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.

A meta-synthesis of the experience of paediatric nurses in communication with children.

AIM: This study aimed to conduct a meta-synthesis to explore the experiences of paediatric nurses in communication with children. METHOD: We conducted a meta-synthesis review, following the outline proposed by Sandelowski, Barrosso & Voils. Our search encompassed six electronic databases, namely PubMed, Scopus, EBSCO (MEDLINE), Web of Science, SAGE, and Wiley. The Primary keywords used were "nurse", "child", "communication", and "qualitative". We included qualitative articles in English within the field of paediatric nursing between 1990 and 2023. Initially, 1980 records were identified which reduced to 1339 references after removing duplicates. Subsequently, we assessed 112 full-text articles for eligibility and 14 relevant studies were ultimately included in our review. Quality appraisal was conducted using the Critical Appraisal Skill Programme checklist with no study being excluded based on quality criteria. Data were synthesized using the qualitative thematic analysis method. RESULTS: The data analysis yielded three themes and seven sub-themes. These themes include swinging between triadic and dyadic communication, applying a hybrid of communication methods, and influential factor in communication. CONCLUSIONS: This study highlighted the significance of establishing a balanced approach between dyadic communication (nurse and child) and triadic communication (nurse-parent-child) in paediatric care. Paediatric nurses emphasized the simultaneous use of verbal and non-verbal methods to enhance effective communication. Additionally, identifying the influential factors in communication can aid in developing and improving nurses' competency in communication skills within paediatric departments. IMPLICATIONS: Understanding the communication process and the factors that influence it can be instrumental in equipping paediatric nurses with enhanced communication skills in their practice. IMPACT: Establishing a balanced approach between dyadic communication (nurse and child) and triadic communication (nurse-parent-child) in paediatric care is crucial. Paediatric nurses emphasized the simultaneous use of verbal and non-verbal methods to enhance effective communication. Identifying the influential factors in communication can aid in developing and improving nurses' competency in communication skills within paediatric departments.

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.

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.

Using Electronic Software for Nursing Documentation in Nursing Students.

AIM: This study aimed to assess the effect of using electronic software for nursing documentation on students. METHOD: A quasi-experimental study was performed. The study population comprised 80 nursing students who were randomly divided into 2 groups. The software used for nursing documentation was designed according to the nursing process model. Students in the experimental group received theoretical and practical training. The control group attended a 1-day course on the nursing process model. A questionnaire was used to assess student satisfaction in nursing documentation. The data were analyzed using the Statistical Package for Social Sciences software 16 (Chicago, USA). The standard and comprehensiveness of documentation were analyzed using the summative content analysis with the MaxQDA 10 software (USA). TREND statement was followed for reporting. RESULTS: The analysis showed that the mean scores of satisfaction in both groups increased significantly (p < .05). Furthermore, the result of the summative content analysis showed that the comprehensiveness and the standard of nursing documentation increased significantly in the experimental group (p < .05). CONCLUSION: The findings confirmed the usefulness of electronic software in improving the standard and comprehensiveness of nursing documentation and the students' satisfaction.