Understanding the experiences of caregivers of HIV-exposed children under five: A phenomenological inquiry.

Background: Children born to mothers with HIV require special care from the womb to the postnatal period, and caregivers involved in their care face several challenges. Objective: This study aimed to explore caregivers' experiences providing care for HIV-exposed children under five. Methods: This study employed a phenomenological approach. Ten caregivers of HIV-exposed children living in Jakarta, Indonesia, were selected using snowball techniques. Online in-depth interviews were conducted to collect data from September 2021 to July 2022, and thematic analysis using Colaizzi's method was performed for data analysis. Results: The study involved ten caregivers (nine females and one male) aged between 23 and 42 years. Seven of them were mothers who tested HIV-positive, while one was an adoptive father, one was a mother's sister, and one was an aunt of HIV-exposed children. The majority of them were housewives and had a low educational background. Three themes were generated: (i) disease-transmission foreboding, (ii) prejudice against mothers and children exposed to HIV, and (iii) seeking support. Conclusion: Caring for HIV-exposed children poses emotional and physical challenges for caregivers, necessitating support from health professionals and peer groups. Nurses play essential roles in improving caregiver well-being and supporting optimal growth and development in HIV-exposed children under five by designing intervention programs. Furthermore, to enhance home-based HIV care in Indonesia, the government must implement social interventions that target families with limited resources.

The impact of parental psychological distress on child behavior issues in hospitalized children.

Child hospitalization has a negative impact on both children and parents' psychological well-being. Although prior studies in the general context demonstrated a favorable link between parental psychological distress and child behavior problems, research in the hospital situation was restricted. The purpose of this study was to see if parental psychological distress has an effect on child behavior problems in hospitalized children in Indonesia. This cross-sectional study included 156 parents who were recruited from four pediatric wards using a convenience sampling method between August 17 and December 25, 2020. The Hospital Anxiety and Depression Scale and the Child Behavior Checklist 1.5-5 and 6-18 were utilized. Parental anxiety was found to be a significant predictor of increased total behavior issue, internalizing behavior, externalizing behavior, anxious/ depressed, somatic complaints, and violent conduct in hospitalized children. Parental depression, on the other hand, was not related with any of the child behavior issue syndrome measures. The findings imply that identifying and treating parent anxiety early on is critical for preventing or reducing child behavior problems during hospitalization.

Effectiveness of web-based play therapy intervention in supporting the development of children with attention deficit/hyperactivity disorder.

The high prevalence of children with Attention Deficit/ Hyperactivity Disorder (ADHD) in Indonesia has become a concern for nursing because ADHD might emerge as neurological developmental problems if not treated early through appropriate intervention. This study aims to determine the effectiveness of web-based play therapy on the emotional, behavioural and social development of school-age children with ADHD. This study employs a quasi-experimental non-equivalent control group design with purposive sampling technique, and 126 children with ADHD (patients at a psychiatric hospital in Indonesia) as participants. The results show that play therapy is an effective intervention for the emotional, behavioural and social development of school-age children with ADHD (p = 0.048, p = 0.030, p = 0.030; α= 0.05). This study is recommended as a reference for optimising nursing care for children with ADHD using information technology in the form of web-based play therapy designed in line with the fundamentals of intervention for children with ADHD, using attractive features and flexible access.

"I can live a normal life": Exploring adherence to antiretroviral therapy in Indonesian adolescents living with HIV.

Background: Adherence to antiretroviral therapy (ART) can be challenging since it needs to be continued for a lifetime. At their age, adolescents start to be responsible for their life, and this continued therapy might be a challenge for them. Objective: This study explored the experiences of adherence to ART in adolescents living with HIV in Jakarta, Indonesia. Methods: A qualitative study with an Appreciative Inquiry (AI) approach was employed to explore challenges adolescents face in ART adherence which focused more on positive aspects of the experience. In-depth interviews were conducted with ten adolescents who were selected purposively based on criteria including those aged 13-19 years, having been diagnosed with HIV infection and receiving ART for more than a year, and never having discontinued ART. All participants were registered in the outpatient clinic in one top referral hospital in Jakarta. The data were analyzed using thematic analysis. Results: Five themes were identified from the data: living a normal life, wanting to be healthy, taking medication on time, challenges in undergoing treatment, and there is hope. Conclusion: Adolescents with HIV want to live as normal and healthy as possible, like other adolescents. Even though adolescents face several challenges to comply with ART, they try to take the medication as prescribed. The findings of this study serve as input for nurses to maintain compliance with ARVs in adolescents who have HIV.

The effect of storytelling on fear in school-age children during hospitalization.

Hospitalization places children in conditions that may nurture fears of new surroundings, strangers, and unknown actions. Storytelling can be administered as a distraction from the fears that a child experiences during treatment. This study aims to determine the effectiveness of storytelling against fear due to hospitalization in school-age children admitted to the hospital. This study used a quantitative approach with a pre-experimental design and the method used was nonequivalent control group pretest-posttest design. Subjects in this study consisted of two groups namely the intervention and the control groups. The total number of respondents was n=32 and located at the Maternity and Children Hospital in Indonesia. Bivariate analysis showed that storytelling intervention had a significant relationship with the fear of hospitalization among the hospitalized school-age children (p-value=0.001< 0.05). Also, there was a significant difference between the fear score in the intervention and the control groups (p-value=0.001<). Therefore, applying storytelling in the nursing intervention of pediatric patients in hospitals can be recommended to minimize the fear in children.

Right lateral position can improving oxygen saturation and respiratory rate on under-five children with pneumonia.

Pediatric patients with pneumonia experience respiratory distress in the form of shortness of breath and rapid breathing, which affects oxygen saturation. Oxygen saturation and respiratory rate can be increased by providing the right lateral position. Fulfillment of oxygen will affect the healing of children and can reduce the length of stay in hospital. The purpose of this study was to identify the effect of right lateral positioning on oxygen saturation and respiratory rate in under-five children with pneumonia. The study design was a quasi-experimental pre-posttest with control group design. Respondents were 32 infants with pneumonia, (right lateral=16 and control group=16), selected by consecutive sampling. Univariate and bivariate analyzes were performed. There was a significant difference in oxygen saturation before and after right lateral position (p-value=0.000) and there was a significant difference in the respiratory rate before and after right lateral position (p-value=0.000). The results can be used to improve health services by promoting the right lateral position as a selftreatment intervention for increasing oxygen saturation and stabilizing respiratory rate in infants with pneumonia.

"Becoming an independent feeder": infant's transition in solid food introduction through baby-led weaning.

BACKGROUND: Baby-led weaning (BLW), a method for introducing complementary foods, has become popular because it is considered beneficial for infants. METHODS: This study investigated the experiences of mothers when using BLW in Jakarta, Indonesia using a qualitative descriptive approach. Thirteen mothers participated who had introduced complementary feeding using BLW for a minimum of 6 months. Semi-structured interviews and thematic analysis was used to work with the data. RESULTS: Three themes were identified: avoiding being a 'picky' eater; infants gagging and choking; and becoming independent feeders. CONCLUSION: Further research related to the growth and development of baby-led weaning infants in Indonesia is recommended.

Effectiveness of a conservation energy model for febrile neutropenia in children with cancer.

Febrile neutropenia is a complication of chemotherapy that occurs in children with cancer. This paper aimed to provide an overview of the application of the Levine Energy Conservation Model for treating fever neutropenia in children with cancer. The method involved a case study of five children with cancer treated for febrile neutropenia using the nursing process approach. The nursing process, according to the Levine Energy Conservation Model, focuses on increasing the body's adaptability through four forms of conservation, namely, the conservation of energy, personal integrity, structural integrity, and social integrity. Trophicognosis in the five cases under management identified hyperthermia and the risk of infection transmission. Other nursing problems were nutritional imbalances that were less than the body's needs and the risk of bleeding. These problems can hinder the process of adapting children with cancer to the challenges of disease and the treatment of side effects in achieving self-integrity.

Feeding practices for toddlers with stunting in Jakarta: A case study.

Stunting represents a child's failure to thrive. On the basis of the World Health Organization child growth standards, stunting is a height of <-2 SD of the z-score for the child's age. There are several major causes of stunting. One is the inability to optimize child feeding practices. The aim of this study was to explore the feeding practices that lead to stunting in toddlers in Jakarta. The participants in this study were 15 mothers. Content analysis was the method that was chosen for this study. The data analysis revealed four themes that describe the feeding practices for toddlers with stunting in Jakarta: i) mothers providing instant porridge and ready-to-serve steamed chicken rice; ii) a feeding frequency of small portions only 2-3 times per day; iii) a lack of diet diversity; and iv) the suboptimal intake of iron-rich foods. The provision of effective education about appropriate feeding practices to pregnant women and mothers with toddlers is expected to reduce the incidence of stunting in Indonesia.

"Fat Kids Are Adorable": The Experiences of Mothers Caring for Overweight Children in Indonesia.

This study aims to explore mothers' experiences in caring for overweight children under five years of age. This study used a descriptive phenomenology approach, with in-depth interviews with ten mothers who had overweight children under five years of age (2-5 years) selected by purposive sampling. The data was then analyzed using thematic analysis based on Collaizi's approach. This study produced eight themes illustrating that mothers were not only unaware of the children's overweight condition, but even felt more pleased to have overweight kids. This caused mothers not to give the optimum effort in limiting their children's food intake. The low awareness mothers had towards their children's overweight condition indicated the need for an intervention program that focuses on overweight children under five years of age to empower the family and increase family awareness in managing obesity early.

An Ethnographic Study on Feeding Bugis Children Aged 0-23 Months in Palopo, South Sulawesi, Indonesia.

This study aimed to explore Bugis culture related to feeding practice in children age 0-23 months. The study used a qualitative research method with an ethnographic study approach. Observations and focused group discussions were conducted on 22 caregivers, while in-depth interviews were conducted with a customary leader, two cadres, and a village mindwife. Data analysis applied a thematic analysis with an ethnonursing approach. This study resulted in three themes: giving sweet food, choosing a qualified person to give the first bribe, and delayed feeding of animal-sourced food (ASF) before the age of one year. These results affirm that culture is one of the most influential aspects of feeding children. The culture embraced by parents and society can affect the nutritional intake of children, especially during the first 1000 days of life.

Combining Natural Ingredients and Beliefs: The Dayak Tribe's Experience Caring for Sick Children with Traditional Medicine.

Instead of seeking conventional health care, the Dayak tribe in Borneo, Indonesia, treats sick children at home with traditional medicine. The objective of this descriptive, qualitative study was to explore the Dayak tribe's use of traditional medicine to care for sick children. Comprehensive interviews were conducted with 10 caregivers, with collected data analyzed using content analysis. Key recurring themes identified were: 1) traditional medicine as first aid; 2) ease of access and cost-effectiveness; 3) traditional medicine was not always effective; 4) a combination of natural ingredients and beliefs; 5) the importance of "communicating" with plants; and 6) engagement with metaphysical forces. Health professionals should respect familial cultures' beliefs regarding the provision of health care at home. Furthermore, they need to develop competency in performing cultural assessments and providing information to these parents on the risks of not seeking professional emergency care for children with conditions that can't be handled at home with traditional medicine.

Effect of Audiovisual Distraction on Distress and Oxygenation Status in Children Receiving Aerosol Therapy.

Aerosol therapy, a treatment for children with disorders of the respiratory system, often causes distress, especially in young children. Distress during aerosol therapy can decrease the effectiveness of the treatment. This study aimed to determine the effect of audiovisual distraction on distress levels and oxygenation status (measured by oxygen saturation and respiratory frequency) in children who receive aerosol therapy for disorders of the respiratory system. A quasi-experimental design was employed, specifically a non-equivalent control group, pre-test-post-test design. The study sample consisted of 38 children who were divided into 2 groups (control and intervention), each group consisting of 19 children. The results of this study showed that there were significant differences in distress scores between the control group and the intervention group (p = .0001). There were also significant differences in the mean value changes in oxygenation status before and after intervention between the control and intervention groups. These findings could be used to prevent distress and increase oxygenation status in children who receive aerosol therapy.

The Effectiveness of Distraction (Cartoon-Patterned Clothes and Bubble-Blowing) on Pain and Anxiety in Preschool Children during Venipuncture in the Emergency Department.

In preschool children, venipuncture is considered a bodily threat that can cause pain and anxiety, as well as being a traumatic experience. If the pain and anxiety felt by a child during a venipuncture is not addressed properly, it can result in a traumatic experience, and traumatic events in childhood can have long-term consequences. Atraumatic treatment in the emergency department has been little explored in previous research; therefore, the present study assessed the effectiveness of using the distractions of cartoon-patterned clothes and bubble-blowing on the pain and anxiety of preschool children during venipuncture in the emergency department. This was a quasi-experiment that used a post-test only, control group design approach. The sample consisted of 57 preschool children who were due to undergo venipuncture and who were divided into 3 intervention groups. The results showed that distraction using bubble-blowing is effective in reducing pain and anxiety during venipuncture, while cartoon-patterned clothing is only effective in reducing anxiety. Distractions can refocus the attention of a child away from pain and anxiety during venipuncture. It can inhibit the transmission of pain impulses, such that these impulses are not transmitted to the brain. As a result, the sensation of pain is not experienced.