient Care (SBAR-HP) was designed to standardise and improve this process by addressing common barriers such as omission of critical information and lack of structure.</div></div><div><h3>Methods</h3><div>A pre–post quasi-experimental study was conducted at Vall d'Hebron Barcelona Hospital Campus using the Handoff CEX Scale to assess quality, adherence, and satisfaction before and after implementing the SBAR-HP. Descriptive analyses and the Wilcoxon test were used to evaluate pre–post changes, alongside a logistic regression model.</div></div><div><h3>Results</h3><div>A total of 110 nurses participated before the implementation and 81 afterwards. Of the total participants, 92.7 % were women, with a mean age of 31.1 years (SD = 9.1). Handover quality improved significantly following the introduction of SBAR-HP: the setting dimension rose from 3.8 to 5.3 (<em>p</em> < 0.00001), organisation from 5.9 to 6.7 (<em>p</em> = 0.00354), and overall quality from 51.5 to 69 (p < 0.00001). A total of 70.3 % rated their adherence as ≥7/9, and 71.6 % positively assessed its applicability. A positive correlation was observed between self-assessed performance and handover quality, supporting the tool's effectiveness in structuring the process.</div></div><div><h3>Conclusion</h3><div>The SBAR-HP is an effective tool for structuring nursing handovers, fostering clear and safe communication in paediatric settings. Its adoption may enhance both patient safety and staff satisfaction.</div></div><div><h3>Implications for practice</h3><div>Implementing the SBAR-HP tool in paediatric settings may enhance handover quality, promote safer communication among nurses, and foster a culture of structured clinical exchange.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 324-330"},"PeriodicalIF":2.3,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607009","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}
Pub Date : 2025-11-21DOI: 10.1016/j.pedn.2025.11.009
Xinyu Yao , Linlin Zhang
Background
Pediatric vascular surgery poses unique postoperative challenges, where specialized nursing care is critical for preventing complications. This study evaluated the impact of nurse-led interventions on outcomes in pediatric vascular surgery patients.
Methods
A prospective cohort study was conducted at a tertiary pediatric center (2018–2023) involving 312 patients undergoing vascular surgery. Patients were divided into standard care (n = 156) and nurse-led intervention (n = 156) groups. The intervention group received care from specialized nurses with lower nurse-to-patient ratios (NPR) (2.97:1 vs 5.03:1), enhanced monitoring, and structured early mobilization. Primary outcomes included surgical site infections (SSI), deep vein thrombosis (DVT), length of stay (LOS), and time to ambulation. Secondary outcomes were intensive care unit (ICU) days, catheter duration, and 30-day readmissions. Statistical analyses included chi-square tests, Mann-Whitney U tests, and logistic regression.
Results
The nurse-led group showed significantly lower SSI (9.6 % vs 21.5 %, p < 0.001) and DVT rates (6.4 % vs 18.1 %, p < 0.001). Time to ambulation improved (7.95 vs 15.83 h, p < 0.001), and hospital LOS shortened (5.44 vs 6.61 days, p = 0.002). Catheter duration decreased (3.00 vs 4.00 days, p < 0.01), while dressing changes increased (3.00 vs 2.00, p < 0.05). Logistic regression identified catheter days (OR 1.45, p = 0.0001) and 24-h pain scores (OR 1.64, p = 0.001) as key SSI predictors.
Conclusion
Nurse-led interventions with optimized staffing and specialized protocols significantly reduce complications in pediatric vascular surgery. These findings advocate for investment in specialized nursing programs to enhance surgical outcomes.
儿童血管手术具有独特的术后挑战，其中专业护理对预防并发症至关重要。本研究评估了护士主导的干预措施对儿童血管手术患者预后的影响。方法在某三级儿科中心（2018-2023年）对312例血管手术患者进行前瞻性队列研究。患者分为标准治疗组（n = 156）和护士主导干预组（n = 156）。干预组由专科护士护理，护患比（NPR）较低（2.97:1 vs 5.03:1），加强监测，有组织的早期动员。主要结局包括手术部位感染（SSI）、深静脉血栓形成（DVT）、住院时间（LOS）和活动时间。次要结局是重症监护病房（ICU）天数、导管持续时间和30天再入院率。统计分析包括卡方检验、Mann-Whitney U检验和逻辑回归。结果护理组SSI （9.6% vs 21.5%, p < 0.001）和DVT发生率（6.4% vs 18.1%, p < 0.001）显著降低。活动时间改善（7.95 vs 15.83 h, p < 0.001），住院LOS缩短（5.44 vs 6.61天，p = 0.002）。导管持续时间减少（3.00 vs 4.00天，p < 0.01），换药时间增加（3.00 vs 2.00, p < 0.05）。Logistic回归发现导管天数（OR 1.45, p = 0.0001）和24小时疼痛评分（OR 1.64, p = 0.001）是关键的SSI预测因子。结论以护士为主导的干预措施，优化人员配置和专业方案，可显著减少儿童血管手术并发症。这些发现提倡对专业护理项目进行投资，以提高手术效果。
{"title":"The role of pediatric nurses in managing post-vascular surgery complications in children","authors":"Xinyu Yao , Linlin Zhang","doi":"10.1016/j.pedn.2025.11.009","DOIUrl":"10.1016/j.pedn.2025.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric vascular surgery poses unique postoperative challenges, where specialized nursing care is critical for preventing complications. This study evaluated the impact of nurse-led interventions on outcomes in pediatric vascular surgery patients.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted at a tertiary pediatric center (2018–2023) involving 312 patients undergoing vascular surgery. Patients were divided into standard care (<em>n</em> = 156) and nurse-led intervention (n = 156) groups. The intervention group received care from specialized nurses with lower nurse-to-patient ratios (NPR) (2.97:1 vs 5.03:1), enhanced monitoring, and structured early mobilization. Primary outcomes included surgical site infections (SSI), deep vein thrombosis (DVT), length of stay (LOS), and time to ambulation. Secondary outcomes were intensive care unit (ICU) days, catheter duration, and 30-day readmissions. Statistical analyses included chi-square tests, Mann-Whitney <em>U</em> tests, and logistic regression.</div></div><div><h3>Results</h3><div>The nurse-led group showed significantly lower SSI (9.6 % vs 21.5 %, <em>p</em> < 0.001) and DVT rates (6.4 % vs 18.1 %, p < 0.001). Time to ambulation improved (7.95 vs 15.83 h, p < 0.001), and hospital LOS shortened (5.44 vs 6.61 days, <em>p</em> = 0.002). Catheter duration decreased (3.00 vs 4.00 days, <em>p</em> < 0.01), while dressing changes increased (3.00 vs 2.00, <em>p</em> < 0.05). Logistic regression identified catheter days (OR 1.45, <em>p</em> = 0.0001) and 24-h pain scores (OR 1.64, <em>p</em> = 0.001) as key SSI predictors.</div></div><div><h3>Conclusion</h3><div>Nurse-led interventions with optimized staffing and specialized protocols significantly reduce complications in pediatric vascular surgery. These findings advocate for investment in specialized nursing programs to enhance surgical outcomes.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 291-299"},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569749","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}
Family-centered care (FCC) is a vital approach to pediatric care provision based on the useful collaboration of healthcare providers, patients, and patient families. This study aimed to explore the dimensions, challenges, and improvement strategies of FCC in the pediatric emergency department (PED).
Methods
This mixed-methods systematic review was conducted using the Preferred Reporting Items for Systematic reviews (PRISMA). Literature search was performed in five online databases, namely Scopus, Web of Science, Proquest, PubMed, and Science Direct to find studies published in 2010–2024. Eligible quantitative, qualitative, and mixed-methods studies were included and reviewed. The quality of the selected articles was assessed using the instruments developed by the Joanna Briggs Institute. The data were analyzed and combined using thematic analysis.
Findings
Four hundred and thirteen articles were identified, 24 of which were eligible for inclusion in the study. FCC dimensions were emotional support, coordination, informed patient and family participation in decision-making, timely and accurate care, pain management, continuity of care and transition, and a safe and child-centered environment. FCC challenges were family dissatisfaction, family attendance during invasive procedures, limited psychosocial support for families, communication barriers, and participation in pediatric research. FCC improvement strategies were communication improvement strategies, fulfillment of emotional and social needs, improving of system efficiency, innovative solutions and virtual care, organizational modifications, and creation of a safe, comfortable, and supportive environment.
Conclusion
This study assessed FCC dimensions, challenges, and improvement strategies. Its findings can be used to improve healthcare providers' knowledge about FCC decision-making and planning in PED.
以家庭为中心的护理（FCC）是儿科护理提供的一种重要方法，它基于医疗保健提供者、患者和患者家属的有益合作。本研究旨在探讨儿科急诊科（PED） FCC的维度、挑战和改进策略。方法采用系统评价首选报告项目（PRISMA）进行混合方法系统评价。在Scopus、Web of Science、Proquest、PubMed和Science Direct 5个在线数据库中进行文献检索，查找2010-2024年发表的研究。纳入并回顾了合格的定量、定性和混合方法研究。所选文章的质量使用由乔安娜布里格斯研究所开发的工具进行评估。采用专题分析方法对数据进行分析和组合。研究结果确定了413篇文章，其中24篇符合纳入研究的条件。FCC维度包括情感支持、协调、知情的患者和家属参与决策、及时准确的护理、疼痛管理、护理的连续性和过渡，以及安全和以儿童为中心的环境。FCC面临的挑战是家庭不满、侵入性手术期间的家庭出席、家庭的有限社会心理支持、沟通障碍和参与儿科研究。FCC改善策略包括沟通改善策略、情感和社会需求的满足、系统效率的提高、创新解决方案和虚拟护理、组织修改以及创造安全、舒适和支持性的环境。本研究评估了FCC的维度、挑战和改进策略。其研究结果可用于提高医疗保健提供者对PED FCC决策和计划的认识。
{"title":"Dimensions, challenges, and improvement strategies of family-centered care in emergency pediatric settings: A mixed-methods systematic review","authors":"Arezoo Ghavi , Zohreh Nabizadeh-Gharghozar , Leila Valizadeh , Aydin Feyzi","doi":"10.1016/j.pedn.2025.11.007","DOIUrl":"10.1016/j.pedn.2025.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Family-centered care (FCC) is a vital approach to pediatric care provision based on the useful collaboration of healthcare providers, patients, and patient families. This study aimed to explore the dimensions, challenges, and improvement strategies of FCC in the pediatric emergency department (PED).</div></div><div><h3>Methods</h3><div>This mixed-methods systematic review was conducted using the Preferred Reporting Items for Systematic reviews (PRISMA). Literature search was performed in five online databases, namely Scopus, Web of Science, Proquest, PubMed, and Science Direct to find studies published in 2010–2024. Eligible quantitative, qualitative, and mixed-methods studies were included and reviewed. The quality of the selected articles was assessed using the instruments developed by the Joanna Briggs Institute. The data were analyzed and combined using thematic analysis.</div></div><div><h3>Findings</h3><div>Four hundred and thirteen articles were identified, 24 of which were eligible for inclusion in the study. FCC dimensions were emotional support, coordination, informed patient and family participation in decision-making, timely and accurate care, pain management, continuity of care and transition, and a safe and child-centered environment. FCC challenges were family dissatisfaction, family attendance during invasive procedures, limited psychosocial support for families, communication barriers, and participation in pediatric research. FCC improvement strategies were communication improvement strategies, fulfillment of emotional and social needs, improving of system efficiency, innovative solutions and virtual care, organizational modifications, and creation of a safe, comfortable, and supportive environment.</div></div><div><h3>Conclusion</h3><div>This study assessed FCC dimensions, challenges, and improvement strategies. Its findings can be used to improve healthcare providers' knowledge about FCC decision-making and planning in PED.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 300-314"},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569659","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}
Pub Date : 2025-11-20DOI: 10.1016/j.pedn.2025.11.025
Mona Metwally El-Sayed , Samah Mohamed Taha , Mahmoud Abdelwahab Khedr , Ayman Mohamed El-Ashry , Shaimaa Mohamed Amin , Eman Sameh Abd Elhay , Hassan Mohammed Sonbol
Background
This study investigated the moderating effect of parenting styles on the relationship between cyber-victimization and suicidal probability among adolescents.
Methods
A cross-sectional descriptive correlational survey was conducted with 1017 adolescents, utilizing the cyber-victimization scale, parental authority questionnaire, and suicide probability scale. Path analysis was employed
Results
Permissive parenting had a direct effect on suicidal probability, with an effect size of 0.239 and a critical ratio (CR 3.927, p < 0.001), suggesting that this parenting style is linked to a higher risk of suicidal ideation among adolescents. Conversely, authoritative parenting demonstrated a significant adverse effect on suicidal probability, with a direct impact of −0.316 (CR = −6.498, p < 0.001). The authoritarian parenting style also showed a significant positive effect on suicidal probability, with a direct impact of 0.424 (CR = 7.995, p < 0.001). Additionally, direct cyber victimization had a notable impact on suicidal probability, yielding a direct effect of 0.413 and an indirect effect of 0.116 (CR = 2.623, p = 0.009)
Conclusion
Permissive and authoritarian parenting styles are linked to an increased risk of suicide among adolescents. In contrast, authoritative parenting appears to offer protective benefits against the effects of cyberbullying. The younger adolescents and those living in urban areas as particularly vulnerable to online harassment, with financial difficulties and excessive internet use further complicating these challenges
Implications to practice
Promoting supportive parenting practices and creating safe online environments are essential strategies for improving adolescents' mental health and mitigating risks associated with suicide and victimization.
本研究旨在探讨父母教养方式对青少年网络受害与自杀倾向的调节作用。方法采用网络受害量表、父母权威问卷和自杀概率量表对1017名青少年进行横断面描述性相关调查。通径分析结果表明，父母管教方式对青少年自杀概率有直接影响，效应值为0.239，存在临界比（CR = 3.927, p < 0.001），表明父母管教方式与青少年自杀意念风险增加有关。相反，权威教养对自杀概率有显著的不利影响，其直接影响为- 0.316 （CR = - 6.498, p < 0.001）。专制教养方式对自杀概率也有显著的正向影响，其直接影响为0.424 （CR = 7.995, p < 0.001）。此外，网络直接伤害对青少年自杀概率有显著影响，其直接效应为0.413，间接效应为0.116 （CR = 2.623, p = 0.009）。结论纵容型和专制型父母教养方式与青少年自杀风险增加有关。相比之下，权威型父母似乎对网络欺凌的影响有保护作用。年龄较小的青少年和生活在城市地区的青少年特别容易受到网络骚扰，经济困难和过度使用互联网使这些挑战进一步复杂化。对做法的影响促进支持性养育做法和创造安全的网络环境是改善青少年心理健康和减轻与自杀和受害相关风险的重要战略。
{"title":"Cyber-victimization and suicidal probability among adolescents: The moderating role of parenting styles from a nursing perspective","authors":"Mona Metwally El-Sayed , Samah Mohamed Taha , Mahmoud Abdelwahab Khedr , Ayman Mohamed El-Ashry , Shaimaa Mohamed Amin , Eman Sameh Abd Elhay , Hassan Mohammed Sonbol","doi":"10.1016/j.pedn.2025.11.025","DOIUrl":"10.1016/j.pedn.2025.11.025","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the moderating effect of parenting styles on the relationship between cyber-victimization and suicidal probability among adolescents.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive correlational survey was conducted with 1017 adolescents, utilizing the cyber-victimization scale, parental authority questionnaire, and suicide probability scale. Path analysis was employed</div></div><div><h3>Results</h3><div>Permissive parenting had a direct effect on suicidal probability, with an effect size of 0.239 and a critical ratio (CR 3.927, <em>p</em> < 0.001), suggesting that this parenting style is linked to a higher risk of suicidal ideation among adolescents. Conversely, authoritative parenting demonstrated a significant adverse effect on suicidal probability, with a direct impact of −0.316 (CR = −6.498, p < 0.001). The authoritarian parenting style also showed a significant positive effect on suicidal probability, with a direct impact of 0.424 (CR = 7.995, p < 0.001). Additionally, direct cyber victimization had a notable impact on suicidal probability, yielding a direct effect of 0.413 and an indirect effect of 0.116 (CR = 2.623, <em>p</em> = 0.009)</div></div><div><h3>Conclusion</h3><div>Permissive and authoritarian parenting styles are linked to an increased risk of suicide among adolescents. In contrast, authoritative parenting appears to offer protective benefits against the effects of cyberbullying. The younger adolescents and those living in urban areas as particularly vulnerable to online harassment, with financial difficulties and excessive internet use further complicating these challenges</div></div><div><h3>Implications to practice</h3><div>Promoting supportive parenting practices and creating safe online environments are essential strategies for improving adolescents' mental health and mitigating risks associated with suicide and victimization.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 250-261"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569510","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}
Pub Date : 2025-11-20DOI: 10.1016/j.pedn.2025.11.019
Arezoo Ghavi , Kathleen L. Meert , Hadi Hassankhani
Background
Supporting parents is a key component of family-centered care in pediatric settings. Evidence-based guidelines for supporting parents during pediatric resuscitation are lacking.
Purpose: This study aimed to develop and evaluate an instructional framework to guide healthcare professionals in supporting parents before, during, and after pediatric resuscitation.
Design and methods
A sequential exploratory mixed-methods design was employed, comprising three phases: (1) qualitative exploration through semi-structured interviews with parents and health professionals, systematic reviews, and two Delphi rounds to identify parental needs; (2) development of an evidence-based instructional framework based on these findings; and (3) implementation of the framework in the quantitative phase to evaluate its effect on parents' acute stress and health professionals' perceptions of family-centered care.
Results
The instructional framework included 138 items on supporting parents during pediatric resuscitation, which were categorized into four components: supporting parents before (41 items), during (19 items), after successful (14 items), and after unsuccessful (64 items) pediatric resuscitation. The instructions reduced acute stress among parents and improved the perception of family-centered care among health professionals.
Conclusion
The findings suggest that the use of an instructional framework to support parents before, during, and after their child's resuscitation may be beneficial in clinical practice. Standardized, evidence-based training to support parents during pediatric resuscitation may enhance both parental well-being and family-centered care in acute settings.
Implications to practice
Knowledge about parental needs and support preferences provides new information that can be used to support parents during resuscitation according to family-centered care principles in clinical practice.
{"title":"Supporting parents during pediatric resuscitation: A sequential exploratory mixed-methods study for development and evaluation of an instructional framework","authors":"Arezoo Ghavi , Kathleen L. Meert , Hadi Hassankhani","doi":"10.1016/j.pedn.2025.11.019","DOIUrl":"10.1016/j.pedn.2025.11.019","url":null,"abstract":"<div><h3>Background</h3><div>Supporting parents is a key component of family-centered care in pediatric settings. Evidence-based guidelines for supporting parents during pediatric resuscitation are lacking.</div><div><em>Purpose:</em> This study aimed to develop and evaluate an instructional framework to guide healthcare professionals in supporting parents before, during, and after pediatric resuscitation.</div></div><div><h3>Design and methods</h3><div>A sequential exploratory mixed-methods design was employed, comprising three phases: (1) qualitative exploration through semi-structured interviews with parents and health professionals, systematic reviews, and two Delphi rounds to identify parental needs; (2) development of an evidence-based instructional framework based on these findings; and (3) implementation of the framework in the quantitative phase to evaluate its effect on parents' acute stress and health professionals' perceptions of family-centered care.</div></div><div><h3>Results</h3><div>The instructional framework included 138 items on supporting parents during pediatric resuscitation, which were categorized into four components: supporting parents before (41 items), during (19 items), after successful (14 items), and after unsuccessful (64 items) pediatric resuscitation. The instructions reduced acute stress among parents and improved the perception of family-centered care among health professionals.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the use of an instructional framework to support parents before, during, and after their child's resuscitation may be beneficial in clinical practice. Standardized, evidence-based training to support parents during pediatric resuscitation may enhance both parental well-being and family-centered care in acute settings.</div></div><div><h3>Implications to practice</h3><div>Knowledge about parental needs and support preferences provides new information that can be used to support parents during resuscitation according to family-centered care principles in clinical practice.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 276-290"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569657","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}
Pub Date : 2025-11-20DOI: 10.1016/j.pedn.2025.11.026
L. Ruiz-Azcona , C. Lechosa-Muñiz , M.R. Ardila-Valle , R. Gómez-Gómez , M.O. Gómez-Paz , A. Gómez-Sánchez , R. Pardo-Vitorero , M. Paz-Zulueta , M.J. Cabero-Pérez
Introduction
Preoperative anxiety in pediatric patients negatively impacts their well-being, highlighting the need for effective non-pharmacological interventions.
Objective
To analyze the impact of a clown therapy intervention before a surgical procedure to decrease preoperative anxiety and postoperative pain in hospitalized pediatric patients and their families.
Methods
This quasi-experimental study took place from October 2023 to November 2024 and included children aged 3 to 12 who were hospitalized in the pediatric inpatient and resuscitation unit of a tertiary care hospital in northern Spain. A total of 204 children participated, divided into two groups.
Results
The mean age of children was 6.96 ± 2.72 years, and that of parents was 40.90 ± 5.77 years. Children in the intervention group showed significantly lower preoperative anxiety (mYPAS: 5.57 ± 1.49) compared to controls (6.18 ± 1.92; p = 0.012). Parental anxiety (STAI) was also lower in the intervention group (13.84 ± 7.02) versus the control group (15.63 ± 10.10; p = 0.142). Positive correlations were observed between children's preoperative anxiety and postoperative pain (r = 0.40, p < 0.001), and between parental and child anxiety (r = 0.19, p = 0.007). Thirty days post-discharge, children in the intervention group exhibited fewer maladaptive behaviors at home.
Conclusion
Clown therapy reduces preoperative anxiety in pediatric patients and may contribute to a more humanized, emotionally supportive hospital environment.
Implications for practice
Incorporating clown therapy into perioperative care may enhance emotional support, reduce anxiety, and improve the overall surgical experience, highlighting the importance of addressing emotional well-being.
儿科患者术前焦虑会对他们的健康产生负面影响，因此需要有效的非药物干预。目的分析手术前小丑疗法干预对减少住院儿科患者及其家属术前焦虑和术后疼痛的影响。方法这项准实验研究于2023年10月至2024年11月进行，纳入了西班牙北部一家三级医院儿科住院和复苏病房住院的3至12岁儿童。共有204名儿童参加了这项研究，他们被分为两组。结果患儿平均年龄为6.96±2.72岁，家长平均年龄为40.90±5.77岁。干预组患儿术前焦虑（mYPAS: 5.57±1.49）明显低于对照组（6.18±1.92;p = 0.012）。干预组家长焦虑（STAI）得分（13.84±7.02）低于对照组（15.63±10.10;p = 0.142）。患儿术前焦虑与术后疼痛呈正相关（r = 0.40, p < 0.001），父母焦虑与患儿焦虑呈正相关（r = 0.19, p = 0.007）。出院后30天，干预组儿童在家中表现出较少的适应不良行为。结论小丑疗法可减少儿科患者的术前焦虑，并有助于营造更人性化、情感支持的医院环境。将小丑疗法纳入围手术期护理可以增强情感支持，减少焦虑，改善整体手术体验，强调处理情感健康的重要性。
{"title":"Assessing clown therapy to reduce preoperative anxiety in hospitalized children: A quasi-experimental design","authors":"L. Ruiz-Azcona , C. Lechosa-Muñiz , M.R. Ardila-Valle , R. Gómez-Gómez , M.O. Gómez-Paz , A. Gómez-Sánchez , R. Pardo-Vitorero , M. Paz-Zulueta , M.J. Cabero-Pérez","doi":"10.1016/j.pedn.2025.11.026","DOIUrl":"10.1016/j.pedn.2025.11.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative anxiety in pediatric patients negatively impacts their well-being, highlighting the need for effective non-pharmacological interventions.</div></div><div><h3>Objective</h3><div>To analyze the impact of a clown therapy intervention before a surgical procedure to decrease preoperative anxiety and postoperative pain in hospitalized pediatric patients and their families.</div></div><div><h3>Methods</h3><div>This quasi-experimental study took place from October 2023 to November 2024 and included children aged 3 to 12 who were hospitalized in the pediatric inpatient and resuscitation unit of a tertiary care hospital in northern Spain. A total of 204 children participated, divided into two groups.</div></div><div><h3>Results</h3><div>The mean age of children was 6.96 ± 2.72 years, and that of parents was 40.90 ± 5.77 years. Children in the intervention group showed significantly lower preoperative anxiety (mYPAS: 5.57 ± 1.49) compared to controls (6.18 ± 1.92; <em>p</em> = 0.012). Parental anxiety (STAI) was also lower in the intervention group (13.84 ± 7.02) versus the control group (15.63 ± 10.10; <em>p</em> = 0.142). Positive correlations were observed between children's preoperative anxiety and postoperative pain (<em>r</em> = 0.40, <em>p</em> < 0.001), and between parental and child anxiety (<em>r</em> = 0.19, <em>p</em> = 0.007). Thirty days post-discharge, children in the intervention group exhibited fewer maladaptive behaviors at home.</div></div><div><h3>Conclusion</h3><div>Clown therapy reduces preoperative anxiety in pediatric patients and may contribute to a more humanized, emotionally supportive hospital environment.</div></div><div><h3>Implications for practice</h3><div>Incorporating clown therapy into perioperative care may enhance emotional support, reduce anxiety, and improve the overall surgical experience, highlighting the importance of addressing emotional well-being.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 268-275"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569660","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}
Pub Date : 2025-11-20DOI: 10.1016/j.pedn.2025.11.020
Julie Desorcy BSN, RN, CPN , Michelle Czarnecki MSN, PMGT-BC, APNP, CPNP, AP-PMN , Melodee Liegl MA , Amy Y. Pan PhD , Elizabeth B. Roth MD , Eileen Sherburne PhD, ACNS-BC, FNP-BC, CRRN, CNRN, WCC
Background
Pediatric patients who are unable to void after orthopedic surgery can develop post-operative urinary retention (POUR). The aims of this study were to identify variables that contributed to POUR by comparing characteristics of children who did and did not require urinary intervention and to identify which variables predict patients who are at risk for POUR.
Methods
This retrospective chart review evaluated 73 pediatric patients who developed POUR after an orthopedic procedure and matched their characteristics to 73 pediatric patients who did not develop POUR. Multiple levels of analysis were performed to compare variables between groups.
Results
Groups were similar regarding patient characteristics of pre-op mobility, the presence of a neurological disorder, and the placement of an indwelling catheter (IUC) during surgery. The POUR group was had greater immobility after surgery (p < .001); received significantly more opioid (p < .001) for a longer period of time (p < .001). Conditional logistic regression identified post-operative immobility, opioid consumption, duration of opioid exposure, and the presence of patient-controlled analgesia (PCA) as predictors of POUR development.
Discussion
Nurses caring for pediatric patients following orthopedic surgery can assess for predictive factors and can plan for proactive bladder scanning to aid in early detection of POUR. This study adds to the literature by identifying comonalities in pediatric patients developing POUR after orthopedic surgery.
Practice implications
Consideration should be given to assessing bladder fullness, establishing mobility, and reducing opioid need before removing the IUC or delaying the removal of the IUC for a short time.
{"title":"Development of post-operative urinary retention (POUR) in pediatric patients undergoing orthopedic surgery","authors":"Julie Desorcy BSN, RN, CPN , Michelle Czarnecki MSN, PMGT-BC, APNP, CPNP, AP-PMN , Melodee Liegl MA , Amy Y. Pan PhD , Elizabeth B. Roth MD , Eileen Sherburne PhD, ACNS-BC, FNP-BC, CRRN, CNRN, WCC","doi":"10.1016/j.pedn.2025.11.020","DOIUrl":"10.1016/j.pedn.2025.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric patients who are unable to void after orthopedic surgery can develop post-operative urinary retention (POUR). The aims of this study were to identify variables that contributed to POUR by comparing characteristics of children who did and did not require urinary intervention and to identify which variables predict patients who are at risk for POUR.</div></div><div><h3>Methods</h3><div>This retrospective chart review evaluated 73 pediatric patients who developed POUR after an orthopedic procedure and matched their characteristics to 73 pediatric patients who did not develop POUR. Multiple levels of analysis were performed to compare variables between groups.</div></div><div><h3>Results</h3><div>Groups were similar regarding patient characteristics of pre-op mobility, the presence of a neurological disorder, and the placement of an indwelling catheter (IUC) during surgery. The POUR group was had greater immobility after surgery (<em>p</em> < .001); received significantly more opioid (p < .001) for a longer period of time (p < .001). Conditional logistic regression identified post-operative immobility, opioid consumption, duration of opioid exposure, and the presence of patient-controlled analgesia (PCA) as predictors of POUR development.</div></div><div><h3>Discussion</h3><div>Nurses caring for pediatric patients following orthopedic surgery can assess for predictive factors and can plan for proactive bladder scanning to aid in early detection of POUR. This study adds to the literature by identifying comonalities in pediatric patients developing POUR after orthopedic surgery.</div></div><div><h3>Practice implications</h3><div>Consideration should be given to assessing bladder fullness, establishing mobility, and reducing opioid need before removing the IUC or delaying the removal of the IUC for a short time.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"86 ","pages":"Pages 262-267"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569509","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}
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