Medical device-related pressure injuries in paediatric patients: An incidence study in a children's hospital.

AIM: To determine the incidence of pressure injuries from medical devices in children. BACKGROUND: Medical devices can cause pressure injuries on skin and soft tissues. DESIGN: A prospective, descriptive study adhering to STROBE guidelines. METHODS: This study was conducted in the third-level Paediatric Intensive Care Unit of Ege University Hospital in Izmir, Türkiye between April 2019 and October 2019 in Türkiye. Patients aged between 1 month and 18 years with medical devices were observed for pressure injuries using Braden scales and a specific monitoring form. RESULTS: In this study, we followed 522 medical devices applied to 96 patients. The three most commonly used medical devices were the ECG probe (21%), the blood pressure cuff (16%) and the saturation probe. Out of the 522 medical devices followed, 36 caused pressure injuries (6.8%). CONCLUSION: The incidence of medical device-related pressure injuries was found to be high. Effective training and implementation strategies need to be devised for paediatric nurses to prevent pressure injuries associated with medical devices. RELEVANCE TO CLINICAL PRACTICE: The results of this study reveal that pressure injuries related to medical devices are an important health problem in paediatric hospitals. Therefore, awareness-raising and educational activities among health professionals and nurses should be accelerated. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution in the study.

The experiences of the families with children diagnosed with osteogenesis imperfecta: A Qualiative study in Turkey.

BACKGROUND: The diagnosis of osteogenesis imperfecta affects the whole lives of family members. This study aims to investigate the lived experience of families with children diagnosed with osteogenesis imperfecta. DESIGN AND METHODS: This study used a qualitative, phenomenological design. The study sample consisted of parents of the children who were followed up with the diagnosis of osteogenesis imperfecta in the pediatric endocrinology clinic in Turkey. In order to collect data, a semi-structured interview form was prepared, and data were collected by way of face-to-face interviews. The lived experience of families were analyzed using qualitative methods. The life experiences of the families were analyzed in depth using qualitative methods. RESULTS: In the study, six themes were identified, including having a child diagnosed with osteogenesis imperfecta, family process, life patterns, emotional dimension, social life, and economic dimension. The results revealed that parents did not know about the disease upon learning of the child's diagnosis. Parents stated that they experienced anxiety, disappointment, sadness, denial, and despair when they first learned about their children's diagnosis. They also indicated that having a child with osteogenesis imperfecta affected the whole family in physiological, psychological, and social aspects. CONCLUSION: Parents and children should be given information about the disease since the first diagnosis of osteogenesis imperfecta, and psychosocial support should be provided. Families that can not get sufficient psychosocial support experience difficulties in the medical and care management of the disease. PRACTICE IMPLICATIONS: Knowing and understanding the lived experiences of families living with osteogenesis imperfecta can guide the planning and implementation of quality nursing care processes.

Efficacy of Veinlite PEDI in Pediatric Peripheral Intravenous Access: A Randomized Controlled Trial.

METHODS: A total of 112 pediatric patients were enrolled in the study. Children who presented to the emergency department aged 1 to 10 years old were randomly assigned to the Veinlite PEDI (Veinlite) group or standard of care (SoC) group. The primary outcome measure was first attempt success. Secondary outcome measures were number of intravenous (IV) attempts and time to peripheral intravenous catheter (PIC) placement. RESULTS: A total of 110 patients completed the study: 58 boys and 52 girls. The first attempt success rate was significantly higher in the Veinlite group compared with the SoC group (92.9% vs 72.2%, P < 0.004). In addition, the Veinlite group had a fewer number of attempts compared with the SoC group (1.07 ± 0.54 vs 1.31 ± 0.25, P = 0.04). The Veinlite group resulted in a shorter total time of attempts per patient compared with the SoC group (49.98 ± 18.4 vs 59.68 ± 22.5 P = 0.01). CONCLUSIONS: The use of new technology in the Veinlite PEDI (TransLite, Sugar Land, Tex), to assist with peripheral IV access in children, improves the first time success rate for IV access. Improved visualization of veins also reduced the number of attempts and the time required for PIC placement. These results suggest that the new technology of the Veinlite results in better PIC access than Veinlite transilluminaton device with white light.

Psychometric Properties of the Turkish Version of the Neonatal Infant Acute Pain Assessment Scale.

PURPOSE: Even the healthiest neonates experience pain during painful interventions (e.g. administration of Vitamin K, heel lance) in their first moments of life. This study aimed to examine the validity and reliability of the Turkish version of the Neonatal Infant Acute Pain Assessment Scale. DESIGN AND METHODS: This methodological study was conducted with 100 newborns receiving treatment and care in a tertiary neonatal intensive care unit. The data were collected using the Neonate Demographic Form, the Neonatal Infant Acute Pain Assessment Scale, and the Premature Infant Pain Profile. The scale was analyzed in terms of validity, internal consistency, and interobserver reliability. RESULTS: The content validity index of the scale was found to be between 0.87 and 1.00, while Cronbach's alpha coefficient was between 0.708 and 0.833. According to the item analysis results, item-total correlation values were high. A strong positive correlation was found between the scores of the two scales that were analyzed for concurrent validity. CONCLUSIONS/PRACTICE IMPLICATIONS: The Turkish version of the Neonatal Infant Acute Pain Assessment Scale was determined to be valid and reliable. More studies should be done to accurately measure and effectively manage neonatal pain.

The effect of simulation-based education on childhood epileptic seizure management knowledge, skills, and attitudes of nursing students.

BACKGROUND: Lack of knowledge about epileptic seizure management and negative attitudes toward children with epilepsy among nursing students may negatively affect the quality of healthcare services they deliver. AIM: This study aimed to examine the effect of training given to nursing students using simulation and standard child mannequins on their childhood epileptic seizure management knowledge, skills, and attitudes. METHODS: Participants (n = 72) were recruited from a Nursing Faculty in Izmir, Turkey. Students were randomly assigned to the intervention and control groups (n = 36 in each). The intervention group received simulation-based training on epilepsy while the control group received standard child mannequin training on epilepsy. One week after the training, the students were asked to demonstrate their epileptic seizure management knowledge and skills on a simulation model or a standard child mannequin. During this process, they were observed and assessed by two independent observers on the basis of a list of epileptic seizure management skills. All participants completed the personal information form, the Epilepsy and Epileptic Seizure Management Knowledge Test, and the Epilepsy Knowledge and Attitude Scale before, and after the training, McNemar's test, repeated measure ANOVA (intravenous), dependent t-test, chi-square test, Fisher's exact test, independent t-test, Pearson's correlation analysis, and Pearson's chi-square test were used to compare the groups. Intraclass correlation coefficient (ICC) was used to evaluate the consistency between observers. RESULTS: The epilepsy knowledge scale mean scores of both groups significantly increased after their respective trainings (p < 0.001), but the difference between the groups was not statistically significant (p = 0.829). There was no statistically significant difference between the pre- and posttraining epilepsy attitude scale mean scores of the control group (p = 0.630), however, a statistically significant increase was observed in the epilepsy attitude scale mean score of the intervention group (p = 0.008). In addition, both groups' self-confidence in epileptic seizure management significantly increased after the training (p = 0.000). CONCLUSIONS: Simulation-based training was beneficial for students insofar as it helped them to develop positive attitudes toward epilepsy.

The effectiveness of aromatherapy massage using lavender oil as a treatment for infantile colic.

The aim of this paper was to investigate the effect of aromatherapy massage using lavender oil as a possible treatment for this condition. This research was carried out on a group of 40 infants between 2 and 6 weeks of age with a gestational age of 38-42 weeks and normal development and growth. All the infants weighed between 2500 and 4000 g at birth and all exhibited the signs of colic. Infants in the treatment group received abdominal massage by their mothers using lavender oil, while those in the control group were not subject to an intervention. The infants in both control and treatment groups were monitored once a week by the researchers, in total five times. The effect of the massage was measured in terms of changes in the length of time the infants cried per week. The use of aromatherapy massage using lavender oil was found to be effective in reducing the symptoms of colic.

Depression among mothers of children and adults with an intellectual disability in Turkey.

The aim of this study was to determine sociodemographic factors that play a role in depression among mothers of children and adult with an intellectual disability. The research was conducted in 24 special education and rehabilitation centres in Izmir (in Turkey) provincial centre in which intellectually disabled individuals are taught. A total of 355 mothers were reached in the research. Data were collected using face-to-face interviews. Two forms were used for data collection in the research: Family Description Questionnaire Form and Beck Depression Inventory. The mothers included in the study had mean depression scores of 16.7 +/- 10.06 (minimum: 0, maximum: 49). There was a significant relation between depression scores of the mothers and education level of the mothers and their spouses and financial status of the families. Mothers with insufficient income and lower education levels were found to be at risk of depression.

The effects of auditory interventions on pain and comfort in premature newborns in the neonatal intensive care unit; a randomised controlled trial.

OBJECTIVE: This study investigated the effects of three auditory interventions; white noise, recorded mother's voice, and MiniMuffs, applied during a heel lance on pain and comfort in premature infants in the neonatal intensive care units. DESIGN AND METHODS: This experimental, parallel, randomised controlled research was conducted in a state hospital tertiary-level neonatal intensive care unit. The sample comprised sixty-four premature infants with gestational ages of 31-36 weeks. The infants were randomly assigned to four groups: i) white noise, ii) recorded mother's voice, iii) MiniMuffs, and iv) control. Pain and comfort of newborns were evaluated according to the Neonatal Infant Pain Scale (NIPS) and the COMFORTneo scale. Oxygen saturation, heart rate, and crying time were also measured. RESULTS: The mean of oxygen saturation levels in the white noise, recorded mother's voice, and MiniMuffs group were higher than the control group. The heart rate, crying time, mean NIPS score, COMFORTneo score of the premature neonates in the white noise, recorded mother's voice, and MiniMuffs groups were significantly lower than the control group (p < .001). CONCLUSION: Auditory interventions used during heel lance reduce the pain and increase the comfort of the premature infants. White noise is extremely effective in preventing infants's pain.

Semiologic seizure classification: the effectiveness of a modular education program for health professionals in pediatrics.

We tested the effectiveness of a modular education program on Semiologic Seizure Classification (SSC) in helping health professionals in pediatrics correctly recognize seizures in childhood. The study samples included 20 residents, 20 nurses, and 10 EEG technicians working in pediatrics. The study was conducted in two steps. First, a modular education program comprising CD-ROMs including 58 video clips of epileptic seizures designed for the original SSC was developed. Second, each participant took a pretest by viewing the pretest CD-ROM, participated in the modular education program with a CD-ROM, and finally took a posttest with the posttest CD-ROM. The pretest scores were found to be low in each subgroup of the study population: the average scores were 8 for the residents (minimum 4-maximum 10), 2 for the nurses (min 0-max 4), and 2.5 for the EEG technicians (min 0-max 8). After participating in the modular education program, correct recognition of seizures increased in the posttest: the average scores were 15.5 for the residents (min 9-max 20), 15 for the nurses (min 13-max 20), and 13.5 for the EEG technicians (min 3-max 19). The increase in the scores in the subgroups and in all study groups in general was found to be statistically significant (P<0.05). The modular education program developed for SSC was found to be highly effective in teaching health professionals working in general pediatric clinics to correctly recognize seizure types.

Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit.

AIM: This study was planned for the purpose of determining the effect of stress-reducing nursing interventions on the stress levels of mothers and fathers of premature infants in a Neonatal Intensive Care Unit (NICU). DESIGN: Randomised intervention. BACKGROUND: The physical and psychosocial environment of the NICU is a major factor in the stress experienced by the family. METHOD: Interviews were conducted with the parents of premature infants who agreed to participate in the research. An approximately 30-minute educational programme about their infant and the intensive care unit was held for the mothers and fathers in the intervention group within the first week after their infant was admitted to the intensive care unit. Then they were introduced to the unit and personnel. They were given the information they requested and their questions were responded to. The parents in the control group received nothing in addition to the routine unit procedures. The mothers and fathers' stress scores were measured for both groups after their infants' 10th day in the NICU with the Parental Stress Scale: NICU (PSS:NICU). RESULTS: The difference between the intervention group and the control group mothers' mean stress score was found to be statistically significant (t = 4.05, p < 0.05). It was determined that the stress scores for the fathers in the treatment group in this research were lower, but the difference between the two groups was not found to be statistically significant (p > 0.05). CONCLUSION: It has been determined that parents experience very high stress levels when their infants are admitted to an NICU and that there are nursing interventions which can be implemented to decrease their levels of stress. RELEVANCE TO CLINICAL PRACTICE: Determining the sources of stress experienced by parents can help NICU nurses use appropriate interventions in cooperation with other members of the team to decrease the stress that parents experience.

The effect of nesting positions on pain, stress and comfort during heel lance in premature infants.

BACKGROUND: Nesting positions are commonly used in procedural analgesic administration in premature neonates. The effectiveness of nesting positions is questioned. The aim of the this study was to assess the pain, stress, comfort and salivary cortisol and melatonin values in nesting positions during the heel lance procedure in premature infants at the NICU. METHODS: Experimental research; repeated measurement design. The sample comprised 33 premature neonates with gestational age of 31-35 weeks who had been hospitalized in the NICU. Nesting positions were given using linen or towels. The procedure of heel lance was recorded on camera. The camera recordings were evaluated according to the NIPS and the COMFORTneo scale. Saliva samples were obtained five minutes prior to and 30 min after the heel lance procedure. Salivary Cortisol and Melatonin were measured using the Salimetrics Cortisol Elisa Kit and the Salimetrics Melatonin Elisa Kit. RESULTS: The crying time, the mean NIPS score, the COMFORTneo score, the COMFORTneo NRS-pain scores and the COMFORTneo NRS-distress scores for premature neonates who were in the prone position during the procedure were significantly lower than the scores in the supine position (p < 0.000). Furthermore, the level of salivary cortisol five minutes prior to and 30 min after the heel lance procedure had significantly decreased in the prone position; however, there were insignificant differences in the mean levels of salivary melatonin between the positions. CONCLUSIONS: Nesting in the prone position has a pain reducing effect, enhancing comfort and reducing stress in premature infants.

Infiltration and extravasation in pediatric patients: A prevalence study in a children's hospital.

PURPOSE: The aim of this study is to determine the prevalence of infiltration and extravasation among children staying in a children's hospital and the interventions carried out when infiltration or extravasation occurred. METHODS: A prospective and descriptive research design was used in the study, conducted between September 2015 and February 2016, and determined the prevalence of infiltration and extravasation and their characteristics. The study sample consisted of 297 peripheral catheters in 173 pediatric patients. RESULTS: Of 297 peripheral catheters, 50.8% were located on the right and 30.6% were inserted in the dorsal metacarpal vein. Infiltration and extravasation occurred in 2.9% and 2.3% of the patients, respectively. The prevalence of infiltration and extravasation was 5.5 and 4.4 per 1000 patient-days, respectively. The applied interventions after infiltration or extravasation included covering with a gauze dressing or alcohol-soaked cotton, cold application, irrigation with physiological saline, and elevation. CONCLUSION: The infiltration and extravasation prevalence were found to be high, but the interventions to address them were inadequate. Training and implementation strategies should be planned for pediatric nurses to prevent infiltration and extravasation.

A study of the relationship between the study process, motivation resources, and motivation problems of nursing students in different educational systems.

BACKGROUND: The study process is related to students' learning approaches and styles. Motivation resources and problems determine students' internal, external, and negative motivation. Analyzing the study process and motivation of students yields important indications about the nature of educational systems in higher education. OBJECTIVES: This study aims to analyze the relationship between the study process, and motivation resources and problems with regard to nursing students in different educational systems in Turkey and to reveal their effects according to a set of variables. DESIGN: This is a descriptive, cross-sectional and correlational study. SETTINGS: Traditional, integrated and problem-based learning (PBL) educational programs for nurses involving students from three nursing schools in Turkey. PARTICIPANTS: Nursing students (n=330). METHODS: The data were collected using the Study Process Questionnaire (R-SPQ-2F) and the Motivation Resources and Problems (MRP) Scale. RESULTS: A statistically significant difference was found between the scores on the study process scale, and motivation resources and problems scale among the educational systems. This study determined that the mean scores of students in the PBL system on learning approaches, intrinsic motivation and negative motivation were higher. A positive significant correlation was found between the scales. CONCLUSIONS: The study process, and motivation resources and problems were found to be affected by the educational system. This study determined that the PBL educational system more effectively increases students' intrinsic motivation and helps them to acquire learning skills.

[Investigation of nurses' pain related knowledge, attitude and clinical decision making skills]. / Hemsirelerin agri ile ilgili bilgi, davranis ve klinik karar verme yeteneklerinin incelenmesi.

The purpose of this study was to investigate the nurses' ain related knowledge, attitude and clinical decision making skills. Three instruments were used in the study: (1) Nurses' Introduction Form, (2) The Nurses' Knowledge and Attitudes Questionnaire and (3) Clinical Decision Making Survey Questionnaire developed by McCaffery and Ferrell was translated into Turkish and used with permission. The results showed that many nurses have inadequate knowledge about pain assessment and management, nurses' (% 47.4) did not observe patient's behaviors to determine/assess the patient's intensity of pain and % 74.5 of nurses' did not use pain assessment scales to measure the patient's pain.

[Validity and reliability study of sedation diagnosis method comfort scale]. / Sedasyon tanilama yöntemi- konfor skalasinin geçerlik güvenirlik çalismasi.

OBJECTIVES: The aim of the present methodological descriptive study was to test the validity and reliability of the COMFORT scale. METHODS: The study was conducted at a pediatric critical care unit at a university hospital between February 2009 and June 2010. Study sample included 84 pediatric patients (n=37) receiving mechanical ventilation. Data were collected via child information form, COMFORT scale, and visual analog scale (VAS). Having been assured of the language and context validity of the scale, researchers conducted reliability tests (Cronbach's alpha coefficient, item analysis), inter- and intra-observer reliability tests, and correlation analyses based on the data obtained during their own observations. RESULTS: Cronbach's alpha coefficient was 0.77. Results of the item analysis indicated that item-total correlations were satisfactorily high. Significance of inter-observer agreement was analyzed for each item, and it was found that weighted kappa values varied between 0.703 and 0.888. Convergent validity tests demonstrated a positive strong correlation between COMFORT scale scores of the primary researcher and the assistant researchers (r= 0.961, p<0.000), and between the scores of the COMFORT scale and the VAS (r= 0.775, p<0.000; r=0.786, p<0.000). CONCLUSION: It was concluded that the COMFORT scale was a valid and reliable method of measuring sedation levels of children receiving mechanical ventilation and being sedated in a pediatric critical care unit.

Nutritional style of parents and examination of the effective factors.

AIM: This study was performed to determine the nutritional style in parents who had children aged between 3 and 6 years and the effective factors. MATERIAL AND METHODS: The sample number of this descriptive study was calculated with the sample formula for unknown population and the parents of 300 children aged between 3 and 6 years who attended a nursery school in the province of Izmir constituted the sample. The sample was reached in two periods. "The Sociodemographic Data Form" and "the Parent Nutritional Style Scale" were used as data collection tools. Written approval was obtained from the scientific ethics committee of the Ege University, Faculty of Nursery (B.30.2.EGE.0.82.00.00/29-288). The heights and weights of the children were measured by the investigators with certain measurement tools. The body mass index standard deviation score (BMI SDS) was calculated for each child. The children whose body mass index standard deviations were between +2 and -2 standard deviation were considered to have normal weight. The Auxology program was used to obtain these data. The body mass indexes of the parents were calculated according to the height and weight values stated by themselves. In analyses of the data, student's t-test and Mann-Whitney U test were used for comparison of two groups. Variance analysis and Kruskal-Wallis variance were used for multiple comparisons; Bonferrroni corrected Mann-Whitney U test and Shefee test were used for advanced analysis. RESULTS: It was found that the variables including the age, education level, number of children, working status of the mothers and the perception of the child's weight by the mother affected the nutritional style of the parents. The mean "emotional" and "instrumental" nutrition subdimension scores of the mothers who were young, who had an education of primary school and who were housewifes, the mean "encouraging nutrition" subdimension scores of the mothers who had small for gestational age babies and the mean "emotional" nutrition sub-dimension scores of the mothers who perceived their babies' weights as lower than normal were found to be higher (p<0.05). No significant difference was found in the nutritional style in relation with the child's BMI SDS and the mother's own BMI. CONCLUSIONS: The nutritional styles of parents are affected by some sociodemographic and anthropometric properties, but the relation with the child's weight should be demonstrated by observational studies.

Quality of life and chemotherapy-related symptoms of Turkish cancer children undergoing chemotherapy.

This cross-sectional and descriptive study was designed to determine symptoms emerging due to chemotherapy treatment and their effects on children's quality of life. The research was carried out between February 2008 and February 2009 at the pediatric oncology clinics in four hospitals, focusing on 93 patients receiving chemotherapy. A survey form, the Pediatric Quality of Life Inventory (PedsQL 4.0) and the Memorial Symptom Assessment Scale (MSAS) were used as data collection tools. Chi-square and Student t tests were performed for data analysis. Some 51.6% of the children were aged 13-15 years old, and 51.8% were boys and 50.5% were diagnosed as having solid tumors. There were significant relations between: antimetabolite chemotherapeutics and feeling irritable and worrying (p=0.001, p=0.030); vinkoalkaloid and numbness/tingling in hands/feet (p=0.043); antracyclines and lack of energy and skin changes (p=0.021, p=0.004); and corticosteroids and lack of appetite, nausea and sadness (p=0.008, p=0.009, p=0.009). Several symptoms such as feeling sad, worrying and feeling irritable caused a significant decrease in the total domain of quality of life scores (p=0.034, p=0.012, p=0.010, respectively). Chemotherapeutic drugs can cause symptoms that can seriously affect quality of life in children.

Supporting the need for home care by mothers of children with hemophilia.

This research is a descriptive study that took place in Turkey and was intended to determine the difficulties experienced by mothers of children with hemophilia in maintaining their care at home and establishing appropriate interventions. Research data were collected using a survey prepared by the researchers after reviewing the existing literature. The survey contained 2 sections: (a) questions about the mothers' sociodemographic data and (b) 5 questions about the difficulties that mothers with hemophiliac children experience. Mothers were observed to have not received education about accidents and first aid and were afraid that their child would have an accident (55%); they experienced difficulty finding medications (75%); they felt they needed healthcare personnel during medication administration (85%); and they were sad that their child was ill (80%). Pediatric haematology nurses should strive to educate mothers with hemophiliac children about the disease and how to deal with accidents, first aid, and medication administration; home care services should be organized and made available for all hemophiliac children and their families.

The Turkish version of the breastfeeding attrition prediction tool.

This study demonstrates that the original English version of the Breastfeeding Attrition Prediction Tool (BAPT) was successfully adapted to Turkey, as methodologically demonstrated here. The results of this study show that the Turkish version of the BAPT is similar to the original version and that it can be used with Turkish women to identify mothers who may be at high risk of weaning prematurely.

Health professionals' estimation of cancer-related fatigue in children.

Many studies show that cancer-related fatigue is one of the most common symptoms experienced by children as a side effect of cancer therapy. This problem has grown considerably in recent years; the exact mechanisms underlying fatigue remain unclear. Therefore, assessing and managing this symptom can be problematic. This article describes the findings from a survey evaluating how health professionals (n = 56) at the Pediatric Oncology Centers in Izmir currently define and assess cancer-related fatigue. The results demonstrate that while the problems associated with fatigue are acknowledged, assessment tools are not widely used, and the majority of health professionals report that they would benefit from further education on the subject to assist in the care of patients.