Development of Adolescents' perceptions of the nursing image scale and evaluation of its psychometric properties: A methodological study.

BACKGROUND AND PURPOSE: It is important to assess the perception of the nursing image among adolescents, the group closest to the career decision, to enhance their view of the nursing image. This study was conducted to develop the Adolescents' Perceptions of Nursing Image Scale (APNIS) and evaluate its psychometric properties. METHOD: The study has a descriptive, cross-sectional, correlational, and methodological design. The study was conducted with 614 adolescents aged 12-18 years in Turkey between October 15, 2022, and December 15, 2022. The data were analyzed using the Kaiser-Meyer-Olkin coefficient, Barlett's test, factor analyses, Cronbach's alpha reliability coefficient, split-half analysis, item sum statistics, Hotelling's T2, and test-retest analysis. RESULTS: As a result of the explanatory factor analysis, the items on the scale were collected under six sub-dimensions, and the scale explained 62.843% of the total variance. Confirmatory factor analysis showed that the model fit was adequate. The total internal consistency Cronbach alpha value of the scale is 0.90, and the sub-dimension Cronbach alpha values are between 0.70 and 0.90. The Spearman-Brown coefficient of the scale was 0.94, the Guttman-split-half coefficient was 0.94, Hotelling's T2 value was 373.829, F = 9.510, and p < 0.001. As a result of the Tukey summability analysis, F = 0.431 and p > 0.05, the scale was found to be summable. The test-retest result of the scale was r = 0.899. CONCLUSION: The 38-item APNIS is a valid and reliable tool that assesses adolescents' perceptions of the nursing image. PRACTICE IMPLICATIONS: The scale, including universal items about the nursing image, is easy and practical to use.

Effectiveness of breast milk in the healing of medical adhesive-related skin injuries in peripheral intravenous catheter securement: A randomized controlled trial.

BACKGROUND: Skin injuries, which are more prevalent among premature infants, can prolong the hospital stay of preterms in neonatal intensive care units. AIM: This study aimed to assess the effectiveness of breast milk in reducing the healing time of skin injuries caused using medical adhesive for securing peripheral intravenous catheters (PIVCs) in late preterm infants, which was evaluated using the Neonatal Skin Condition Scale (NSCS). A randomized controlled trial was conducted with two parallel groups in a 1:1 allocation ratio. STUDY DESIGN: It was conducted in the Neonatal Intensive Care Unit of a hospital in Karaman, Turkey between August and November 2022 with 72 preterm infants born at 35-36 weeks with stable health status and having intravenous catheter securement to the skin with medical adhesive tapes, with the tapes remaining on the skin for a minimum of 24 h and a maximum of 32 h. Preterm infants were randomly assigned to breast milk or routine care groups. The site of the skin injuries was evaluated by two independent observers using the NSCS once every 60 min until the injury was completely healed. A one-way ANOVA and repeated measures analysis of variance was used to analyse the data. RESULTS: The average postnatal age was 3.32 ± 0.99 days, and the total duration of medical adhesive tape on the skin was 28.21 ± 2.59 h. A significant difference was found between the mean skin condition scale scores of the infants in the breast milk group (F = 117.219, p < .001) and the routine care group (F = 122.247, p < .001) according to time within the group. The skin injuries of preterm infants in the breast milk group decreased significantly in the first 3 h after the procedure. CONCLUSION: Breast milk application was more effective than routine care in reducing the healing time of skin injuries. RELEVANCE TO CLINICAL PRACTICE: It can be recommended to use breast milk to heal skin injuries in preterm infants.

Media Parenting Scale for School-Aged Children (MEPA-20): Psychometric Properties of the Turkish Version.

BACKGROUND AND PURPOSE: Media parenting refers to the strategies and behaviors parents use to interact with their children regarding the amount, content, and context of screen use. Children's media/screen use is a significant indicator of media parenting practices. Therefore, this study aimed to determine the psychometric properties of the Turkish version of the Media Parenting Scale for School-Aged Children (MEPA-20). METHODS: This methodological study involved 524 parents with children aged 6-10 and was conducted between October 15, 2022, and February 15, 2023. In the data analysis, the Content Validity Index, Explanatory and Confirmatory Factor Analyses, Cronbach's alpha, Test-retest reliability, Hotelling T2 test, and item-total score correlation were used. The test-retest reliability analysis of the Turkish version of MEPA-20 was performed with 30 parents after 4 weeks. RESULTS: MEPA-20 consists of 20 items and three sub-dimensions (active, restrictive, and over-protective mediation). The MEPA-20 Turkish version and its three factors were found to indicate acceptable levels of internal consistency and reliability. The three-factor construct validity of the MEPA-20 Turkish version determined with Explanatory Factor Analyses was successfully confirmed with Confirmatory Factor Analysis. CONCLUSION: The MEPA-20 is a valid and reliable tool for assessing the media parenting practices of parents of children aged 6-10 years in the Turkish population. PRACTICE IMPLICATIONS: Based on the impact of media parenting practices on child and family health, nurses should raise awareness and support parents regarding children's healthy screen use.

Investigation of fathers' metaphors regarding child sexual abuse in Turkey: A metaphor study.

BACKGROUND AND PURPOSE: This study was designed to determine the perceptions of fathers about child sexual abuse in Turkey using metaphors to facilitate understanding of child sexual abuse. METHODS: The study was conducted as a qualitative study based on metaphor analysis. The data were collected from 164 Turkish fathers in Turkey between August 2022 and September 2022 using a descriptive information form for fathers and a semi-structured interview form exploring fathers' perceptions of child sexual abuse. The semi-structured interview form included metaphor statements like "Child sexual abuse is like....... because .......", and "Child sexual abuse reminds me of the color....... because .......". The data were analyzed using the content analysis technique. The study was reported based on Standards for Reporting Qualitative Research (SRQR). RESULTS: According to the results, 77.4% of the fathers had knowledge about protecting their children from sexual abuse, 40.9% got this information from the internet, and only 11.1% educated their children about sexual abuse. Seventy three percent of the fathers were afraid of confusing their children while educating them. The fathers involved in the study used 20 metaphors related to "child sexual abuse" and "the color evoked by child sexual abuse". The metaphors created by the fathers were analyzed under six categories: "emotions, feeling inadequate, punishment method, abuser, child concept, and uncertainty". CONCLUSION: Based on the results of the study, fathers had common feelings and emphasize the same concepts about child sexual abuse. PRACTICE IMPLICATIONS: Metaphors provide a unique approach to identifying fathers' conceptual images of child sexual abuse.

Effectiveness of stress ball and relaxation exercises on polymerase chain reaction (RRT-PCR) test-induced fear and pain in adolescents in Türkiye.

PURPOSE: This study aimed to determine the effectiveness of stress balls and relaxation exercises in relieving PCR test-induced fear and pain in adolescents. DESIGN AND METHODS: A randomized controlled experimental study with a parallel-group design was conducted. The sample size was determined by G*Power analysis, and 32 adolescents were included in each group accordingly. The data were collected using the Adolescent and Parent Information Form, The Children's Fear Scale, and The Wong-Baker Faces Pain Scale. Descriptive statistics, t-test, paired t-test, ANOVA, and Tukey's forward analysis were used to analyze the data. RESULTS: The mean age was 14.93 ± 2.07 years for the adolescents, 43.58 ± 4.50 years for the mothers, and 48.25 ± 4.92 years for the fathers. Adolescents were stratified according to age, gender, and fear of invasive procedures, and homogeneity was ensured in their distribution to the groups. The pre-procedural level of fear was moderate in each group with no significant difference (p > 0.05). However, a significant difference was found between the groups in terms of both post-procedure levels of fear and pain. The pre-procedural fear of the adolescents in the control group (3.91 ± 0.29) did not change much after the procedure (3.91 ± 0.30), while there was a decrease in the other groups. The least post-procedure fear (0.09 ± 0.29) and pain (0.44 ± 0.67) were found to be in the relaxation exercise group. CONCLUSIONS AND PRACTICE IMPLICATIONS: Relaxation exercise is the most effective method to reduce fear and pain during the PCR procedure. It is recommended to use it during the PCR procedure for being easily accessible, applicable, and cost-effective. Clinical Trials ID: NCT05250544.

Attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children.

BACKGROUND AND PURPOSE: The study aimed to evaluate the attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children. METHODS: This descriptive and cross-sectional study was conducted with the fathers of children in the pediatric outpatient clinic at a state hospital between December 30, 2021, and April 15, 2022. The study was reported based on STROBE. The data were collected from 297 fathers using the Descriptive Information Form, the Attitudes Scale Toward Sex education (ASTSE), and the Sexual Communication Scale for Parents(SCSP). RESULTS: Sample statistics demonstrate that 67.7% of the participants did not receive sex education in their childhood, and 57.4% stated that their children received sex education only from their mothers. Higher attitudes toward sexual education were found in the fathers with a university or higher education degree (χ2 = 15.396; p < 0.01), and those giving sex education to their children (χ2 = 18.388;p < 0.001). Higher total scores were obtained on the sexual communication scale by fathers with university and higher education degrees (χ2 = 12.898;p < 0.01) and those who received sex education in their childhood (t = 2.330;p = 0.021). There is a highly significant positive correlation between the mean scores of the role of a parent subscale of the ASTSE and the mean total score of the SCSP (r = 0.81;p < 0.001). CONCLUSIONS: There is a positive correlation between fathers' parental role attitudes toward sex education and their sexual communication with their children. PRACTICE IMPLICATIONS: Supporting fathers' sexual communication with their children can positively affect fathers' attitudes and communication toward sex education.

The effect of using maternal voice, white noise, and holding combination interventions on the heel stick sampling.

BACKGROUND: Heel stick sampling, a common procedure in newborns, causes acute pain. AIMS: This study aims to measure the outcome of five various non-pharmacologic pain relief groups; maternal voice, white noise, holding, maternal voice+holding, and white noise+holding. METHODS: The study is an open label, randomized controlled trial. A total of 178 newborns were included in this study. Newborns were randomly allocated to each group; white noise (n = 31), maternal voice (n = 31), holding (n = 30), white noise+holding (n = 29), maternal voice+holding (n = 28), and control (n = 29) interventions. Newborns' pain responses were evaluated using the Neonatal Infant Pain Scale (NIPS), and the Premature Infant Pain Profile (PIPP). The primary measured outcomes were the newborns' pain levels, while the secondary outcomes were the heart rate and changes in oxygen saturation. The mean values of pain in neonates between groups were evaluated one minute before (Phase1), during (Phase2), and one minute after (Phase3) the procedure. RESULTS: The research results are given with comparisons in three time periods (Phase1, Phase2 and Phase3). White noise and white noise+holding were found to have the lowest mean NIPS and PIPP score (p < 0.001). The mean heart rate was found to be the lowest in the white noise+holding group (p < 0.001). There was no significant difference between the groups in terms of oxygen saturation score (p = 0.453). CONCLUSION: The white noise+holding applied to newborns during heel stick sampling were effective in pain reduction. Nurses and midwives can use white noise+holding method. IMPLICATIONS TO PRACTICE: These results contribute to the pain management of newborns.

The emotional neglect potentials of nurses working in the COVID-19 service towards their children: A qualitative study.

PURPOSE: This study aims to examine in depth the potential child emotional neglect behaviors of nurses working in the COVID-19 service, and their feelings, thoughts, and experiences regarding the causes and effects on their children. DESIGN AND METHODS: The study was designed as a qualitative study based on a descriptive phenomenological approach. A purposeful sample of service providers (N = 22) in the COVID-19 clinics of the region's largest hospital in northeast Turkey in terms of education and patient care were recruited for the study. The data were collected through semi-structured interviews using the individual in-depth face-to-face interview method. The interviews were audio-recorded, transcribed verbatim, and analyzed with Braun and Clarke's thematic analysis method. The research was reported by following Consolidated criteria for reporting qualitative research-COREQ. RESULTS: The findings enabled the identification of four unique themes expressed by the participants: parent-child interaction, social impact, physiological impact, and psychological impact. The first theme consists of adversely affected time nurses spent with their children, decreased physical contact, and communication problems; the second theme includes nurses' and their children's social isolation and social stigma; the third theme includes a change in eating habits and daily activities; the fourth theme includes fear of losing parents and emotional change. CONCLUSIONS AND PRACTICE IMPLICATIONS: To prevent the increased emotional neglect potential due to the COVID-19 pandemic, it is necessary to regulate the working conditions of parents who are nursing professionals and support the parent/child emotionally and psychologically.

The concept of pain inventory for children: The reliability and validity study of the Turkish version.

BACKGROUND AND PURPOSE: Pain experiences in childhood are very likely to be reflected in adulthood. The early evaluation of the concept of pain in children may eventually lead to. better patient outcomes in the future. Therefore, we aimed to culturally and developmentally adapt the Concept of Pain Inventory for Children (COPI) for Turkish children. METHODS: This descriptive, correlational study was conducted with 239 post-operative children aged 8-12 years between June and December 2021. The research adhered to COSMIN guidelines. The data were collected using a descriptive information form and the COPI. Factor analysis, Cronbach's alpha, and item-total score analysis were used for the data analysis. RESULTS: The resulting unidimensional scale consists of 12 items in Turkish. The scale explained 65% of the total variance. The exploratory factor analysis showed that the factor loadings of items ranged from 0.64 to 0.91. The confirmatory factor analysis showed that the factor loadings of items ranged from 0.66 to 0.92. Goodness of fit indexes were found to be as follows: Normed Fit Index >0.90; Incremental Fit Index >0.90; Comparative Fit Index >0.90; and the Root Mean Square Error of Approximation <0.08. The total Cronbach's alpha coefficient of the scale was 0.78 (reliable). CONCLUSIONS: The 12-item Turkish translation of the COPI was deemed valid and reliable in 8-12-year-old children in a post-operative setting. PRACTICE IMPLICATIONS: Evaluation of children's pain concepts during childhood may contribute to the identification of conceptual gaps for pain science education.

Student nurses' perceptions of a patient safety culture: A descriptive and cross-sectional study.

PURPOSE: The aim of this study was to evaluate nursing students' perceptions of a patient safety culture in one university in Turkey. DESIGN AND METHODS: The sample of this descriptive cross-sectional study consisted of 299 undergraduate nursing students. Data were collected by having participants complete the Patient Safety Culture Scale (PSCS) and a personal information form. FINDINGS: Participants' scores on the PSCS were found to be moderate, and no significant differences were found between participants' study levels. Female students and students who had willingly chosen the nursing profession obtained statistically significantly higher scores on the PSCS, indicating positive perceptions of a patient safety culture. PRACTICE IMPLICATIONS: The inclusion of patient safety education and training of nurses in the nursing curriculum may contribute to students' development of a patient safety culture.

The image of nursing among nursing and other healthcare professional university students: A mixed-method study.

AIM: This study had three objectives: (1) determining the image of nursing in the eyes of undergraduate health sciences students; (2) identifying factors affecting that image; and (3) evaluating students' views and experiences regarding that image. BACKGROUND: If healthcare students perceive nursing positively, it may result in directing future generations to nursing, and improving nursing, and reducing the need for nurses. DESIGN: This study adopted an explanatory sequential design with participant selection variant. The design involved data collection in two consecutive phases. METHODS: A mixed-method design using quantitative data and qualitative interviews was used. In the quantitative phase, a descriptive and cross-sectional research method was used. The qualitative phase was based on phenomenological research. The quantitative portion was performed with 1556 participants in their second, third or fourth year during the 2019-2020 academic year. Students were from the nursing, emergency and disaster management, nutrition and dietetics, occupational health and safety, health management, and social work departments. The qualitative portion was performed with 29 participant volunteers. Participants were interviewed on the phone. The data were collected using an introductory information form, a nursing image scale, and semi-structured interviews. The quantitative data were analyzed using descriptive statistics and the independent-samples t-test, Mann-Whitney U test, one-way ANOVA, and stepwise linear regression. The quantitative data were analyzed using thematic analysis. RESULTS: There were significant relationships between participants' nursing image scale total scores and their department (p < 0.001), education year (p = 0.014), age (p = 0.032) and desire to recommend the nursing profession (p < 0.001). Nursing image scale total score was significantly higher in nursing departments than in other departments. Second-year participants and 18-20-year-olds had higher total scores than fourth-year participants and 21-23-year-olds, respectively, and those who would recommend the nursing profession had higher total scores than those who would not recommend it (p < 0.05). Analysis of the qualitative data produced six main themes: perceptions of the nursing profession, perceived nursing figure, nurse knowledge, relationship with healthcare professionals, reason for preference and job gender. CONCLUSION: This study employed a mixed-method design involving both quantitative and qualitative stages. The results highlighted the image of nursing and its significance in the eyes of prospective healthcare professionals. Detecting nursing image early can increase professional training and improve the professional image of nursing. We should take into account the factors that negatively affect the image of nursing to plan nursing education better in the future.

The effect of expressed breast milk, swaddling and facilitated tucking methods in reducing the pain caused by orogastric tube insertion in preterm infants: A randomized controlled trial.

BACKGROUND: Orogastric tube feeding is used to support the nutrition of preterm infants. Although nonpharmacological methods are effective in reducing the pain caused by orogastric tube insertion, only limited studies have been found addressing this pain. No study has used combined nonpharmacological methods to reduce this orogastric tube insertion pain. OBJECTIVE: This randomized controlled study aims to compare the effects of expressed breast milk, swaddling, facilitated tucking, expressed breast milk+swaddling, expressed breast milk+facilitated tucking and routine care methods on preterm infant pain and the physiological parameters (i.e., heart rate, oxygen saturation) before, during and after orogastric tube insertion procedures. DESIGN: Randomised controlled trial. SETTING: Three level III neonatal intensive care units in Turkey. METHOD: Preterm infants born at 32-34 weeks gestation were randomly assigned to six groups: routine care (n = 33), swaddling (n = 30), facilitated tucking (n = 32), expressed breast milk (n = 31), swaddling+expressed breast milk group (n = 30), and facilitated tucking+expressed breast milk group (n = 31). Orogastric tube insertion included four phases: baseline (the last one minute of 30 min without stimuli), the insertion, recovery (one minute after insertion), and recovery (two minutes after insertion). The four phases were videotaped. Premature infant pain profile score, heart rate and oxygen saturation were assessed by two independent evaluators who were blinded to the purpose of the study. Data were assessed by analysis of variance for the multiple repeated measurements, bonferroni and generalised estimating equation logistic regression. RESULTS: There was a significant main effect of the intervention groups for all the pain and physiological parameters (heart rate: F = 3.99, p = 0.001; oxygen saturation: F = 5.22, p<0.001; pain profile 1 score: F = 9.55, p<0.001; pain profile 2 score: F = 9.74, p<0.001). The use of the nonpharmacological methods combined or alone was more effective in reducing infants' pain profile score and physiological variables than routine care. Infants receiving swaddling+expressed breast milk had significantly lower pain profile scores during the insertion (phase2) (5.2 ± 1.7) than those receiving routine care (9.5 ± 3.6), swaddling (8.8 ± 2.9), facilitated tucking (7.2 ± 3.2), expressed breast milk (7.9 ± 2.6), facilitated tucking+expressed breast milk (6.6 ± 2.3) (p<0.001). The breast milk group had 6.195 times more pain than the swaddling+expressed breast milk, while the facilitated tucking group had 6.301, the facilitated tucking+expressed breast milk group had 3.107, the control group had 13.015, and the swaddling group had 7.892 times more pain. CONCLUSION: The swaddling+expressed breast milk method is clinically better pain relief nonpharmalogical option and is the recommended method to nurses for the orogastric tube insertion procedures, preterm infants.

Educating children through their parents to prevent child sexual abuse in Turkey.

PURPOSE: The aims of this study were to train parents to recognize and prevent child sexual abuse (CSA); evaluate the problems encountered by parents; and evaluate the overall effectiveness of the CSA training program. DESIGN AND METHODS: The study used a pretest/posttest design. The study was conducted with a sample of 58 children (aged 3-6 years) and 64 parents. FINDINGS: Children who received CSA prevention education from their parents demonstrated improved knowledge about private parts and about what they should do if they suspect sexual abuse. The parents stated that they encountered some problems (other family members objected to the child being given such training). PRACTISE IMPLICATIONS: Children's risk of abuse may be reduced if their parents teach them about CSA correctly.