Determination of Risk Factors for Nausea and Vomiting in Children After Appendectomy.

PURPOSE: This study aimed at investigating the risk factors for postoperative nausea and vomiting (PONV) in pediatric patients undergoing appendectomy. DESIGN: This is a prospective, descriptive, cross-sectional study. METHODS: The study involved 163 children aged 5 to 18 years who underwent appendectomy in the pediatric surgery clinic of a tertiary hospital between December 2022 and June 2023. The study data were collected through the patient information form, Baxter Retching Faces scale, and Wong-Baker Faces Pain Rating Scale, which included questions about the descriptive and clinical characteristics of the participants and was prepared by the researcher consistent with the literature. FINDINGS: A significant relationship was observed between the severity of postoperative pain and the occurrence of PONV in patients with both nonperforated and perforated appendicitis (P < .001). In addition, operative time and the time to the first oral feeding were shorter in patients with nonperforated appendicitis in the non-PONV group (P = .005 and P = .042, respectively) Logistic regression analysis revealed that postoperative pain, family history of PONV and appendix perforation were risk factors for PONV in children with both nonperforated and perforated appendicitis (P < .001, P = .040, and P < .001, respectively). CONCLUSIONS: In children undergoing appendectomy, family history of PONV, severity of postoperative pain, increased operative time, and increased transition time to oral feeding are risk factors for PONV. Pediatric nurses, who have an important role in the management of PONV, should evaluate patients in terms of PONV risk in the preoperative period within the scope of evidence-based practices and perform pharmacological or nonpharmacological interventions according to the degree of risk.

Effect of pacifier and pacifier with dextrose in reducing pain during orogastric tube insertion in newborns: a randomized controlled trial.

OBJECTIVE: This study aimed to assess the efficacy of pacifier use, with and without 25% dextrose, in reducing pain during orogastric tube insertion in newborns. STUDY DESIGN: In a randomized controlled trial involving 60 newborns at a public hospital from April to December 2019, participants were divided into three groups: pacifier (n = 20), pacifier with 25% dextrose (n = 20), and control (n = 20). A pacifier, with and without dextrose, was used for the experimental groups, while the control group performed a routine procedure. Neonatal infant pain scale, crying duration, heart rate (HR), and oxygen saturation (SpO2) were evaluated. RESULTS: Results indicated that the control group experienced significantly higher pain levels, elevated HRs, decreased SpO2, and prolonged crying. Conversely, the pacifier with 25% dextrose group showed a notable reduction in crying duration. CONCLUSION: A pacifier, with and without 25% dextrose, effectively reduces pain and improves physiological and behavioral parameters during orogastric tube insertion. CLINICAL TRIAL NUMBER: NCT05462964 CLINICAL TRIAL REGISTRATION: The protocol for this randomized controlled experimental trial is registered on ClinicalTrials.gov. The clinical trial registration number is https://clinicaltrials.gov ; NCT05462964.

Effects of menthol gum chewing on postoperative nausea, vomiting, and length of hospital stay in children undergoing appendectomy: A randomized controlled trial.

PURPOSE: This study aimed to determine the effects of menthol gum chewing on nausea, vomiting, and length of hospital stay after appendectomy in children. BACKGROUND: Postoperative nausea and vomiting (PONV) can be induced by general anesthesia. Several drugs are available to reduce the risk of PONV; however, their cost and side effects limit their clinical use. METHOD: This was a randomized controlled clinical trial that included 60 children aged 7-18 years who underwent an appendectomy at the Pediatric Surgery Clinic of a tertiary hospital between April and June 2022. Data for this study were collected via the developed information form, which included participants' descriptive characteristics and bowel function parameters, and the Baxter Retching Faces (BARF) nausea scale. Children in the study group who underwent an appendectomy were given chewing gum and asked to chew it for an average of 15 min, whereas those in the control group received no intervention. RESULTS: The BARF nausea score measured during the menthol gum chewing period was lower in the study group, and the difference score value calculated after pretest time was higher in the study group, as expected (p < 0.001). Moreover, menthol gum chewing was found to shorten hospital stay by 1 day (p < 0.05). CONCLUSION: Menthol gum chewing reduced the severity of postoperative nausea and length of hospital stay. PRACTICE IMPLICATION: Chewing gum can be used as a nonpharmacological method by pediatric nurses in clinical practice to reduce the severity of postoperative nausea and length of hospital stay.

Assessment of postoperative pain in children with computer assisted facial expression analysis.

PURPOSE: The present study was conducted to evaluate the use of computer-aided facial expression analysis to assess postoperative pain in children. DESIGN AND METHODS: This was a methodological observational study. The study population consisted of patients in the age group of 7-18 years who underwent surgery in the pediatric surgery clinic of a university hospital. The study sample consisted of 83 children who agreed to participate and met the sample selection criteria. Data were collected by the researcher using the Wong Baker Faces pain rating scale and Visual Analog Scale. Data were collected from the child, mother, nurse, and one external observer. Facial action units associated with pain were used for machine estimation. OpenFace was used to analyze the child's facial action units and Python was used for machine learning algorithms. The intraclass correlation coefficient was used for statistical analysis of the data. RESULTS: The pain score predicted by the machine and the pain score assessments of the child, mother, nurse, and observer were compared. The pain assessment closest to the self-reported pain score by the child was in the order of machine prediction, mother, and nurse. CONCLUSIONS: The machine learning method used in pain assessment in children performed well in estimating pain severity.It can code facial expressions of children's pain and reliably measure pain-related facial action units from video recordings. APPLICATION TO PRACTICE: The machine learning method for facial expression analysis assessed in this study can potentially be used as a scalable, standard, and valid pain assessment method for nurses in clinical practice.

Evaluation of breastfeeding success and self-efficacy in mothers giving birth via vaginal delivery or cesarean section: a cross-sectional study.

This cross-sectional observational study was conducted to compare breastfeeding success and breastfeeding self-efficacy levels of mothers who gave birth via vaginal delivery (spontaneous or via epidural analgesia) or cesarean section (under general or spinal anesthesia). The study was conducted between September 2019 and February 2020 in the obstetric clinic. Data were collected using a Data Collection Form, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the LATCH Breastfeeding Evaluation Tool. Throughout the study, we followed the STROBE Checklist. Mothers who gave birth via spontaneous vaginal delivery had a statistically higher mean Breastfeeding Self-Efficacy score (54.92 ± 7.72; p < .001) than those who gave birth under spinal anesthesia (43.21 ± 10.04; p < .001) and then those who gave birth via cesarean section under general anesthesia (37.39 ± 10.64; p < .001). The difference between the delivery modes in terms of breastfeeding self-efficacy and breastfeeding success scores was statistically significant (respectively, KW = 40.168, p < .001 and KW = 52.420, p < .001). In order to increase the breastfeeding success of mothers who give birth via cesarean section under general anesthesia or spinal anesthesia, lactation nurses need to strengthen the perception of breastfeeding self-efficacy and provide more breastfeeding support to them compared to mothers who give birth via SVD.

Effect of antenatal educational intervention on maternal breastfeeding self-efficacy and breastfeeding success: a quasi-experimental study.

OBJECTIVE: To examine the effect of breastfeeding educational intervention given in the antenatal period on LATCH and breastfeeding self-efficacy scores. METHOD: A total of 80 pregnant who met the research criteria were randomly assigned to intervention (n = 40) or control (n = 40) groups. Pregnant women received to the control group received only standard care while breastfeeding education was accepted to the intervention group along with standard care. Both groups were visited at their home, and the personal data form, the LATCH Breastfeeding Assessment Tool, and Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) were applied in the postpartum 1st week. End of the study, brochures prepared by the researcher were given to both groups. RESULT: The mean breastfeeding self-efficacy and LATCH scores were higher in the intervention group compared to the control group. Breastfeeding success was found to increase as the maternal breastfeeding self-efficacy perception increased. CONCLUSION: Breastfeeding education given in the antenatal period increased maternal breastfeeding self-efficacy perception and breastfeeding success in the postpartum 1st week period.Study is registered at ClinicalTrials.gov NCT04757324.

Hand Dermatitis among Nurses during the COVID-19 Pandemic: Frequency and Factors.

OBJECTIVE: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence. METHODS: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms. RESULTS: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period. CONCLUSIONS: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene.

The Effect of Cold Application on Relieving Drug Infusion-Related Pain in Children: A Randomized Controlled Experimental Trial in Turkey.

BACKGROUND: Parenteral IV drug administration in hospital environments can cause many complications at the infusion site. Nerve endings on the venous walls may be affected during antibiotic drug infusion, depending on the drug molecule, which results in pain. PURPOSE: This study aims to assess the effect of cold application on relieving drug infusion-related pain (lincosamide class clindamycin phosphate) in children. DESIGN & METHODS: This study included 120 pediatric patients (40 in the experimental, 40 in the placebo, and 40 in the control groups) aged 6 to 18 and hospitalized in a pediatric hospital. In the experimental group, a cold pack kept in the refrigerator was applied to the area above the IV catheter before drug infusion, while a cold pack kept at room temperature was applied in the placebo group. In the control group, drug infusion was routinely administered. RESULTS: The experimental, placebo and control groups' 5th minute mean VAS scores were 0.98 ± 2.17, 3.95 ± 4.08, and 4.73 ± 3.89, respectively (p < 0.001), being higher in the control and placebo groups compared to the experimental group. No difference was found between the groups based on the VAS measurements at the 10th minute (p = 0.053). A difference was found between the groups based on the VAS measurements at the 15th minute (p=0.026). The VAS score of control group was higher than that of the placebo group (p = 0.032). CONCLUSION: Cold application was effective in relieving drug infusion-related pain. IMPLICATIONS FOR PRACTICE: This method may be recommended for general use in clinics since it is easy-to-use and economic. This method can ease the treatment process between nurses and children and increase patient satisfaction.

The Effect of Different Audio Distraction Methods on Children's Postoperative Pain and Anxiety.

PURPOSE: The aim of the study was to determine the effect of different auditory methods of attention distraction on postoperative pain and anxiety in children. DESIGN: The study was conducted as a pretest-posttest experimental study to determine the effect of classical music, Turkish music, and audiobook on the reduction of postoperative pain and anxiety in children. METHODS: The patient population of the study comprised children who had undergone a surgical operation in the pediatric surgery clinics. A total of 90 children were included in the sample of the study. The data were collected using the Visual Analog Scale, the Wong-Baker Faces Pain Scale, and the State-Trait Anxiety Inventory for children, in addition to the sociodemographic data form of the child and the parent. FINDINGS: Classical music, Turkish music, and audiobook methods played an effective role in decreasing postoperative pain and the anxiety state in children. Classical music listening was the most effective method in reducing the pain in children in the postoperative period in the three groups in the study. CONCLUSIONS: We demonstrated that different auditory attention distraction methods had a decreasing effect on postoperative pain and anxiety in children.

Efficacy of Buzzy® on pain and anxiety during catheterization in children.

BACKGROUND: The use of a peripheral intravenous cannula is a common clinical practice, and it is known to be a major source of pain and anxiety in children. The aim of this study was to examine the effect of the use of the Buzzy® on pain and anxiety in children during peripheral cannula application. METHODS: The research sample consisted of 60 children between the ages of 8 and 16. For children in the experimental group, external cold and vibration were applied by means of the Buzzy® device. Before and during the peripheral intravenous cannula procedure, the levels of fear and anxiety relating to the procedure of the child patients in both the experimental and control groups were assessed by the children themselves and by an independent observer. Immediately after the vein entry procedure had been carried out, the level of pain felt by the children was determined. RESULTS: The results of the statistical analysis showed no statistically significant difference between the anxiety levels of the groups before and after the procedure (P > 0.05). The results of the statistical analysis also showed no statistically significant difference between the postprocedural mean pain scores of the children as reported by the children themselves and by the observer (P > 0.05). CONCLUSIONS: In this study, unlike most studies in the literature, the conclusion was reached that the use of the Buzzy® to reduce pain and anxiety during the application of a peripheral intravenous cannula in children was not effective.

Hand Dermatitis in Nursing Students.

OBJECTIVE: To determine the frequency of self-reported hand dermatitis and the factors influencing its prevalence among nursing students. METHODS: Researchers collected demographic data and used a self-assessment form to identify dermatologic symptoms. The questionnaires were distributed to the students and collected again after the students completed the forms. RESULTS: Hand dermatitis was present in 20.9% of nursing students. The most common symptoms were irritation/pruritus, redness/cracking, flaking/rash, swelling, and vesicles in hands. The grade of the student, the presence of allergy complaints, and medication used to treat dermatitis were statistically significantly associated with dermatitis prevalence. The use of gloves and cleansing agents used in handwashing were factors linked to hand dermatitis. CONCLUSIONS: Hand dermatitis increases in parallel with the increase of clinical practice hours among nursing students. Familial and environmental factors also increase the risk of hand dermatitis.

Determination of the Personal Values of the University Students in Different Departments.

This research aims to examine the personal values of the first-year university students studying in different departments. This is a descriptive cross-sectional survey study. Research population is composed of first-grade students approving to participate and studying in the Nursing Department in the School of Health, Biology Department in the Faculty of Science and Letters and the Department of Early Childhood Education in the Faculty of Education of Uludag University. "Student Information Form" and "Schwartz Values Inventory" were used for data collection. When the values inventory is examined, it is seen that the point averages of the students are the highest in safety sub-dimension and the lowest in power sub-dimension. Power, achievement, and hedonism and tradition point averages of the students in the Nursing Department of Health Sciences are higher than those of the students in the departments of science and educational sciences, and the difference in between was found out to be statistically significant. Point average in the achievement sub-dimension was found out to be high among male students (p < 0.01). It was found out that the point averages of female students for hedonism, universalism, benevolence and conformity are higher than those of male students, while the achievement point averages were higher among male students.

Using a Virtual Reality Headset to Decrease Pain Felt During a Venipuncture Procedure in Children.

PURPOSE: This experimental study was conducted to determine the effect of using a virtual reality headset on decreasing the pain felt during a venipuncture procedure in children. DESIGN: This was a randomized controlled study. METHODS: The population included 120 children (experimental group = 60, control group = 60) aged 9-12 years who underwent blood collection at a children's hospital clinic. This study collected data using the information form regarding introductory characteristics of children and the venipuncture procedure, the Visual Analogue Scale, and the Wong-Baker Faces Pain Scale. FINDINGS: This study found that the levels of pain that experimental group children felt during the venipuncture procedure were lower than the levels of pain indicated by control group children (P < .05). CONCLUSIONS: It was determined that using a virtual reality headset has an effect on decreasing the pain felt during the venipuncture procedure.

Preventing Child Sexual Abuse: Body Safety Training for Young Children in Turkey.

The "Body Safety Training Program" is an education program aimed at ensuring children are informed about their body and acquire self-protection skills. In this study, a total of 83 preschoolers were divided into experimental and control groups; based on a power analysis, 40 children comprised the experimental group, while 43 children comprised the control group. The "Body Safety Training Programme" was translated into Turkish and content validity was determined regarding the language and cultural appropriateness. The "What If Situations Test" (WIST) was administered to both groups before and after the training. Mann-Whitney U Test, Kruskal-Wallis Variance Analysis, and the Wilcoxon Signed Ranks Test were used to compare between the groups and the Spearman correlation analysis was used to determine the strength of the relationship between the dependent and independent variable. The differences between the pretest and posttest scores for the subscales (appropriate recognition, inappropriate recognition, say, do, tell, and reporting skills), and the personal safety questionnaire (PSQ) score means for the children in the experimental group were found to be statistically significant (p < .001). The posttest-pretest difference score means of the experimental group children for WIST saying, doing, telling and reporting, total skills, and PSQ were found to be statistically significant as compared to that of the control group (p < .05). The "Body Safety Training programme" is effective in increasing the child sexual abuse prevention and self-protection skills in Turkish young children.

Determining the Appropriateness of the "What If" Situations Test (WIST) with Turkish Pre-Schoolers.

Measurement instruments are needed to assess the child's sexual abuse prevention program. The purpose of the study was to determine the reliability and validity of the WIST (What If Situations Test) for Turkish culture. Participants were children of the 3-6 age group attending pre-school education institutions and the sample size was identified by means of a power analysis. Seventy children were identified as the sample with 0.85 power and 0.05 type I error according to the power analysis. Language validity, content validity, internal validity coefficient (Cronbach alpha coefficient), and test-retest analyses were conducted in terms of validity and reliability in the scope of efforts for adaptation to Turkish culture. Firstly, Kendall W = 0.83 was the score for the expert opinions concerning the content validity of the language validity scale. It was found that the Cronbach alpha coefficients were between 0.68 and 0.90 for the scale sub-dimensions of appropriate and inappropriate recognition, saying, doing, telling, and reporting. The test-retest reliability of the scale was found to be r = 0.89 and the test-retest reliabilities for the sub-dimensions (appropriate recognition, inappropriate recognition, say skills, do skills, tell skills, and reporting skills) were between r = 0.48 and r = 0.92. The test-retest reliability for the Personal Safety Questionnaire (PSQ), as having complimentary items to the WIST, was found to be r = 0.82. The reliability and validity analysis of the 'What If' Situations Test (WIST), used to evaluate pre-schoolers' skills regarding self-protection against sexual abuse, showed that the Test's adaptation to Turkish culture was reliable and valid.

Evaluation of students' knowledge about paediatric dosage calculations.

Medication errors are common and may jeopardize the patient safety. As paediatric dosages are calculated based on the child's age and weight, risk of error in dosage calculations is increasing. In paediatric patients, overdose drug prescribed regardless of the child's weight, age and clinical picture may lead to excessive toxicity and mortalities while low doses may delay the treatment. This study was carried out to evaluate the knowledge of nursing students about paediatric dosage calculations. This research, which is of retrospective type, covers a population consisting of all the 3rd grade students at the bachelor's degree in May, 2015 (148 students). Drug dose calculation questions in exam papers including 3 open ended questions on dosage calculation problems, addressing 5 variables were distributed to the students and their responses were evaluated by the researchers. In the evaluation of the data, figures and percentage distribution were calculated and Spearman correlation analysis was applied. Exam question on the dosage calculation based on child's age, which is the most common method in paediatrics, and which ensures right dosages and drug dilution was answered correctly by 87.1% of the students while 9.5% answered it wrong and 3.4% left it blank. 69.6% of the students was successful in finding the safe dose range, and 79.1% in finding the right ratio/proportion. 65.5% of the answers with regard to Ml/dzy calculation were correct. Moreover, student's four operation skills were assessed and 68.2% of the students were determined to have found the correct answer. When the relation among the questions on medication was examined, a significant relation (correlation) was determined between them. It is seen that in dosage calculations, the students failed mostly in calculating ml/dzy (decimal). This result means that as dosage calculations are based on decimal values, calculations may be ten times erroneous when the decimal point is placed wrongly. Moreover, it is also seen that students lack maths knowledge in respect of four operations and calculating safe dose range. Relations among the medications suggest that a student wrongly calculating a dosage may also make other errors. Additional courses, exercises or utilisation of different teaching techniques may be suggested to eliminate the deficiencies in terms of basic maths knowledge, problem solving skills and correct dosage calculation of the students.

A determination of the quality of life of children and adolescents with type 1 diabetes and their parents.

OBJECTIVE: Type 1 diabetes is a chronic illness which can have a negative effect on the health care and development of children and can put their lives in danger. This descriptive study aimed to determine the quality of life and the factors affecting it of children and adolescents with type 1 diabetes using the Pediatric Quality of Life Inventory (PedsQL). METHODS: The study was conducted in the Child Endocrinology Unit of a University Hospital in Bursa, Turkey. Totally 64 children eight-12 years and 85 adolescents aged 13-18 with type 1 diabetes and their parents were recruited. HbA1c measurements were obtained from the records of the endocrinology clinicare, which were made once every three months, and the average of the last three measurements was taken in the study. The PedsQL was used to measure quality of life of the children and adolescents. The data was analyzed using SPSS version 20.0 and P < 0.05 was considered significant. The demographic data of the children and parents were analyzed using means and percentiles. Pearson's correlation analysis was used to assess the relationship between two averages. RESULTS: Of the sub-groups on the scale, affective and school function scores were somewhat low, and social function scores were high. The quality of life scores of the children and adolescents were found to correlate with those of their parents. A negative correlation was found between HbA1c levels and adolescent quality of life, a positive correlation was found between the child's age and the quality of life of the child and parents, and a negative correlation was found between the number of children in the family and the quality of life of the child and parents. CONCLUSIONS: An evaluation of the quality of life after a diagnosis of diabetes can be used to assess the problems which may be faced by children and adolescents and to combat these problems.

Social support and anxiety levels of parents with disabled children.

PURPOSE: This is a descriptive study carried out to determine the state-trait anxiety and social support perceptions of parents with disabled children. DESIGN/METHODS: This study has been carried out on 75 parents whose children attended the Private Rehabilitation Center. The data included the personal information form composed by the investigators, the state-trait anxiety inventory, and the multi-dimensional scale of perceived social support. FINDINGS: The disabilities of the children were mental in 26.7%, physical in 25.3%, and physical/mental in 12%. As the degree of disability increased and the income levels decreased, the trait anxiety scores of the parents increased. There was a significant negative correlation between parental age and social support. Among the parents, 37.3% experienced problems with their spouses after having a child with a disability. CONCLUSIONS: The development and implementation of alternative support systems for of parents with disabled children would be beneficial.

Use of complementary and alternative medicine and the anxiety levels of mothers of children with chronic diseases.

AIMS: This study aimed to determine the use of complementary and alternative medicine (CAM) by mothers with a chronically ill child and their anxiety levels. METHODS: This study used a descriptive design. The study was conducted with 135 mothers of a chronically ill child at a general pediatric and oncology unit in Uludag University Hospital, Bursa, Turkey. A questionnaire, including sociodemographic items and the State-Trait Anxiety Inventory, were given to the mothers. RESULTS: In the study, 42.29% of the mothers reported using one or more CAM therapies for their child with a chronic disease, including herbal medicine, taking the child to hodja (prayers), a special diet, and a special massage. The mothers experienced anxiety and the presence of a disease within the close family circle increased the anxiety level of the mothers. CONCLUSION: Herbs and other alternative supplements were used by some children with a chronic disease in Turkey. The most commonly used CAM therapies included oral herbal medicine, taking the child to hodja, massage, and diets. Therefore, it is important to consider the implications of the popularity of complementary therapies. Most of the mothers used more than one of these therapies for their child and the anxiety level of the mothers was found to be moderate.