Examination of Care Burden and Stress Coping Styles of Parents of Children with Autism Spectrum Disorder

OBJECTIVE

The study was conducted to examine the caregiver burden and stress coping styles of parents of children with Autism Spectrum Disorder (ASD).

DESIGN AND METHODS

This descriptive cross-sectional study was conducted with parents of 131 children with ASD who were enrolled in a private education practice center in Istanbul between August 2015 and August 2016. The data were collected using a questionnaire prepared by the researchers, and the "Caregiver Strain Index" and "Ways of Coping Questionnaire."

RESULTS

The mean age of the children in the sample group was 4.83 ± 0.99 years; 63.4% were boys. Nearly 40% (38.2%) were diagnosed as having ASD at the age of 2 years. It was determined that the parents of children with ASD had a higher burden of care (CSI mean score: 7.68 ± 4.30). The caregiver burden was significantly higher (p < 0.05) for parents of one child as compared to parents with more children, and parents with daughters compared to parents with sons. In addition, the mothers were found to have higher scores of 'submissive approach' and 'seeking social support' than fathers.

CONCLUSION

Parents of children with ASD had a higher caregiver burden. Scores of approach types of self-confident, helpless, optimistic, and seeking social support were significant predictors of caregiver burden.

PRACTICE IMPLICATIONS

Nurses are encouraged to take a more active role to improve the health of children with autism and families should contribute to mitigating the burden care of parents by informing families about social support systems.

Effect of two different feeding methods on preventing ventilator associated pneumonia in the paediatric intensive care unit (PICU): A randomised controlled study

BACKGROUND

For infants and children who require intubation in the paediatric intensive care unit (PICU), ventilator-associated pneumonia (VAP) is a significant cause of secondary morbidity and mortality linked with extended use of intubation. Nurses are primarily responsible for the prevention of VAP and there are a number of procedures that contribute towards this end. Although enteral nutrition has been reported to be effective in the prevention of VAP, this remains controversial.

OBJECTIVE

To compare and evaluate the effects of intermittent feeding through a nasogastric catheter with those of continuous feeding through a nasoduodenal catheter in preventing VAP in the PICU.

DESIGN

The research design was a randomised, controlled experimental study.

METHODS

Forty paediatric patients were randomised and divided into two groups of 20: one group for nasoduodenal (ND) feeding and the other for nasogastric (NG) feeding. Patients were assessed for the development of VAP using the clinical pulmonary infection score and Centers for Disease Control and Prevention criteria while working in accordance with the VAP prevention bundles introduced within the unit.

RESULTS

The incidence of paediatric VAP was 15%. The rate of VAP in patients who were ND fed was 10%, whereas the rate of VAP in patients who had NG feeding was 20%. No statistically significant difference was observed between the ND- and NG-fed patients (p=0.661).

CONCLUSION

Although the results of our study were not statistically significant, nasoduodenal feeding helped to reduce the incidence of VAP.

Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit

BACKGROUND

Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs.

OBJECTIVES

To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections.

METHODS

A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group. Patient care was provided in accordance with prevention bundles. Patients were followed up for development of catheter-related bloodstream infections.

RESULTS

Catheter colonization occurred in 4 patients in the standard group (8%) and in 1 patient in the chlorhexidine group (2%). Catheter-related bloodstream infections occurred in 5 patients in the standard group (10%) and in 1 patient in the chlorhexidine group (2%). Although more patients in the standard group had catheter-related bloodstream infections, the difference in infection rates between the 2 groups was not significant (P = .07).

CONCLUSIONS

Use of chlorhexidine-impregnated dressings reduced rates of catheter-related bloodstream infections, contamination, colonization, and local catheter infection in a pediatric intensive care unit but was not significantly better than use of standard dressings.

Effect of Two Bathing Methods on Physiologic Parameters in Pediatric Intensive Care

To determine the effect of traditional and disposable bed baths performed in the pediatric intensive care unit (PICU) on the physiologic parameters of children. This research was conducted as a randomized controlled trial with children who were monitored in the PICU. It was found that the pulse and blood pressure immediately after the bath were higher for both bath applications and was the lowest 30 minutes after the bath (p < .05). Children who used traditional baths had a lower body temperature than those who used the disposable bed bath after bathing for the second day. Oxygen saturation averages were found that within the group to be the highest 30 minutes after bathing methods (p < .05). Both bathing methods applied in the PICU had a positive effect on physiologic parameters. It may be recommended to regularly perform the most appropriate bathing for patients with stable hemodynamics in PICUs.

Umbilical Cord Care and Infection Rates in Turkey

OBJECTIVE

To compare the efficacy of umbilical cord sponging with 70% alcohol, sponging with 10% povidone-iodine, and dry care on the time to umbilical cord separation and bacterial colonization.

DESIGN

Prospective, interventional experimental study design.

SETTING

Three different family health centers in Istanbul, Turkey.

PARTICIPANTS

In total, 194 newborns were enrolled in one of three study groups: Group 1, 70% alcohol (n = 67); Group 2, 10% povidone-iodine (n = 62); and Group 3, dry care (n = 65).

METHODS

Data were collected between January 2015 and July 2015. Umbilical separation time and umbilical cord bacterial colonization were considered as the study outcomes.

RESULTS

The most commonly isolated bacteria were Staphylococcus aureus, Escherichia coli, and enterococci. There was no significant difference among the groups for umbilical cord separation times (p > .05).

CONCLUSION

Dry care may be perceived as an attractive option because of cost benefits and ease of application.

Effects of ShotBlocker® and the Helfer skin tap technique on pain and fear experienced during intramuscular injection among children aged 6-12 years in pediatric emergency units: A randomized controlled trial

BACKGROUND

In pediatric emergency units, intramuscular injection is one of the most common procedures that cause pain and fear in children. Reducing pain and fear is important for patient comfort.

OBJECTIVE

This randomized controlled experimental study aimed to determine the effects of ShotBlocker® and the Helfer skin tap technique on the pain and fear experienced by children aged 6-12 years during intramuscular injection in pediatric emergency units.

METHODS

This study was conducted from April 2022 to October 2023 among 177 children aged 6-12 years. ShotBlocker and the Helfer skin tap technique were applied during intramuscular injection among children in the intervention groups (ShotBlocker group: n = 59, Helfer skin tap technique group: n = 59), while children in the control group received routine injections. (n = 59). The levels of pain and fear were measured.

RESULTS

In the analysis of the age distribution of the children, the average age of the Helfer skin tap technique group was found to be 8.54 ± 2.00 years; ShotBlocker group, 8.46 ± 1.99 years; and control group, 9.19 ± 2.01 years. There was a significant difference in the post-intervention Wong-Baker Pain Scale and Child Fear Scale scores based on the evaluation of the children, parents, and observer nurses between the groups (p < 0.05). The pain and fear scores of the ShotBlocker group were lower than those of the control group (p < 0.05).

CONCLUSIONS

ShotBlocker is more effective in reducing pain than the Helfer skin tap technique among children receiving intramuscular injection. These cheap and easy-to-use methods are recommended for use in emergency units.

The effect of mobile game training designed for asthmatic children on asthma management and quality of life

PURPOSE

This study aimed to examine the effect of mobile game training designed for children with asthma on inhaler use skills, asthma symptoms and treatment needs, and quality of life.

DESIGN AND METHODS

This randomized controlled study was conducted between April and October 2023 at "Pediatric Asthma and Allergy Clinic" in Turkey. The sample of the study consists of a total of 74 children diagnosed with asthma, including the Mobile game (n: 37) and the Control group (n: 37). In the study, a mobile game was developed for children with asthma between the ages of 8-12. In collecting research data; Child and Parent Information Form, Inhaler Use Skill Evaluation Form, Asthma Symptom and Treatment Need Scoring (Asthma Symptom Score [ASS], Rhinitis Symptom Score [RSS] and Total Symptom Score [TSS]), DISABKIDS Asthma Scale were used.

RESULTS

There was no significant difference between the groups in terms of the demographic status of the children (p > 0.05). It was determined that the average inhaler use skill score and DISABKIDS asthma scale Child/Parent score average of the children in the mobile game group were higher than the control group (p < 0.05). When the children's final follow-up ASS, RSS and TSS total scores were examined; It was determined that there was a statistically significant difference between the children in the mobile game and control groups (p < 0.05).

CONCLUSIONS

As a result of this study, it was determined that mobile game training designed for children is an effective method in increasing children's ability to use inhaler medications, reducing asthma symptoms and treatment needs, and improving quality of life.

PRACTICE IMPLICATION

Nurses can improve children's quality of life by using mobile game training programs that attract children's attention.

Effect of Pressure Injury Prevention Guides Used In a Pediatric Intensive Care

The aim of this study was to determine the effectiveness of a pressure injury prevention guide used in a pediatric intensive care unit (PICU) on the occurrence of pressure injuries. The design is a pre-post intervention with a control group and a prospective intervention group. Pressure injuries occurred on 9.4% of children in the nontreatment group, and in 3.6% of children in the treatment group. There was a statistically significant difference in the occurrence of pressure injuries between the nontreatment group and the treatment group (p = .033). The average Braden Q pressure injury score was 12.20 ± 2.280 at the beginning of the intensive care hospitalization, and 13.73 ± 3.312 at discharge in the treatment group (p < .001). The results show that the risk of pressure injuries was reduced and pressure injuries occurred later when an evidence-based pressure injury prevention guide was used.

A study protocol to develop virtual reality software in the care management of patients in intensive care

BACKGROUND

The use of virtual reality is increasing in nursing to ensure patient safety and to improve the quality of care in the education of nurses.

AIM

To develop a virtual reality software for intensive care patient care management and to investigate the effect of this software on novice intensive care nurses.

STUDY DESIGN

This study protocol contains a randomized controlled experimental design research. The nurses will be divided into control (n = 34) and study groups (n = 34) by randomization. The research will be conducted in four steps: (1) according to Kolcaba's Comfort Theory, the protocol for care management of an intensive care patient will be prepared and transferred to the virtual reality software, (2) the nurses in both groups will be given theoretical training, (3) a routine orientation training programme will be applied to the nurses in the control group, and those in the study group will be given virtual reality goggles. (4) Tools such as a 'Clinical Practice Skills Observation Form and Knowledge Level Questionnaire' and 'Problem-Solving Inventory', 'Clinical Decision-Making Scale in Nursing', 'State Anxiety Inventory' and 'Satisfaction Level Questionnaire' will be applied to both groups before commencing the theoretical training, 1 week after the application and in the first month of the application.

RESULTS

This protocol describes an experimental study aiming to test the impact of virtual reality software on novice intensive care nurses in the care management of an intensive care patient.

CONCLUSIONS

The results and recommendations will be shared after the study is completed.

RELEVANCE TO CLINICAL PRACTICE

Within the scope of the research, the virtual reality software to be developed for the care management of an intensive care patient will provide important contributions to the development of nurses' problem-solving and clinical decision-making skills and reduce state anxiety levels in orientation to the intensive care unit (ICU).

Effect of using a kaleidoscope projector and matching cards on fear and vital signs in children aged 3-6 years receiving inhaled medication

AIM

The aim of this study was to investigate the effect of the use of projector kaleidoscope and matching card on children's fear and physiological parameters in children aged 3-6 years receiving inhaled medication.

METHODS

This randomised controlled study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The sample of children was allocated to the projector kaleidoscope group (n = 38), matching card group (n = 38) and control group (n = 38). Fear and vital signs were measured.

RESULTS

In the study, the mean age of the children in the projector kaleidoscope group was 4.39 ± 1.10, the mean age of the children in the matching card group was 4.34 ± 0.96 and the mean age of the children in the control group was 4.28 ± 1.18. There was a statistically significant difference between the post-test scores of the Children's Fear Scale in the evaluation of parents and nurses according to the groups of children. There was a statistically significant difference between the respiratory post-test scores according to the groups of children. It was observed that the mean heart rate of the control group participants was higher than that of the children in the matching card group. There were no statistically significant differences in the post-test saturation values among the groups of children.

CONCLUSION

It was observed that the projector kaleidoscope and matching card reduced fear and prevented increased respiratory rate in children receiving inhaler medication. In addition, it was determined that matching card had more effect on heart and respiratory rate than projector kaleidoscope.

Effect of short film video and video-based education on fear, pain, and satisfaction of children undergoing day surgery

PURPOSE

This study aims to determine the effect of introducing the operating room environment with different informative multimedia methods to pediatric patients aged 7-12 in the preoperative period in day surgery on fear, pain, and patient satisfaction in three different groups comparatively.

DESIGN AND METHODS

This randomized controlled study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The sample of children was allocated to the Short Film Group (n:30), Video Based Education Group (n:30) and Control Group (n:30). Fear, pain, and satisfaction were measured.

RESULTS

The age distribution of the children in the study was 7.57 ± 1.25 years in the short film group, 7.27 ± 0.52 years in the video-based education group, and 7.57 ± 2.27 years in the control group. There was no significant difference between the groups in terms of demographic status, fear, and vital signs before the procedure. Fear, pain, and satisfaction levels of children in short film groups were lower than video-based education groups.

CONCLUSION

The result of this research reveals that preoperative short film education in children is more effective than video-based education in reducing fear, pain, and satisfaction levels. This intervention could be an effective method to improve outcomes. Nurses can increase children's comfort by using educational programs that attract children's attention.

PRACTICE IMPLICATIONS

Healthcare team members working in pediatric surgical units can use the short film method, which is effective, easy, and applicable in the field, to reduce pain and fear in the preoperative period and increase satisfaction in children undergoing day surgery.

Emotions and difficulties experienced by parents of children with autism: A qualitative study

RATIONALE

This study was performed to determine the difficulties experienced by the parents of children with autism.

METHODS

A qualitative method was used to determine the difficulties experienced by the parents. The sample of the study consisted of parents with 24 children with autism who met the inclusion criteria. The data were analysed by the MAXQDA qualitative data analysis programme in accordance with Colaizzi's seven-stage method.

RESULTS

Total of 5 themes and 29 codes were gathered in line with the data obtained from the interviews. Five main themes of the interviews emerged; emotions experienced by parents; adaptation to family life; difficulty in social relationships; limited opportunity for entertainment/activity and financial difficulty. Parents whose income were less than or equal to their expenses particularly stated that they had economic difficulties in the transportation of their children to places such as hospitals/schools/special education.

CONCLUSION

In accordance with the findings of this study, it was determined that almost all of the parents with a child diagnosed with autism experienced sadness, denial, shock, depression, self-blame in the period when their children were first diagnosed, and later accepted the disease. In addition, it was detected that parents had difficulties in family relations, social relations, entertainment/activity and economic aspects.

Turkish validity and reliability of the universal mental health literacy scale for adolescents (10-14 years): A methodological study

RATIONALE

Mental health literacy enables adolescents to acquire information that will accompany them in their future lives and to define their attitudes and behaviors.

AIMS AND OBJECTIVES

This study evaluated the Turkish validity and reliability of the Universal Mental Health Literacy Scale for Adolescents (10-14 years).

METHODS

This is a methodological, correlational, cross-sectional, and descriptive study. The study was conducted with 223 adolescents. Data were collected by 'Information Form' and 'Universal Mental Health Literacy Scale for Adolescents.' Exploratory Factor Analysis, Confirmatory Factor Analysis, and Pearson Correlation analysis were used to assess the validity and reliability of the UMHL-A.

RESULTS

Item Content Validity Index (I-CVI) scores ranged from 0.94 to 0.96, while the Scale Content Validity Index (S-CVI) was 0.95. For 'Help-seeking and Stigma dimensions' χ2/df = 3.347, NFI = 0.804, IFI = 0.854, TLI = 0.778, CFI = 0.849, RMSEA = 0.103. For 'Knowledge of Mental Health and Knowledge of Mental Illnesses dimensions' χ2/df = 1.959, NFI = 0.731, IFI = 0.847, TLI = 0.774, CFI = 0.837, RMSEA = 0.066. The internal consistency and time stability were affirmed by a Hotelling T-square value of 15.241 and an F-test result of 27.793.

CONCLUSIONS

This study reveals that the Turkish validity and reliability of the Universal Mental Health Literacy Scale for Adolescents is a valid and reliable tool for assessing mental health literacy among adolescents. The UMHL-A scale is a valid tool to evaluate critical aspects of mental health literacy in adolescent populations and can be used in both research and clinical practice in mental health education and intervention. It is recommended that the Turkish version of the Universal Mental Health Literacy Scale should be used to determine resilience in adolescents.

The Impact of Cold Spray and Ice Application During Intravenous Access on Pain and Fear in Children Aged 7-15 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial

INTRODUCTION

Many strategies have been developed to prevent procedural pain in pediatric emergency units, where nurses play a vital role in ensuring patient comfort. Easy-to-use and inexpensive nonpharmacologic analgesic methods are important in emergency units. This study was conducted to determine the effect of cold spray and ice applied during venipuncture on the level of fear and pain in children aged 7 to 15 years.

METHODS

This was a randomized controlled experimental study of 96 children between the ages of 7 and 15 years (cold spray group, ice group, and control group) who were scheduled to have venous access in the pediatric emergency clinic and met the sampling criteria.

RESULTS

Evaluations of the children, parents, and observers in the groups found a statistically significant difference between the pain and fear scores after the intervention compared with the preintervention (P < .001). The pain and fear scores of the children in the control group were higher than the scores of those in the spray and ice groups (P < .001); the pain and fear scores of the children in the spray group were lower than the scores of the children in the ice group and statistically significant (P < .001).

DISCUSSION

In conclusion, cold spray applied during intravenous access in children aged 7 to 15 effectively reduces pain and fear and should be used in the emergency unit.

Global trends in technology-dependent children, home care, and parental discharge education: A bibliometric analysis using Biblioshiny

BACKGROUND

Parents of technology-dependent children constitute a different population in society and face diverse problems during caregiving.

METHODS

This study aimed to identify and visualize studies conducted from 1990 to 2024 on technology-dependent children, home care, and parental discharge education and determine global trends. A descriptive and bibliometric study design was employed. Data were obtained from the Web of Science Core Collection database, and bibliometric analyses were performed with performance analysis, visualization, and mapping using the Biblioshiny interface in the R software. Screening yielded a total of 157 publications. A total of 138 publications were included.

FINDINGS

The keywords frequently used by the authors included "home care," "technology-dependent children," "palliative care," "home mechanical ventilation," "child," "family," and "pediatric." Co-author keywords with moderate centrality and density are "home mechanical ventilation" (Betw = 106.47), "technology-dependent" (Betw = 106.47), "home mechanical ventilation" (Betw = 106.47). Each article had 4.41 co-authorships, with an international co-authorship rate of 6.52 %.

CONCLUSIONS

This study provided important data on studies focusing on technology-dependent children, home care, and parental discharge education.

APPLICATION TO PRACTICE

Since the number of studies in the field is small, the findings of this study are essential in guiding researchers about gaps in the literature.

Effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by children during vaccination: A randomized controlled trial

PURPOSE

Vaccination is an invasive procedure that causes pain. Uncontrolled pain negatively affects all aspects of life, including health. This study aimed to determine the effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by 4-year-old children during measles-mumps-rubella (MMR) vaccination.

METHODS

This study adopted a randomized controlled experimental design. The study sample consisted of 96 children (Helfer skin tap technique group: n = 32, Buzzy® group: n = 32, control group: n = 32) who received MMR vaccination. Children in the Buzzy® and Helfer skin tap technique groups received their respective interventions before and after vaccine injection, while children in the control group received routine vaccine injection.

RESULTS

Based on the parents' and nurse's observations, the pain and fear scores after vaccine injection were lowest in the Buzzy® group and highest in the control group. Based on the children's assessments, the pain scores after vaccine injection were lower in the Buzzy® group than in the Helfer skin tap technique group.

CONCLUSION

Buzzy® application and the Helfer skin tap technique have beneficial effects on children's pain and fear during MMR vaccination. Buzzy® application is more effective in reducing pain and fear during vaccine injection in children than the Helfer skin tap technique.

PRACTICE IMPLICATIONS

Nurses can increase the comfort of children by reducing pain during vaccination using Buzzy®.

The effect of watching videos using virtual reality during operating room transfer on the fear andanxiety of children aged 6-12 undergoing inguinal hernia surgery: A randomized controlled trial

BACKGROUND

Being in a hospital and undergoing a surgical intervention are very stressful for the children and their parents. It is critical to keep the pain, fear and anxiety of children at a minimum level during this period in order to have a better process.

PURPOSE

The aim of this study was to evaluate the effect of watching videos using virtual reality on fear and anxiety of children aged 6-12 years old during operating room transfer for inguinal hernia surgery.

METHODS

This prospective and randomized controlled study used parallel trial design guided by the CONSORT checklist. The study was conducted with two groups: the group that watch videos using virtual reality group and the control group. Data were collected using follow-up forms; the Children's State Anxiety Scale and the Children's Fear Scale.

RESULTS

Children in the virtual realty group had lower anxiety and fear scores than the children in the control group (p < 0.05). Evaluation of the in-group measurements demonstrated that the fear and anxiety scores of the children in the virtual reality group decreased after the transfer compared to that of the pre-transfer, while the children in the control group experienced higher fear and anxiety scores (p < 0.05).

CONCLUSION

Virtual reality is an effective method to reduce fear and anxiety in children aged 6-12 years old during their transfer to the operating room.

IMPLICATIONS FOR PRACTICE

Evidence-based protocol and guidelines should be developed for nonpharmacological methods such as virtual reality for procedural fear and anxiety in children.