Pain care for children with cognitive impairment: A parent-nurse partnership.

PURPOSE: To explore nurses' experiences of establishing partnerships with parents for pain care of hospitalized children with cognitive impairment (CI) and identify related facilitators and barriers. DESIGN AND METHODS: In this qualitative, interpretive descriptive study, individual semi-structured interviews were conducted via videoconferencing with pediatric nurses from inpatient wards in a Canadian pediatric quaternary hospital. Verbatim transcripts were analyzed using an inductive, data-driven thematic analysis approach. RESULTS: Eleven nurses were interviewed. The overarching theme was Assessing Pain as an Outsider: "A Complete Guessing Game". Seven major themes were identified.: Relying on Parent Expertise for Pain Assessment, Brainstorming with Parents for Pain Treatment, Supporting Parents as Advocates for Pain Care, Individualizing Pain Care with Parents, Involving the Child in Pain Care: A Spectrum, Barriers to Partnership in Pain Care and Facilitators to Partnership in Pain Care. CONCLUSIONS: Nurses described the many ways they involve parents as partners in pain care. However, nurses shared strong feelings of uncertainty associated with pain care in children with CI. Consequently, nurses felt the need to rely on parents for appropriately assessing and treating pain in children with CI. Findings highlighted the practice and education gaps that may contribute to nurses' uncertainty and reliance on parents. PRACTICE IMPLICATIONS: By identifying related practice and education gaps, healthcare organizations can implement strategies to further support nurses in establishing partnerships and potentially optimize pain care practices.

Global prevalence and risk factors of emergence delirium in pediatric patients undergoing general anesthesia: A systemic review and meta-analysis.

PROBLEM: Emergence delirium (ED) in children post-general anesthesia has been persistently underestimated, impacting the well-being of children, nurses, and even parents. This study employs integrated analysis to establish a comprehensive understanding of ED, including its occurrence and related risk factors, emphasizing the imperative for enhanced awareness and comprehension among pediatric nursing care providers. ELIGIBILITY CRITERIA: A systematic review and meta-analysis were conducted using four electronic databases, namely PubMed, CINAHL via EBSCOhost, Embase via Elsevier, and ProQuest Dissertations and Theses. RESULTS: This meta-analysis included 16 studies involving 9598 children who underwent general anesthesia. The pooled prevalence of ED was 19.2% (95% confidence interval [CI] = 0.12 to 0.29), with younger patients exhibiting a higher prevalence of ED. ED research is scant in Africa and is mostly limited to the Asia Pacific region and Northern Europe. Neck and head surgery (odds ratio [OR] = 2.34, 95% CI = 1.29 to 4.27) were significantly associated with ED risk. CONCLUSIONS: ED should be monitored in children who receive general anesthesia. In this study, ED had a prevalence rate of 19.2%, and head and neck surgery were significantly associated with ED risk. Therefore, healthcare professionals should carefully manage and prevent ED in children undergoing general anesthesia. IMPLICATIONS: A comprehensive understanding of ED's prevalence and risk factors is crucial for enhancing nursing care. Adopting a family-centered care approach can empower parents with information to collaboratively care for their children, promoting a holistic approach to pediatric healthcare.

The Effect of Therapeutic Play on Children's Pain, Anxiety and Mothers' Anxiety during Pre- and Postcircumcision Period.

PURPOSE: The study was conducted to determine the effect of the therapeutic play method implemented on the pre- and postcircumcision pain and anxiety levels of children and mothers' anxiety levels in the pediatric surgery clinic. DESIGN: Prospective, randomized clinical trial. METHODS: The study consisted of children between the ages of 3 to 6 admitted to the pediatric surgery clinic and their mothers (N = 120; Therapeutic playgroup = 60, Control group = 60). As a therapeutic play method the children and their mothers used play dough during the structured conversation for about 10 minutes before and after the operation. A questionnaire, the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, the Children's Emotional Manifestation Scale (CEMS) anxiety scale, and State-Trait Anxiety Inventory-S (STAI-S) anxiety scale for parents were used to collect data. FINDINGS: In the pre- and postcircumcision period, the pain and anxiety levels of children and mothers' anxiety levels in the therapeutic playgroup were statistically lower compared to the control group (P < .05). In the postoperative period, a positive and significance correlation was found between anxiety levels of the mothers and pain and anxiety levels of children in the control group (P < .05). CONCLUSIONS: The therapeutic play method was effective in reducing the pain and anxiety levels of children and mothers' anxiety in the pre- and postcircumcision period.

Effect of vibratory device on the time of administration of vaccines and on patient satisfaction measures.

Previous studies have demonstrated that Buzzy® is effective for pain reduction during vaccination. This study aimed to determine if Buzzy® would have an effect on either duration of vaccine administration and/or patient satisfaction. Pediatric patients aged birth to 18 years old receiving a vaccination were randomized to either a control group receiving no intervention, or the experimental group, utilizing Buzzy®. Time of administration was measured by the number of seconds required by nursing to administer vaccines. Patient satisfaction was measured with a survey given to guardians. Time required was reduced by almost 2 min when utilizing Buzzy®, with median time dropping to 190, 95% CI [26.99, 415.92] seconds from 333, 95% CI [51.35, 627.21] seconds. Patient satisfaction surveys showed positive impacts of using the device, with 100% that used the device reporting that it "made a difference in the pain level experienced," but did not demonstrate statistical significance. This study shows that use of Buzzy® increases efficiency of appointments with possible positive effect on patient satisfaction.

Culturally sensitive emergency care for sexual and gender minority youth: A quality improvement initiative.

BACKGROUND: Despite evidence of the impact of provider implicit bias and overt discrimination experienced by sexual and gender minority youth (SGMY), evidence surrounding sexual and gender minority cultural sensitivity training for pediatric emergency health professionals is limited. No targeted training existed to improve the clinical preparedness of healthcare professionals serving SGMY by increasing providers' knowledge and attitudinal awareness in a pediatric emergency department at a large, urban pediatric hospital in the Southeastern United States. METHODS: The Institute for Healthcare Improvement's [15] Model for Improvement informed the project and was completed in four Plan-Do-Study-Act cycles. A cross-sectional, pre-test post-test design was used to gather demographic data, administer the LGBT-DOCSS questionnaire, and collect participant feedback on the training session. The LGBT-DOCSS results were analyzed using an independent samples t-test. INTERVENTIONS: Evidence-based pedagogical strategies were utilized for a 60-minute staff training session. Staff (n = 25) had six opportunities to attend one of the training sessions over a period of 4 months. RESULTS: Self-selection and voluntary participation contributed to recruiting participants who demonstrated high baseline LGBT-DOCSS scores, particularly on the subscales that measure knowledge and attitudinal awareness. After the sessions, participants showed an increase in LGBT-DOCSS scores with a statistically significant increase in the clinical preparedness subscale. CONCLUSIONS: This project was the first at the institution to focus on culturally sensitive emergency care for sexual and gender minority youth. The content was well received by staff, who demonstrated increased clinical preparedness after the training. Implementing the training as a required component of new nurse orientation and onboarding is the next step in creating a safety culture for SGMY in the PED setting.

Social Responsibility and Commitment to Children; Pediatric Nurses' Experiences With Redeployment During the First Wave of COVID-19: A Qualitative Study.

COVID-19 represented a challenge for health care worldwide and led to new tasks and a rethinking of resource use. It was necessary to establish capacity within hospitals and to reassign critical resources between hospitals. This study aimed to explore pediatric nurses' experiences of redeployment, new tasks, and use of specialized competencies during the first wave of COVID-19. An exploratory design, involving qualitative individual interviews with 12 pediatric nurses was used. The analysis resulted in 3 main themes. Firstly, a feeling of social responsibility focused on how pediatric nurses felt committed to use their competencies during the crisis, whether they remained on the pediatric ward or were redeployed. Secondly, fewer children to counterbalance the shortage of pediatric nurses showed how redeployment was offset by fewer pediatric patients. Thirdly, adapting pediatric nursing competencies to new tasks described how the nurses adapted their skills to new tasks either in pediatric or adult wards. The results revealed that pediatric nurses had a social and ethical commitment to society in a crisis. They agreed to be redeployed and take on new tasks but were still concerned about the health and well-being of the children and their families, which led to a sense of ambivalence. They questioned whether their skills were being used appropriately in redeployment to adult wards. Fewer pediatric patients mitigated the workload of the remaining nurses. There is a risk of neglecting the needs of hospitalized children and their families during a pandemic. There was concern that "voluntary coercion" was a counterproductive strategy for reassignment.

Assessing the readiness to transition to adult care, perceived medication barriers, and glycemic control among teens with type 1 diabetes.

AIM: This study assessed the readiness to transition (RT) from pediatric to adult care, perceived medication barriers (PMB), and glycemic control in teens with type one diabetes (T1D). BACKGROUND: During the transition from pediatric to adult care, teens with T1D are at risk of long-term complications related to impaired adherence. With the increasing prevalence of T1D in Saudi Arabia, research is required to identify the challenges facing teens with T1D during their transition. METHODS: This was a cross-sectional study with a convenient sample of 83 adolescents (12-17 years old) diagnosed with T1D for ≥6 months, their parents, and their pediatric endocrinologists from the pediatric endocrinology clinic in a tertiary hospital in Riyadh. The RT Questionnaire was used to measure RT, and the Medication Barriers Scale was used to measure PMB. Glycemic control was measured using hemoglobin A1c (HbA1c). RESULTS: About 96 % of teens had HbA1c > 7 %. Male teens had higher HbA1c than female teens. Teens and their parents reported high PMB and low RT. PMB (teens), disease duration, family history of diabetes mellitus, and comorbidity were significant predictors of RT (parents). PMB (teens), teens' age, and having a family history of diabetes mellitus were significant predictors of RT (providers). RT (parents) and RT (providers) were the only significant predictors of HbA1c, with RT (providers) being the strongest predictors of HbA1c. CONCLUSIONS: Health policy reform is required to develop national RT programs to prepare teens with T1D to take full responsibility for managing their medical conditions while ensuring adherence.

The effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing.

PURPOSE: Comparing the effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. DESIGN AND METHODS: In this quasi-experimental study, 76 undergraduate nursing students were enrolled through a convenience sampling method, and were allocated to one of the three groups of serious game, problem-based learning, and control through the block randomization method. Data were collected using a valid and reliable 3-part researcher-made tool, completed before and two weeks after the intervention. Statistical analysis was performed using paired t-test, analysis of covariance, and Bonferroni post hoc test. A significance level of <0.05 was considered. RESULTS: After the intervention, mean scores of both knowledge and clinical decision-making skill increased significantly in both intervention groups (p < 0.05). Mean post-test scores of both knowledge and clinical decision-making skill in the serious game group, and only clinical decision-making skill in the problem-based learning group were significantly higher than the control group (p < 0.05). However, no significant difference was observed regarding mean post-test scores of both knowledge and clinical decision-making skill between the intervention groups (p > 0.05). CONCLUSIONS: Both serious game and problem-based learning are proven to be effective in improving nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. PRACTICE IMPLICATIONS: Since learning now occurs beyond classrooms and the new generation of students spend most of their time in virtual places, utilizing technology-based teaching methods like serious games can benefit both educators and students by providing continuous education, saving their time and expenses, etc.

Problem-solving processes for central venous catheter occlusion within pediatric cancer care: A qualitative study.

PURPOSE: Central venous access devices play a crucial role in healthcare settings. However, there is concern regarding the high incidence of blockages occurring before the completion of treatments and existing guidelines for occlusion management are not consistently followed. To explore the decision-making and problem-solving process of occlusion management and identify enablers and barriers to implementing evidence for occlusion management in pediatric cancer care. METHODS: A qualitative design with individual semi-structured interviews. Participants were selected by purposeful sampling from a tertiary-referral pediatric facility, and semi-structured interviews were conducted. RESULTS: A total of 13 clinicians and 5 parents were interviewed. The thematic analysis revealed four main decision-making/problem-solving themes: 1) clinical reasoning and judgement for central venous access devices occlusion, 2) capability in central venous access devices occlusion management, 3) colleague collaboration in the escalation process and 4) lack of adequate support to manage the occlusion. This study identified positive and negative influences on the problem-solving process, including clinicians' psychological capabilities, social and physical resources, and beliefs about consequences. CONCLUSION: This study found that clinicians in pediatric cancer care were able to manage central venous access device occlusions using clinical reasoning and judgment skills, which may conflict with evidence-based practices. The study confirmed the importance of a team approach and prior experience in managing central venous access devices in pediatric oncology settings and identified potential conflicts between clinician decisions based on the patient's current and anticipated conditions and implementation of evidence-based practice. Improving documentation and providing visual aids could benefit clinicians' problem-solving processes.

Developing and validating a 2D digital version of the Brazilian Children's anxiety questionnaire.

PURPOSE: This study aims to transpose the printed Brazilian Children's Anxiety Questionnaire (CAQ BR) into a 2D digital format, validate it with nurses and hospitalized children, and analyze the association between the printed and 2D digital format versions. DESIGN AND METHOD: This is a descriptive and multicentric study, conducted from 2021 to 2022 on working in pediatric care at two hospitals in Brazil. The nurses analyzed the printed and digital instruments and subsequently applied them to a child and proposed suggestions. A cutoff score of 0.80 on the content validity index was used; items that scored an average lower than the CVI in the study were adequate. Eighty children responded to the questionnaires sequentially according to the randomization table. A 90% agreement rate was used. RESULTS: The digital instrument was validated in content by 51 experts, with a CVI of 0.95. Face validation data for 80 children (mean age = 7.9 years) shows a 90% agreement rate. The intraclass correlation index for the general score was 0.87 and 95% CI (0.79-0.91), which shows good stability of the children's responses in both questionnaires. In addition, 59% (n = 47) of the children reported a preference for the digital questionnaire. CONCLUSIONS: The digital CAQ BR can be used as an audiovisual instrument by nurses when implementing the systematization of nursing care in pediatrics. PRACTICAL IMPLICATIONS: The digital 2D version was successfully applied and can be used in hospitals to measure children's self-reported anxiety.

Challenges experienced by pediatric nurses in the process of developing innovative products: A qualitative study.

OBJECTIVE: As essential healthcare providers, nurses are key to contributing innovations to improve the quality of care. This study aimed to explore the challenges pediatric nurses face in developing and patenting innovative products. METHOD: A qualitative descriptive design has been used in this study. The study sample consists of pediatric nurses who had developed innovative products and successfully obtained product registrations. Purposive sampling was used to select 17 pediatric nurses who met the inclusion criteria. Data were collected through semi-structured, individual, in-depth interviews. RESULTS: Two main themes and two related subthemes were identified. The first main theme is 'product development and management challenges.' The subthemes of this theme are 'unknown ecosystem' and 'burnout.' The second theme is 'protecting ideas and innovation.' The subthemes of this theme are 'fear of idea theft' and 'dead patents.' CONCLUSION: Nurses face challenges, such as taking part in an unfamiliar innovation ecosystem, burnout due to long processes, and fear of idea theft. At the same time, commercialization of these innovations and market demand emerge as additional challenges. PRACTICE IMPLICATIONS: Identifying the challenges experienced by pediatric nurses during the innovation process can help to develop strategies to overcome difficulties, create an innovation culture, and increase the quality of pediatric patient care.

"100 Things I Wish Someone Would Have Told Me": Everyday Challenges Parents Face While Caring for Their Children With a Tracheostomy.

Equitable access to appropriate care, emergency department services, and in-home support aids are needed to minimize the occurrences of adverse events that have a significant impact on families. However, many families of children with medical complexity (CMC) lack consistent care due to issues of health inequity. We conducted 11 qualitative interviews with primary caregivers who were asked about their experiences of providing care to children who have a tracheostomy and are supported by multiple life-saving machines at home. Guided by ecological systems theory, we identified three themes that contextualize the lived experiences of the participants who expressed needs that arose from poor interactions within the mesosystem. Findings convey participant frustrations that result from insufficient support, ineffective training, and inadequate healthcare coverage. Although each theme is organized systematically to emphasize specific concerns within the mesosystem, together these themes emphasize the inextricable relationship between daily needs with systemic barriers to care. We provide a discussion of these needs with a broader context that also impacts the perceived quality of care among families managing the needs of their children who are supported by life-saving technology. By addressing existing challenges and identifying opportunities for improvement within the healthcare system, we seek to contribute to the collective effort of advocating for ethical systemic change on behalf of CMC and their families.

Construction and Validation of a Simulation Scenario for Teaching Family-Focused Care in Pediatric Oncology.

Clinical simulation can be a promising teaching strategy to help nurses develop behaviors that improve family care actions, promoting safe and high-quality care. The objective of this study was to build, validate, and test a simulation scenario in pediatric oncology family-focused care (FFC) following an initial diagnosis of cancer. It is a six-step methodological study based on the philosophy of Family-Centered Care (FCC), with a user-centered design. The evaluators established a Content Validity Index (CVI) > 0.8 for validation. Pilot testing included the Simulation Design Scale. The data were analyzed by descriptive statistics. A total of 35 experts participated in this study. All 19 items in the scenario were validated and considered relevant, in a single round, with the item-level CVI ranging between 0.8 and 1 and a scale-level CVI of 0.92. The high-fidelity developed and validated clinical simulation scenario is a consistent tool for the education of advanced practice nurses.

An Exploratory Analysis of the Roles of Nurses on a Pediatric Rehabilitation Unit in South Korea Perceived by Pediatric Rehabilitation Professionals.

Rehabilitation addresses not only children's disabilities but also their physical, psychological, social, and cultural impairments. Hence, pediatric rehabilitation adopts a multidisciplinary approach; it encompasses the vital role of not only physicians and rehabilitation therapists, but also of nurses. This study conducts a content analysis of the experiences of healthcare professionals specializing in pediatric rehabilitation to explore the roles nurses working on pediatric rehabilitation units are expected to perform. After analyzing the interviews with 12 experts in pediatric rehabilitation, the roles of pediatric rehabilitation nurses were broadly categorized into five areas (caregivers, team members, counselors, researchers, and educators) with eight sub-groups and 24 specific roles. This study is significant because it provides profound insights into the roles of pediatric rehabilitation nurses in Korea. These insights can serve as foundational data for formulating policies for healthcare personnel in pediatric rehabilitation, and provide evidence for establishing a much-needed system for certified rehabilitation nurses in Korea.

An evaluation of pediatric emergency cases in the first year of the COVID-19 pandemic: A single-centre experience.

AIM: Nurses responsible for the care of children in the emergency department must be aware of the case profile of the pandemic era, better prepare for developing crises, and identify preventive services. The study aims to determine the pediatric emergency cases admitted during the pandemic and compare them to those during the pre-pandemic period. METHODS: The current study was designed as a single-center, retrospective, cross-sectional, and descriptive research. All patients aged between 0 and 18 who presented to the pediatric emergency department and had electronic patient records were included in the research population. The data were gathered over two periods: the pre-pandemic period from 2019 to 2020 and the pandemic period from 2020 to 2021. A total of 145,591 patient records were analyzed. RESULTS: The number of admissions declined by 51.6% during the pandemic, and a noticeable difference in the reasons for emergency department visits (p = 0.001) was detected. The pandemic saw a decrease in the cases of respiratory, gastrointestinal diseases, and ear, nose, and throat problems. In contrast, there was an increase in the cases of musculoskeletal system diseases, infections, falls, traumas, and neonatal problems. CONCLUSION: The number of pediatric emergency cases decreased significantly during the pandemic, and compared to the pre-pandemic period, some changes in these cases were observed. PRACTICAL IMPLICATIONS: Particular attention should be given to ensuring that mothers of newborn infants receive adequate nursing care. Nurses working in the emergency department should keep their knowledge up-to-date regarding the changing health issues specific to the pandemic period.

Developing the scale of genetic/genomic awareness in pediatric nurses.

OBJECTIVE: In recent years, genomic information and technology have been increasingly integrated into healthcare services for the prevention of genetic diseases, screening, diagnosis, treatment selection, and follow-up of treatment efficacy. The aim of the study was to develop the Scale of Genetic/Genomic Awareness in Pediatric Nurses (SGAPN) and to evaluate its psychometric properties. MATERIAL AND METHODS: This was a methodological study covering the development of the SGAPN and testing its psychometric properties. SGAPN items were developed based on a literature review and were evaluated by content validity. The SGAPN was then tested for internal consistency coefficients, face validity, criterion validity, and construct validity in a convenience sample of 280 pediatric nurses. RESULTS: The SGAPN is a scale consisting of 32 items. Its Cronbach alpha value was calculated as 0.893. It has a structure with three factors including "genetic/genomic information" (13 items), "genetic transmission information" (7 items), and "genetic education and practices" (12 items). The Cronbach alpha values of the factors were 0.845, 0.600, and 0.893, respectively. CONCLUSION: It is suggested that the SGAPN can be used as a valid and reliable scale in the evaluation of the genetic/genomic information, education, and practices of pediatric nurses.

Development and psychometric analysis of the smombie scale for adolescents.

PURPOSE: Adolescent pedestrian accidents are increasing because of the "smombie" phenomenon, referring to pedestrians who are distracted by their smartphones and become unaware of their surroundings. In the field of nursing, this phenomenon can negatively affect adolescents' health and well-being. We developed the "smombie scale for adolescents" and examined its psychometric properties. DESIGN AND METHODS: We revised five items and the response scale of an existing smombie scale for adults based on cognitive interviews and content validity test, and included guiding descriptions for adolescents. Using the revised scale, we surveyed 430 adolescents from South Korea to assess construct validity through confirmatory factor analysis. To review group validity, a logistic regression was conducted using responses to the item on whether participants experienced accidents related to smartphone usage on the street or sidewalk. RESULTS: The 15 items in the four-factor structure, which was validated using confirmatory factor analysis, demonstrated: a chi-square value (p) of 232.63 (< 0.001), root mean square error of approximation of 0.06, goodness of fit index of 0.93, and Tucker-Lewis index of 0.94. The scale's Cronbach's α was 0.85, indicating good internal consistency. Logistic regression results considering actual accident occurrence showed that Factor 1 (perceived risk) and Factor 3 (pending instant message) were significantly correlated with smombie-related accidents. CONCLUSIONS: The smombie scale for adolescents demonstrated adequate construct and group validity, and good reliability. PRACTICE IMPLICATIONS: Its application can yield valuable insights into the effectiveness of pediatric nurses' educational and preventative efforts related to the smombie phenomenon in adolescents.

The association of fear of COVID-19 on occupational stress in pediatric nurses: Examining the mediating role of psychological well-being.

PURPOSE: This study investigated the associations of fear of COVID-19 with occupational stress and the mediating role of psychological well-being in pediatric nurses. METHODS: This cross-sectional study was conducted between December 2021 and February 2022. The sample consisted of 464 pediatric nurses from public or university hospitals in Türkiye. Data were collected using a sociodemographic characteristics questionnaire, the Fear of COVID-19 Scale, the Occupational Stress Scale, and the Psychological Well-Being Scale. The data were analyzed using Pearson's correlation and regression analysis. RESULTS: Participants' fear of COVID-19 was positively associated with their occupational stress (F = 17.263; p < 0.001) but negatively associated with their psychological well-being (F = 10.575; p = 0.001). Their psychological well-being was negatively associated with their occupational stress (F = 22.084; p < 0.001). Nurses fear of COVID-19 explained three and 2 % of their occupational stress and psychological well-being, respectively. Nurses' psychological well-being explained 4 % of their occupational stress. The results showed that participants' psychological well-being did not mediate between their fear of COVID-19 and occupational stress. CONCLUSION: Pediatric nurses fear COVID-19 but have an above-mean level of occupational stress and psychological well-being. In conclusion, psychological well-being does not mediate between pediatric nurses' fear of COVID-19 and occupational stress. PRACTICE IMPLICATIONS: The pandemic was a traumatic experience for pediatric nurses. Hospital administrators and nurse managers must monitor the psychosocial health of pediatric nurses and support them in times of crisis.

Psychometric properties of the Turkish version of the parental competence scale for parents of children with autism.

BACKGROUND: Parental competence is an important concept in increasing the quality of care provided to individuals with special needs and the quality of life of parents. This study was aimed to evaluate the psychometric properties of the Turkish version of the Parental Competence Scale designed for parents of children with autism spectrum disorders. METHOD: This methodological study was conducted with 433 parents of children with autism between November 2021 and February 2023. Information Form, the Parental Competence Scale for Parents of Children with Autism, and the Parental Self-Efficacy Scale were used to collect the data. The data were assessed using content and construct validity, item analysis, confirmatory factor analysis, and internal consistency. Guidelines for reporting reliability and agreement studies (GRRAS) were adhered to in the study. FINDINGS: The content validity index of the scale was 0.93. Item-total score correlation values ranged from 0.338 to 0.846. As a result of confirmatory factor analysis, the two-factor structure of the scale consisting of 19 items was confirmed. Factor loads were >0.30 and fit indices were >0.80. The Cronbach's alpha coefficient of the Turkish version of the scale was 0.85, and the Cronbach's alpha values of its sub-dimensions were 0.71 and 0.79. CONCLUSION: The parental competence scale for parents of children with autism is a valid and reliable measurement tool for Turkey. PRACTICE IMPLICATIONS: Pediatric nurses, all health professionals, special education professionals and teachers can use this scale in interventional studies aiming to evaluate or improve the competencies of parents with autistic children in the future.

La enfermera oncológica infantil en primera persona: influencia en el cuidado entregado / Transitioning from nurse to pediatric oncology nurse: first-person nursing experience

Objetivo principal: Explorar la vivencia de las enfermeras oncológicas pediátricas de un hospital público chileno al trabajar en unidades oncológicas pediátricas y determinar si esta vivencia influye en el cuidado entregado. Metodología: Investigación fenomenológica. Se realizó entrevista en profundidad y fotointervención a cinco enfermeras oncológicas pediátricas entre septiembre 2019 y junio 2020. Resultados principales: La creación de lazos emocionales profundos y significativos con sus pacientes, hace a estas enfermeras mover los límites profesionales autoimpuestos, quedando expuestas al sufrimiento que produce la enfermedad y el duelo, resignificando sus vidas. Reconocen entregar un cuidado particular: Sentipensante. La sobrecarga laboral y emocional, sumado al poco reconocimiento de su rol, favorecerían los conflictos. Se observa búsqueda de contención emocional, reconociendo la necesidad de contención profesional. Conclusión principal: La vivencia de estas enfermeras permea el cuidado entregado y las hace transitar hasta ser enfermeras oncológicas infantiles.(AU)

Objective: To explore the experience of pediatric oncology nurses in a Chilean public hospital when working in pediatric oncology units and to determine whether this experience influences the care provided. Methods: Phenomenological research. In-depth interview and photointervention were conducted with five pediatric oncology nurses between September 2019 and June 2020. Results: The creation of deep and meaningful emotional bonds with their patients, makes these nurses move the self-imposed professional limits, being exposed to the suffering produced by the disease and bereavement, resignifying their lives. They recognize to deliver a particular care: Sentipensante. The work and emotional overload, added to the little recognition of their role, would favor conflicts. The search for emotional support is observed, recognizing the need for professional support. Main conclusion: The experience of these nurses permeates the care delivered and makes them transition to become pediatric oncology nurses.(AU)