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Özdemir G, Küçük Alemdar D. Turkish validity and reliability study of the Alder hey child triage pain scale. J Pediatr Nurs 2024; 77:e480-e486. [PMID: 38762426 DOI: 10.1016/j.pedn.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
AIM This study was performed to examine the Turkish validity and reliability of the Alder Hey Triage Pain Scale (AHTPS) for children aged 3-15 years who attended the pediatric emergency service with a complaint of pain. MATERIAL AND METHOD The sample for the methodological research was composed of 300 children between the ages of 3 and 15 who attended the University Training and Research Hospital Pediatric Emergency Clinic with a complaint of pain. Data were collected by using the Child and Parent Descriptive Information Form, Emergency Service Patient Triage, Treatment and Observation Form, AHTPS, and Wong-Baker Faces Pain Scale (WBFPS). RESULTS Of the children participating in the study, 54.3% were female and 30.7% were between the ages of 12-15. The total content validity index score of the AHTPS was determined as 0.99 and the content validity rate score was 0.98. The interobserver concordance of AHTPS was examined and the concordance of two observers was significant and very good (p < 0.001). For the concordance of scale with similar scales, the WBFPS was used and during the 1st and 2nd measurements, intra-observer reliability of AHTPS was statistically significant and very good (p < 0.001). Cronbach alpha values of the scale were in the range of 0.619 and 0.679 and the scale was reliable. CONCLUSIONS As a result, the adaptation of the AHTPS to Turkish is a valid and reliable measurement tool. PRACTICE IMPLICATIONS Pain assessment for children attending the emergency service should be performed more systematically with scales like the AHTPS.
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Affiliation(s)
- Gamze Özdemir
- Ministry of Health Ordu State Hospital, Department of General Surgery, Ordu, Turkey
| | - Dilek Küçük Alemdar
- Ordu University Faculty of Health Sciences, Department of Nursing, Ordu, Turkey.
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Li J, Deng Q, Zhao S, Sun J. Analysis of the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis. BMC Nurs 2024; 23:436. [PMID: 38926673 PMCID: PMC11202246 DOI: 10.1186/s12912-024-01851-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/05/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE This study aimed to analyze and explore the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis. METHODS A total of 76 eligible patients with concealed penis were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group received integrated medical and nursing care intervention. Outcomes include pain levels, comfort status, incidence of complications, and nursing satisfaction were collected and analyzed to investigate the nursing effects of the integrated medical and nursing care model. RESULTS After 2/3 days of nursing intervention, the patients in the observation group had significantly lower pain scores (measured by FPS-R) compared to the control group (P < 0.05). The patients in the observation group also had significantly higher comfort scores (measured by Kolcabal) compared to the control group (P < 0.05). The incidence of complications in the observation group was significantly lower than that in the control group (2.63 vs. 23.68, P < 0.05). Parental satisfaction in the observation group was significantly higher than that in the control group (P < 0.05). CONCLUSION The integrated medical and nursing care intervention in correction surgery for children with concealed penis demonstrated positive nursing effects. It effectively reduced pain, improved comfort, lowered the risk of complications, and increased parental satisfaction. This approach maximizes the role of nursing care and is recommended for clinical implementation.
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Affiliation(s)
- Junting Li
- Pediatric Urology Surgery, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University-Anhui Campus, No. 39, Wangjiang East Road, 230051, Hefei, Anhui Province, China
| | - Qifei Deng
- Pediatric Urology Surgery, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University-Anhui Campus, No. 39, Wangjiang East Road, 230051, Hefei, Anhui Province, China
| | - Shengfang Zhao
- Pediatric Urology Surgery, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University-Anhui Campus, No. 39, Wangjiang East Road, 230051, Hefei, Anhui Province, China
| | - Jingjing Sun
- Pediatric Urology Surgery, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University-Anhui Campus, No. 39, Wangjiang East Road, 230051, Hefei, Anhui Province, China.
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Buang SNH, Loh SW, Mok YH, Lee JH, Chan YH. Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit. Front Pediatr 2022; 10:907268. [PMID: 35757116 PMCID: PMC9226486 DOI: 10.3389/fped.2022.907268] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Palliative care (PC) is an integral component of optimal critical care (CC) practice for pediatric patients facing life-threatening illness. PC acts as an additional resource for patients and families as they navigate through critical illness. Although PC encompasses end of life care, it is most effective when integrated early alongside disease-directed and curative therapies. PC primarily focuses on improving quality of life for patients and families by anticipating, preventing and treating suffering throughout the continuum of illness. This includes addressing symptom distress and facilitating communication. Effective communication is vital to elicit value-based goals of care, and to guide parents through patient-focused and potentially difficult decision-making process which includes advanced care planning. A multidisciplinary approach is most favorable when providing support to both patient and family, whether it is from the psychosocial, practical, emotional, spiritual or cultural aspects. PC also ensures coordination and continuity of care across different care settings. Support for family carries on after death with grief and bereavement support. This narrative review aims to appraise the current evidence of integration of PC into pediatric CC and its impact on patient- and family-centered outcomes. We will also summarize the impact of integration of good PC into pediatric CC, including effective communication with families, advanced care planning, withholding or withdrawal of life sustaining measures and bereavement support. Finally, we will provide a framework on how best to integrate PC in PICU. These findings will provide insights on how PC can improve the quality of care of a critically ill child.
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Affiliation(s)
- Siti Nur Hanim Buang
- Pediatric Palliative Care Service, Department of Pediatric Subspecialities, KK Women's and Children's Hospital, Singapore, Singapore
| | - Sin Wee Loh
- Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yee Hui Mok
- Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yoke Hwee Chan
- Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
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Thrane SE, Williams E, Grossoehme DH, Friebert S. Reiki Therapy for Very Young Hospitalized Children Receiving Palliative Care. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:15-29. [PMID: 35722865 DOI: 10.1177/27527530211059435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Approximately half of children receiving palliative care are under age five; however, there are a few studies exploring palliative care interventions for this population. The purpose of this study was to evaluate the effects of Reiki on pain, stress, heart, and respiratory rates, oxygenation, and quality of life (QoL) in hospitalized young children receiving palliative care services. Methods: In this single-group pilot study, hospitalized children receiving palliative care who were aged 1-5 years received two Reiki sessions per week for 3 weeks. Physiologic measures were assessed pre/post each session, and parent report measures of pain and QOL were collected at baseline, 3 weeks, and 6 weeks. The parent rating of Reiki's perceived efficacy and their own symptoms were also measured. Results: Sixteen families consented. Children had a mean age of 26 months and included nine boys and seven girls. Results were not significant but there were medium-to-large clinical effect sizes for children's QoL, stress, oxygenation, heart, and respiratory rates. Parents' physical and mental health scores decreased over time. Children exhibited signs of relaxation such as quiet sleep post-Reiki versus active awake pre-Reiki session. Conclusion: Reiki is a noninvasive relaxing therapy that is useful for hospitalized young children receiving palliative care. The children reacted positively in both action and outcome measures. Multisite studies with larger sample sizes are needed to be able to generate enough scientific evidence to fully recommend Reiki as an adjunct for pain management.
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Affiliation(s)
- Susan E Thrane
- College of Nursing, Martha S. Pitzer Center for Women, Children and Youth, 2647The Ohio State University, Columbus, OH, USA
| | | | - Daniel H Grossoehme
- Haslinger Family Pediatric Palliative Care Center, 1079Akron Children's Hospital, Akron, OH, USA
- Department of Family and Community Medicine, 6969Northeast Ohio Medical University, Rootstown, OH, USA
| | - Sarah Friebert
- Haslinger Family Pediatric Palliative Care Center, 1079Akron Children's Hospital, Akron, OH, USA
- College of Medicine, Northeast Ohio University, Rootstown, OH, USA
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Grunauer M, Mikesell C, Bustamante G, Cobo G, Sánchez S, Román AM, Icaza-Freire AP, Gavilanes AWD, Wang NE. Pain Assessment and Management in Pediatric Intensive Care Units Around the World, an International, Multicenter Study. Front Pediatr 2021; 9:746489. [PMID: 34778135 PMCID: PMC8581242 DOI: 10.3389/fped.2021.746489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/04/2021] [Indexed: 12/11/2022] Open
Abstract
The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.
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Affiliation(s)
- Michelle Grunauer
- School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
- Pediatric Intensive Care Unit, Hospital de los Valles, Quito, Ecuador
| | - Caley Mikesell
- School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | - Gissela Cobo
- School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Sebastián Sánchez
- School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Ana María Román
- School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | | | - Nancy Ewen Wang
- Emergency Medicine, Stanford University School of Medicine, Stanford, CA, United States
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Kenfield M, Zacharias N, Abd-Elsayed A. Intrathecal Drug Delivery for the Treatment of Cancer-Associated Chronic Pain in Children. Neuromodulation 2021:S1094-7159(22)00576-1. [PMID: 34520605 DOI: 10.1111/ner.13535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Management of refractory cancer-associated pain can be particularly challenging. Regional anesthesia is an alternative modality to treat acute and chronic refractory pain. Intrathecal (IT) drug delivery of opioids and other adjuncts has been used to treat refractory cancer-associated pain. This method has been shown to be relatively safe and effective, often associated with fewer systemic side effects when compared to oral or IV opioid administration. While intrathecal drug delivery systems (IDDS) are regularly used in the adult cancer population for the treatment of refractory, chronic pain, there is limited evidence of similar use in the pediatric setting. MATERIALS AND METHODS We performed a systematic review using conventional Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to identify studies reporting IT drug delivery for the treatment of pediatric cancer-related pain. The primary outcome was satisfaction with analgesia categorized as "satisfactory" or "unsatisfactory." Functional benefits, previous systemic pharmaceutical interventions, previous non-IT regional interventions, indication for IT drug delivery, IT drugs used, and method of delivery were collected. RESULTS A total of 11 studies were identified, describing 16 patients with cancer-related pain treated with IT drug delivery. The average age of the cohort was 12.25 years, with ages ranging from 3 to 19 years. Most patients were adolescent (10/16). All patients had cancer diagnoses, with most patients suffering from solid tumor pain (14/16). Nearly all patients achieved satisfactory analgesia through IT drug delivery (15/16) and most reported functional benefits in addition to analgesia (13/16). Majority received IT drugs via external catheters (9/16). One severe complication of respiratory depression was reported, which resolved following naloxone administration. CONCLUSIONS There exist children with cancer whose pain is refractory to the standard approaches and may benefit from IT drug delivery. The existing data, although limited and of low tier evidence, suggest that IT drug delivery has been effective in the pediatric cancer population.
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Affiliation(s)
- Meaghan Kenfield
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Nicholas Zacharias
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alaa Abd-Elsayed
- Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Kernebeck S, Busse TS, Jux C, Meyer D, Dreier LA, Zenz D, Zernikow B, Ehlers JP. Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians. CHILDREN-BASEL 2021; 8:children8080695. [PMID: 34438586 PMCID: PMC8392291 DOI: 10.3390/children8080695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements.
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Affiliation(s)
- Sven Kernebeck
- Chair of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
- Correspondence: ; Tel.: +49-(0)2302/926-786-13
| | - Theresa Sophie Busse
- Chair of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
| | - Chantal Jux
- Chair of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
| | - Dorothee Meyer
- PedScience Research Institute, 45711 Datteln, Germany; (D.M.); (L.A.D.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Larissa Alice Dreier
- PedScience Research Institute, 45711 Datteln, Germany; (D.M.); (L.A.D.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Daniel Zenz
- Smart-Q Softwaresysteme GmbH, Lise-Meitner-Allee 4, 44801 Bochum, Germany;
| | - Boris Zernikow
- PedScience Research Institute, 45711 Datteln, Germany; (D.M.); (L.A.D.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
- Pediatric Palliative Care Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany
| | - Jan Peter Ehlers
- Chair of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
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Thrane SE, Maurer SH, Danford CA. Feasibility and Acceptability of Reiki Therapy for Children Receiving Palliative Care in the Home. J Hosp Palliat Nurs 2021; 23:52-58. [PMID: 33252426 PMCID: PMC7785613 DOI: 10.1097/njh.0000000000000714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Reiki is often used but not well studied in children. Yet, this gentle, light-touch therapy promotes relaxation and is appropriate for those receiving palliative care. This quasi-experimental pre-post mixed-methods 1-group pilot study examined the feasibility and acceptability of Reiki therapy as a treatment for children aged 7 to 16 years receiving palliative care. During the study, we recorded recruitment, retention, data collection rates, and percent completion of the intervention. Structured interviews with the mothers and verbal children were conducted to elicit their experience. Qualitative data were analyzed using thematic analysis. Twenty-one parent-child dyads agreed to participate and signed consent, whereas 16 completed the study (including verbal [n = 8] and nonverbal [n = 8] children). Themes included "feeling better," "hard to judge," and "still going on." Mothers and children were generally positive regarding the experience of receiving Reiki therapy. Children reported they "felt really relaxed," and mothers stated, "It was a good experience" and "She was relaxed afterward." The results of this pilot study show that Reiki was feasible, acceptable, and well-tolerated. Most participants reported it was helpful. Reiki therapy may be a useful adjunct with traditional medical management for symptoms in children receiving palliative care.
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