A Literature Review of Percutaneous Endoscopic Gastrostomy: Dealing With Complications.

Sufficient energy and essential nutrients are vital for normal growth and development in childhood. Ideally, nutrition should be provided orally. However, if the gastrointestinal system is functional, enteral tube feeding can be used when nutritional requirements cannot be provided orally, thus providing nutritional benefits and enabling positive disease management in pediatric patients. Postoperative care in children allows monitoring of the position and functionality of the tube; performing nutrition intolerance, growth, hydration, and nutritional assessments; and performing metabolic and complication follow-ups. Tube feeding in pediatric patients is beneficial and has positive effects in controlling and managing diseases and providing appropriate nutrition in children. However, in postoperative patients, it is important to prevent potential complications, which can be classified into 5 groups: mechanical, gastrointestinal, metabolic, infectious, and pulmonary complications. Important points for managing complications include having enteral nutrition practices based on evidence-based guidelines, sharing outcomes with nurses working in clinical settings, creating enteral feeding guides in clinical settings, providing patients/patients' family with training in line with these guides, and maintaining follow-ups at home. This literature review discusses complications and practices regarding the management of complications after percutaneous endoscopic gastrostomy.

Effects of 3 Different Methods of Care on the Peristomal Skin Integrity of Children with Percutaneous Endoscopic Gastrostomy Tubes: A Prospective Randomized Controlled Trial.

OBJECTIVE: There are a limited number of studies examining the effects of products used in stoma care. This study compares the effects of 3 different methods of care on the peristomal skin integrity of children with percutaneous endoscopic gastrostomy (PEG) tubes. METHODS: In this randomized controlled study, 60 children were allocated to the 3 study groups (group 1: hydrogel, group 2: soap and water, group 3: saline solution). Dressings were changed daily for all groups during the first week, then weekly for group 1 and daily for groups 2 and 3. The evaluations were performed using a PEG Region Peristomal Skin Integrity Observation Form and devices measuring stoma region pH, moisture, and temperature. One evaluation was performed in a hospital and 4 during home visits in the first month after PEG insertion. MAIN RESULTS: Moisture levels in the stoma region were normal in the saline solution group, high in the hydrogel group, and low in the soap and water group (P < .05). Complications potentially affecting peristomal skin integrity in the stoma region (erythema, drainage, hemorrhage, hypergranulation tissue) were observed most frequently in the soap and water group (5%-45%) and least frequently in the hydrogel group (15%-25%). However, there was no statistically significant difference among the groups with respect to these complications (P > .05). CONCLUSIONS: Because the dressing requires 6 times fewer changes per month, and wound site infection in the stoma site is minimized, the use of glycerin hydrogel should be considered for inclusion in pediatric stoma care procedures.

How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study.

UNLABELLED: Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." DESIGN AND METHODS: The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). RESULTS: The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. CONCLUSIONS: Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. PRACTICE IMPLICATIONS: The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation.

Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis.

PURPOSE: This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life. METHODS: Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I2 and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias. RESULTS: Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life. CONCLUSION: This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.

Home Gastrostomy Feeding Education Program: Effects on the Caregiving Burden, Knowledge, and Anxiety Level of Mothers.

BACKGROUND: It is highly important for healthcare professionals to give discharge education to families to increase their knowledge of gastrostomy care and complications and to inform them about the correct behaviors. The purpose of the present descriptive pretraining and posttraining evaluation study was to investigate the effects of a standardized, evidence-based discharge education program prepared for children with gastrostomy tubes on the caregivers' knowledge, anxiety levels, and caregiving burden. METHODS: The primary caregivers of children with a gastrostomy tube (n = 30) were interviewed on the first day of the education program and the first week and third month after the program, and a pretest/posttest, the Zarit Caregiver Burden Scale and the State-Trait Anxiety Inventory were applied. Complications were determined by assessing the number of unplanned clinic visits and complications in the study group compared with the historical control group (historical comparison; n = 30). RESULTS: The study revealed that the knowledge levels of mothers increased in the first week and third month after training, and their caregiving burden and state-trait anxiety levels significantly decreased. Although some complications arising from the enteral nutrition process were observed, it was found that the complications were fewer, and the difference was statistically significant compared with the group that did not receive the standardized, evidence-based discharge education program. CONCLUSION: The standardized education program should be recommended because caregivers managed the home care process more successfully, and the stress, anxiety, and difficulties experienced during homecare decreased.

Validity and reliability of the Turkish version of three screening tools (PYMS, STAMP, and STRONG-kids) in hospitalized children.

BACKGROUND: There are different malnutrition screening tools developed in the English language, but limited data available on the validity of their versions translated into other languages. The aim of this study is to construct a Turkish version of PYMS, STRONG-kids, and STAMP and to determine their validity and reliability in a pediatric population. METHODS: The present study was conducted at two stages. First, the process of translating PYMS, STRONG-kids, and STAMP into the Turkish language was performed. In the second stage, the validity and reliability were evaluated in the new version of the tools. The anthropometric assessment was used as the reference standard in evaluating the validity of criteria. The reliability was observed through inter-rater and intra-rater agreement. RESULTS: 202 children in total were involved in the present study, 42 of whom took part in the reliability phase. The inter-rater agreement between one dietitian and one nurse was kappa (κ) = 0.955 (95% CI 0.904-1.000) for PYMS, 0.901 (95% CI 0.828-0.974) for STRONG-kids, and 0.963 (95% CI 0.912-1.000) for STAMP (almost perfect agreement). Sensitivity of the PYMS, STRONG-kids, and STAMP were 96.8%, 87.1%, and 77.4%, respectively. Specificity of the PYMS, STRONG-kids, and STAMP was found to be 65.0%, 30%, and 60.0%, respectively. CONCLUSION: The inter-rater and intra-rater reliability of the three tools were determined to be good. While PYMS was found to be more sensitive in detecting the malnutrition risk when compared to the other tools, STRONG-kids had the lowest specificity according to the agreement between tool results and anthropometric assessment.

The experiences, perceptions and challenges of mothers managing asthma in their children: a qualitative study.

BACKGROUND: Despite the fact that childhood asthma poses an important burden, especially on the families, little is known about the emotional experiences of mothers. This article describes the predominant emotional challenges and experiences reported by mothers of children with asthma. METHODS: Individual, semi-structured, in-depth interviews with a qualitative study method was used in collection of the data. Face-to-face interviews with mothers of children with asthma were conducted using sociodemographic data form and semi-structured interview forms developed by the investigators. The transcribed interview texts were analyzed according to a qualitative content analysis. RESULTS: A total of 20 mothers were interviewed. We found that the experience of mothers of the children with asthma was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation to later processing the difficult situation affected by the asthma. First moment at diagnosis, relaxation against uncertainties, anxiety, fear, truly acceptance, sadness were the predominant emotions. Mothers described experiences and challenges of frequent admission to emergency, administration of medication and treatments, school problems, limitations in physical activity and spouse relationship problems. Experiences of problems contributed to hopelessness, abandoned, angry and burnout. Mothers had concerns about the chronic nature of the disease, side effects of medications, complications that might develop, factors influencing the disease, and future plans. CONCLUSIONS: Mothers of children with asthma described complex emotional journeys. This has implications for healthcare providers who need to be aware of the complexity of these emotional journeys to support parents more effectively, thereby helping improve patient outcomes. Parents should be trained for symptoms and disease management with a written action plan. It is imperative to realize multi-disciplinary team collaboration and to regularly review training and information. Future research should concentrate on promoting awareness, education, advocacy, and support for parents of asthmatic children.

[Examining the Psychological Resilience of Adolescents with Leukemia: A Comparative Study]. / Lösemili Adölesanlarda Psikolojik Saglamligin Incelenmesi: Karsilastirmali Bir Çalisma.

AIM: This descriptive and comparative research was conducted to determine the level of psychological resilience of adolescents diagnosed with leukemia. METHOD: The sample research group comprised of eighty adolescents in the 15-18 age group who have leukemia in pediatric hematology outpatient clinics. The sample comparison group comprised of eighty healthy adolescents in the 15-18 age group who were students from years 9, 10, 11, and 12th in a high school. Data was collected using a socio-demographic questionnaire and the California Healthy Kids Survey Resilience and Youth Development Module High School Questionnaire form. The Mann-Whitney U Test, Kruskal Wallis variance analysis, homogeneity test (Levene), and Ki kare Test were used to evaluate the data. RESULTS: It was seen that there were no significant differences between the psychological resilience of adolescents with leukemia and healthy adolescents (p>0.05) Females were observed to have higher levels of psychological resilience than males in the research group. A lower level of psychological resilience was identified in adolescents from the research group who did not receive psychological support during the illness compared with those who received psychological support (p<0.05). The sub-factor point average of caring relationships and high expectations at school were higher in the research group, whereas the sub-factor point average of goals and aspirations were higher in the healthy adolescents (p<0.05). CONCLUSION: As a result, it was suggested that preventive mental health services should be planned and implemented to develop resilience levels and protective relationships provided by the school, friends, family and society should be supported.

A systematic review of nutrition-based practices in prevention of hypertension among healthy youth.

The aim of this systematic review was to analyze the results of observational and interventional research/studies on nutrition-based practices in the prevention of hypertension among healthy youth. The MEDLINE/PubMed database was searched using the key words, "hypertension," "nutrition/diet," "prevention" and "youth." Inclusion criteria were: 1) sample with a majority of adolescents, defined as 10-24 years of age, or findings for adolescents reported separately from other age groups; 2) primary research reports; 3) studies with normotensive participants; and 4) studies that focused on preventing hypertension/lowering blood pressure through at least one nutritional practice. Results of the analysis indicated that increased consumption of unsaturated fats, fruits, vegetables and low-fat dietary products, decreased consumption of dietary sodium and beverages containing caffeine, and breastfeeding were found to have preventive effects against high blood pressure in later years of life. The effects of training given during youth to encourage a healthy lifestyle and behavior changes based on diet and physical activity were also noted.