A qualitative exploration of nurses' views on technology-based interventions in pediatric oncology care.

OBJECTIVES: Recent technological advancements offer tools for pediatric oncology care, but their integration into clnical practice is still under research. This study aimed to explore pediatric oncology nurses' perspectives on integrating technology-based interventions into care. METHODS: A descriptive phenomenological qualitative study was conducted with 13 pediatric oncology nurses. The focus groups were led by the research members, and each group included four to five participants. Nurses were asked to discuss their perceptions of the technology-based intervention, the type of technology used in the clinic, and the advantages and disadvantages of the technology. The focus groups were audio-recorded and professionally transcribed. The transcripts were analyzed thematically by two study team members using MAXQDA. The Consolidated Criteria for Reporting Qualitative Research were followed. RESULTS: The mean age of nurses was 38.46 ± 5.23 years and 92.3 % had more than 10 years of professional experience. As a result of the focus group interviews, three main themes and seven sub-themes were identified. These main themes included: (i) Need for competence and training for technology-based interventions, (ii) Effectiveness of technology-based interventions in pediatric patient care, and (iii) Challenges in integrating technology-based interventions into care. CONCLUSION: The study found that from the perspective of pediatric oncology nurses, technology-based interventions have multifaceted benefits and are effective in improving patient outcomes and care; however, nurses' limited ability to use technology-based interventions restricts them from integrating their care. IMPLICATIONS TO PRACTICE: It is recommended that nurses should be trained on technology-based interventions and the safe use of these interventions.

Heart at the center of life: An in-depth examination of the experiences in the life journeys of adolescents diagnosed with congenital heart disease.

BACKGROUND: The experiences and needs of adolescents undergo significant changes due to the rapid physiological, psychological, and social transformations that occur during this period. Examining the experiences of adolescents with chronic diseases throughout their life journeys will help to identify and meet their needs. This study aims to contribute to the literature gap by focusing on the experiences of adolescents with congenital heart disease (CHD) during their life journey. METHODS: This qualitative study included 17 adolescents diagnosed with CHD and was conducted in two hospitals between January and November 2023. Data collection included face-to-face semi-structured interviews with participants, while analysis was conducted using MAXQDA software. RESULTS: The findings revealed three main themes describing the experiences in the life journeys of adolescents with CHD. These are the Emotional Journey: Remembering the Past and Persoal Challenges; the Health Journey: Attitudes of Health Professionals and Information Sharing; and the Social Journey: Relationships with peers, teachers, and family members. CONCLUSION: This study provides valuable insights into the experiences of adolescents living with CHD and highlights the emotional, health, and social challenges they face. APPLICATION TO PRACTICE: The study suggests that healthcare providers should prioritize building solid relationships with adolescents with CHD, involving them in decision-making and meeting their emotional needs. Public awareness about CHD should also be increased to reduce stigma. A multidisciplinary approach is crucial to optimize health outcomes and quality of life for adolescents with CHD.

Golden Breath: Feasibility and acceptability of a biofeedback-based virtual reality game on reducing children's needle-related pain and fear.

BACKGROUND: Needle procedures can cause pain and fear in children. Current literature reports that biofeedback-based virtual reality applications may help alleviate children's pain and fear. This study aims to evaluate the feasibility, acceptability, and safety of the newly developed game Golden Breath, which uses biofeedback-based virtual reality to reduce children's needle-related pain and fear. METHODS: The development of Golden Breath includes; (1) development of the application's features based on needs assessment, (2) gamification of the application content based on literature, (3) development of the prototype, (4) expert evaluation and feedback on the application content, (5) usability testing by 11 children (4-12 years). RESULTS: Regarding acceptability, the expert evaluation showed a high usability of the system. All children provided positive feedback and reported high satisfaction with Golden Breath. The game was feasible and effective for reducing children's pain and fear levels during needle procedures. Golden Breath was deemed safe for children because it did not cause symptoms such as dizziness, vomiting, or nausea. CONCLUSION: The expert evaluation, children's feedback, and pilot study results showed that the Golden Breath game is feasible, acceptable, and safe for children during the needle-related procedure. The pilot study revealed that the Golden Breath game effectively reduced pain and fear during blood sampling in children. PRACTICE TO IMPLICATIONS: It is recommended that healthcare professionals use Golden Breath to optimize the well-being of children receiving treatment for chronic and acute diseases.

Utilizing Digital Tools for Self-Report Symptom Assessment and Management in Pediatric Oncology: A Systematic Review.

CONTEXT: The evaluation of digital tools for measuring self-reported symptoms in children and adolescents undergoing cancer treatment is a critical area of research with significant implications for clinical practice and patient outcomes. OBJECTIVE: This study aims to identify, evaluate, and summarize evidence on digital tools that enable self-reported symptom assessment and management for pediatric oncology patients. METHODS: Seven academic databases, including PubMed, Cochrane Library, Scopus, Web of Science, CINAHL, and Medline (OVID), were searched systematically from inception until February 28, 2024. Inclusion criteria were the following: (a) study subjects were pediatric oncology patients and young adults, (b) using digital tools, (c) self-report symptom assessment and management, (d) employed either qualitative or quantitative study design, (e) written in English (f) published in peer-reviewed journals. This is a systematic review, and its protocol was registered in PROSPERO (ID: CRD42024528285). The study was conducted following the PRISMA statement. RESULTS: Twenty-seven studies were included in this systematic review. All included studies were conducted to develop digital tools for assessing and managing the symptoms. Eight of these studies focused only on the pain; three were only for nausea and vomiting, one for nausea, and the other 15 for all symptoms. The studies' quality ranged from low to high, with overall scores ranging between 4 and 24 out of 28. CONCLUSION: It shows that studies have generally focused on developing digital tools to address pain, nausea, vomiting, and other symptoms commonly experienced by pediatric oncology patients. While the quality of the included studies ranged from low to high, the overall findings show promise for the effectiveness and usability of these digital tools for symptom assessment and management in pediatric oncology care.

The predictive power of coping strategies of pediatric oncology patients on their quality of life and their attitudes toward diseases.

BACKGROUND/OBJECTIVES: Pediatric oncology patients face several physical and psychological challenges that can significantly impact their quality of life (QoL) and attitudes toward their illness. Coping strategies are pivotal in managing the emotional and physical burdens of disease. This study aimed to examine the impact of coping strategies of pediatric oncology patients on their QoL and attitudes towards their illness. DESIGN/METHODS: The descriptive, correlational, and cross-sectional study was conducted with 112 pediatric oncology patients aged 10-18 years. The Sociodemographic Form, Pediatric Cancer Coping Scale (PCCS), Pediatric Quality of Life Inventory (PedsQL), and Child Attitude Towards Illness Scale (CATIS) were used for data collection. RESULTS: Significant correlations were identified between cognitive coping, defensive coping, and CATIS (p < .001). The PCCS and subdimensions significantly predicted CATIS (p < .001), accounting for 15.3% of the cognitive and defensive coping variation. However, there was no relationship between PCCS total and subdimension scores on PedsQL (p = .534). The PedsQL and subdimensions significantly predicted CATIS (p < .001) and accounted for 27.2% of the variation in physical health summary score, emotional functioning, psychosocial health summary score, and total PedsQL score. CONCLUSION: The study reveals that cognitive coping strategies positively predict attitudes toward illness, whereas defensive coping strategies have an inverse effect. The study proposes that comprehensive care models in pediatric oncology support effective coping mechanisms and enhance the QoL of those who receive them.

Effects of technology-based interventions on chemotherapy-induced nausea, vomiting, and quality of life in pediatric patients: A systematic review and meta-analysis.

PURPOSE: This study aims to synthesize and analyze the impact of technology-based interventions on chemotherapy-induced nausea, vomiting, and quality of life in pediatric patients. DESIGN AND METHODS: Seven electronic databases were searched: PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Scopus, and Google Scholar. The JBI checklist assessed the studies' methodological quality. This study was performed based on the PRISMA checklist. RESULTS: This review incorporated five published studies, exploratory randomized controlled trials, and non-randomized pre and post-test control group studies involving 232 pediatric oncology patients receiving chemotherapy. The meta-analysis revealed a significant impact of technology-based interventions on alleviating chemotherapy-induced nausea and vomiting (Hedge's g = -0.707, Q = 9.61, I2 = 47.97%, p < 0.001). It was found that a significant effect of technology-based interventions on the patient's quality of life was observed (Hedge's g = -0.745, Q = 5.431, I2 = 63.74%, p < 0.001). CONCLUSIONS: These findings indicated that technology-based interventions have significant potential in managing chemotherapy-induced nausea and vomiting and quality of life. PRACTICE IMPLICATIONS: Future research endeavors should explore this aspect further, employing a broader range of outcome measures and longer-term follow-up assessments better to understand their impact on pediatric oncology patients' well-being.

Comparison of the effect of natural products and breast milk for preventing and treating nipple trauma and pain in lactating women: A systematic review and meta-analysis.

INTRODUCTION: Prevention and management of nipple problems are crucial during the postpartum period for effective breastfeeding. Breastmilk is the most commonly recommended method for lactating women. However, insufficient studies have proven its superiority over other methods in the current literature. This study aims to determine the effects of natural products compared to breast milk in preventing and treating nipple trauma and pain in lactating women. METHODS: In this review, we investigated studies from PubMed, Web of Science, Cochrane Library, MEDLINE, CINAHL, Scopus, and Google Scholar databases that met the inclusion criteria. We also assessed the studies' methodological quality with the Cochrane and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. RESULTS: A total of ten published studies, including 1139 lactating women, were included in this review. The meta-analysis results showed a significant effect of natural product intervention on nipple trauma (Hedge's g -0.702, Q = 81,154, I2 =91,374 %, p < 0.001), soreness (Hedge's g =-0.648, Q = 7,092, I2 =71,801 %, p < 0.001), and pain levels (Hedge's g =-0.613, Q = 25,058, I2 =76,056 %, p < 0.001) experienced by lactating women. CONCLUSION: The findings showed that natural products have greater potential than breast milk in managing nipple pain, trauma, and soreness. However, the evidence for these interventions is low or very low quality. Further research is needed to determine the most effective treatment for nipple trauma in lactating women.

Development and psychometric analysis of care needs scale for mothers of children with congenital heart disease.

PURPOSE: This cross-sectional study aimed to create and evaluate a care needs scale for mothers of children with congenital heart disease (CHD) to determine its psychometric properties. DESIGN AND METHODS: This methodological research was conducted with 155 mothers whose children were diagnosed with CHD and were treated at a university hospital. The study's methodology included scale development, specialist opinions, and a pilot test. Data analysis involved descriptive statistics, exploratory and confirmatory factor analyses, and reliability assessments. RESULTS: The 11-item scale was created using component analysis, expert comments, and pilot testing. It was divided into two categories: Information Needs Regarding Disease and Treatment and Needs Regarding Care. The Exploratory Factor Analysis revealed a 2-factor structure, explaining 41.5% of the variance. Reliability analysis showed reliable dimensions, and Tukey's scalability test indicated the scale requires separate dimension evaluation. The model fit indices were obtained as CMIN/DF (72.751/41) = 1.774, GFI = 0.925, IFI = 0.923, TLI = 0.893, CFI = 0.920, RMSEA = 0.071, SRMR = 0.063. The Cronbach's alpha coefficient for subdimension 1 was 0.758, and for subdimension 2 was 0.678, indicating reliable dimensions. CONCLUSION: The developed scale provides a valuable tool for assessing the care needs of mothers of children with CHD, contributing to enhancing maternal support programs in pediatric cardiology clinics. PRACTICE IMPLICATIONS: Assessment of the care needs of mothers who have children with CHD is promising for the development of educational programs on this subject and to ensure the competence of mothers for care.

The effect of a biofeedback-based virtual reality game on pain, fear and anxiety levels during port catheter needle insertion in pediatric oncology patients: A randomized controlled study.

PURPOSE: It is essential to control pain, fear, and anxiety related to medical procedures to improve the well-being of the child and family trying to cope with the disease process. This study investigated the impact of the biofeedback-based virtual reality game (BioVirtualPed) on pain, fear, and anxiety levels during port needle insertion in pediatric oncology patients (POPs). METHODS: This randomized controlled study was conducted at a hospital between August and December 2023 involving 62 POPs aged 6-12 and their mothers. The intervention group wore a virtual reality headset and a respiratory sensor during the procedure. Data were collected using the Descriptive Information Form, Wong-Baker Pain Assessment Scale, Child Fear Scale, Children's State Anxiety, Satisfaction Scoring-Visual Analog Scale, and ADXL354 Sensor. Statistical analysis was performed using IBM SPSS for Windows Version 24.0. RESULTS: The intervention group showed lower mean pain scores than the control group (p < 0.001). There was no difference in pre-procedure fear and anxiety scores between groups (p > 0.05 and p > 0.05, respectively). Post-procedure fear and anxiety scores were lower in the intervention group (p < 0.001 and p < 0.001, respectively). The intervention group's mean respiratory rates were lower (p < 0.001), and their satisfaction scores were higher (p < 0.001). Agreements between POPs and mothers on pain, fear, and anxiety scores were good and excellent across groups (p < 0.001). CONCLUSIONS: The BioVirtualPed reduced procedure-related pain, anxiety, and fear, increased care satisfaction, and had a positive effect on the mean respiratory rate, hence it shows promising results, but these findings need further comfirmation.

Impact of psychosexual development theory-based breastfeeding education on infant feeding attitudes and knowledge of primiparous mothers: A randomized controlled study.

PURPOSE: The first year of life is known as the "Oral Stage" in psychosexual development theory. We investigated the impact of psychosexual development theory-based breastfeeding education on primiparous mothers' feeding attitudes and behaviors. DESIGN AND METHODS: We conducted this randomized controlled study at a baby-friendly hospital between December 2022 and July 2023. Participants were randomized to intervention (n = 21) and control (n = 19) groups. All participants received the same standard discharge education in the hospital, and the intervention group received additional psychosexual development theory-based breastfeeding education. Data collection for both groups involved conducting face-to-face and telephone interviews, utilizing the Personal Information Form, IOWA Infant Feeding Attitude Scale (IIFAS), Breastfeeding Form, and Psychosexual Theory and Breastfeeding Knowledge Form. The study was recorded in the Clinicaltrials.gov PRS system (ID: NCT06009120). RESULTS: The mean IIFAS score of mothers in the intervention group was 76.23 ± 4.10, while mothers in the control group was 66.31 ± 5.72, which was statistically significant (p < .001). Additionally, mothers in the intervention group fed their babies with formula less often on days 5 to 8 after birth (p < .05) and breastfed more frequently and for longer durations on days 3 to 8 compared to the control group (p < .05). CONCLUSIONS: Psychosexual development theory-based breastfeeding education reduced the use of formula, increased mothers' attitudes towards breastfeeding, and increased the duration and frequency of breastfeeding. PRACTICE IMPLICATION: Integrating psychosexual development theory-based breastfeeding education into routine maternal and infant care may enhance breastfeeding attitudes and practices, potentially improving infant feeding outcomes.

The effect of Transition to Adulthood Training Program for mothers of young adults with intellectual disability on family quality of life and perceived stress level: A pilot randomized controlled study.

Families cannot easily identify and cope with the changing health problems and needs of children transitioning into adulthood. This pilot randomized controlled study aims to improve the family's quality of life and reduce mothers' perceived stress levels by implementing an educational program (Transition to Adulthood Training Program - TATP). A total of 33 mothers of children with intellectual disabilities were randomly assigned to the groups. Data were collected using the Personal Information Form, Beach Center Family Quality of Life (BCFQOL), and Perceived Stress Scale. The intervention group showed a significant increase in the BCFQOL mean score rather than the control group (p<.001). There was a significant decrease in the perceived stress scores of the mothers in the intervention group after the TATP training sessions (p<0.05). The TATP intervention not only increased the quality of family life for these mothers but also led to a reduction in their perceived stress levels.

A Biofeedback Based Virtual Reality Game for Pediatric Population (BioVirtualPed): A Feasibility Trial.

OBJECTIVE: This trial aims to assess the acceptability, feasibility, and safety of BioVirtualPed, a biofeedback-based virtual reality (VR) game designed to reduce pain, anxiety, and fear in children undergoing medical procedures. METHODS: An Oculus Quest 2 headset was used in the VR experience, respiratory data was captured using an ADXL354 accelerometer, and these data were integrated into the game with ArdunioUno software. The sample of this study consisted of 15 pediatric oncology patients aged 6 to 12 years between July and August 2023. BioVirtualPed's acceptability, feasibility, and safety were evaluated through child and expert feedback, alongside metrics including the System Usability Scale, Wong-Baker Pain Rating Scale, Child Fear Scale, Child Anxiety Scale-Status, Satisfaction Scoring, and various feasibility and safety parameters. RESULTS: Regarding the acceptability, the expert evaluation showed a mean score of 122.5 ± 3.53, indicating high usability for the system. All children provided positive feedback, and both children and their mothers reported high satisfaction with using BioVirtualPed. The BioVirtualPed was feasible for reducing children's pain, fear, and anxiety levels. All the children complied with the game, and no one withdrew from the trial. BioVirtualPed did not cause symptoms of dizziness, vomiting, or nausea in children and was found to be safe for children. CONCLUSION: The findings showed that BioVirtualPed meets the following criteria: feasibility, user satisfaction, acceptability, and safety. It is a valuable tool to improve children's experience undergoing port catheter needle insertion procedures. IMPLICATION FOR NURSING PRACTICE: Integration of VR interventions with BioVirtualPed into routine nursing care practices has the potential to effectively manage the pain, anxiety, and fear experienced by children undergoing medical procedures. The safety, feasibility, and acceptability results are promising for further research and integration into pediatric healthcare practice.

Taboo words in pediatric oncology: Communication experiences of nurses and physicians with dying children and their families.

PURPOSE: Despite the numerous benefits of effective communication between patients, families, and healthcare professionals, there are still substantial barriers and communication challenges. This study investigated the experiences of nurses and doctors working in different pediatric hematology-oncology units in Turkey communicating with children and their parents about end-of-life issues. METHOD: This qualitative study was conducted with twenty-four physicians and nurses. A descriptive phenomenological approach was used. Data were analyzed using Braun and Clarke's six-step reflexive thematic analysis. The MAXQDA software was used to facilitate data management. RESULTS: The findings revealed three main themes describing end-of-life communication experiences of physicians and nurses: Avoiding communication with a dying child, Everyone knows but nobody talks, and Complicating aspects of the setting. CONCLUSIONS: Communication with dying children and their families is essential. However, multiple barriers remain for healthcare providers to do so. That issue burdens the child and their family more during the end-of-life, which is already a challenging experience to handle. Healthcare professionals need urgent training in communication with the dying children and their families.

The Effect of Psychosocial Support Videos Provided by the Community on Disease Attitudes and Symptoms of Pediatric Oncology Patients: Randomized Controlled Study.

OBJECTIVE: This study aimed to evaluate the impact of psychosocial support videos provided by the community on the attitudes of pediatric oncology patients aged between 10 and 18 years toward their illness and treatment-related symptoms. DATA SOURCES: This prospective randomized controlled study was conducted with 52 pediatric oncology patients aged between 10 and 18. The data were collected using the Information Form, Child Attitude Towards Illness Scale (CATIS), and Memorial Symptom Assessment Scale (MSAS). When the control group received standard care, the intervention group received psychosocial support videos provided by the community at the beginning of the week for 1 month. CONCLUSION: This study suggests that the implemented intervention positively affected pediatric patients' symptom management, psychological well-being, and attitudes toward their illness. Considering that today's adolescents have grown up in the age of technology and show great interest in technology and media use, it is clear that psychosocial support videos may attract the attention of this age group. Producing and sharing similar content for other children with similar health problems may positively affect the psychosocial health outcomes of pediatric patients. IMPLICATIONS FOR NURSING PRACTICE: It has been found that it is beneficial to include community-supported psychosocial support in the nursing care of pediatric oncology patients. For this reason, it is recommended that nurses actively participate in developing psychosocial support strategies and take the lead in creating and making the content accessible.

The effects of child health nursing curriculum-integrated therapeutic activities on therapeutic communication skills of nursing students: Non-randomized study.

BACKGROUND: Effective therapeutic communication with hospitalized children is increasingly recognized as crucial for child-centered care in all healthcare settings. The quantity and quality of training nurses receive to promote and enhance nurse-child communication are vital. This study aims to evaluate the impact of planned therapeutic communication activities for the Child Health Nursing Course on the therapeutic communication skills of nursing students. METHOD: A non-randomized study with a pre-test and post-test design was conducted with 28 junior nursing students in Turkey. Data were collected using an 'Information Form' and the 'Therapeutic Communication Skills Scale for Nursing Students'. The Child Health Nursing Course curriculum incorporated lectures with various activity designs to enhance students' therapeutic communication skills. RESULTS: The curriculum-integrated therapeutic activities significantly decreased non-therapeutic communication skills in students, with a large effect size [d: 0.827, 95% CI: (0.393)-(1.296)]. Furthermore, the activities led to a significant increase in Therapeutic Communication Skills-1 with a large effect size [d: -0.943, 95% CI: (-1.416) - (-0.513)], and improved Therapeutic Communication Skills-2 with a large effect size [d: -1.285, 95% CI: (-1.827) - (-0.804)]. CONCLUSION: The findings indicate that therapeutic activities effectively improved the therapeutic communication skills of nursing students. PRACTICE IMPLICATIONS: Integrating therapeutic activities into the Child Health Nursing Course curriculum is recommended to enhance nursing students' therapeutic communication skills.

Effect of virtual reality on pain during burn dressing in children: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Burn dressing, a necessary and regular procedure for burn management, causes significant pain and distress for children. Recent technological advancements in VR have opened up new possibilities for pain management in children undergoing burn dressing. However, there is limited evidence regarding their efficacy in burn dressing specifically. This study aims to synthesize and analyze the effect of VR on pain during burn dressing in children. METHODS: In this review, we investigated studies from PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Scopus and Google Scholar databases that met inclusion criteria. We also assessed the studies' methodological quality with the Cochrane and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. RESULTS: A total of six published studies including 241 pediatric patients were included in this review. The meta-analysis results showed a significant effect of VR intervention on the pain levels of children (Hedge's g = -1199, Q = 31,106, I2 = 83,926%, p < 0.001). CONCLUSION: Findings from this study show that VR is a promising and effective intervention for reducing pain scores in children undergoing dressing changes for burn injuries. IMPLACATION TO PRACTICE: Our meta-analysis suggest that the significant potential of integrating VR into clinical practice, presenting a non-pharmacological intervention to reduce pain during dressing changes in pediatric burn patients. Implementing VR in healthcare settings can lead to improved pain management and better patient outcomes for pediatric population.