Child Health Nurses' Acceptance and Use of a Novel Telehealth Platform: A Mixed-Method Study.

Telehealth appointments in the healthcare sector have increased since the COVID-19 pandemic, increasing patients' access to services. However, research exploring nurse perceptions of implemented telehealth services in the community sector is limited. Within the context of quality improvement, the current study aimed to understand child health nurses' acceptance and use of a novel telehealth platform using mixed methods. A total of 38 child health nurses completed an online survey that included multiple-choice questions based on an expanded Technology Acceptance Model and open-ended questions exploring barriers and facilitators to use. Results demonstrated that despite 70% of nurse users having completed less than three sessions with parents, perception and acceptance scores were high. Overall, 85% of variance in satisfaction with the platform and 46% of variance in intention to use the platform were predicted by perception scores. Three consistent themes generated from data were facilitators for use and five as barriers, which provided further understanding to findings. To ensure telehealth is adapted into routine clinical care, facilitators and barriers for implementation need to be identified and addressed. Nurses need to be engaged in implementation and ongoing maintenance to ensure the uptake and optimal use of technology within nursing care.

An Integrative Review of Grandparents' Experiences in Childhood Cancer.

Background: While it is generally accepted that childhood cancer has a profound impact on the family unit, there has been little focus on the experiences of grandparents who are affected by the diagnosis. Grandparents play an integral role throughout the child's illness trajectory as they are called upon to provide support physically, spiritually, emotionally, and at times financially. This integrative review examines the current research specific to grandparents' experiences of childhood cancer. Method: CINAHL, PubMed, and Web of Science were searched using the key terms "grandparent*" AND "experience*" AND "child*" AND "cancer." Inclusion criteria used for this review were as follows: electronic full text, peer-reviewed, and published in English between 2012 and 2022. Results: Grandparents of children with cancer experience an emotional whirlwind, a double-whammy effect, the giving and receiving of support, a balancing act, and attempt to find meaning throughout the diagnosis. They feel unacknowledged and unsupported by the health care team. Discussion: It is difficult to deny the emotional and familial impact the child's cancer diagnosis has not only on the child and immediate family but also on grandparents. While the reports of grandparents are consistent across studies, there have been lackluster attempts to mitigate the suffering experienced by this group. Pediatric oncology nurses, with their family-centered care approach, are in a unique position to uncover and meet the specific needs of grandparents of children diagnosed with cancer.

Descrição das características clínicas e epidemiológicas de pacientes pediátricos internados e diagnosticados com COVID-19 / Description of clinical and epidemiological features of hospitalized pediatric patients diagnosed with COVID-19

INTRODUÇÃO: Apesar da disseminação mundial da COVID-19, os padrões epidemiológicos e clínicos da doença ainda permanecem incertos na faixa etária pediátrica. OBJETIVO: Descrever as características epidemiológicas, clínicas, laboratoriais e radiológicas dos pacientes pediátricos diagnosticados com doença causada pelo SARS-CoV-2, hospitalizados na enfermaria do Hospital Regional João Penido, situado em Juiz de Fora/MG. MÉTODOS: Foi realizado um estudo do tipo coorte, com coleta de dados do período da internação referente a critérios epidemiológicos, clínicos, laboratoriais e radiológicos através de formulário próprio desenvolvido para a pesquisa de pacientes pediátricos hospitalizados no período de 11 de março de 2020 até 11 de março de 2021, que receberam diagnóstico de COVID-19, confirmado por RT-PCR ou por sorologia IgM/IgG. RESULTADOS: Dos pacientes com COVID-19, 49,2% tinham idade até 3 anos, 66,2% eram do sexo masculino e, dentre as comorbidades, doença respiratória crônica foi a de maior prevalência (26,9%). A maioria dos pacientes apresentou quadro clínico respiratório (72,7%). Com relação à gravidade da doença, 38,5% apresentaram doença leve, 23,1% moderada, 23,1% grave e 12,3% crítica. No desfecho, 98,5% tiveram alta hospitalar e apenas 1 paciente, que possuía diversas comorbidades, evoluiu a óbito. CONCLUSÃO: A COVID-19 possui apresentações clínicas, radiológicas e laboratoriais variadas e, não existindo tratamento único ou específico, os casos devem ser analisados e conduzidos de forma individual.

INTRODUCTION: Despite the worldwide dissemination of COVID-19, the epidemiological and clinical patterns of the disease remain uncertain in the pediatric age group. OBJECTIVE: To describe the epidemiological, clinical, laboratory and radiological characteristics of pediatric patients diagnosed with disease caused by SARS-CoV-2, hospitalized in the ward of Hospital Regional João Penido, located in Juiz de Fora, MG. METHODS: A cohort study was carried out, with data collection from the period of hospitalization regarding epidemiological, clinical, laboratory and radiological criteria through a specific form developed for the research of pediatric patients, hospitalized from March 11, 2020 to March 11, 2021, who received a diagnosis of COVID-19, confirmed by RT-PCR or by IgM/IgG serology. RESULTS: Of the patients with COVID-19, 49.2% were aged up to 3 years, 66.2% were male and, among the comorbidities, chronic respiratory disease was the most prevalent (26.9%). Most patients had a clinical respiratory condition (72.7%). Regarding disease severity, 38.5% had mild disease, 23.1% moderate, 23.1% severe and 12.3% critical. In the outcome, 98.5% were discharged from the hospital and only 1 patient, who had several comorbidities, died. CONCLUSION: COVID-19 has varied clinical, radiological and laboratory presentations and, since there is no single or specific treatment, cases must be analyzed and managed individually.

Pediatric Nurses' Perceived Competencies toward Palliative Care for Terminally Ill Children.

INTRODUCTION: Paediatric palliative care involves the physical, psychological, and spiritual well-being of terminally ill children and their families. Competency in palliative care centred on personal traits and attributes, key abilities to satisfy professional duty through practise, and knowledge of palliative care. OBJECTIVE: Is to identify paediatric nurses' perceived Competencies toward Palliative Care for Terminally Ill Children. METHOD: Used was a descriptive research design. The sample included 72 nurses who worked at neonatal, pediatric intensive care units ( NICU, PICU) in four hospitals affiliated to Universal Health Insurance (UHI) in Port Said City, namely ( El Nasr, El Salam, El Hayah, and pain outpatient clinic at El Tadamon) hospital. The structured questionnaire and the nursing palliative care quiz are the first tools used to evaluate sociodemographic characteristics. Data were gathered using a second tool, the Nurses' Core Competencies in Palliative Care questionnaire. RESULTS: Based on the study, 56.9% of nurses had adequate knowledge, and 47.2% of paediatric nurses agreed that they had some extendable palliative care competences.It can be summarized  that more than sighlty half of the studied sample have adequate knowledge while the rest of the studied sample have inadequate knowledge,with statistically significant relationship between nurses' overall perceived competence and overall knowledge. CONCLUSION: The relationship between nurses' overall perceived competence and overall knowledge was very statistically significant. The Recommendation study's findings highlight the urgent need of creating an evidence-based programme for competency training in palliative care, which should be available in every hospital and adhered to all paediatric nurses.

Pediatric Nurses' Person-Centered Approach to Nausea Management in Children With Cancer.

Background: Nausea is a problematic side effect of childhood cancer treatment. However, it is not clear what interventions and assessments pediatric oncology nurses make when caring for a child with nausea. A person-centered approach can illuminate nausea management in pediatric care. The aim was to investigate how pediatric nurses retrieve the patient's narrative, establish partnership, and document nausea in hospitalized children with cancer. Methods: Individual interviews with nurses were conducted and analyzed using deductive content analysis with the framework of person-centered care. Results: The pediatric nurses described retrieving the patient's narrative regarding their nausea by listening to and observing the child. The pediatric nurses tried to establish a partnership with the child by allowing previous knowledge and the child's own preferences guide the interventions that focus on decreasing the child's nausea. The pediatric nurses also documented the effect of the given interventions and described the child's nausea using subjective words. When planning for the child's care it was rare for the nurses to have a documented care plan, but they did review documentation of previously administered interventions to plan for future care. Discussion: The results highlight the pediatric nurses' willingness to listen to the child, but also emphasize the need to further include the child and the parents in the partnership and documentation of nausea management. Collaboration with the child and the parents contributes to higher quality care and a partnership with trust.

Prazer e sofrimento de profissionais de enfermagem que atuam em emergência pediátrica / Placer y sufrimiento de profesionales de enfermería que actúan en emergencia pediátrica / Pleasure and suffering of nursing professionals working in pediatric emergency

Objetivo: identificar as situações de prazer e sofrimento em profissionais de enfermagem de um serviço de emergência. Método: estudo qualitativo, realizado com profissionais da equipe de enfermagem de um hospital pediátrico de Santa Catarina, Brasil. A produção de informações ocorreu em 2021 por meio de entrevista semiestruturada e a interpretação dos resultados seguiu os passos da análise de conteúdo. Resultados: as fontes de prazer no trabalho foram: melhora da saúde da criança, identificação com a atividade que exerce, reconhecimento no trabalho e trabalho em equipe. No sofrimento destacaram-se: sobrecarga de trabalho, agravamento da doença da criança, espaço físico inadequado, organização do trabalho centrado no gestor e dificuldade de relacionamento entre colegas. Considerações finais: o reconhecimento dos fatores geradores de prazer e sofrimento e as estratégias de defesas possibilitam buscar respostas que permitam ao profissional de enfermagem manter seu ambiente de trabalho produtivo e menos desgastante.

Objetivo: identificar las situaciones de placer y sufrimiento en profesionales de enfermería de un servicio de emergencia. Método: estudio cualitativo, realizado con profesionales del equipo de enfermería de un hospital pediátrico de Santa Catarina, Brasil. La producción de información tuvo lugar en 2021 a través de una entrevista semiestructurada y la interpretación de los resultados siguió los pasos del análisis de contenido. Resultados: las fuentes de placer en el trabajo fueron: mejora de la salud del niño, identificación con la actividad que ejerce, reconocimiento en el trabajo y trabajo en equipo. En el sufrimiento se destacaron: sobrecarga de trabajo, agravamiento de la enfermedad del niño, espacio físico inadecuado, organización del trabajo centrado en el gestor y dificultad de relación entre colegas. Conclusión: el reconocimiento de los factores generadores de placer y sufrimiento y las estrategias de defensa posibilitan buscar respuestas que permitan al profesional de enfermería mantener su ambiente de trabajo productivo y menos agotador.

Objective: to identify situations of pleasure and suffering in nursing professionals of an emergency service. Method: a qualitative study conducted with professionals from the nursing team of a pediatric hospital in Santa Catarina, Brazil. The production of information occurred in 2021 through semi-structured interviews and the interpretation of the results followed the steps of the content analysis. Results: the sources of pleasure at work were: improvement of children's health, identification with the activity they perform, recognition at work and teamwork. In the suffering, there stood out: work overload, worsening of the child's illness, inadequate physical space, organization of work centered on the manager and difficulty of relationship between colleagues. Conclusion: the recognition of the factors that generate pleasure and suffering and the strategies of defenses allows the search for answers that enable the nursing professional to maintain his/her productive and less exhausting work environment.

Percepção de enfermeiras sobre a identificação do paciente como segurança na assistência a criança hospitalizada / Percepción del personal de enfermería de la identificación del paciente como medida de seguridad en la atención a los niños hospitalizados / Perception of nurses on patient identification as safety in the care of hospitalized child

Objetivo: identificar a percepção de enfermeiras que atuam em unidade pediátrica sobre medidas de segurança do paciente. Método: estudo qualitativo, descritivo e exploratório, realizado em um hospital público de Pernambuco, Brasil. Participaram seis enfermeiras atuantes na pediatria. A coleta de dados foi realizada entre novembro e fevereiro de 2021 mediante entrevistas semiestruturadas, a análise dos dados foi realizada por meio da investigação do conteúdo. Resultados: identificou-se três categorias a partir da análise dos resultados, sendo elas a percepção das enfermeiras sobre segurança do paciente, as barreiras de identificação do paciente na unidade pediátrica e a pulseiras de identificação: estratégia para mitigar erros na unidade pediátrica. Considerações finais: foi possível perceber que as enfermeiras acreditam na importância da identificação dos pacientes como uma estratégia para minimizar a ocorrência de erros relacionados a medicamentos e enfatizam que esse ato proporciona uma segurança maior aos profissionais durante a execução dos procedimentos.

Objetivo: identificar la percepción de las enfermeras que trabajan en una unidad pediátrica sobre las medidas de seguridad del paciente. Método: estudio cualitativo, descriptivo y exploratorio, realizado en un hospital público de Pernambuco, Brasil. Participaron seis enfermeras que trabajaban en la unidad pediátrica. La recogida de datos se llevó a cabo entre noviembre y febrero de 2021 mediante entrevistas semiestructuradas, el análisis de datos se realizó mediante investigación de contenido. Resultados: se identificaron tres categorías a partir del análisis de los resultados, siendo éstas la percepción de las enfermeras sobre la seguridad del paciente, las barreras de identificación del paciente en la unidad pediátrica y las barreras de identificación: estrategia para mitigar los errores en la unidad pediátrica. Consideraciones finales: Fue posible notar que las enfermeras creen en la importancia de la identificación del paciente como estrategia para minimizar la ocurrencia de errores relacionados a la medicación y destacan que este acto proporciona mayor seguridad a los profesionales durante la ejecución de los procedimientos.

Objective to identify the perception of nurses who work in a pediatric unit about patient safety measures. Method: qualitative, descriptive and exploratory study, conducted in a public hospital in Pernambuco, Brazil. Six pediatric nurses participated. Data collection was conducted between November and February 2021 through semi-structured interviews; data analysis was conducted through content investigation. Results: three categories were identified from the analysis of the Results: nurses' perception of patient safety, patient identification barriers in the pediatric unit, and identification wristbands: a strategy to mitigate errors in the pediatric unit. Final considerations: it was possible to realize that nurses believe in the importance of patient identification as a strategy to minimize the occurrence of medication-related errors and emphasize that this act provides greater safety to professionals during the execution of procedures.

The Effect of an Acupressure Training Program for Pediatric Nurses Caring for Children Undergoing Chemotherapy.

Acupressure is a nonpharmacological technique that can be used to control chemotherapy-induced nausea and vomiting (CINV) in children with cancer. To use acupressure as a strategy for managing CINV, oncology nurses must have adequate knowledge and skills to implement the technique in clinical practice. Our study aimed to evaluate the effect of an acupressure training program for pediatric nurses caring for children undergoing chemotherapy. We used a quasi-experimental design. Our sample populations included a convenience sample of 36 pediatric nurses and a purposive sample of 45 children undergoing chemotherapy. We used four tools for data collection: (1) a structured questionnaire comprising two parts: (a) characteristics of nurses and children and (b) assessment of nurses' knowledge; (2) an observational checklist for application of acupressure technique; (3) the Baxter Animated Retching Faces (BARF) scale; and (4) a vomiting assessment sheet. We found that after the training intervention, 94.4% ( n = 34) of nurses had a good level of knowledge and skill implementing the acupressure technique. There was a statistically significant difference in the knowledge and skill of the nurses before and after the training intervention, χ 2 (35, N = 36) = 19.113, p = .000. We concluded that the training program significantly improved the nurses' level of knowledge and skill when caring for children undergoing chemotherapy. We also found that after implementing the training intervention, the frequency and severity of CINV decreased among the children we studied. We therefore recommend that acupressure (in combination with antiemetic medication) be included as part of a protocol for chemotherapy administration in children.

El rol del pediatra en la prevención de la fecundidad adolescente / The role of the pediatrician in the prevention of adolescent fertility

La fecundidad adolescente en Cuba es elevada y muestra resistencia a su reducción en los últimos años a pesar de las acciones realizadas. Para promover una sexualidad responsable en los adolescentes, se requiere de un diferente y particular accionar de los pediatras. El objetivo de esta colaboración es aportar elementos que sensibilicen e involucren a los pediatras cubanos para que ofrezcan orientación a los adolescentes sobre el ejercicio de una sexualidad plena, libre y responsable, que contribuya a la reducción de la fecundidad y al cuidado integral de la salud sexual y reproductiva. El método utilizado fue la revisión de las legislaciones vigentes y las recomendaciones de varias sociedades internacionales de pediatría, respecto a la función e importancia de la especialidad en la prevención del embarazo adolescente. Se destacan las ventajas del pediatra para la prevención de la fecundidad adolescente, se explican las habilidades que deben adquirir para informar y orientar a los adolescentes, se analizan las barreras que debe favorecer el acceso del adolescente a la prevención de la fecundidad y se exponen las recomendaciones específicas para su actuación Se concluye que los pediatras cubanos pueden contribuir a la reducción de la fecundidad y mejorar el cuidado integral de la salud sexual y reproductiva de los adolescentes(AU)

Adolescent fertility in Cuba is high and shows resistance to its reduction in recent years despite the actions taken. To promote responsible sexuality in adolescents, a different and particular action of pediatricians is required. The objective of this collaboration is to provide elements that sensitize and involve Cuban pediatricians to offer guidance to adolescents on the exercise of a full, free and responsible sexuality, which contributes to the reduction of fertility and comprehensive care of sexual and reproductive health. The method used was the review of current legislation and the recommendations of several international pediatric societies, regarding the role and importance of the specialty in the prevention of adolescent pregnancy. The advantages of the pediatrician for the prevention of adolescent fertility are highlighted, the skills they must acquire to inform and guide adolescents are explained, the barriers that the pediatrician must face to favor the access of adolescents to prevent fertility are analyzed, and the specific recommendations for the action of the pediatrician in the prevention of adolescent fertility are exposed. It is concluded that Cuban pediatricians can contribute to the reduction of fertility and improve the comprehensive care of sexual and reproductive health of adolescents(AU)

Factors impacting pediatric registered nurse attitudes toward caring for dying children and their families: A descriptive study.

PURPOSE: The purpose of this study was to gain knowledge of the educational preparation and attitudes of registered nurses at a southeastern pediatric hospital toward caring for dying children and their families. DESIGN AND METHODS: A descriptive study with two independent samples was used to examine the attitudes of registered nurses at a pediatric hospital in southeastern United States. Participants completed the Frommelt Attitude Toward Care of the Dying Scale, Form B, a 30-item survey. Descriptive and inferential statistics were used to analyze data. RESULTS: One hundred and thirty-two registered nurses participated in the study. Results indicated a statistically significant difference in attitudes toward caring for dying pediatric patient scores in registered nurses working in the hematology/oncology and intensive care units compared to the other units (p = 0.0017; 95% CI: 2.39-10.12). CONCLUSIONS: This study described the educational preparation and attitudes of registered nurses who care for children who are dying and their families. Additionally, pediatric end-of-life care is complex and is further influenced by experiences and attitudes. Future research is needed to identify educational needs to care for pediatric patients and their families at the end of life. PRACTICE IMPLICATIONS: Findings from this project indicated end-of-life care education should be integrated into undergraduate curricula. New nurse graduates who are entering the workforce should receive education on end-of-life care, especially if they are entering into a pediatric specific organization. Healthcare organizations should include end-of-life care education as part of the orientation process and annual competency process.

The Impact of Psychological Capital and Workplace Social Support on Pediatric Oncology Nurses' Post Traumatic Stress Disorder (PTSD) Symptomology.

Introduction: Work-related post traumatic stress disorder (PTSD) can develop in nurses. Pediatric oncology nursing is a potentially high-risk subspecialty for PTSD secondary to the nature of the work. This study aimed to describe the prevalence of PTSD symptomology and explore relationships between nurse psychological capital, workplace social supports, and PTSD symptomology in pediatric oncology nurses. Methods: The study utilized a cross-sectional correlational survey design. Pediatric oncology nurses working in direct patient care in the United States completed a demographics questionnaire, Psychological Capital Questionnaire (PCQ), Coworker Support Scale, Supervisor Support Scale, and the Post traumatic Checklist for Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Descriptive and inferential statistics, including logistic regression models, were used to analyze data. A cutoff score of ≥31 on the PCL-5 was used to determine the prevalence of PTSD symptomology. Results: The sample included 424 nurses. The prevalence of PTSD symptomology was 13.4%. Work setting (inpatient), decreased coworker and leadership social support, and psychological capital were independently associated with PTSD symptomology. After controlling for covariates, only psychological capital was associated with PTSD symptomology. For a 1 unit decrease in PCQ score, pediatric oncology nurses were 4.25 times more likely to have PTSD symptomology. Discussion: PTSD prevalence rates in pediatric oncology nurses are aligned with rates found in other nursing specialties. Nurse psychological capital may play a protective role against PTSD symptomology. Implications for Future Research: Findings support PTSD as a serious workplace concern for nurses. Workplace programs that foster nurses' psychological capabilities should be considered to protect against the development of PTSD symptomology.

Conceptualización y percepción de enfermería sobre el cuidado del niño / Nursing Conceptualization and Perception about Child Care

Introducción: El cuidado es la esencia de enfermería y se fundamenta en la relación terapéutica enfermera-niño-familia, con abordaje integral en el contexto hospitalario. Objetivo: Discutir en base a la literatura cómo enfermería conceptualiza y percibe el cuidado del niño. Métodos: Revisión sistemática de artículos publicados entre 2010 y 2020 en las bases de datos SciELO, BVS, REDALYC, ERIC, Science Direct y LILACS. En la estrategia de búsqueda se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Se revisaron 275 artículos (español, portugués e inglés), tras aplicar criterios de inclusión y exclusión, se obtuvieron 20. Conclusiones: El cuidado del niño tiene diversas dimensiones para su comprensión: significado del cuidado, las competencias de la enfermera, la participación de la madre y los factores que intervienen en el cuidado, con una visión humanística e integradora, mediante una relación empática entre la enfermera-madre-niño, con conocimientos científicos actualizados, experticia en los procedimientos, aplicación de principios éticos y valores, la comprensión de la psicología infantil, gran sensibilidad humana y manejo del estrés, sin dejar de lado la familia y el juego terapéutico(AU)

Introduction: Care is the essence of nursing and is based on the nurse-child-family therapeutic relationship, with a comprehensive approach in the hospital setting. Objective: To discuss, based on the scientific literature, how nursing conceptualizes and perceives child care. Methods: A systematic review was carried out of articles published between 2010 and 2020 in the SciELO, BVS, REDALYC, ERIC, Science Direct and LILACS databases. The PRISMA flowchart (Preferred Reporting Items for Systematic Review and Meta-Analyses) was used in the search strategy. A total of 275 articles published in Spanish, Portuguese and English were reviewed. After applying inclusion and exclusion criteria, twenty articles were chosen. Conclusions: Child care has several dimensions for its understanding: meaning of care, the nurse's competences, the mother's participation, and factors involved in care; with a humanistic and integrative vision, through an empathic nurse-mother-child relationship, with updated scientific knowledge, expertise in procedures, application of ethical principles and values, understanding of child psychology, great human sensitivity and stress management, without neglecting the family and therapeutic play(AU)

Rol de enfermería frente al delirium en unidad de cuidado intensivo pediátrico: Scoping Review / Nursing role in delirium management in pediatric intensive care units: A scoping review

Introducción: El manejo integral de delirium tiene componentes de diferente índole y el rol de enfermería frente a éste puede ser difuso. Objetivo: Identificar en la literatura disponible los cuidados de enfermería no farmacológicos para niños hospitalizados en Unidad de Cuidado Intensivo Pediátrica que presenten delirium. Materiales y métodos: Se realizó una búsqueda estratégica en Web Of Science, Medline, Science Direct, Scielo, Biblioteca Virtual en Salud, LILACS y Open Grey utilizando los términos "nursing care", "child OR children", "delirium", y "Pediatric Intensive Care Unit". La extracción y análisis de los datos se dio por medio de una matriz. Resultados: Se identificaron 12 artículos que cumplían con los criterios de inclusión y se clasificaron en 4 categorías según la intervención principal desarrollada en el estudio: Abordaje investigativo, intervenciones de confort, intervenciones integrales, e intervenciones educativas. Discusión: El cuidado de enfermería frente al delirium comprende medidas preventivas o curativas que parten del paciente como centro y se extienden hasta su entorno y su familia. Las intervenciones de enfermería pueden estar interrelacionadas de manera que se sustentan y complementan entre ellas. Algunas actividades de cuidado pueden considerarse un indicador de calidad de la atención en salud. Conclusión: Para abordar integralmente el delirium pediátrico es necesario incidir sobre los factores individuales, ambientales y estructurales que contribuyen a su aparición. El cuidado de enfermería frente al delirium constituye una forma de proteger y promover el bienestar y el desarrollo inmediato y futuro de los niños.

Introduction: Comprehensive management of delirium has components of different kinds, and the role of nursing in it may be unclear. Objetive: To identify in the literature available non-pharmacological nursing care for children with delirium hospitalized in Pediatric Intensive Care Units. Materials and Methods: A strategic search was performed in Web of Science, MEDLINE, Science Direct, Scielo, Virtual Health Library, LILACS, and Open Grey using the terms "nursing care," "child OR children," "delirium," and "Pediatric Intensive Care Unit." Data extraction and analysis were performed using a matrix. Results: Twelve articles were identified that met the inclusion criteria and were classified into four categories according to the main intervention developed in the study: Research approach, comfort interventions, comprehensive interventions, and educational interventions. Discussion: Nursing care for delirium includes preventive or curative measures starting from the patient as the center and extending to the patient's environment and family. Nursing interventions may be interrelated in a way that supports and complements each other. Some care activities may be considered an indicator of the quality of care. Conclusions: A comprehensive approach to pediatric delirium requires addressing individual, environmental, and structural factors that contribute to its onset. Delirium nursing care is a way to protect and promote children's immediate and future well-being and development.

Introdução: O manejo integral do delirium possui componentes de natureza diversa e o papel da enfermagem frente a ele pode ser difuso. Objetivo: identificar os cuidados de enfermagem não farmacológicos na literatura disponível para crianças internadas na UTI. Cuidado com delírio. Materiais e métodos: Foi realizada uma busca estratégica no Web Of Science, Medline, Science Direct, Scielo, Biblioteca Virtual em Saúde, LILACS e Open Gray utilizando os termos "cuidado de enfermagem", "criança OR crianças", "delirium" e " Unidade de Terapia Intensiva Pediátrica". A extração e análise dos dados se deu por meio de uma matriz. Resultados: oram identificados 12 artigos que atenderam aos critérios de inclusão e foram classificados em 4 categorias de acordo com a principal intervenção desenvolvida no estudo: abordagem investigativa, intervenções de conforto, intervenções integrais e intervenções educativas. Discussão: O cuidado de enfermagem contra o delirium inclui medidas preventivas ou curativas que partem do paciente como centro e se estendem ao seu ambiente e família. As intervenções de enfermagem podem ser inter-relacionadas de forma que se apoiem e se complementem. Algumas atividades assistenciais podem ser consideradas um indicador da qualidade da assistência à saúde. Conclusões: Para abordar de forma abrangente o delirium pediátrico, é necessário focar nos fatores individuais, ambientais e estruturais que contribuem para o seu aparecimento. A assistência de enfermagem ao delirium é uma forma de proteger e promover o bem-estar e o desenvolvimento imediato e futuro da criança.

Diagnósticos de Enfermagem Pediátrica na Atenção Primária à Saúde: Revisão Integrativa da Literatura / Diagnósticos de Enfermería Pediátrica de Atención Primaria de Salud: Revisión Integrativa de la Literatura / Pediatric Nursing Diagnoses in Primary Health Care: Integrative Literature Review

Objetivo: identificar os Sistemas de Classificação de Diagnósticos de Enfermagem na Prática Clínica de Enfermagem Pediátrica, na Atenção Primária em Saúde. Método: revisão integrativa de literatura de artigos publicados entre 2007 a 2016, nas bases de dados Cumulative Index to Nursing & Allied Health Literature, Medline e Lilacs, pelos descritores: diagnóstico de enfermagem, criança e atenção primária em saúde. Resultados: dos 12 artigos incluídos, NANDA foi o mais abordado 58%, CIPE® 25% considerado marco unificador da prática clínica de enfermagem no SUS, contribuíram nas intervenções das necessidades básicas da criança e família, ressignificando o papel do enfermeiro junto à equipe de saúde e dos seus usuários. Conclusão: a adoção destes sistemas no âmbito do SUS colabora com a sistematização da prática clínica da profissão junto às crianças e suas famílias, ao mesmo tempo em que fortalece a importância do profissional enfermeiro na atenção à saúde integral infantil.(AU)

Objective: identify Nursing Diagnosis Classification Systems in the Pediatrical Nursing Clinical Practice , in Primary Health Care. Method: integrative literature review of articles published from 2007 to 2016, on data bases Cumulative Index to Nursing & Allied Health Literature, Medline and Lilacs, by descriptors: nursing diagnosis, child and primary health care. Results: out of the 12 included articles, NANDA was the most approched one 58%, CIPE ® 25% considered a unifying framework of nursing clinical practice at SUS, they contributed to interventions in the basic needs of children and family, reframing the nurse's role alongside the health team and their users. Conclusion: the adoption of these systems within SUS collaborates in clinical practice profession systematization alongside children and their families, while strengthening the importance of the professional nurse in the integral child health care(AU)

Objetivo: identificar los sistemas de clasificación de diagnósticos de enfermería en la práctica clinica de enfermería pediátrica, en la Atención Primaria de Salud. Método: revisión integrativa de literatura de artículos publicados entre 2007 y 2016, en las bases de datos Cumulative Index to Nursing & Allied Health Literature, Medline y Lilac, por los descriptores: diagnóstico de enfermería, niño y atención primaria en salud. Resultados: de los 12 artículos incluidos, NANDA fue el más abordado 58%, CIPE ® 25% considerado marco unificador de la práctica clínica de enfermería en SUS, contribuyeron en las intervenciones de las necesidades basicas del niño y familia, resignificando el papel del enfermero junto al equipo de salud y sus usuarios. Conclusión: la adopción de estos sistemas en el ámbito del SUS colabora con la sistematización de la práctica clínica de la profesión junto a los niños y sus familias, al mismo tiempo en que fortalece la importancia del profesional enfermero en la atención a la salud integral del niño(AU)

A structural equation model of developing a partnership between pediatric nurses and parents of children with cancer in South Korea.

PURPOSE: A trust-based cooperative partnership between pediatric nurses and parents of children with cancer is a significant factor in improving parents' coping abilities and reducing their anxiety. We aimed to identify factors and construct a structural equation model of developing a partnership between pediatric nurses and parents of children with cancer in South Korea. The model was based on Lazarus and Folkman's stress-coping-adaptation model. DESIGN AND METHODS: Data were collected utilizing a structured questionnaire, which included the following variables: parental stress, perceived nursing support, empowerment, coping, communication with nurses and nurse-parents partnership. The study participants included 205 parents of children diagnosed with cancer and receiving treatment as either inpatients or outpatients in South Korea. We used SPSS/WIN 26.0 to analyze the data and AMOS 26.0 to conduct the structural equation modeling. RESULTS: Empowerment (ß = 0.536, p = 0.001) and communication with nurses (ß = 0.169, p = 0.021) explained 26.0% of the total variance of nurse-parents partnership. CONCLUSIONS: The final model constructed here was confirmed to be suitable for explaining and predicting parent-nurse partnerships. Our results are meaningful in constructing partnership model between pediatric nurses and parents of children with cancer based on conceptual model. PRACTICAL IMPLICATIONS: Strategies and efforts to enhance communication with nurses and parental empowerment will be helpful for enhancing parent-nurse partnerships as children and parents go through the treatment process.

Caring for sick kids: An integrative review of the evidence about the prevalence of compassion fatigue and effects on pediatric nurse retention.

PROBLEM: Compassion Fatigue (CF) in healthcare professionals has been explored in multiple studies, but few focused on hospital-based pediatric nurses. The purpose of this integrative review is to synthesize the evidence about CF prevalence in nurses caring for pediatric patients, and to describe its effects on retention and job satisfaction. ELIGIBILITY CRITERIA: Included studies were in English from any date describing research or quality improvement studies about CF in pediatric nurses. SAMPLE: An integrative review of nine electronic databases yielded 13 articles about 1921 nurses. Data were synthesized from four qualitative and nine quantitative studies separately before integrating results. A risk of bias analysis was included for evidence level and quality. RESULTS: Overall CF prevalence was low, but 14% of nurses were at high risk of burnout and 10% were at high risk for secondary traumatic stress. Studies examining the effects of CF on retention found no significant relationship. Most studies were about critical care or oncology nurses. CONCLUSIONS: A subset of pediatric nurses is highly vulnerable to CF, but more high-quality evidence is needed to fully address this topic. Leaders should study CF prevalence, protective and exacerbating factors, relationships between CF and retention, and targeted strategies to resolve CF in high-risk nurses.

Impacto na saúde mental de enfermeiros pediátricos: um estudo transversal em hospital pediátrico terciário durante a pandemia de COVID-19 / Mental health impacts in pediatric nurses: a cross-sectional study in tertiary pediatric hospital during the COVID-19 pandemic / Impacto en la salud mental de enfermeros pediátricos: un estudio transversal en un hospital pediátrico de tercer nivel durante la pandemia de COVID-19

Resumo Objetivo: avaliar problemas de saúde mental em enfermeiros pediátricos durante a pandemia causada pelo coronavírus 2019. Método: estudo transversal realizado com enfermeiros pediátricos do Instituto da Criança e do Adolescente, por meio de uma pesquisa online de autoavaliação sobre prática clínica e impacto na saúde mental, durante a pandemia de COVID-19. Foram avaliadas escalas de autoavaliação validadas para ansiedade, depressão e burnout. Resultados: 107/298(36%) enfermeiros responderam, dos quais 90% eram do sexo feminino, a mediana de idade atual era 41(23-64) anos, 68% trabalhavam com adolescentes, 66% trabalhavam na linha de frente. Burnout, ansiedade e depressão moderada/grave ocorreram em 65%, 72% e 74% dos enfermeiros, respectivamente. Falta de protocolo de tratamento padronizado nas enfermarias (27% vs. 10%, p=0,049), depressão moderada/grave (74% vs. 16%, p=0,002) e burnout (82% vs. 58%, p=0,01) foram significativamente maiores em enfermeiros pediátricos com ansiedade, em comparação com enfermeiros sem essa condição. Os enfermeiros pediátricos que trabalhavam com adolescentes apresentaram maior frequência de burnout, quando comparados aos que não trabalhavam com esse grupo (77% vs. 32%, p=0,0001). A análise multivariada revelou que o cumprimento adequado da quarentena aumentou a presença de ansiedade em 4,6 vezes [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusão: a maioria dos enfermeiros pediátricos atuava na linha de frente da COVID-19, em condições precárias, trabalhando com equipe reduzida e enfrentando perdas expressivas de renda. A ansiedade atual foi um tema relevante e o burnout também foi uma condição mental importante para esses profissionais, reforçando a cultura do bom trabalho em equipe, das práticas de colaboração e do cuidado psicológico/psiquiátrico.

Abstract Objective: to assess mental health issues in pediatric nurses during coronavirus pandemic in 2019. Method: cross-sectional study was conducted with pediatric nurses at the Instituto da Criança e do Adolescente based on online self-rated survey about clinical practice and mental health impact during COVID-19 pandemic. Validated self-reported scales for anxiety, depression and burnout were used for assessing these professionals. Results: 107/298 (36%) nurses answered, 90% were female, median age was 41(23-64) years, 68% worked with adolescents, 66% in frontline. Burnout, anxiety and moderate/severe depression occurred in 65%, 72% and 74%, respectively. Lack of standardized treatment protocol for nurses (27%vs.10%, p=0.049), moderate/severe depression (74% vs. 16%, p=0.002) and burnout (82% vs. 58%, p=0.01) were significantly higher in pediatric nurses with anxiety compared to those without. Pediatric nurses that worked with adolescents compared to those that did not showed higher frequency of burnout in the former group (77% vs. 32%, p=0.0001). Multivariable analysis revealed that adequate quarantine adherence increased the presence of anxiety in 4.6 times [OR4.6(CI 1.1-20.2), p=0.04]. Conclusion: most pediatric nurses who had worked in the frontline of COVID-19 were under precarious conditions, working with reduced team, and with an expressive changes in their monthly income. Current anxiety was a relevant issue, burnout was also an important mental condition for these professionals, reinforcing culture of good teamwork, collaboration practices and psychological/psychiatric approach.

Resumen Objetivo: evaluar los problemas de salud mental en enfermeros pediátricos durante la pandemia del coronavirus 2019. Método: estudio transversal realizado con enfermeros pediátricos del Instituto da Criança e do Adolescente mediante una encuesta de autoevaluación en línea sobre la práctica clínica y el impacto en la salud mental durante la pandemia de COVID-19. Se evaluaron escalas de autoevaluación validadas para ansiedad, depresión y burnout. Resultados: respondieron 107/298 (36%) de los enfermeros, de los cuales 90% eran del sexo femenino, la mediana de edad actual fue de 41 (23-64) años, 68% trabajaban con adolescentes, 66% trabajaban en primera línea. Burnout, ansiedad y depresión moderada/grave ocurrieron en 65%, 72% y 74% de los enfermeros, respectivamente. Falta de protocolo de tratamiento estandarizado en las enfermerías (27% vs. 10%, p=0,049), depresión moderada/grave (74% vs. 16%, p=0,002) y burnout (82% vs. 58%, p=0,01) fueron significativamente mayores en enfermeros pediátricos con ansiedad en comparación con enfermeros sin esta condición. Los enfermeros pediátricos que trabajaban con adolescentes presentaron mayor frecuencia de burnout en comparación con los que no trabajaban con adolescentes (77% vs. 32%, p=0,0001). El análisis multivariado reveló que el adecuado cumplimiento de la cuarentena aumentó 4,6 veces la presencia de ansiedad [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusión: La mayoría de los enfermeros pediátricos trabajaban en la primera línea de la COVID-19, en condiciones precarias, trabajando con un equipo reducido y enfrentando importantes pérdidas de ingresos. La ansiedad actual fue un tema relevante y el burnout también fue una condición mental importante para estos profesionales, reforzando la cultura del buen trabajo en equipo, las prácticas colaborativas y la atención psicológica/psiquiátrica.

Vaccine hesitancy among paediatric nurses: Prevalence and associated factors.

OBJECTIVE: This study describes the prevalence of vaccine hesitancy associated with the Catalan systematic childhood vaccination calendar and some related psychosocial determinants among paediatric primary care nurses in Barcelona (Spain). METHODS: Cross-sectional descriptive study. In 2017 we invited the paediatric nurses (N = 165) working in Barcelona public primary health centres with paediatric departments (N = 41) to participate. They answered a questionnaire with sociodemographic and behavioural variables: severity and perceived probability of contracting the diseases of the vaccines in the vaccination schedule; safety and protection offered by each vaccine; and beliefs, social norms, and knowledge about vaccines. Outcome variable was vaccine hesitancy, dichotomized into not hesitant (nurses who would vaccinate their own offspring), and hesitant (including those who would not vaccinate them, those who had doubts and those who would delay the administration of one or more vaccines). We performed bivariate analysis and adjusted logistic regression models. RESULTS: 83% of paediatric nurses (N = 137) agreed to participate. 67.9% had the intention to vaccinate their children of all the vaccines in the systematic schedule. 32.1% of nurses experienced vaccine hesitancy, especially about the HPV (21.9%) and varicella (17.5%) vaccines. The multivariate analysis suggests associations between hesitancy and low perception of the severity of whooping cough (aOR: 3.88; 95%CI:1.32-11.4), low perception of safety of the HPV vaccine (aOR:8.5;95%CI:1.24-57.8), the belief that vaccines are administered too early (aOR:6.09;95%CI:1.98-18.8), and not having children (aOR:4.05;95%CI:1.22-13.3). CONCLUSIONS: Although most paediatric nurses had the intention to vaccinate their own children, almost one-third reported some kind of vaccine hesitancy, mainly related to doubts about HPV and varicella vaccines, as well as some misconceptions. These factors should be addressed to enhance nurses' fundamental role in promoting vaccination to families.

Pleasure and suffering in the work of nurses at the oncopediatric hospital unit: qualitative research.

OBJECTIVE: To analyze the experiences that generate pleasure and suffering in the work of nurses in an oncopediatric inpatient unit. METHODS: Qualitative, exploratory, descriptive study. Data collection took place from March to May 2018, through interviews with eight nurses in an oncopediatric inpatient unit. RESULTS: The verbalized experiences of pleasure were the work developed with children, participation in the treatment and cure of patients and the recognition of family members in relation to the work performed. The suffering experiences were palliative care and death of patients, performing invasive procedures and organizing work. FINAL CONSIDERATIONS: It was possible to analyze the experiences of pleasure and suffering of nurses in an oncopediatric unit through the psychodynamics of work, allowing to reinvent prevention and intervention measures by managers in health/mental illness processes at work.

Addressing Environmental Smoke Exposure During Pediatric Hospitalization: Attitudes and Practices of Pediatric Nurses Versus Respiratory Therapists.

BACKGROUND: Tobacco smoke exposure leads to numerous adverse health effects in children. Providing cessation interventions to caregivers who smoke during pediatric hospitalizations can help protect children from such exposure. Both pediatric registered nurses (RNs) and pediatric respiratory therapists (RTs) are well positioned to provide these interventions. Little is known about their rates of participation in cessation efforts. Our objective was to compare the attitudes and practice of pediatric RNs versus pediatric RTs to evaluate their relative cessation-intervention practices in the in-patient pediatric setting. METHODS: An online survey was sent to pediatric RNs and RTs at 4 tertiary pediatric hospitals in California. The survey assessed individual demographics, work environment, experience, beliefs, and practices related to smoking cessation activities. Questions used 3-point and 5-point Likert scales and were compared with the chi-square test. Institutions with a response rate < 20% were excluded. RESULTS: A total of 401 respondents were included in the final analysis (292 RNs, 109 RTs). RTs versus RNs were older (42.0 y vs 35.4 y, respectively, P < .001) and more likely to be former smokers (29.9% vs 13.3%, respectively, P < .001). RNs reported lower levels of confidence in discussing smoking cessation with parents, with 11.7% saying they felt "very confident" compared to 29.0% of RTs (P < .001). RNs also reported screening for smoke exposure less frequently than RTs, with 18.8% responding "often" or "always" compared to 28.9% of RTs (P = .033). RNs had lower rates of advising parents "to make a smoke-free home policy" compared to RTs (ie, 13.4% vs 26.9%, respectively, P = .002). CONCLUSIONS: Compared to in-patient pediatric RNs, RTs reported higher rates of confidence in providing cessation interventions, screening for smoke exposure, and counseling on reducing smoke exposure, suggesting that they may be better positioned for intervening. These results can inform the design of an in-patient cessation intervention for caregivers of hospitalized children.