Fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática / Intervening factors in the management of nursing care for children hospitalized with rheumatic heart disease / Factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática

Objetivo: analisar os fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática. Método: estudo descritivo-exploratório com abordagem qualitativa, que utilizou a Teoria Fundamentada em Dados e o Interacionismo Simbólico, respectivamente, como referencial metodológico e teórico. A coleta de dados foi realizada em uma instituição especializada em atendimento cardiológico, no munícipio do Rio de Janeiro. Foram entrevistados 19 profissionais de enfermagem através de um roteiro semiestruturado. Resultado: emergiram os seguintes fatores intervenientes na prática da gerência do cuidado: condição socioeconômica da família, comportamento da criança, condições de trabalho, comunicação ineficaz, educação permanente, trabalho em equipe e experiência profissional. Conclusão: os resultados apontam para a necessidade de proposição de estratégias de ação e interação que facilitem a prática gerencial de cuidado à criança com cardiopatia reumática e sua família face aos fatores intervenientes identificados.

Objective: to analyze the factors involved in the management of nursing care for children hospitalized with rheumatic heart disease. Method: this is a descriptive-exploratory study with a qualitative approach, which used Data-Based Theory and Symbolic Interactionism, respectively, as methodological, and theoretical references. Data was collected in an institution specializing in cardiac care in the city of Rio de Janeiro. Nineteen nursing professionals were interviewed using a semi-structured script. Result: the following intervening factors in the practice of care management emerged: the family's socioeconomic status, the child's behavior, working conditions, ineffective communication, continuing education, teamwork, and professional experience. Conclusion: the results point to the need to propose strategies for action and interaction that facilitate management practice in caring for children with rheumatic heart disease and their families, given the intervening factors identified.

Objetivo: analizar los factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática. Método: estudio descriptivo-exploratorio con enfoque cualitativo, cuyos marcos metodológico y teórico fueron la Teoría Fundamentada y el Interaccionismo Simbólico, respectivamente. La recolección de datos se realizó en una institución especializada en atención cardiológica, en la ciudad de Río de Janeiro. Fueron entrevistados 19 profesionales de enfermería mediante un cuestionario semiestructurado. Resultado: surgieron los siguientes factores intervinientes en la práctica de la gestión del cuidado: condición socioeconómica de la familia, comportamiento del niño, condiciones de trabajo, comunicación ineficaz, educación continua, trabajo en equipo y experiencia profesional. Conclusión: los resultados indican que es necesario proponer estrategias de acción e interacción que faciliten la práctica de la gestión del cuidado al niño con cardiopatía reumática y a sus familiares, con respecto a los factores intervinientes identificados.

The itinerary of children in search of healthcare: A scoping review and proposal of an explanatory model.

This scoping review mapped the academic literature focused on the therapeutic itinerary of children who seek care in health services and proposed an explanatory model to expand the concept and classification of these health itineraries. A total of 789 articles were reviewed, of which 28 were eligible for inclusion. In these 28 it was possible to observe that the child's therapeutic itinerary is more than a physical path, but also encompasses all choices within a specific social and cultural environment in which the child is inserted. Our proposal is to expand the concept beyond the therapeutic, classifying the itinerary also according to the objective, the decision-making agent, respect for the presence of company, the health subsystem used, according to the physical continuity of the itinerary, the perception of efficacy of the patient, the nature of the illness, the administration of healthcare, the means of transport used, the person providing information about the itinerary, the planning of the itinerary and its completeness. Knowing the child's itineraries toward healthcare allows the development of innovative discourses and practices for future public policies, through which the principles of comprehensiveness and resoluteness in children's health would be strengthened. There is still a need to deepen knowledge about the meanings and feelings regarding their interpretations of the events suffered in childhood.

Nurses' Knowledge and Attitudes About Pain Management in Pediatric Surgical Wards: An Educational Intervention Study.

BACKGROUND: Pediatric pain management is a constantly developing field. Despite extensive research, several studies have concluded that children's pain is still underestimated and undertreated. Nurses working with children have an important professional and ethical responsibility to possess up-to-date knowledge of pediatric pain management. PURPOSE: The purpose of this study was to identify nurses' knowledge and attitudes regarding pain management in pediatric surgical wards and to investigate the short- and long-term effects of a tailored educational intervention. METHODS: This study has a quasi-experimental design without a control group and uses a previously validated questionnaire, the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain-Norwegian version (PNKAS-N). Nurses in four pediatric surgical wards in one university hospital in Norway answered the survey once before and three times after a tailored educational intervention. RESULTS: Eighty-three nurses answered the PNKAS-N at baseline (response rate of 75%). The nurse's total PNKAS-N mean score was 27.8 (77.3%) at baseline. We identified knowledge and attitude deficits regarding items related to opioid doses, the risk of drug addiction, the risk of respiratory depression, and the choice of pain medication for children. The total PNKAS-N mean score was statistically significantly increased after the intervention, at T2 (85.2%), as compared to baseline, and this improvement was sustained at T3 (83.8%) and T4 (81.4%). CONCLUSION: The tailored educational intervention had a significant effect on nurses' knowledge and attitudes about pediatric pain management.

Signs and symptoms in hospitalized children and adolescents' triggering nurses' awareness - A qualitative study across Denmark and Norway.

BACKGROUND: Assessment of signs and symptoms in hospitalized children presents unique challenges due to the children's age-related differences, such as vital signs and the broad range of medical conditions that affects children. Early detection of clinical changes in children is crucial to prevent deterioration, and while standardized tools exist, there is a growing recognition of the need to consider subjective factors based on experienced nurses' knowledge and intuition. OBJECTIVE: To explore which signs and symptoms, apart from vital signs, that trigger nurses' concern regarding deterioration of hospitalized children and adolescents. DESIGN: This study used a descriptive qualitative design. SETTINGS: The study was conducted at three pediatric departments in Denmark and a nursing department of a university in Norway, offering post graduate education programs for health care professions working with children and adolescents throughout Norway. PARTICIPANTS: A total sample of 29 registered nurses with varying levels of experience participated. METHOD: Four focus group interviews were used to collect data and analyzed with inductive content analysis approach. RESULTS: Nurses' knowledge about children's clinical conditions is influenced by the nurses experience, their use of senses like touching the child with their hands, and the use of various approaches. Information from parents about the child's normal behavior are considered valuable. These sources of information, often difficult to verbalize, might be referred to as intuition or "gut feeling" and often guides the nurses' actions when vital signs appear normal, and nurses rely on their senses to assess the child's condition. Specific indicators triggering concern include changes in respiration, circulation, level of consciousness, and facial expressions. Challenges arise from nighttime assessments, interactions with parents, the presence of electronic devices, and children's ability to compensate. Clinical experience is a significant factor in nurses' ability to recognize changes in in the child's condition. CONCLUSION: This study highlights the multifaceted nature of nurses' assessments of clinical conditions in hospitalized children. Nurses draw on their experiences, intuition, and interactions with parents to complement vital signs-based assessments. Their intuition, or "gut feeling" serves as a valuable tool when vital signs do not fully capture the child's clinical status. Specific signs and symptoms that trigger nurses' concern, along with the challenges they face, contribute to a comprehensive understanding of the complexity of assessing children's clinical conditions. These findings, emphasize the role of nurses in early recognition of clinical deterioration in hospitalized children and the need for assessments that go beyond vital signs. TWEETABLE ABSTRACT: Both objective assessments and intuitive clinical judgment play an important role in identifying potential deterioration in pediatric patients.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning-based random forest approach.

BACKGROUND: Quality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality. METHODS: This study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3-5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results. RESULTS: The score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver. CONCLUSIONS: The proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

Nursing Undergraduate Students' Experiences and Perceptions of Blended Learning in Pediatric Nursing: A Mixed Methods Study.

Introduction: Blended learning is a teaching approach that integrates online self-learning and classroom teaching. It emphasizes students' self-directed learning, actively engaging, as well as communication and collaboration. Blended learning develops the qualities in nursing undergraduate students with problem-solving ability, clinical thinking, and communication skills as nurses have. Currently, learners' experience has become an important factor in determining the success of blended learning. Aim: To learn about the experiences and perceptions of undergraduate nursing students regarding blending learning in pediatric nursing. Methods: A mixed methods design beginning with a quantitative data collection and analysis phase to inform the subsequent qualitative phase was utilized. This study was conducted among undergraduate nursing students at one university in China. In the quantitative study phase, a convenience sample of 59 students completed the online survey while the qualitative study phase included nine students recruited by purposive sampling. The qualitative data were collected using individual semistructured in-depth interviews. Audio data were transcribed and subjected to thematic analysis. The findings from those two phases were integrated into the final analysis. Results: The majority (89.8%) of students reported satisfaction with blended learning. Among various teaching methods, case-based learning (CBL) was the most preferred (98.3%). Regarding the qualitative data, students reported positive experiences with blended learning including well-organized course structure, resourceful course content, and high teacher quality. They stated that blended learning improved the learning outcomes such as improving problem-solving ability and developing clinical thinking. They also provided suggestions for achieving better learning outcomes, including providing stressful learning activities, optimizing online course design, and improving the quality of group learning. Conclusions: The blended learning model of pediatric nursing based on the Community of Inquiry framework provides a positive learning experience for nursing undergraduate students. However, ongoing assessment and improvement of the blended learning process are also needed.

Effects of peer tutoring-based simulation education on caring for children with respiratory infections among nursing students: A mixed-methods study.

Background: Respiratory infections are common in children and can quickly deteriorate, necessitating vigilant nursing care. Simulation training provides a valuable tool for nursing students to learn how to manage children with respiratory infections. Peer tutoring has demonstrated benefits, including the creation of a safe, supportive learning environment and the perception of peer tutors as beneficial role models. This study aimed to develop a simulation education program for the care of children with respiratory infections, involving peer tutoring among nursing students, and to assess its effectiveness. Methods: This mixed-methods study, conducted between July and December 2022, utilized surveys to gather both quantitative and qualitative data. A peer tutoring-based simulation education program for providing care to children with respiratory infections was developed specifically for nursing students. The study was implemented with 49 nursing students from a South Korean university (25 in the experimental group and 24 in the control group). The students' self-efficacy, disposition towards critical thinking, problem-solving ability, and satisfaction with practice were evaluated and analyzed using the unpaired t-test, the chi-square test, and repeated-measures analysis of variance. The learning experiences of the students in the experimental group were further examined using qualitative content analysis. Results: The experimental group demonstrated greater growth in self-efficacy and satisfaction with practice than the control group. However, no significant difference was observed between the experimental and control groups in terms of changes in disposition towards critical thinking and problem-solving ability. From the nursing students who participated in the implementation, three categories were identified: "enhancement of learning," "psychologically secure environment," and "novel experience." Conclusions: The peer tutoring-based simulation education focused on caring for children with respiratory infections effectively improved the self-efficacy and satisfaction of nursing students. This method will be utilized to enhance the learning experience of nursing students in the field of pediatric respiratory care.

Development and psychometric testing of the Pediatric Atraumatic Care Attitude Scale (PACAS) in pediatric nurses.

OBJECTIVE: The study aimed to develop and validate the Pediatric Atraumatic Care Attitude Scale (PACAS) for pediatric nurses, measuring attitudes toward atraumatic care practices. METHODS: This methodological and correlational study included 336 pediatric nurses from various clinics in Turkey, between January and August 2024. Construct validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through item-total score correlation, test-retest reliability, and Cronbach's α coefficients. RESULTS: The content validity index (CVI) for PACAS items ranged from 0.84 to 1.00. The Kaiser-Meyer-Olkin (KMO) coefficient was 0.978, and Bartlett's test of sphericity was significant (χ2 = 14,110.425, P < .001), supporting factor analysis. EFA revealed a two-factor structure with 31 items, explaining 76.7 % of the variance. The factors, "Knowledge and Awareness" and "Practice and Family Involvement," had loadings between 0.716 and 0.901 and 0.751-0.962, respectively. CFA confirmed the model fit (χ2/df = 2.77, RMSEA = 0.073, NFI = 0.92, NNFI = 0.97, CFI = 0.94, GFI = 0.91). Cronbach's α was 0.985, with subscale coefficients of 0.978 and 0.983. Test-retest reliability showed strong correlations (r = 0.980, r = 0.985, r = 0.957), with no significant differences between test and retest scores (P > .05). CONCLUSIONS: PACAS is a reliable and valid tool for assessing pediatric nurses' attitudes toward atraumatic care, with the potential to enhance pediatric nursing practices by improving adherence to atraumatic care principles. IMPLICATIONS TO PRACTICE: PACAS helps integrate atraumatic care into nursing, enhancing pediatric care quality and outcomes.

Epilepsy knowledge scale for parents (EKS-P): Development and psychometric evaluation in Turkish sample.

BACKGROUND: Epilepsy is the most prevalent chronic neurological condition in childhood, affecting approximately 0.5%-1% of children worldwide. OBJECTIVE: This study aimed to (1) develop an "Epilepsy Knowledge Scale for Parents", (2) evaluate the content validity of the scale, and (3) assess its psychometric properties. METHODS: This methodological study was conducted in a tertiary hospital's pediatric neurology outpatient clinic in Turkey. The study comprised two stages involving 500 parents of children with epilepsy. The first stage included validity and reliability analyses, while the second stage involved the calculation of the scale scoring. RESULTS: Exploratory Factor Analysis for the preliminary scale development with 36 items based on expert opinions yielded 29 items and three dimensions. The factors explained 62.83% of the total variance, and the scale exhibited high reliability (Cronbach's alpha = 0.885). Confirmatory Factor Analysis, it was determined that the fit indices were at acceptable (CFI = 0.957, NFI = 0.932) or good level (χ2/df = 2.32, RMSEA = 0.048, GFI = 0.951). Consequently, a final structure comprising 29 items and three dimensions was obtained. The scale score's cutoff value was set at 15.50 points, with scores above this value indicating diagnostic value with 55.6% sensitivity and 80.2% specificity. CONCLUSIONS: The study demonstrated that the "Epilepsy Knowledge Scale for Parents (EKS-P)", designed to assess parents' knowledge of epilepsy, is a reliable and valid measurement tool for the Turkish population. IMPLICATIONS FOR PRACTICE: This scale (EKS-P) developed for parents is recommended to be used in clinical settings and both experimental and non-experimental research.

Burnout inpediatric nurses: Examining the relationship between moral distress and missed nursing care.

PURPOSE: This study investigates the relationship between burnout levels of moral distress and missed nursing care in pediatric nurses. DESIGN AND METHOD: A cross-sectional study was conducted between November and December 2023. Pediatric nurses working in two hospitals and providing direct care to children (n = 140) completed the Moral Distress Scale-Revised Pediatric Nurses, MISSCARE Survey - Pediatric Version and Burnout Measure-Short Version questionnaire. Multivariate regression analysis modeling was applied to test the mediating effect on the relationship between burnout, moral distress, and missed nursing care. RESULTS: There was a significant positive correlation between the Moral Distress Scale-Revised Pediatric Nurses and its sub-dimensions and the Burnout Measure-Short Version (p < 0.05). There was a significant positive correlation between the mean MISSCARE- Survey-Ped score of the nurses participating in the study and its sub-dimensions and Burnout Measure-Short Version (p < 0.05). Providing Benefit-Do No Harm, one of the Moral Distress Scale-Revised Pediatric Nurses sub-dimensions, and Labour Resources, one of the MISSCARE sub-dimensions, were found to be predictors of burnout. The ethical principle of Providing Benefit-Do No Harm was found to mediate between moral distress and burnout and reduce burnout associated with missed care. CONCLUSIONS: Accordingly, as the nurses' moral distress and inability to meet the necessary patient care increase, their burnout levels also increase. Providing Benefit-Do No Harm is an basic ethical principle that will positively affect the burnout level of pediatric nurses. PRACTICE IMPLICATIONS: This study may provide insights into ethics training, communication improvement strategies, and individual support intervention programs aimed at reducing moral distress, and burnout and improving the coping mechanisms of nurses working in pediatric wards.

Enhancing clinical reasoning and student confidence through pediatric simulation.

BACKGROUND: The education-to-practice gap is magnified in pediatric nursing due to decreasing pediatric content offered in undergraduate programs, including less pediatric clinical time and inconsistent and inadequate clinical experiences. PURPOSE: Examine student perceptions of learning and confidence by comparing a high-fidelity pediatric simulation series and acute care pediatric clinical. METHODS: The SET-M tool compared settings and included open-ended questions to add insight. SAMPLE: In an undergraduate nursing program in a university in the Midwest United States, 124 students completed the anonymous survey rating each experience for learning and confidence in assessment, clinical decision-making, communication, and safety. RESULTS: Students rated the simulation series higher than clinical for all categories except patient communication. CONCLUSION: Student perceptions of learning in high-fidelity simulation revealed increased confidence and competence and the belief that simulation complements the clinical experience and bridges the theory and clinical courses.

Effectiveness of a pediatric critical care pilot preceptor program: Improved confidence and competency outcomes among a cohort of professional nurses in Blantyre, Malawi.

BACKGROUND: Availability of high-level pediatric training for nurses in Malawi is limited. To address this gap, a novel pediatric critical care nurse preceptor program was developed and implemented by pediatric nurse specialists. AIM: Evaluate the effectiveness of a pediatric critical care nurse preceptor program, via change in nurses' knowledge, skills, confidence, and precepting competence. DESIGN: A 12-month pediatric critical care nurse preceptor program with assessments at baseline, end of intensive (3 months), and end of program (6 months). SETTING: Blantyre, Malawi. PARTICIPANTS: Nurses with two or more years of pediatric nursing experience (N = 20) nominated by unit managers. METHODS: Quantitative data were collected throughout program implementation. Assessments included: (1) multiple choice knowledge test, (2) Objective Structured Clinical Examinations in two areas (vital signs and airway, breathing, circulation, disability, exposure assessments; and blood gas and electrolyte analysis), (3) group simulations (cardiopulmonary resuscitation or respiratory distress), (4) Likert-scale clinical confidence survey, and (5) Likert-scale precepting competence survey. Data were analyzed using repeated measures ANOVA with pairwise comparisons. For Likert-scale surveys, median confidence scores were compared using a Friedman test with post hoc pairwise comparisons using Wilcoxon signed-rank tests. RESULTS: Participants demonstrated significant improvement in clinical knowledge (p < .001), vital signs and airway, breathing, circulation, disability, exposure assessment (p = .001), blood gas and electrolyte analysis (p = .001), CPR (p < .001) and respiratory distress (p < .001) simulations, clinical confidence (p = .002), and precepting competence (p = .041). CONCLUSION: This pediatric critical care nurse preceptor program was effective in improving participants' confidence and competence (knowledge and skills) in pediatric critical care nursing and precepting. Results suggest the program's potential to address the shortage of highly trained pediatric critical care nurses in Malawi. This lays groundwork for refining and expanding preceptorship, ultimately improving pediatric critical care nursing education in resource-limited settings.

A critical perspective on institutional violence against hospitalized children: Testimonies by health professionals and family members.

The purpose of this study is to understand institutional violence (IV) in the relationships between health professionals, hospitalized children, and family members. This is a qualitative study developed at the pediatric inpatient unit of a university hospital in the city of Salvador, Bahia, Brazil. The research participants consisted of 39 health professionals who specialized in pediatrics and 10 family members of hospitalized children. Semi-structured interviews were the method used for data collection. Using discourse analysis as a basis and taking a Foucauldian perspective, the researchers observed that the expressions of IV could be traced to abusive power relations within the system. We found four discursive forms within the data set: communication problems as IV, violence through inattention and neglect, violence as an action and consequent materialization on the body, and psychological violence as a submission mechanism. Based on these findings, we argue that professionals, managers, the scientific community, and users might be able to better guarantee the safety of children by recognizing IV and effectively intervening in it.

Factors influencing job stress in pediatric nurses during the pandemic period: Focusing on fatigue, pediatric nurse-parent partnership.

PURPOSE: The purpose of this study was to identify the factors influencing pediatric nurses' job stress, including their level of fatigue and partnerships with the parents of patients. This investigation aimed to findings of this study may lead to the development of strategies to reduce pediatric nurse's job stress. DESIGN AND METHODS: Participants were recruited from pediatric, pediatric intensive care, and neonatal intensive care units across seven general hospitals. Eligibility requires a minimum of 6 months of experience in pediatric nursing. The sample size was determined using the G*power program, considering various variables, including age, marital status, presence of children, and work-related characteristics, leading to a final sample size of 135, adjusted for a 10% dropout rate. Data collection was conducted through self-report questionnaires, and analysis involved frequency, percentage, mean, standard deviation, t-tests, ANOVA, and stepwise multiple regression, using SPSS Statistics 27.0. RESULTS: This study confirmed a significant correlation between pediatric nurses' fatigue and job stress, with higher levels of fatigue associated with increased job stress. Stepwise regression analysis showed that fatigue and age were significant predictors of job stress among pediatric nurses, explaining 23% of the variance. However, detailed analysis showed that younger nurses had lower job stress scores compared to older nurses. This result suggests that more experienced nurses may experience higher job stress due to increased responsibilities and emotional burdens. PRACTICE IMPLICATIONS: This study identified the need for effective strategies to manage fatigue and reduce job stress among pediatric nurses during the COVID-19 pandemic. Younger nurses, particularly those under 25 and between 26 and 30 years old, experience lower job stress compared to older nurses. Comprehensive support systems should be developed, including workload management, emotional support, and programs to enhance partnerships between nurses and parents. These strategies can improve job satisfaction and the quality of care provided to young patients. Additionally, they ensure a more resilient and effective healthcare workforce during pandemics and similar crises.

Comparing the effects of problem- and task-based learning on knowledge and clinical decision-making of nursing students concerning the use of transfusion medicine in pediatric nursing: An educational quasi-experimental study in Iran.

Background: In the pediatric care field, ensuring safe and effective blood transfusions, promptly identifying adverse reactions, and implementing appropriate interventions are crucial. Therefore, undergraduate nursing curricula need to be structured to meet these professional standards and prepare nursing students, as future team members, to respond to relevant clinical situations. The objective of this study was to investigate how problem- and task-based learning affects knowledge and clinical decision-making of undergraduate nursing students concerning the use of transfusion medicine in pediatric nursing. Material and methods: This quasi-experimental study involved 82 nursing students recruited from two nursing schools in Iran using convenience sampling. Participants received educational content through either problem- (n = 40) or task-based learning (n = 42) methods. A researcher-made tool, comprising three parts and proven to be valid and reliable, was utilized for data collection. The tool was administered both before and immediately after the intervention. Data were analyzed using Wilcoxon rank-sum, Mann-Whitney U, Spearman's correlation and multivariate analysis of covariance tests via SPSS v16.0. A p-value of <0.05 was considered significant for all tests. Results: The median post-test knowledge and clinical decision-making scores within problem- and task-based learning groups were 62.68 vs. 74.65 and 53.33 vs. 76.67, respectively. Significant differences were observed between the mean pre- and post-test scores of both variables within both intervention groups (p < 0.05). Multivariate analysis of covariance revealed that task-based learning resulted in significant differences between the two groups in terms of knowledge (F = 87.9 %, p = 0.002, Eta2 = 0.114) and clinical decision-making (F = 99.9 %, p < 0.001, Eta2 = 0.271). Conclusions: Given the greater effectiveness of task-based learning, nursing schools are advised to utilize this method in undergraduate nursing curricula to ensure the adequacy of the clinical skills acquired by nursing students prior to graduation.

Exploration of trust between pediatric nurses and children with a medical diagnosis and their caregivers on inpatient care units: A scoping review.

PROBLEM: Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units. ELIGIBILITY CRITERIA: Using the Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews, CINAHL, MEDLINE, PsycINFO, Cochrane DSR, Cochrane Central, and JBI EBP were searched for qualitative, quantitative, mixed methods, and review studies with no time limits published in English. Included studies presented findings on the experiences of developing trust between pediatric nurses and children under 18 years of age and their caregivers within inpatient care units. RESULTS: A total of 12,269 titles and abstracts were reviewed independently by two reviewers. 366 full-text articles were retrieved, a final of 81 studies were included in the review. CONCLUSIONS: Trust was bi-directional between nurses and children/caregivers, developed over time during multiple interactions, and foundational to the development of relationships. Distinct facilitators and barriers to the development of trust between nurses and children/caregivers were identified. The development of trust was rewarding and enriching for both nurses and children/caregivers and was the fundamental to the provision of safe and high-quality nursing care. IMPLICATIONS: Findings provide nurses with direction and strategies on how to develop and maintain trust with children/caregivers on inpatient care units. The development of training programs and interventions geared at equipping nurses with the skills to develop trust with children/caregivers is needed.

The psychometric properties of the Turkish version of the parents' perception of satisfaction with care from pediatric nurse practitioners instrument.

AIM: This study was carried out to adapt a measurement tool that can be used to measure the perceived satisfaction level of parents of pediatric patients hospitalized in a pediatric clinic with care from pediatric nurses and to examine its psychometric properties. DESIGN AND METHOD: The study was conducted methodologically with 301 parents of children who were hospitalized in the pediatric clinic of a university hospital between September and December 2023. Explanatory and confirmatory factor analyses were performed on the data to establish the validity of the scale, Cronbach's alpha reliability coefficient, split-half, item-total score methods were utilized to test its reliability. RESULTS: The scale consisted of 26 items and a single dimension. It was determined that the total explained variance ratio was 79.246%. According to the confirmatory factor analysis results, goodness of fit values were determined as RMSEA = 0.077, CFI = 0.96, IFI = 0.97, RFI = 0.92, NFI = 0.93, and TLI = 0.96. Cronbach's alpha coefficient was calculated as α = 0.989 for the total scale. CONCLUSION: The Parents' Perception of Satisfaction with Care from Pediatric Nurse Practitioners Instrument is a valid and reliable measurement tool that can be used to measure the perceived satisfaction level of parents of pediatric patients hospitalized in a pediatric clinic with nursing care. IMPLICATIONS FOR PRACTICE: The scale can contribute to determining the perceived satisfaction levels of parents of pediatric patients hospitalized in the pediatric clinic with nursing care and, if there is a problem, to providing regular in-service training for pediatric nurses who are responsible for pediatric patient safety and quality of care.

The mediating role of pediatric nursing competence in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students.

AIM: This study was conducted to determine the mediating role of pediatric nursing competence in the relationship between self-efficacy in pediatric drug administration and medical error tendency in nursing students. BACKGROUND: The self-efficacy of nursing students towards drug administration knowledge and practices is one of the determinants of achieving the goals of nursing education programs related to drug administration. DESIGN: The sample of the descriptive and correlational study consisted of a total of 303 3rd and 4th-year students taking the Pediatric Health and Diseases Nursing course at the Department of Nursing. Data were collected using the Pediatric Nursing Competency Scale (PNCS), the Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSC) and the Medical Errors Tendency Scale (METS). Pearson correlation analysis, linear regression analysis, independent groups t-test, one-way analysis of variance (ANOVA) and post hoc (Tukey, LSD) test were used to analyze the data. In addition, hierarchical regression analyses regarding the mediation effect were performed using PROCESS Model 4 developed by Hayes (2013) for SPSS. RESULTS: When the correlation levels between the total scores of MASSC, PNSC and METS were analyzed, a positive moderate correlation was found between PNSC and MASSC total scores, a positive weak correlation was found between METS and MASSC total scores and a positive weak correlation was found between METS and PNSC total scores (p<0.05). As a result of the analysis, the model was found to be significant and the total change in METS was explained by 17.3 % of the total change in METS (F=63.289;p=0.000). It was found that PNSC was a partial mediator variable between MASSC and METS. CONCLUSION: As a result of the study, it was determined that pediatric nursing competence had a partial mediating role in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students.

Investigating the Efficacy of a Handheld Fan Intervention in Children With Dyspnea: A Randomized Controlled Study.

INTRODUCTION: Dyspnea associated with acute respiratory tract infections is a common cause of emergency admissions and can be distressing for children. This study aimed to evaluate the impact of a handheld fan intervention on physiological parameters in pediatric patients with dyspnea. METHODS: A total of 59 children aged 2 to 12 years presenting to an emergency department for upper respiratory tract infection between March 2022 and March 2023 were assigned to the experimental group (n = 32) or control group (n = 27) by urn randomization. Both groups received the hospital's standard care, including 3 doses of inhaled bronchodilator at 20-minute intervals. The fan intervention consisted of parents applying a handheld electric fan to the child's face at a distance of 15 cm for 5 minutes after each inhaler treatment. Oxygen saturation, heart rate, and respiratory rate were recorded before treatment and after the 3 inhaler treatments. RESULTS: There were no statistical differences in descriptive characteristics between the experimental and control groups (P > .05). Oxygen saturation values were significantly higher in the control group before treatment but showed greater increases in the intervention group after treatment (P < .001). The intervention group also exhibited greater reductions than the control group in both heart rate and respiratory rate after the third treatment than pretreatment values (P < .05). DISCUSSION: The handheld fan intervention effectively supports inhaler treatment for children with dyspnea. Further studies are recommended to assess its impact across different age groups and clinical conditions.