Nurses' Perspectives Regarding Challenges of Providing Perinatal/Neonatal End-of-Life Care in a Regional Hospital: An Exploratory Qualitative Study.

AIM: This qualitative study aimed to explore nurses' perspectives regarding the challenges of providing perinatal/neonatal end-of-life care in a regional hospital. METHODS: This exploratory qualitative study was conducted with 20 nurses working in Turkey. Study data were collected through in-depth and semi-structured individual interviews. The interviews were then submitted to thematic analysis. RESULTS: Three themes emerged from analyses of the interviews: (1) inadequate support for delivery of palliative care, (2) perceptions of family readiness, and (3) providing information/education to the family. The most prominent difficulties experienced by nurses were inadequacy of unit and equipment and lack of trained personnel. Another important issue that stood out was families' not accepting the end-of-life care decision for the fetus or the neonate and their having unrealistic expectations. CONCLUSION: Study results have provided important considerations for regional isolated neonatal and perinatal units, and they will be used to inform clinical practice improvements, staff education support, policies/procedures, family support, and further research relating to end-of-life care provision for the most vulnerable babies and their families.

The relationship between media exposure and mental health in children following Kahramanmaras earthquakes in Turkey.

PURPOSE: We aimed to explore the relationship between media exposure to the Kahramanmaras earthquakes and its impact on children's mental health difficulties. METHODS: This cross-sectional study was conducted with 409 parents between March and July 2023. Parents were invited to participate in an online survey through social media platforms. The data was collected using the 'Descriptive Characteristics Form', the 'Media Exposure Form Related to the Earthquake', and the 'Strengths and Difficulties Questionnaire'. RESULTS: The results indicated that exposure to images of earthquake-related events on the first day after the earthquake (p < 0.001), people rescued alive from the rubble on television (p < 0.001), earthquake victims staying on the streets/in tents on television (p = 0.006), and earthquake-related events while alone on the Internet (p = 0.02) were significantly associated with the impact of children's mental difficulties. Furthermore, exposure to images of people pulled deceased from the rubble (p < 0.001), exposure to images of demolished houses on the Internet (p = 0.007), and exposure to images of destroyed roads on the Internet (p = 0.01) were found to significantly predict the impact of children's mental difficulties (r2 = 0.29; p < 0.001). CONCLUSIONS: This study has shown that children who are exposed to screen media may experience difficulties in coping mentally, leading to emotional and behavioral problems. PRACTICE IMPLICATIONS: Children who have experienced natural disasters may be exposed to distressing images on screen, which can lead to difficulties and stress. To reduce the risk of mental health problems related to disasters, nurses may suggest that victims limit their exposure to television footage.

Barriers experienced by nurses in communication for sexual health education for children with intellectual disability: a qualitative study.

Nurses have important responsibilities in the development of health and care services for children with intellectual disabilities. This is because it is usually the nurse who first encounters the child in all kinds of care and treatment services. Barriers to the provision of sexual healthcare by nurses have not yet been clearly discovered. This study aimed to identify the barriers experienced by nurses regarding communication for sexual health education for children with intellectual disabilities. This study was carried out with 19 nurses through in-depth interviews. The thematic analysis method was used for data analysis. Four themes emerged related to barriers in communication for sexual health education for children with intellectual disabilities by nurses as (1) communication of nurses with their patients, (2) communication on an individual level, (3) communication on the family level, and (4) institutional factors. These barriers included the lack of knowledge of children, families, and nurses, insufficient institutional support, attitudes towards sexuality and stigmatization of the family, and the prevention of sexual health education services by the aggressive behaviors of children. It is recommended to provide sexual health education to nurses and families to minimize problems in the sexual health of children with intellectual disabilities. Nurses should also be trained on sexual health policy and how to put it into practice.

Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study.

BACKGROUND: Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain. AIM: This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection. METHOD: This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4-10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong-Baker FACES Pain Rating Scale, the Child Anxiety Scale-State, and the Child Fear Scale. RESULTS: After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p<0.001 for all scores). CONCLUSION: The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection.

The effect of swaddling method applied to preterm infants during the aspiration procedure on pain.

PURPOSE: The study was carried out to determine the effect of the swaddling method on pain in preterm infants (between 27 and 36 weeks) hospitalized in the Neonatal Intensive Care Unit during the aspiration procedure. Preterm infants were recruited by convenience sampling from level III neonatal intensive care units in a city in Turkey. METHOD: The study was conducted in a randomized controlled trial manner. The study consisted of preterm infants (n = 70) receiving care or treatment at a neonatal intensive care unit. While swaddling was applied to the infants in the experimental group before the aspiration process. The pain was assessed before, during, and after the nasal aspiration using the Premature Infant Pain Profile. RESULTS: No significant difference was found in terms of pre-procedural pain scores whereas a statistically significant difference was detected in terms of pain scores during and after the procedure between the groups. CONCLUSION: It was determined in the study that the swaddling method reduced the pain of the preterm infants during the aspiration procedure. IMPLICATIONS FOR PRACTICE: This study emphasized that swaddling had pain-reducing during the aspiration procedure in the neonatal intensive care unit in preterm infants. It is recommended that future studies be conducted using different invasive procedures in preterm infants born earlier.

Perception of Coronavirus in Children Through the Interpretation of Metaphors.

The purpose of this study is to determine the perception of coronavirus in children between the ages of 7-18 through the interpretation of metaphors. This qualitative study was conducted with a total of 34 children between the ages of 7-18 years The metaphors obtained from the content analysis were categorized into two main themes and sub-themes. The main themes were categorized as barrier at COVID-19 and fear at coronavirus as fear. The most striking metaphors in the study, such as death, deadly, disease, scary, germ, snake venom, black hole, darkness, gun, lead, were the metaphors in the "Deadly" category, which were revealed by children. In unexpected situations, it is beneficial for parents and health care professionals to establish clear, open, and reassuring communication with their children.

Automatic gender determination from 3D digital maxillary tooth plaster models based on the random forest algorithm and discrete cosine transform.

BACKGROUND AND OBJECTIVE: One of the first stages in the identification of an individual is gender determination. Through gender determination, the search spectrum can be reduced. In disasters such as accidents or fires, which can render identification somewhat difficult, durable teeth are an important source for identification. This study proposes a smart system that can automatically determine gender using 3D digital maxillary tooth plaster models. METHODS: The study group was composed of 40 Turkish individuals (20 female, 20 male) between the ages of 21 and 24. Using the iterative closest point (ICP) algorithm, tooth models were aligned, and after the segmentation process, models were transformed into depth images. The local discrete cosine transform (DCT) was used in the process of feature extraction, and the random forest (RF) algorithm was used for the process of classification. RESULTS: Classification was performed using 30 different seeds for random generator values and 10-fold cross-validation. A value of 85.166% was obtained for average classification accuracy (CA) and a value of 91.75% for the area under the ROC curve (AUC). CONCLUSIONS: A multi-disciplinary study is performed here that includes computer sciences, medicine and dentistry. A smart system is proposed for the determination of gender from 3D digital models of maxillary tooth plaster models. This study has the capacity to extend the field of gender determination from teeth.

Gray level co-occurrence and random forest algorithm-based gender determination with maxillary tooth plaster images.

Gender is one of the intrinsic properties of identity, with performance enhancement reducing the cluster when a search is performed. Teeth have durable and resistant structure, and as such are important sources of identification in disasters (accident, fire, etc.). In this study, gender determination is accomplished by maxillary tooth plaster models of 40 people (20 males and 20 females). The images of tooth plaster models are taken with a lighting mechanism set-up. A gray level co-occurrence matrix of the image with segmentation is formed and classified via a Random Forest (RF) algorithm by extracting pertinent features of the matrix. Automatic gender determination has a 90% success rate, with an applicable system to determine gender from maxillary tooth plaster images.