Atraumatic care practice from the child and parent perspective: The case of a pediatric phlebotomy unit.

PURPOSE: This study aimed to determine the effect of the child's self-selected distraction methods used during the phlebotomy procedure on the feeling of fear and pain in children and parental satisfaction. METHODS: The study, planned as a randomized controlled trial, was conducted with 219 children aged 5-10 years and their parents in the pediatric phlebotomy unit between March and June 2023. Different distraction methods (foam balloon, stress ball, musical book) were applied to the children in the intervention group during the phlebotomy procedure. The data were analyzed with the SPSS 22.0 package program. RESULTS: There was a statistically significant difference between the scores of the children in the intervention and control groups on the Children's Fear Scale before the phlebotomy, and on the Wong-Baker Faces Pain Rating Scale after phlebotomy according to self- and parental assessment (p < 0.05). A statistically significant difference was found between the satisfaction levels of the parents after the procedure in the intervention and control groups with the health care service provided during the phlebotomy process (p < 0.05). CONCLUSION: Distraction methods, one of the atraumatic nursing interventions used before the phlebotomy procedure, were determined to be effective in reducing the child's fear and the pain experienced due to the procedure. The study also showed that the satisfaction of parents was positively affected by the atraumatic care provided to their children. PRACTICE IMPLICATIONS: The atraumatic care approach should be used to prevent anxiety and fear experienced by parents and children and to reduce the child's pain.

Effect of different materials used in the removal of orogastric catheter adhesive on the skin in premature babies in Turkey.

Purpose To compare the effectiveness of sunflower oil and silicone-based spray used to remove medical adhesives from the orogastric catheter in preventing the skin injury of premature infants in the neonatal intensive care unit. METHODS: This randomized controlled experimental study was conducted on premature infants, born between 32 and 36 weeks, hospitalized in the Neonatal Intensive Care Unit located in the city center of the Black Sea region. There were 86 participants in the study; 43 were in the control group (silicone-based spray), and 43 were in the intervention group (sunflower oil). The "Neonatal Skin Condition Score Scale" evaluated premature infants' skin. RESULTS: Mean skin condition score of premature infants for whom silicone-based adhesive remover spray was applied was 3.63 ± 0.78, whereas the mean skin condition score measured three hours later was 3.17 ± 0.37. Mean skin condition score of premature infants for whom sunflower oil was applied as a medical adhesive remover was 3.40 ± 0.62, whereas the mean skin condition score measured three hours later was 3.07 ± 0.25. No statistically significant difference was determined between the mean skin condition scores of premature infants in both groups evaluated immediately after removing the medical adhesive and 3 h there after (p>0.05). CONCLUSIONS: There is no difference between the skin condition of premature infants for whom silicone-based medical adhesive remover spray is used and the skin condition of premature infants for whom sunflower oil is used to remove the orogastric tube adhesive. PRACTICE IMPLICATIONS: Pediatric nurses should use medical supplies suitable for the skin condition of premature infants and should frequently evaluate the baby's skin condition. Since silicone-based adhesive remover sprays have a risk of toxicity by being absorbed by the skin, it is recommended to use herbal, cost-effective, non-toxic products. CLINICAL TRIAL NUMBER: NCT06280326.

Effect of environmental education program implemented with university student participation on secondary school students' environmental attitude.

Study aimed to increase university students' sensitivity and the environmental attitudes of secondary school students through environmental education program. It was planned as quasi-experimental research. The first phase was completed with five fourth-year students who took Social Awareness Course at a university's nursing department in Turkey. In second phase, sample consisted of 264 5th-grade students studying at Secondary School in Black Sea Region. University students implemented Environmental Education Program for secondary school students for four weeks. Mean environmental attitude scale score of 5th-grade students before education was 2.79 ± 0.32, and after education was 3.51 ± 0.41. A statistically significant difference was determined between mean total scale scores of university and 5th-grade students before and after education (p ˂ 0.05). It was determined that environmental sensitivity of university students and environmental attitudes of secondary school students were at medium level before Environmental Education Program and high level after education.

The effects of vibration and pressure interventions on children's pain, fear and anxiety: A randomized controlled trial.

AIM: The effects of vibration and pressure methods on the level of fear, anxiety, and pain of pediatric patients who were admitted to the emergency department for intramuscular injection were evaluated. METHODS: This was a parallel group and a randomized controlled study conducted in Turkey. The study sample consisted of 114 children aged between 5 and 10 years who presented to the emergency department to receive intramuscular ceftriaxone injection as part of their treatment. The children were randomized into three groups: Vibration Intervention Group (n = 38), Pressure Intervention Group (n = 38) and Control Group (n = 38). Before the procedure, the level of anxiety and fear of the children were evaluated, and the level of perceived pain during the procedure was immediately evaluated after the intervention. Parents and nurses also rated the level of pain. Data were analyzed with non-parametric tests using SPSS version 26.0. RESULTS: According to the evaluations made by children, mothers, and nurses, there was a significant difference between pain scores of children in the vibration and pressure intervention groups during the procedure and children in the control group (p < 0.000). There was a significant difference between anxiety and fear scores of children in the vibration and pressure groups and children in the control group before and after the intervention according to the evaluations of the children, mothers, and nurses (p < 0.000). CONCLUSION: Vibration and pressure interventions used during intramuscular injections administered to children in the emergency department were found to reduce pain, anxiety, and fear based on the evaluations of children, mothers, and nurses. PRACTICE IMPLICATIONS: Vibration and pressure are effective and useful in relieving pain associated with intramuscular injections in children aged between 5 and 10 years.

The effect of the distraction methods used before the COVID-19 test on the fear and anxiety levels of children: a RCT study.

The current study aimed to investigate the effect of the distraction methods employed before nasopharyngeal swab sampling from children within the scope of the COVID test on their anxiety and fear levels. The study was an RCT with parallel groups conducted according to the CONSORT statement at the pediatric emergency unit of a hospital in Turkey. Children aged 5-10 years were randomized into three groups: Kaleidoscope, Visual Illusion Cards, and control. Data were collected by the researchers using the Descriptive Characteristics Form, the Children's Anxiety Meter-State, and the Children's Fear Scale. According to the reports of the children, the parents, and the nurse, the mean anxiety score and the mean fear score in the experimental groups were significantly lower after the nasopharyngeal swab procedure compared to the control group (p < .05). Fear and anxiety were observed less in the visual illusion cards group and the kaleidoscope group.

Characterization of prodigiosin pigment by Serratia marcescens and the evaluation of its bioactivities.

The aim of the present study is to discover a bacterial pigment providing protection and prevention of neurological damage and cancer development, which can have a role as a non-synthetic food additive in the food industry as well as an active drug ingredient of anticancer drugs and pharmaceuticals for neural injury. Within this scope, Serratia marcescens MB703 strain was used to produce prodigiosin. Characterization of the prodigiosin was carried out using UV-VIS, and FT-IR. In addition, its inhibitory action on AChE and antioxidant activities were determined. The cytotoxic, genotoxic and antigenotoxic activities of the prodigiosin as well as its antiproliferative activities were detected. It was determined that the maximum production of the prodigiosin (72 mg/L). The prodigiosin was found to cause no significant difference in its inhibitory effect on AChE. The prodigiosin was found effective on all antioxidant parameters tested. The IC50 values of the prodigiosin on SK-MEL-30 and HT-29 cells were calculated as 70 and 47 µM, respectively. This IC50 values of the prodigiosin showed no cytotoxic effect on L929 cells. Prodigiosin did not have genotoxic effect alone and also seem to decrease DNA damage induced by H2O2 in L929 cells. The findings of in vitro experimental studies suggest that using the prodigiosin pigment as a drug candidate for cancer and neurodegenerative disease therapy is both effective and safe.

The effect of virtual reality on Children's anxiety, fear, and pain levels before circumcision.

BACKGROUND: Circumcision is one of the oldest and most frequently performed surgical interventions in many societies across the world. Boys undergoing this procedure experience anxiety and fear during the preoperative period. In addition, postoperative pain in children is reported to be associated with anxiety and fear. AIM: This study aimed to examine the effects of using virtual reality (VR) intervention before circumcision on the pre-and postoperative anxiety and fear levels and postoperative pain symptoms in children. MATERIAL AND METHODS: This randomized controlled experimental study included 5-10-year-old boys referred to a pediatric hospital for circumcision between June and September 2019. Randomization was performed using the randomized block design, and the subjects were divided into control (n = 38) and experimental (n = 40) groups. The data were collected using a participant information form, the children's fear scale (CFS), the children's anxiety meter scale (CAM-S), and the Wong-Baker Faces Pain Rating Scale (WBS); data were analyzed using SPSS 22.0 package program. RESULTS: Of the children included in the study, 59% were between the ages of five and six years and 78.2% had no previous hospital experience. Children in the experimental group had significantly lower mean scores of CAM-S and CFS in the pre-and postoperative periods than those in the control group. Also, the mean postoperative WBS score was significantly lower in the experimental group than in the control group. DISCUSSION: Results of this study were similar to those reported previously that VR interventions were effective in reducing fear and anxiety in the preoperative period (Dehghan et al., 2019, Ryu et al., 2018; Olbrechta et al., 2020). Previous studies have shown that patient immersion in interactive VR provides a distraction from painful stimuli and can decrease an individual's perception of the pain (Pouarmand et al., 2018; Chad et al., 2018). CONCLUSION: Distracting children using a VR intervention before circumcision decreased their anxiety and fear both before and after the surgery, and it was found that the pain symptoms were lower in the postoperative period.