Determining the fever-related knowledge and practices of mothers with children aged 1-5 years presenting to a child emergency service with fever complaints in Turkiye.

PURPOSE: This study aimed to evaluate and determine the knowledge and practices of mothers with children aged between 1 and 5 years presenting to a pediatric emergency service with fever complaints regarding fever management. DESIGN AND METHODS: This study was descriptive and correlational study was conducted between March and May 2019 with mothers over the age of 18 who brought their children aged 1-5 years to the XX State Hospital Pediatric Emergency Department with fever complaints. To evaluate the descriptive characteristics of the mothers and their practices when their children had a fever, data were collected with a questionnaire form consisting of 36 open-ended questions and the Parents' Fever Management Scale-Turkish Version (PFMS-TR). The data were analyzed using the SPSS 21 software with frequency, percentage, mean, standard deviation, min-max values, chi-squared, Cronbach's alpha, ANOVA, t-test, Kruskal- Wallis test, post hoc analysis with Bonferroni correction and correlation analysis, where p < 0.05, was considered statistically significant. RESULTS: Of the mothers included in the study, 36.9% (n = 118) were between the ages of 33 and 39, 33.4% (n = 107) were graduates of higher education and 57.2% (n = 183) were homemakers. The mean number of people living at the homes of the participants was 4.26 ± 1.24 (min = 3, max = 8), the mean number of their children was 2.0 ±,97 (min = 1, max = 6), and the mean age of their children was 2.90 ± 1. 37 (min = 1, max = 5). The most common practices of the mothers when their children had fever were taking off their clothes and giving them antipyretic drugs. Moreover, the inappropriate practices of the mothers included rubbing the child with a vinegar and water mixture (11.9%) and cold application (8%). While 55.9% of the mothers were worried that the child would suffer post-fever convulsions 25.9% of them were worried that the child would suffer brain damage. A significant relationship was found between the mean scores of the mothers on PFMS-TR and their educational and economic statuses (p < 0.05). CONCLUSIONS: Fears of fever are common in mothers, but their knowledge and practices about fever are inaccurate / incomplete. PRACTICE IMPLICATIONS: Parents should be informed about fever with up-to-date information by nurses, and the appropriate attitude should be established on this issue. Efficient educational activities can reduce fears of mothers and prevent ill-advised practices.

Effects of Music during Multiple Cesarean Section Delivery.

This experimental study was conducted to determine the level of anxiety in women undergoing multiple cesarean section. Sixty multiple cesarean section referrals were randomly assigned to either the experimental or control groups. Data was collected at the Karaman Public Health Hospital in Turkey, from June 2015 to June 2016. Songs chosen earlier by the patients were played during the cesarean section procedure for the experimental group. The control group was studied without music. Data was collected using a questionnaire form, and Visual Analogue Scale (VAS) was used to determine the anxiety levels. The t-test and chi-square test were used to analyse statistically significant differences between the groups. The VAS scores before and during the procedure showed significantly lower scores for the experimental group, compared to the control group (p<0.05). Music therapy reduces the physiological and cognitive responses of anxiety in patients undergoing multiple cesarean section, and can be used in the clinical practice.

Pain and factors that affect its definition as defined by preschool age children: a qualitative study

The aim of this study was to determine the definitions of pain by pre-school age children and factors that affect these definitions. The study was conducted on children aged between four and six years (N=146) in the city of Karaman in Turkey. Qualitative and quantitative research design were used together in this study. This study's qualitative tradition method was phenomenologic research. The data were assessed using descriptive statistics and thematic analysis. The children's definitions of pain were found to be affected by their hospital and daily life experiences. The preschool age children generally defined pain in similar ways, and everything that made children feel pain made them think about it. Sometimes their family members, hospital equipment, and health staff lead them to think about pain.

Non-pharmacological strategies used to reduce procedural pain in infants by nurses at family health centres.

OBJECTIVE: To determine the methods used by nurses working in family health centres to decrease pain during medical procedures in infants. METHODS: This descriptive, cross-sectional study was conducted at family health centres in the county town of Bandirma, and city centres of Karaman and Gaziantep, Turkey, in September and October 2015, and comprised nurses. Data was collected through face-to-face interviews using a questionnaire. SPSS 15 was used for data analysis. RESULTS: Of the 144 participants, 71(49.3%) were aged 31-40 years, 74(51.4%) had a bachelor's degree, and 76(52.8%) had worked in a family health centre for 1-5 years. It was observed that 91(63.3%) nurses used contact/massage for decreasing the pain during vaccinations and 72(50.3%) used skin-to-skin contact during heel lance. A statistically significant difference was found between the level of education and use of non-pharmacological methods (p<0.05). CONCLUSIONS: Nurses used different non-pharmacologic methods during invasive procedures.

Physicians' and nurses' medical errors associated with communication failures.

OBJECTIVE: To determine medical errors associated with communication failures among physicians and nurses. METHODS: This cross-sectional, descriptive study was conducted at 20 state hospitals and 14 training and research hospitals affiliated with the Istanbul City Health Directorate in Turkey, and comprised physicians and nurses. Data were collected between August 2012 and February 2013. A 16-item questionnaire was used that included questions regarding socio-demographic features such as age, gender, educational status, institution, occupation and working years. Questions also aimed at determining medical errors related to communication failures. The questionnaire was completed by the participants during face-to-face interviews. RESULTS: Of the 2,273 participants, 1,654(72.8%) were nurses and 619(27.2%) were physicians. Besides, 340(54.9%) physicians and 811(49.03%) nurses worked in state hospitals. The mean age of the physicians was 37.76±9.20 years (range: 22-62 years), and that of the nurses was 32.61±7.38 years (range: 17-62 years). Moreover, 137(22.1%) physicians and 258(15.3%) nurses had previously experienced medical errors. Also, 74(54%) physicians and 135(52.3%) nurses had experienced medical errors due to some communication error. The most common medical errors by physicians were incorrect drug administration 45(32.8%), and delivery of drugs to the wrong patient by nurses 103(40.7%). In addition, 58(42.3%) physicians made medical errors in adult surgical clinic services while 102(39.5%) nurses made medical errors in adult internal medicine clinics. CONCLUSIONS: The majority of medical errors originated from communication failures.

Effects of music therapy and distraction cards on pain relief during phlebotomy in children.

AIM: To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy. METHODS: This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. RESULTS: Two hundred children (mean age: 9.01±2.35years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p=0.72, p=0.23, p=0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p=0.092, p=0.096, respectively). CONCLUSIONS: Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed.

Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit.

BACKGROUND: Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. OBJECTIVES: To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. METHODS: A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group. Patient care was provided in accordance with prevention bundles. Patients were followed up for development of catheter-related bloodstream infections. RESULTS: Catheter colonization occurred in 4 patients in the standard group (8%) and in 1 patient in the chlorhexidine group (2%). Catheter-related bloodstream infections occurred in 5 patients in the standard group (10%) and in 1 patient in the chlorhexidine group (2%). Although more patients in the standard group had catheter-related bloodstream infections, the difference in infection rates between the 2 groups was not significant (P = .07). CONCLUSIONS: Use of chlorhexidine-impregnated dressings reduced rates of catheter-related bloodstream infections, contamination, colonization, and local catheter infection in a pediatric intensive care unit but was not significantly better than use of standard dressings.

Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: ball squeezing, balloon inflating and distraction cards.

AIMS AND OBJECTIVES: This study aimed to investigate three different distraction methods (squeezing a soft ball, balloon inflation and distraction cards) on pain and anxiety relief in children during phlebotomy. BACKGROUND: Needle-requiring medical procedures such as venipuncture, phlebotomy and intramuscular injections are common and significant sources of pain for children, and these cause anxiety, distress and fear. DESIGN: This study was a prospective, randomised controlled trial. METHODS: The sample consisted of children (n = 120) who required blood tests. Data were obtained through face-to-face interviews with the children, their parents and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. RESULTS: One hundred and twenty children (mean age: 9·64 ± 2·07 years) were included. No difference was found between the groups in the self-, parent- and observer-reported procedural pain levels (p = 0·446, p = 0·467, p = 0·318 respectively). Furthermore, no significant differences were observed between the groups in procedural child anxiety levels according to the parents and observer (p = 0·323, p = 0·144 respectively). CONCLUSION: Pain and anxiety relief was seen in the three methods used during phlebotomy; however, no statistically significant difference was observed. RELEVANCE TO CLINICAL PRACTICE: This study contributes to the literature on nonpharmacologic pain relief methods during phlebotomy in children.

The effects of three different distraction methods on pain and anxiety in children.

This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 ± 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 ± 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 ± 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception.