An evaluation of pediatric emergency cases in the first year of the COVID-19 pandemic: A single-centre experience.

AIM: Nurses responsible for the care of children in the emergency department must be aware of the case profile of the pandemic era, better prepare for developing crises, and identify preventive services. The study aims to determine the pediatric emergency cases admitted during the pandemic and compare them to those during the pre-pandemic period. METHODS: The current study was designed as a single-center, retrospective, cross-sectional, and descriptive research. All patients aged between 0 and 18 who presented to the pediatric emergency department and had electronic patient records were included in the research population. The data were gathered over two periods: the pre-pandemic period from 2019 to 2020 and the pandemic period from 2020 to 2021. A total of 145,591 patient records were analyzed. RESULTS: The number of admissions declined by 51.6% during the pandemic, and a noticeable difference in the reasons for emergency department visits (p = 0.001) was detected. The pandemic saw a decrease in the cases of respiratory, gastrointestinal diseases, and ear, nose, and throat problems. In contrast, there was an increase in the cases of musculoskeletal system diseases, infections, falls, traumas, and neonatal problems. CONCLUSION: The number of pediatric emergency cases decreased significantly during the pandemic, and compared to the pre-pandemic period, some changes in these cases were observed. PRACTICAL IMPLICATIONS: Particular attention should be given to ensuring that mothers of newborn infants receive adequate nursing care. Nurses working in the emergency department should keep their knowledge up-to-date regarding the changing health issues specific to the pandemic period.

The Effect of Distraction Methods During Venous Blood Sampling on Pain Levels in School-Age Children: A Systematic Review.

OBJECTIVES: This systematic review was conducted to examine the available evidence on the effects of distraction methods during venous blood sampling on pain levels in school-age children. DESIGN: A systematic review. DATA SOURCES: Pubmed, Web of Science, Scopus, Science Direct were searched using search terms. REVIEW/ANALYSIS METHODS: A systematic review of all relevant articles published between June 2017 and June 2022, was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The applied search strategy identified 612 articles in four databases. A total of 2,032 school-age children in the 15 studies who met the study inclusion criteria were included in the review. Four studies used active distraction, eight studies used passive distraction, and three studies used both distraction methods. CONCLUSIONS: Active and passive distractions are efficacious interventions during venous blood sampling in reducing pain in school-age children. However, more studies are needed to determine the superiority between these two methods.

Effects of two different ball types on pain and anxiety during venous blood draw in children: A randomized controlled study.

BACKGROUND: Children presenting to hospitals for healthcare are often exposed to venous blood draw procedures which cause significant pain and stress for children. OBJECTIVES: Tactile stimulation and active distraction methods can be used during procedural pain management in children. This study was conducted to determine and compare the effects of tactile stimulation and active distraction methods on levels of pain and anxiety during venous blood draw procedure in children. METHODS: A randomized controlled study design was adopted with a parallel trial design to compare four different intervention groups with a control group. The children's anxiety levels were evaluated using the Children's Fear Scale, and their perceived pain levels were evaluated using the Wong Baker Pain Scale. RESULTS: The results of the child and observer evaluations revealed the perceived level of pain during the procedure to be lower in the intervention groups than in the control group, and lower in the spiky ball groups than in the round ball groups. The level of anxiety during the procedure was found to be significantly lower than that recorded prior to the procedure, based on the self-evaluation of the child and the evaluation of the observer in the intervention groups. A positive correlation was found between pain and anxiety levels during the procedure. PRACTICE IMPLICATIONS: The results of this study support the effectiveness of the spiky ball method to reduce perceived pain and anxiety in children during venous blood draw procedures in the pediatric blood draw units.

Missed nursing care in pediatric emergency departments in Turkey: A cross-sectional study.

OBJECTIVE: A pediatric emergency department deals with a vast number of patients and a high load of emergent/high-priority healthcare practices. Therefore, at times, it is possible to experience missed nursing care in this department. This study aims to ascertain the types of and reasons for missed nursing care cases in pediatric emergency departments in Turkey. METHOD: This is a cross-sectional survey study. Survey data were collected from 155 nurses using the "Introductory Information Form" and the "MISSCARE-Pediatric Emergency Department Survey." RESULTS: Gastrostomy care, colostomy care, tracheotomy care, and teaching about hospital discharge were the care practices most often missed. The volume of patients, urgent patient situations, an inadequate number of nurses in charge, too many inexperienced nurses in the department, and assignment of work outside the scope of the job are the main reasons for missed care. CONCLUSION: Pediatric emergency department patients experience missed nursing care and nurses should be supported more in order for them to provide efficient care to children.

Compassion fatigue and burnout in Turkish pediatric emergency nurses during the COVID-19 pandemic.

PURPOSE: This study was conducted to determine compassion fatigue and burnout in nurses working in the pediatric emergency department (PED) during the COVID-19 pandemic in Turkey. DESIGN AND METHODS: This descriptive and cross-sectional study was conducted with 164 nurses working in the PED and following the social media platforms of the Emergency Nurses Association between September 1, 2020, and January 1, 2021. Data were collected using the online survey method with the Descriptive Data Form, Maslach Burnout Inventory (MBI), and Compassion Fatigue-Short Scale (CF-SS). RESULTS: Pediatric emergency nurses reported that they experienced high emotional exhaustion (28.25 ± 6.05) and depersonalization (11.89 ± 2.39), low personal accomplishment (17.98 ± 3.12), and moderate compassion fatigue (4.99 ± 1.43). CONCLUSION: Pediatric emergency nurses had high levels of burnout and moderate levels of compassion fatigue during the pandemic in Turkey. To prevent any long-term negative effects of the pandemic, addressing the physiological, psychological, and psychosocial needs of nurses should be prioritized. PRACTICAL IMPLICATIONS: Compassion fatigue and burnout can affect the quality of care provided by nurses, but also negatively affect their well-being and quality of life during the pandemic. Therefore, the development of interventions to reduce compassion fatigue and burnout can help manage these symptoms.

Impact of flipped classroom approach on undergraduate nursing student's critical thinking skills.

BACKGROUND: Enriching the undergraduate nursing main courses innovative approaches such as flipped classroom method, which may aid improving students' metacognitive learning strategies, are regarded to be very important in terms of enhancing critical thinking and problem-solving skills in nursing care. AIM: This study aimed to determine if there were significant differences in performance and critical thinking skills of nursing students who were taught using the flipped classroom method versus those who were taught using the online traditional learning approach. Another aim was for students to describe their opinions of using the flipped classroom method. METHODS: This study adopted a quasi-experimental study design. A total of 63 nursing students participated in the study. The experimental group followed the flipped classroom learning approach, while the control group followed the online traditional learning approach. The study involved a pre- and post-test assessment to examine the students' learning achievements and critical thinking skills. RESULTS: The results indicate that the flipped classroom approach has no significantly different effect on students' academic achievement and critical thinking, compared to online traditional lecturing. However, in contrast to the analysis of the results, students generally stated that learning with a flipped classroom approach was more helpful and efficient, and that the method provided a dynamic learning session during lectures. CONCLUSIONS: Flipped classroom approach planned for a part of the pediatric nursing education did not show significant difference compared to online traditional lecturing.

The Effect of Concealing the Hydration Fluid on Anticipatory Nausea-Vomiting in Pediatric Hematology-Oncology Patients Undergoing Chemotherapy Treatment: A Randomized Controlled Study.

PURPOSE: The aim of this study was to assess the effectiveness of concealing the hydration fluid bottle in order to reduce the experience of anticipatory nausea and vomiting before chemotherapy treatment in pediatric hematology oncology patients undergoing chemotherapy treatment. DESIGN AND METHODS: The study was carried out as a randomized controlled clinical trial. The study was conducted sixty-two pediatric oncology patients who underwent chemotherapy in a hospital in Ankara, Turkey. The patients were randomly alloceted to an intervention group (n = 32) or a control group (n = 30). Patients in the intervention group concealing the hydration fluid bottle throughout the duration of hydration; patients in the control group received routine procedure (No concealment intervention) during hydration degree of nausea and vomiting were measured by the Baxter Retching Faces (BARF) scale. RESULTS: This study found no differences in the characteristics of the patients or in degree of nausea and vomiting between groups at enrollment. After concealing the hydration fluid bottle during the hydration, BARF scores were lower in the intervention group (p < .001). CONCLUSION: Concealing the hydration fluid had significant effects on degree of nausea and vomiting in pediatric oncology patient who received hydration before chemotherapy. APPLICATION TO PRACTICE: This approach can be added as routine care as an effective non pharmacological intervention for pediatric oncology patient with receiving chemotherapy.

Active and Passive Distraction Interventions in a Pediatric Emergency Department to Reduce the Pain and Anxiety During Venous Blood Sampling: A Randomized Clinical Trial.

INTRODUCTION: Distraction is a method that is easy to use in emergency departments and effective in relieving procedural pain and anxiety. This study aimed to determine the effect of 2 new distraction methods-1 active distraction (rotatable wooden toy) and 1 passive distraction (toy wristband)-on procedural pain, fear, and anxiety in children during venous blood sampling. METHODS: This study was a randomized controlled experimental study. The sample consisted of 216 children aged 6 years to 12 years. They were divided into 3 groups using the block randomization procedure: active distraction group (n = 72); passive distraction group (n = 72); and control group (n = 72). The levels of pain and anxiety in the children were measured before and during the blood sampling by the children themselves, their parents, and the researcher using the Visual Analog Scale, the Wong-Baker FACES Pain Rating Scale, and the Children's Fear Scale. RESULTS: The children and their parents included in the control and experimental groups had similar sociodemographic characteristics. The active distraction group had lower levels of procedural pain, fear, and anxiety than the other groups (children's visual analog scale score, F = 134.22; P < 0.05; Wong-Baker FACES Pain Rating Scale score, F = 137.54; P < 0.001; and Children's Fear Scale score, F = 92.44; P < 0.001). DISCUSSION: Both the toy wristband and rotatable wooden toy interventions can be used to reduce procedural pain, fear, and anxiety in children during blood sampling in emergency departments.

Effects of Massage Therapy on Indirect Hyperbilirubinemia in Newborns Who Receive Phototherapy.

OBJECTIVE: To evaluate the effects of massage therapy on total serum bilirubin (TSB) levels and frequency of defecation, urination, and feeding in newborns who receive phototherapy for indirect hyperbilirubinemia. DESIGN: A randomized controlled clinical trial. SETTING: Ankara University Cebeci Research and Training Hospital and 29 May State Hospital in Ankara, Turkey. PARTICIPANTS: Fifty full-term newborns with indirect hyperbilirubinemia who underwent phototherapy. METHODS: The newborns were randomly allocated to an intervention group (n = 25) or a control group (n = 25). Newborns in the intervention group received massage therapy throughout the duration of phototherapy for 15 minutes twice per day; newborns in the control group received routine care during phototherapy. Every 24 hours, TSB levels were measured, and the frequencies of defecation, urination, and feeding were also calculated for each newborn. RESULTS: We found no differences in the characteristics of the newborns or in TSB levels between groups at enrollment. After treatment, TSB levels were lower in the intervention group (p < .001). Frequencies of defecation, urination, and feeding were significantly greater in the intervention group than in the control group. CONCLUSION: Massage therapy had significant effects on TSB levels, feeding, breastfeeding, defecation, and urination in newborns who received phototherapy for indirect hyperbilirubinemia. Massage therapy can be added as routine care for full-term newborns with hyperbilirubinemia under phototherapy and may be an effective supplementary intervention.

Complementary and integrative health methods used for the treatment of oral mucositis in children with cancer in Turkey.

PURPOSE: We aimed to determine the complementary and integrative health (CIH) methods used by parents to treat oral mucositis in their children who have cancer. DESIGN AND METHODS: In this multicenter, cross-sectional study, data for the study were collected via the demographic form and CIH form for oral mucositis. The data collection tools were filled out by the researchers during the face-to-face interviews. The parents (N = 302) of children with cancer who had undergone at least one round of chemotherapy were included in this study. RESULTS: According to the parents' statements, oral mucositis developed in 91.1% of the children with cancer, and CIH was used in 50.9% of them to treat its side effects. Parents stated that to deal with the oral mucositis, they mainly used black mulberry (41.5%), carbonate (15.2%), and honey (11.6%). Some of the parents (51.8%) used CIH for their children without informing their healthcare providers. PRACTICE IMPLICATIONS: The majority of healthcare providers were unaware of the parents' use of CIH for their children's oral mucositis treatment. Parents' opinions of these methods, of which the side effects and potential interactions with chemotherapeutic agents are not precisely known, and their use by parents for their children's oral mucositis should be evaluated by healthcare providers.

The clinical effect of classical music and lullaby on term babies in neonatal intensive care unit: A randomised controlled trial.

OBJECTIVE: To investigate the effect of music during routine nursing care on full-term newborns physiological measurements, hospital stay and stress symptoms. METHODS: The randomised controlled trial was conducted at the Level II neonatal intensive care unit of a state hospital in Turkey from November 2014 to August 2015, and comprised full-term newborns. Three groups were formed by simple randomisation according to babies' Score for Neonatal Acute Physiology with Perinatal Extension-II; classical music, lullaby, and a control group. An audio system was installed in the incubators, and the sound level was set at 65dB for 30 minutes of classical music or lullabies during daily routine nursing care. Vital signs and stress indicators of the babies were measured before, during and after care. Their weight was measured daily, while length and head chest circumference were measured weekly. RESULTS: There were 45 newborns; 15(33.3%) in each of the three groups. Classical music had a positive effect on maintaining body temperature and oxygen saturation values of the babies (p<0.05). Classical music and lullabies reduced stress symptoms comp a red to the controls ( p< 0 .0 5 ). CONCLUSIONS: Lullaby and classical music application during routine nursing care showed the potential to maintain physiological parameters and in reducing stress.

Abuse of working children and influencing factors, Turkey.

OBJECTIVE: The study was planned as the research of the kind/kinds of abuse and the factors influencing the abuse that the children under 18 who are working full-time at a workplace and enrolled in a vocational training center subjected to. METHOD: Questionnaires were administered to 595 apprentices who were attending a vocational training center. RESULTS: It was determined that totally 62.5% of the apprentices are subjected to abuse at their workplaces -21.8% physical, 53.6% emotional and 25.2% sexual-, 100% of them are subjected to physical neglect, and 28.7% of them are subjected to emotional neglect. While being subjected to abuse in the family increases all kinds of abuse; divorced parents, being male, low wage of the apprentice increase the possibility of the physical abuse at a work place; the low family income and the extended working time of the apprentice increase the possibility of sexual abuse. Working conditions and workplace characteristics, evaluated within the context of physical neglect are bad in all apprentices. In all kinds of abuse, employer abuse is higher than other people at work. CONCLUSION: In spite of their being legally protected in theory, the children who are being employed with labor contracts can not benefit from this protection practically at their workplaces. It is seen that most apprentices are subjected to abuse and neglect. Employment of the children is an area which is open to exploitation. It is necessary to prevent the abuse of working children and workplaces should be constantly inspected. The relation between domestic abuse and workplace abuse demonstrates that families occupy the key point in the vicious circle of violence.

Turkish mothers' perceptions of their children's weight.

PURPOSE: This study was designed to determine mothers' perceptions and concerns about their preschool children's weight. DESIGN AND METHOD: This descriptive survey was carried out with mothers of 4- to 6-year-old children attending preschool. RESULTS: The prevalence of overweight among preschool children was 25.4%, but 73.3% of mothers of overweight children did not think that their children were overweight. Only 12.8% of mothers were concerned about their children being currently overweight; 8.1% worried that their children would become overweight. PRACTICE IMPLICATIONS: Understanding parental views about their children's weight is a key step for designing effective prevention strategies.