Effect of kangaroo mother care on cerebral oxygenation, physiological parameters, and comfort levels in late-premature infants: A randomized controlled trial.

OBJECTIVE: To measure the effects kangaroo mother care (KMC) on the regional cerebral oxygen saturation (rSO2) measured with near-infrared spectroscopy (NIRS) in premature infants and to study the physiological stability and comfort of the infants during such interventions. DESIGN: This was a prospective, single-centered, single-blind, 2-arm, parallel-group randomized controlled trial conducted. SETTINGS: The study was carried out in a tertiary neonatal intensive care unit in Medical Faculty Hospital in Konya/Turkey. PARTICIPANTS: Premature infants born between 24 and 36+6 weeks. Participants were randomly assigned to one of two groups: kangaroo care (n = 20) and control groups (n = 20). The rSO2, oxygen saturation (%SpO2), heart rate (HR), respiratory rate, body temperature, and comfort levels of the infants were evaluated in three stages. FINDINGS: In the 60th min measurement of the intervention group, rSO2, body temperature, heart rate, respiratory rate, and, comfort level, the comfort level was found to be higher and significant in the 30th and 60th min measurements (p < 0.001). In the intervention group, the rSO2 (p < 0.001), body temperature (p < 0.001), HR (p < 0.001), SpO2 (p < 0.001), respiratory rate (p < 0.001), and comfort levels (p < 0.001) scores with the control group and the group × time interaction was significant. KEY CONCLUSIONS: KMC moderately increased the rSO2 levels and also created a moderate effect size on the physiological parameters and comfort levels of the newborns, which implicates its short-term benefits for premature infants. PRACTICE IMPLICATIONS: KMC may be beneficial in stabilizing rSO2 and physiological parameters and increasing comfort in premature infants. The trial was registered in ClinicalTrials.gov (identifier: NCT04725435).

Effect of Nurse Support in the Immediate Postpartum Period on Mothers' Breastfeeding Self-Efficacy Levels in Turkey: A Quasi-Experimental Study.

OBJECTIVES: This study aimed to determine the effect of nurse-based breastfeeding support during the immediate postpartum period on mothers' breastfeeding self-efficacy levels. METHODS: A quasi-experimental study was conducted with 256 mothers in the immediate postpartum period (128 in the intervention group who received nurse-based breastfeeding support and routine care and 128 in the control group who received routine care) during February-June 2018. Data were collected using the Mother-Infant Data Sheet, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Nurse-Parent Support Tool (NPST). RESULTS: BSES-SF and NPST mean scores of mothers in the intervention group were higher than those of mothers in the control group (p < 0.01). While the association between breastfeeding self-efficacy and nurse support was low in the control group (0.271), it was rather high in the intervention group (0.693) (p < 0.05). It was found that nurse support explained 48% of the variance in breastfeeding self-efficacy in the intervention group, but only 7.3% of the variance in breastfeeding self-efficacy in the control group. CONCLUSIONS FOR PRACTICE: The results of the study indicate that nurse support for mothers in the immediate postpartum period based on breastfeeding training has a positive impact on breastfeeding self-efficacy.

The effect of two different methods on reducing the pain and fear during phlebotomy to children: A randomized controlled trial.

INTRODUCTION: Reducing pain and fear during painful medical procedures in children is important since mismanagement of pain causes the child and parent to feel anxious, which can have negative long-term consequences. This study aimed to evaluate the effects of two different distraction methods in reducing pain and fear during the phlebotomy procedure in children. METHOD: The study, which has a randomized controlled experimental design was conducted between July and October 2020 with 111 children aged 6-12 years who underwent phlebotomy in the emergency department of a public hospital and their parents. The children were randomly assigned to soap bubble blowing (n:37), ball squeezing (n:37) and control (n:37) groups. During the phlebotomy, soap bubble blowing, and ball squeezing methods were used as active distraction methods. Data were collected using the Wong Baker Faces Pain Rating Scale, and the Children's Fear Scale. RESULTS: The pain scores of the soap bubble blowing group and the ball squeezing group during the phlebotomy procedure were found to be lower than the control group (p < 0.001). In addition, the soap bubble blowing group had lower fear scores than the ball squeezing and control groups (p < 0.001). CONCLUSION: The active distraction methods used in the study reduced pain and fear during the phlebotomy procedure. In addition, the method of soap bubble blowing was found to be a more effective method in reducing fear. Distraction methods should be used as a nursing intervention to reduce pain and fear during the phlebotomy procedure in children.

Effectiveness of maternal-targeted training on nonpharmacologic pain management on heel stick sampling: A randomized controlled trial.

BACKGROUND: Heel stick sampling, which is a common procedure in newborns, causes acute pain, and parents are aware of this. AIM: The current study aimed to investigate the effectiveness of maternal-targeted training on newborn pain management, addressing the use of nonpharmacological methods and anxiety. METHODS: The study is 2-arm, parallel-group randomized controlled trial. A total of 64 mothers were included in this study. Mothers were randomly allocated to each group; intervention (n:32) and control (n=:32). Training on nonpharmacological pain management in newborns was given to the mothers in the intervention group. Data were collected with an Introductory Information Form, Nonpharmacological Pain Management Use Checklist, and State-Trait Anxiety Inventory. RESULTS: Nonpharmacological methods were used for the procedures in the control group and the intervention group, with an absolute difference of 68.8% between groups. The difference was statistically significant (p < 0.001) and had a large effect (d = -79.222; 95% CI, -9.365 to 670.143. There was no significant difference between the groups in terms of anxiety score (p = 0.558). CONCLUSION: Demonstrates the clinical relevance and feasibility of training targeting maternal on neonatal pain management during the heel stick sampling procedure. PRACTICE IMPLICATIONS: When non-pharmacological methods in pain management of newborns were recommended by the nurse, maternal involvement in pain management increased significantly, suggesting that nurses have a key role in ensuring parental involvement. CLINICAL TRIAL REGISTRATION: NCT05173662.

Effects of health promotion program on maternal attachment, parenting self-efficacy, infant development: a randomised controlled trial.

This study was designed to test the efficacy of the health promotion program used on maternal-infant attachment, parental self-efficacy, infant development. For this experimental study parallel-group randomised control design was used. Data was collected from 64 mother and their infants. The intervention group received the health promotion program in addition to standard care, the control group received only the standard care. Family Information Form, Prenatal Attachment Inventory, Maternal Attachment Inventory, Parenting Self-Efficacy Scale, and Denver II Developmental Screening Tests were used for the collection of the data. Pearson χ2 test, Yates corrected χ2 test, independent t-test, and Mcnemar test were used for analysing the collected data. The groups on maternal-infant attachment (d:1.20 [CI:0.671-1.736]), parental self-efficacy (d:1.37 [CI:0.835 to 1.925]), and development delays of infants (p = .003, C.V: 0.41) were found to be statistically significant. Health promotion program positively influenced the maternal attachment, parental self-efficacy, the development of the infants.IMPACT STATEMENTWhat is already known on this subject? Pregnancy and postpartum is a difficult period for mothers. Mothers need support. Parenting self-efficacy and maternal attachment are important for improving infant health. Infant should be supported to prevent developmental delays.What do the results of this study add? With the education and support program applied before and after birth, mother and baby were evaluated together and multi-faceted support was provided.What are the implications of these findings for clinical practice and/or further research? Supporting parenting self-efficacy, maternal attachment and infant development should be started during pregnancy and should be continued in the postpartum period.

Effect of resilience on social appearance anxiety in Turkish early adolescents.

PROBLEM: Preventive and supportive nursing care interventions of school nurses are very important in the early adolescence period, in which the significant physical and sexual changes occur. One ramification of these changes may be social appearance anxiety. This study was carried out to investigate the effects of resilience on social appearance anxiety among early adolescents. METHODS: The study was a cross-sectional design. The study data were collected between February and June 2018. Study sample consists of 495 early adolescents studying at a state secondary school in Turkey. The data were gathered using personal information form, Social Appearance Anxiety Scale (SAAS), and Child and Young Resilience Measure (CYRM-12). The data were analyzed using the independent-sample t test, one-way analysis of variance, and multiple linear regression methods. FINDINGS: In the present study, the mean age of early adolescents was found to be 11.90 (1.07) years. The mean scores of students in SAAS and CYRM-12 were 31.79 (13.30) and 52.96 (5.86), respectively. Social appearance anxiety scores of early adolescents were found to have a negative effect on the resilience levels (ß = -0.294). CONCLUSIONS: It can be suggested to teach adolescents, the interventions about the use of active coping skills aiming to decrease social appearance anxiety and to increase the resilience.

Nursing Students' Views about Do-Not-Resuscitate Orders: Quasi-Experimental Study.

"Do Not Resuscitate" (DNR) order is one of the challenging issues encountered in end of life care. This study aimed to determine the effect of education about DNR on the views of senior nursing students. Students, who selected elective course of palliative care and received education about DNR formed the intervention group (n = 106) while the students who did not select the lesson were in the control group (n = 107). Data were collected using a questionnaire. It revealed that the students who had education about DNR agreed with the positive statements about DNR more than the control group. Also, intervention group students had a high agreement DNR should be a part of vocational training for health professionals. It is important and necessary to focus on the special role of nurses when a DNR order is given, and nursing education raised the awareness and views about DNR according to the data from this study.

The effect of physical and psychosocial symptoms on caregiver burden of parents of children with cancer.

OBJECTIVE: The aim of this study was to investigate the effects of parent's characteristics, physical and psychosocial symptoms, and child-related factors on caregiver burden of parents of children with cancer. METHODS: This is a descriptive and cross-sectional study that included 172 parents of children with cancer. This study was performed between February and July 2019 in three major paediatric haematology and oncology units located in the centre of Turkey. Data were collected by using the descriptive information form, Pittsburgh Sleep Quality Index, Piper Fatigue Scale, Beck Depression Inventory, Trait Scale of the State-Trait Anxiety Inventory, Multidimensional Scale of Perceived Social Support and Zarit Caregiver Burden Scale. For data analysis, average and percentage calculations and multiple linear regression analyses were used. RESULTS: It was found that most of parents had poor sleep quality, moderate depression, fatigue, anxiety, high social support and moderate to severe caregiver burden. It was found that low education level, poor sleep quality, depression, trait anxiety, social support among the factors related to the parents, and the type of treatment and duration of the treatment from the factors related to the child had an effect on the caregiver burden. It was determined that the effective predictive factors explained 73.5% of the parents' caregiver burden. CONCLUSION: Caregiver burden is influenced by the parent- and child-related factors. Paediatric oncology nurses should plan interventions that support parents to cope with the caregiver burden during their children's cancer experience.

Effect of SINC Feeding Protocol on Weight Gain, Transition to Oral Feeding, and the Length of Hospitalization in Preterm Infants: A Randomized Controlled Trial.

BACKGROUND: The present study aims to test the effect of the Safe Individualized Nipple-Feeding Competence (SINC) protocol on the preterm infants' weight gain, transition to oral feeding, and duration of hospitalization. METHODS: The procedure was designed as a single-blind, parallel-group randomized controlled trial. The trial was conducted in a neonatal intensive care unit (NICU) in Konya, Turkey. Data were collected from 80 preterm infants between February 2018 and March 2019. Infants (gestational weeks 28-33) were randomly assigned to the intervention (n = 39) and control groups (n = 41). The intervention group received the SINC feeding protocol, whereas the control group received the standard feeding. Data were collected using the Family Information Form, the Preterm Infant Follow-Up Form, and the SINC Protocol Evaluation Checklist. Infants were followed from hospitalization to discharge. The outcomes were weight gain, transition to oral feeding, and the length of hospitalization from birth to discharge. Pearson χ2 test, Fisher exact test, independent t-test, Mann-Whitney U test, and general linear model test were used in analyzing the data. RESULTS: The main effects of groups on weight measurements were found to be statistically significant (P < .001). There were no significant differences in terms of the transition from gavage to full oral feeding and the length of hospitalization (P > .05). CONCLUSIONS: SINC protocol positively influences weight gain in preterm infants. It is important to evaluate different evidence-based feeding methods both as they apply to the NICU stay and how they may affect long-term outcomes of preterm infant.

Virtual behaviors affecting adolescent mental health: The usage of Internet and mobile phone and cyberbullying.

PROBLEM: An important environmental factor affecting adolescents today is undoubtedly technological tools. This descriptive and cross-sectional study was conducted to evaluate the relationship of adolescents' Internet and mobile phone usage, cyberbullying behaviors, and their self-reported mental health. METHODS: The sample of the study consisted of a total of 426 students including 215 male students and 211 female students. A questionnaire was prepared by the researcher to determine the sociodemographic and personal characteristics and virtual behavioral characteristics of individuals. The Brief Symptom Inventory was used to determine the participants' mental status. FINDINGS: It was found that adolescents' daily Internet usage duration, Internet usage purpose, the place where they use Internet, cyberbullying, and exposure to cyberbullying were related to the adolescents' self-reported mental health (p < .05). CONCLUSION: Several aspects of the virtual behaviors of the adolescents were associated with their sense of mental health issues. In this context, the school health nurse should raise awareness among adolescents about the use of technology and how it might impact their mental wellbeing.

Investigation of stress and nursing support in mothers of preterm infants in neonatal intensive care units.

BACKGROUND: The birth and hospitalisation of a premature infant in a neonatal intensive care unit (NICU) are stressful experiences for the mother and the family. The support of neonatal nurses is necessary to control and reduce the stress of mothers. And nurse-parent support may play a role in effective stress management and make a positive contribution to the health of mothers. AIM: To determine the correlation of stress and nurse-parent support levels with mothers' age and educational status, number of children, gestational week of the infant and the hospitalisation period of the infant among mothers of premature infants hospitalised in the NICU. METHODS: This descriptive and cross-sectional study was conducted in the NICUs of two medical faculties. The study was conducted between March and June 2017 with the participation of 106 mothers with hospitalised premature infants. The data of the study were collected using a 'mother information form', Parental Stressor Scale: Neonatal Intensive Care Unit and Nurse-Parent Support Tool. Number, percentage, mean, standard deviation, t-test, analysis of variance test, Pearson's correlation and multiple regression analysis were used to analyse the data. RESULTS: It was determined that the stress levels were high in mothers regarding their PSS: NICU parental role subscale. The stress levels of mothers with infants connected to mechanical ventilation and fed parenterally were high (p < 0.05). The nurse support levels of mothers with middle- and low-income status were high. Multiple regression analysis, mechanical ventilation was determined to be effective in the use of the PSS:NICU total score (p < 0.05). CONCLUSIONS: As a result, it was determined that mechanical ventilation and parenteral nutrition of the infant increased the stress level of mothers. Furthermore, in the study, the Nurse-Parent Support score of the mothers with middle- and low-income status was higher.

An investigation of the relationship between social support and coping with stress in women with breast cancer.

OBJECTIVES: Social support may play a role in effective stress management and make a positive contribution to the health of women with breast cancer. The aim of this study was to determine the ways of coping with stress and levels of perceived social support of women with breast cancer, as well as the associated factors. METHODS: The descriptive and cross-sectional study was conducted with 100 women with breast cancer at a training and research hospital in Turkey. Data were collected using an information form including sociodemographic and disease characteristics, the Scale of Ways of Coping with Stress, and the Multidimensional Scale of Perceived Social Support. RESULTS: Effective ways of coping with stress were found to be significantly lower in women who were primary school graduates and who did not undergo surgery (P < .05). The women's levels of effective coping with stress decreased with increasing age, and as the score of perceived social support from family and total score of perceived social support increased, so did the levels of effective coping with stress (P < .05). It was determined that social support and age significantly predicted effective stress management (P < .05). CONCLUSIONS: Social support given to women with breast cancer is a key reference point in effective stress management, and increased age also has an important effect on women's ability to cope with stress.

Moral sensitivity, ethical experiences and related factors of pediatric nurses: a cross- sectional, correlational study / Sensibilidad moral, experiencias éticas y factores relacionados de enfermeras pediatras: un estudio transversal de correlación / Sensibilidade moral, experiências éticas e fatores relacionados da enfermagem pediátrica: um estudo transversal correlacional

Abstract: 14. The aim of this study is to determine the ethical experiences and the level of moral sensitivity and related factors of pediatric nurses working in hospital settings. Designed as descriptive and cross-sectional, the study was undertaken at three public hospitals in Konya and Ankara, Turkey and included the participation of a total of 200 pediatric nurses. The Moral Sensitivity Questionnaire (MSQ) was used for evaluation of the ethical sensitivities of the nurses. Of the 200 nurses, 46.5% had working experience of between 1-5 years, 58% were married, 18.6% had not undergone any ethics education, and 59.5% held a bachelor's degree. A large majority (95%) of the pediatric nurses reported that they had encountered ethical problems. The mean moral sensitivity score of the nurses was 95.89±24.34, with higher scores in this area being observed in the nurses who were in the older age group and had worked longer than others (p<0.05). The mean moral sensitivity score of the nurses was determined to be at a medium level and was found to be influenced by the age group they were in and the length of time they had worked.

Resumen: 18. El objetivo de este estudio consiste en determinar las experiencias éticas y el nivel de sensibilidad moral y factores relacionados de enfermeras pediatras que trabajan en hospitales. El diseño del estudio es descriptivo y transversal y se realizó en tres hospitales públicos en Konya y Ankara en Turquía, incluyendo la participación de un total de 200 enfermeras pediatras. Para evaluar la sensibilidad ética de las enfermeras se usó el Cuestionario sobre Sensibilidad Moral (CSM). De las 200 enfermeras, 46,5% tenía experiencia de trabajo entre uno y cinco años, 58% era casada, 18,6% no había recibido educación en ética y 59,5% era licenciada. Una gran mayoría (95%) de las enfermeras pediatras informó que había experimentado problemas éticos. El puntaje medio de sensibilidad moral fue de 95.89±24.34, con puntajes más altos para las enfermeras de mayor edad y que habían trabajado más tiempo (p<0.05). Se determinó que el puntaje medio de sensibilidad moral era de nivel medio y que estaba influenciado por el grupo etario y el tiempo de experiencia de trabajo.

Resumo: 22. O objetivo deste estudo é determinar as experiências éticas e o nível de sensibilidade moral e fatores relacionados da atuação da enfermagem pediátrica no ambiente hospitalar. Concebido como descritivo e transversal, o estudo foi realizado em três hospitais públicos em Konya e Ankara (Turquia) e contou com a participação de um total de 200 enfermeiros pediátricos. O questionário de sensibilidade Moral (MSQ) foi usado para avaliar a sensibilidade ética dos enfermeiros. Dos 200 enfermeiros, 46,5% tinham experiência profissional entre 1 a 5 anos, 58% eram casados, 18,6% não tinham qualquer instrução de estudos de ética e 59,5% tinham graduação. Uma grande maioria (95%) dos enfermeiros pediatras relataram que já encararam problemas éticos. A pontuação média acerca da sensibilidade moral dos enfermeiros foi de 95.89±24.34, com notas mais altas no grupo em que os enfermeiros estavam na faixa etária mais velha e tinham trabalhado mais do que outros (p < 0,05). A pontuação média de sensibilidade moral dos enfermeiros foi determinada em um nível médio e foi identificada pela influência da faixa etária e de tempo que tinham trabalhado.