The Efficacy of Internet-Based Interventions in Family-Centered Empowerment Among Children with Chronic Diseases: A Mixed-Methods Systematic Review.

Background: The incidence of chronic diseases in children is increasing worldwide, which can disrupt the quality of life. Family empowerment (FE) is one approach to strengthen family care among children with chronic diseases. In addition, internet has the potential in healthcare service interventions for families. Purpose: This study aimed to determine the efficacy of internet-based family empowerment interventions among children with chronic diseases. Methods: The study used a mixed-methods systematic review. A literature review was conducted following PRISMA guidelines using the PubMed, Scopus, ScienceDirect, and CINAHL databases. We used the PCC framework: chronic diseases (Population), family empowerment (Concept), and internet-based intervention (Context). Studies were eligible if published between 2013 and 2023, full-text, original study design, and focused on family empowerment in children with chronic diseases. Studies would be excluded if they were not in English or if the population was adults. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT) version 2018. The study analysis used Sequential Explanatory Synthesis, which is a quantitative study (QUAN) synthesis followed by a qualitative study (QUAL) synthesis, then integrated using the QUAL data transformation technique. Results: We highlight the quantitative study findings that an internet-based family empowerment intervention positively impacted family members' ability to care for children with chronic diseases with a mean Family Empowerment Scale (FES) total score of 4.13. We analyzed six study and identified four themes regarding efficacy of internet-based interventions in empowering families with children with chronic diseases: knowledge; availability of resources and time-saving; connectedness and communication; and family management and self-confidence. Conclusion: Our study highlights that online-based interventions in family empowerment positively impact enhancing all domains of empowerment. This findings suggest that internet-based family interventions need to be adopted to fulfill the care needs of children with chronic diseases sustainably.

Ethonursing Study of Pain Management in Neonates in Indonesia.

PURPOSE: Even though Indonesia is comprised of at least 1,300 ethnic groups, no specific traditional method for reducing pain, especially in neonates, has been elaborated. AIM: This study aimed to investigate the traditional methods used by the Sundanese people in Indonesia to manage pain in neonates. METHODS: This ethnonursing study was conducted in the Pangandaran District, West Java Province, Indonesia. Thirty informants including health cadres, midwives, and community leaders in the health sector, such as trained traditional birth attendants and female elders, participated in this study. Data were collected through interviews and focus group discussions, as well as from field notes. Data were analyzed using the four phases of qualitative analysis based on Leininger's theory. RESULTS: Six themes were identified in this study: (1) Preference for the use of traditional methods to treat pain in neonates and infants, (2) Desire to obtain information on the safe use of traditional medicine, (3) Desire to use practical pain management methods, (4) Easy to get modern medicine, (5) Use of medicinal plants, (6) Physical methods. CONCLUSIONS: This study demonstrates the need for better harmonization between the use of traditional and modern medicines, in both research and practice, to determine the most appropriate mix that combines the strengths of each method based on accurate scientific evidence.

Communication between Parents and Preschool-Aged Children about Tuberculosis Preventive Treatment: A Qualitative Study.

Background: Communication with preschool-aged children about Tuberculosis Preventive Treatment (TPT) is a challenge for parents. Good communication can encourage children to be involved in their treatment and enhance their adherence to the treatment. This study aimed to explore the experience of parents in communicating with their preschool-aged children about TPT. Materials and Methods: This study used a qualitative approach. Participants were 10 parents who were selected using the purposive sampling technique from three community health centers in Bandung City, Indonesia. The inclusion criteria for the study were parents who have a child aged 3-5 years who received or was receiving TPT. Semi-structured interviews were conducted to obtain the data, and when saturation was reached, no further interviews were conducted. Subsequently, the interviews were transcribed and analyzed using thematic analysis. Results: The findings revealed three themes with eight categories. The themes were persuading children, lack of understanding, and supporting communication. Conclusions: The findings are relevant for nurses and other health professionals who need to provide adequate information related to TPT and to develop media for parents and children during their communication. Nurses can collaborate with other physicians and software engineers to develop interesting media such as game applications to educate children about Tuberculosis (TB) prevention.

The Impact of Online Learning among Adolescents during the COVID-19 Pandemic: A Qualitative Study of Mothers' Perspectives.

Background: The COVID-19 pandemic changed the educational system from conventional learning in schools to online learning. The use of the internet as a learning medium can have positive and negative impacts on adolescents and cause concern for mothers. In this study, mothers' perspectives were explored with the phenomenological approach to assess their experience of the effect on line learning during the COVID-19 pandemic among adolescents. Materials and Methods: The qualitative study design: phenomenology was conducted on mothers with children at senior high school education levels. The data were collected using in-depth interviews from June to November 2020 in West Java, Indonesia. A total of 13 mothers were recruited using the purposive sampling technique. Data analysis was performed using the Colaizzi method and NVIVO software for managing the coding process. Results: We obtained four themes, namely (1) formation of adolescent behavior with the internet, (2) prevention of internet addiction, (3) disturbance of cognitive development, and (4) negative effect of online learning. Conclusions: The usage of the internet cannot be avoided. By guiding adolescents, the negative effects of the internet could be prevented. Developing learning programs, media, and online learning strategies according to students' needs should be promoted.

Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey.

PURPOSE: To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey. DESIGN AND METHODS: Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed. RESULTS: A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors. CONCLUSION: The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches. PRACTICE IMPLICATION: The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.

Internet Addiction Among Male Adolescents in Indonesia: A Qualitative Study.

Internet has become an important part of the daily life of adolescents. Easy access to internet and its social appeal among adolescent males render them at an increased risk of internet addiction and the associated adverse physical and psychosocial effects. We conducted a qualitative study using a phenomenological approach. A purposive sample of nine male adolescents was recruited in West Java, Indonesia. Semistructured interviews were conducted until data saturation was achieved. Data were subjected to thematic analysis. We identified four main themes from the experiences of adolescents with internet addition: reasons for internet addiction, unmet social need without the internet, effects of internet addiction, and self-control over internet usage. Internet addiction among male adolescents is a major public health problem that should be addressed. The findings of this study may be useful for health professionals and families to help male adolescents manage their internet addiction.

Culturally Based Practice in Neonatal Procedural Pain Management: A Mini Review.

Cultural factors have gradually become important considerations in health services, including in pain management for adult and pediatric patients. However, research on culturally based pain management in neonates remains limited. This mini review aims to provide an overview of procedural pain management in neonates based on cultural approaches from various countries. The review found that there are several analyses of pain management procedures for neonates developed from cultural practices, namely, acupuncture, foot massage and reflexology, Yakson touch therapy, and aromatherapy. The acupuncture method (invasive and non-invasive) is more widely studied using randomized controlled trials (RCTs) than the other methods because the techniques applied can be standardized and measured. There are indications of the positive impact of all the methods examined in this review, but the results of studies have not been consistent because of the diversity of outcome measurement methods used and because of the difficulty of creating standardized procedures to measure pain management methods that are based on cultural practices.

Pain in Neonates: A Concept Analysis.

CONTEXT: The term pain in neonates is emerged in recent decades. However, studies on pain in neonates are still limited and have various indicators. In addition, the term pain still often overlaps with stress in various studies and clinical circumstances. The concepts of pain and stress in the neonates need to be clarified to be better understood and then applied to improve neonates' quality of life. Therefore, the current study aimed at clarifying the concept of pain in neonates. EVIDENCE ACQUISITION: The current study employed the concept analysis approach developed by Walker and Avant. The authors reviewed articles from JSTOR, ScienceDirect, Proquest, Sage, Cochrane, and Springer databases from 1980 to 2016 using keywords pain, stress, neonatal, neonates, and quality of life. RESULTS: Pain had attributes such as tissue damage, physiological changes, metabolic changes, and behavioral changes. Stress had attributes such as physiological changes, metabolic changes, and behavioral changes. CONCLUSIONS: Attributes of pain and stress have similarities and differences. The main difference is the stimulus that induces a response. Pain has an attribute of tissue damage, whereas stress is not always due to tissue damage. The attributes of physical, metabolic, and behavioral changes between pain and stress are similar.

Moving from fear to realization: Family engagement in tuberculosis prevention in children living in tuberculosis Sundanese households in Indonesia.

OBJECTIVE: Children living in tuberculosis households need protection. However, families need to be engaged to prevent tuberculosis transmission to children. This study aimed to analyze the details of "moving from fear to realization," which is one category of a substantive theory of family engagement in tuberculosis prevention in children. METHODS: Fourteen family caregivers participated as key informants after their families met the criteria. The participants were recruited at a lung clinic in West Java, Indonesia and followed up at their homes. The data were gathered using in-depth interviews and analyzed following the coding procedures of the Straussian grounded theory. FINDINGS: "Moving from fear to realization" was the main category that emerged from the experiences of the Sundanese families to begin engaging in tuberculosis prevention in children living in tuberculosis households. It was composed of four sub-categories, namely, fear of tuberculosis, seeking information, following God's will, and awareness of tuberculosis transmission risks. CONCLUSIONS: This study showed how a family moves from fear to the realization of tuberculosis transmission risks. Its findings are useful for nurses to provide optimum care in order to prevent tuberculosis transmission to children with household contact by providing both education and counseling for families.