Establishing a Contextualized Intervention Program for Noise Reduction in a Neonatal Intensive Care Unit.

Objective: This study aimed to examine the effect of a contextualized intervention program on the level of noises in the neonatal intensive care unit (NICU) in Konya, Turkey. Background: For the healthy development of preterm infants, NICUs should have noise levels within safe limits. Methods: A single-center, before-and-after study design was employed. Participants included one head nurse, four physicians, 42 nurses, six physician assistants, and 14 other staff members. The contextualized intervention program involved environmental modification, behavioral modification, and resource management. Sound level measurements were recorded at two-hour intervals over a week before the program's initiation, after the first cycle, and following the installation of central monitor screens. Data analysis utilized SPSS 25, employing percentile calculations, one-way analysis of variance, and Bonferroni tests. Results: The evaluations in the second level of NICU showed that the noise level recorded on weekday mornings and evenings was significantly lower for the third measurement compared to the first and second measurements. However, at the weekend the noise level recorded in the morning was higher in the second measurement than the first, with no significant difference found for the third measurement. The evaluations in the third level of NICU showed that on weekdays the noise level recorded in the third measurement was significantly lower than in the first and second measurements (p < .05). Conclusion: The implementation of a contextualized noise reduction program in our NICU led to significant improvements in noise levels, particularly during morning and evening shifts.

A meta-synthesis of the language of pediatric pain.

AIM: This study aims to conduct a meta-synthesis to explore the language of pain in children. METHOD: We conducted a meta-synthesis, following the outline proposed by Sandelowski. Our search encompassed six electronic databases, namely PubMed, Scopus, EBSCO, Web of Science, SAGE, and Wiley. The Primary keywords used were pediatric pain, pain expression, communication, and qualitative studies. We included articles in English within the field of pediatric nursing between 1989 and 2023. Initially, 563 records were identified which reduced to 508 references after removing duplicates. Subsequently, we assessed 172 full-text articles for eligibility and 10 relevant studies were ultimately included. Quality appraisal was conducted with no study being excluded. Data were synthesized using the qualitative thematic analysis method. RESULTS: The analysis of the data yielded one main theme (the language of pain) and four subthemes. The subthemes were expressive discourse (phonetic expressions, verbal expression, and symbolic expression), subtle gestures of expression (behavioral discrepancies, self-harm, face grimaces, and eye changes), embodied communication (early neonatal to infant movements, older infants movements, and somatic movement), and silent endurance (endurance due to fear of invasive procedure, worrying family, and social isolation). CONCLUSION: From phonetic utterances to nuanced gestures, this study underscores the intricate ways children convey their pain. IMPLICATION: These findings underscore the importance of healthcare practitioners recognizing and interpreting diverse modes of children's pain expression for accurate assessment. Implementing a holistic approach that integrates verbal, nonverbal, and embodied communication can enhance pediatric pain management practices.

Examining the interplay of self-efficacy and emotional autonomy on diabetic control index.

AIM: This study aims to explore the relationship between self-efficacy, emotional autonomy, and diabetic control index in adolescents with type 1 diabetes. METHODS: From January to September 2023, this cross-sectional study involved 112 adolescents aged 14-18 with type 1 diabetes who were seeking medical check-ups at the Medical Faculty Hospital in Konya, Turkey. Data collection included demographic information, the Diabetes Management Self-Efficacy Scale for Adolescents with Type 1 Diabetes, the Emotional Autonomy Scale, and diabetic control index values based on their most recent Hemoglobin A1c levels measurement. Data analysis was performed using SPSS statistical software, with statistical significance set at a p-value <0.05. RESULTS: The results showed a good overall self-efficacy score, indicating a balanced level of confidence in diabetes management. The emotional autonomy findings revealed a moderate level of independence, emphasizing a healthy process of differentiation from parents while acknowledging them as individuals. The ability of adolescents to openly discuss their diabetes may be associated with more favorable glycemic outcomes. However, high emotional autonomy was significantly associated with high Hemoglobin A1c levels. CONCLUSION: This study highlights positive outcomes in adolescent diabetes management, with strong self-efficacy and balanced emotional autonomy. Open communication about diabetes correlates with favorable glycemic outcomes, but caution is necessary as high emotional autonomy is linked to elevated Hemoglobin A1c levels. The importance of receiving parental support in managing diabetes, especially in adolescents with high emotional autonomy should be highlighted.

The Experiences of Children with Primary Immunodeficiency Who Receive Immunoglobulin Subcutaneously Instead of Intravenously.

BACKGROUND: Children with primary immunodeficiency disorder have begun receiving subcutaneous immunoglobulin (SCIg) instead of intravenous immunoglobulin (IVIg). So, we aim to explore the experiences of primary immunodeficiency children with regard to receiving SCIg instead of IVIg. METHOD: We adopted a phenomenological approach in 2022 in Turkey using semi-structured interviews. We recruited 15 participants using the purposive sampling method. RESULTS: The main theme was the sweetness and bitterness of living with SCIg. The first subtheme was sweetness (sense of freedom, having a normal life, saving time, ease of use, and feeling better). The second subtheme was bitterness (worries about taking responsibility for injection, impaired body image due to abdominal edema, and minimal tolerable complications). DISCUSSION: The results show these children had more sweet experiences than bitter ones. Being flexible in choosing a method, teaching patients to apply it correctly, and providing enough time to cope are as reasons for this.

The experiences and coping mechanisms of mothers caring for a child with cerebral palsy.

Mothers caring for a child with cerebral palsy suffer from many physical and psychosocial problems. Their quality of life is significantly lower than mothers with healthy children. The first step in improving these women's quality of life is to improve the understanding of their experiences and coping mechanisms in specific cultural contexts. Therefore, this study aimed to explore the experiences and coping mechanisms of mothers caring for a child with cerebral palsy through a qualitative study conducted in Turkey. The study took place in 2021. Ten mothers were selected to participate through purposeful sampling. Inclusion criteria were mothers who had cared for a child with cerebral palsy for over three years, had no chronic diseases, could speak Turkish fluently, and wanted to participate in the study. The data were collected through semi-structured interviews. Qualitative content analysis was used to analyze the data. Two main themes and three categories emerged from the data analysis. The themes were "dedication" and "seeking." The analysis showed that mothers were dedicated as they engaged in all aspects of care. Their coping mechanisms involved self-focused and problem-focused seeking. These mothers must be acknowledged and supported while considering cultural and religious beliefs.

Determining the relationship between sleep disturbances in children and parental stress during COVID-19 pandemic.

This study aimed to determine the relationship between child sleep disturbances and parental stress during the COVID-19 pandemic. This cross-sectional web-based study was conducted between February and April 2021 among 409 parents residing in Turkey who had children between the ages of 6 and 16 years. Data were collected online using the Sleep Disturbance Scale for Children (SDSC) and the Parental Stress Scale (PSS). In the study, there was a significant relationship found between the mean scores of the SDSC and PSS (r = 0.499, p < 0.001). In the multiple regression analysis, family type, socioeconomic status, occupation, the presence of sleep problems in the child before the pandemic, and the total score of the PSS significantly affected the total score of the SDSC. The presence of sleep problems in the child before the pandemic was significantly associated with the total score of the PSS (p < 0.05). Approximately 3.9% of the children had sleep disturbances (at scores over 70 points) during the COVID-19 pandemic. In conclusion, as the stress levels of parents increase, the rate of sleep disturbances in their children increases, and many demographic characteristics are associated with the occurrence of sleep disturbances in their children. It is important that parents do not reflect on their stress related to the pandemic and that their children maintain a normal sleep pattern whenever possible. School nurses should educate children and their parents about the importance of enough sleep and factors that contribute to inadequate sleep among children during the COVID-19 pandemic.

Noise in a Neonatal Intensive Care Unit: Exploring Its State and Solutions.

BACKGROUND: Concerns regarding the environmental noise issue in neonatal units and an interest in developing strategies to reduce this noise have motivated researchers to conduct comprehensive qualitative research to elucidate the current situation and help improve it. PURPOSE: This study aims to explore the current state of noise and possible solutions in a neonatal intensive care unit (NICU) in Konya, Turkey. METHODS: In 2021, a descriptive exploratory study was conducted with a qualitative content analysis approach. Eighteen nurses, three physicians, seven staff members, and four mothers were selected to participate in the study via purposeful sampling. The data were collected from two semi-structured interviews, six focus groups, six observations, and sound source level measurements using a sound decibel meter. Qualitative content analysis was used to analyze the data. RESULTS: Three main themes and seven major categories emerged from the data analysis. The themes were overt and covert sources, pan-negative effects, and holistic modification. All recorded sound levels exceeded the recommended noise level of 45 dB. Fifty-seven percent of sound sources were in the range of 45-65 dB, and 43% were higher than 65 dB. IMPLICATIONS FOR PRACTICE AND RESEARCH: This study showed that NICU has a noisy environment with hidden sound sources that can negatively affect all people. This situation must be approached seriously by holistic modification involving environmental modification, behavioral modification, and resource management. It highlighted that each environment is unique and needs to be carefully evaluated to find a suitable and cost-effective solution.

Crab barrel syndrome: Looking through the lens of type A and type B personality theory and social comparison process.

Introduction: There are epistemological studies about the main concept, Crab Syndrome. In this context, the study aims to reveal the antecedents of the Crab Syndrome by evaluating the theoretical background of the Crab Barrel Syndrome within the framework of Social Comparison Theory. The main purpose of this study is to identify the precursors of crab barrel syndrome. In line with this main purpose, the study also aims to reveal the relationship between crab barrel syndrome behaviors and type A versus type B personalities, along with the effect of social comparison behaviors. Type A personality represents the personalities of individuals who are stressed, ambitious, competitive, and quickly take action for their aims. Type B, on the other hand, presents the personality types of individuals who are calm, away from competition, and perform their actions slowly. Method: It is designed quantitatively, employing scales to quantify type A and type B personalities, social comparison, and crab barrel syndrome. Hypotheses are tested using structural equation modeling. Result/discussion: It is found that there is a positive relation between the type A personality and the crab barrel syndrome, and a negative one between the syndrome and high self-esteem. The findings suggest that by social comparison, type A and type B personality are precursors of crab barrel syndrome. In the study, the theoretical background of the Crab Syndrome was evaluated within the scope of Social Comparison Theory. In this context, examining the relationship between different organizational behavior theories and crab syndrome is important for other studies.

The effect of anxiety on nicotine dependence among university students during the COVID-19 pandemic.

PURPOSE: This study investigated the effect of anxiety on nicotine dependence among university students during the COVID-19 pandemic. DESIGN AND METHODS: This was a descriptive and correlational study. The sample consisted of 503 university students in Turkey. Data were collected online using a demographic characteristics form, the State-Trait Anxiety Inventory (STAI), and the Fagerström Test for Nicotine Dependence (FTND). FINDINGS: FTND scores differed by gender, family type, and grade level, while STAI scores differed by gender, income, and region of residence (p < 0.05). Fifty-one percent of the participants had moderate anxiety, while 65.2% had low nicotine dependence. FTND and STAI mean scores were strongly correlated (p < 0.05). PRACTICAL IMPLICATIONS: The higher the anxiety, the higher the nicotine dependence among university students during the COVID-19 pandemic.

Hand hygiene and mask-wearing behaviors and the related factors during the COVID 19 pandemic: A cross-sectional study with secondary school students in Turkey.

PURPOSE: The research was conducted to determine the hand hygiene and mask-wearing behaviors and related factors of secondary school students in the COVID-19 pandemic process. DESIGN AND METHODS: This descriptive cross-sectional study was conducted between March 02-April 022021 with 1284 students who continued their secondary education in a province in the east of Turkey. The data were collected face-to-face through the Descriptive Characteristics Form, the Mask-Wearing Behavior Form, and the Hand Hygiene Behavior Form. Percentage, mean, t-test in independent groups, Mann Whitney U test and Multiple Regression analysis were used in the evaluation of the data. Ethical principles were observed at all stages of the study. RESULTS: It was determined that 80.1% of the students used disposable medical masks, 62.1% of their parents chose a mask suitable for the age of the student, and 52.1% used the mask they wore all day long. It was found that 41.4% of the students washed their hands before wearing a mask, and 51.9% after wearing a mask. It was determined that there was a significant relationship between students' mask-wearing behavior and gender, and hand hygiene behavior and gender, grade level, previous training on hand-washing and mask-wearing. As a result of multiple regression analysis, it was found that gender and mother's occupation had a statistically significant effect on mask-wearing behavior, while gender and previous training on mask-wearing had a statistically significant effect on hand-washing behavior. CONCLUSIONS/PRACTICE IMPLICATIONS: Students exhibited correct behaviors regarding hand hygiene and mask-wearing, but some misbehaviors suggest that training is necessary, especially in the COVID-19 pandemic period.

Analysis of nursing students' obsessive and coping behaviors during the COVID-19 pandemic.

PURPOSE: This study was conducted to examine the obsessive behaviors and coping behaviors of nursing students during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN AND METHODS: This descriptive study was conducted between October 4 and October 17, 2020. FINDINGS: In this study, it was found that nursing students had a mean total COVID-19 Obsessive Compulsive Scale score of 3.88 ± 3.02 and a mean total Ways of Coping Inventory (WCI) score of 47.05 ± 11.68. When the subscales of the WCI were examined, mean scores were found to be 13.64 ± 4.85 for the self-confident approach, 8.91 ± 3.35 for the optimistic approach, 7.25 ± 2.24 for the seeking social support approach, 10.97 ± 4.43 for the helpless approach, and 6.24 ± 3.20 for the submissive approach. PRACTICE IMPLICATIONS: Nursing students have low levels of obsession with COVID-19 and moderate levels of coping behaviors. For this reason, it is very important to recognize the psychological symptoms of today's nursing students-the health workforce of the future-and to determine priorities for their solution.

The Effects of Cartoon Assisted Endoscopy Preparation Package on Children's Fear and Anxiety Levels and Parental Satisfaction in Turkey.

PURPOSE: The study was conducted to determine the effect of the cartoon-assisted preparation package, developed for children undergoing an endoscopy procedure, on children's fear and anxiety levels and parental satisfaction. DESIGN AND METHODS: The study was conducted in a randomized controlled experimental design between April 2018-July 2019. The study sample consisted of a total of 65 children and their parents (33 in the intervention group and 32 in the control group) who met the research inclusion criteria in this study population. The intervention group was prepared for an endoscopy procedure with the cartoon-assisted preparation package for endoscopy. RESULTS: The mean fear scores of the children in the intervention group were 3.39 ±â€¯0.56 before endoscopy, 1.67 ±â€¯0.54 during endoscopy, and 0.52 ±â€¯0.67 after endoscopy, with statistically significant difference between the mean fear scores. The mean fear scores in the control group were 3.00 ±â€¯0.80 before endoscopy, 3.13 ±â€¯0.79 during endoscopy, and 2.25 ±â€¯1.16 after endoscopy, with statistically significant difference between the mean fear scores. The anxiety scores of the children were 33.79 ±â€¯4.00 in the intervention group and 36.56 ±â€¯3.52 in the control group before endoscopy, and the difference between anxiety scores was statistically significant (p < 0.05). The mean satisfaction scores of the parents in the experimental group after endoscopy (78.44 ±â€¯10.01) was higher than that of the control group (73.52 ±â€¯12.92), but the difference between the groups was not statistically significant (p > 0.05). CONCLUSION: The cartoon-assisted preparation package for endoscopy was found to be effective in reducing fear and anxiety that may occur in children undergoing endoscopy, in the 7-12 age group.

Validity and reliability of Turkish version of the scales of perceived stigma for children with epilepsy and their parents.

PURPOSE: This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al. This study also aims to analyse the scales' validity and reliability in evaluating stigma perceptions amongst the aforementioned population. METHODS: The population of this methodological study consisted of parents and 85 epileptic children between 9 and 16 years old. This population visited the paediatric neurology clinic of a hospital in Erzurum Province, Turkey, between April 2015 and January 2016. The scales of perceived stigma amongst children with epilepsy and their parents, as well as its Turkish version, were used as measuring tools. Experts were also consulted for their opinions. Meanwhile, Bartlett's test, Kaiser-Meyer-Olkin (KMO) index, exploratory factor analysis, principal component analysis, varimax rotation and scree plot test were used to determine the validity of the study. Moreover, the coefficients of Cronbach's α and Pearson's product-moment correlation were used to identify internal consistency, homogeneity and thus reliability. RESULTS: Evaluations and analyses indicated that the Turkish version of the child and parent scales can be used with a single dimension. The mean scores of such scales were 24.02 ±â€¯8.47 and 15.68 ±â€¯4.04, respectively. All item-total score correlations of the child and parent scales were found to be significant (P < 0.05). The KMO coefficient of the child scale was 0.94, whereas the chi-square value of Bartlett's test of sphericity was significant at 209.311 (P < 0.05). Moreover, the KMO coefficient of the parent scale was found to be 0.80, whereas the chi-square value of Bartlett's test of sphericity was found to be significant at 209.311 (P < 0.05). The Cronbach's α coefficients were 0.95 and 0.87 for the child and parent scales, respectively. CONCLUSION: The Turkish version of the child and parent scales of perceived stigma is valid and reliable in measuring the perception of stigma amongst children with epilepsy and their parents.