Pediatric nursing

Aim.  This paper discusses the design, evaluation and outcomes of a reflective practice intervention (RPI) that taught paediatric critical care nurses how to incorporate a family intervention into their practice.Background.  The literature on reflective practice contains numerous descriptions of reflective practice and various frameworks on how to engage in reflective practice. Additionally, there has been wide debate about the benefits of and problems with the use of reflective practice. However, few empirical studies have been done to evaluate its effectiveness in changing nursing practice.Method.  Van Manen's phenomenological research approach was adapted for use in this study. This approach was consistent with the experiential nature of reflective practice. Interviews were conducted with eight staff nurse participants after the RPI to determine changes in family practice. Analysis of the interview text produced three essential themes.Findings.  Three interrelated themes desc...

Aim.  This paper discusses the design, evaluation and outcomes of a reflective practice intervention (RPI) that taught paediatric critical care nurses how to incorporate a family intervention into their practice.Background.  The literature on reflective practice contains numerous descriptions of reflective practice and various frameworks on how to engage in reflective practice. Additionally, there has been wide debate about the benefits of and problems with the use of reflective practice. However, few empirical studies have been done to evaluate its effectiveness in changing nursing practice.Method.  Van Manen's phenomenological research approach was adapted for use in this study. This approach was consistent with the experiential nature of reflective practice. Interviews were conducted with eight staff nurse participants after the RPI to determine changes in family practice. Analysis of the interview text produced three essential themes.Findings.  Three interrelated themes desc...

O objetivo deste estudo foi identificar os acidentes na infância registrados em um pronto socorro infantil. Os dados foram coletados entre janeiro e março de 1999, através de um questionário contendo dados sobre a identificação da criança e do acidente. A população constou de 942 crianças e a amostra ficou reduzida para 890. Principais resultados: a faixa etária mais atingida foi de 7-11 anos, sendo 56,1% do sexo masculino e 43,9% feminino, o tipo de acidente mais freqüente foi queda (46,9%), os pais estavam presentes em 43,4% dos casos. Em 95,7% das ocorrências a criança recebeu alta hospitalar após o atendimento.

Introduction: Typhoid fever is estimated to have caused 26.9 million cases and 5.74 lakhs deaths worldwide in 2010. It remains a major public health problem in India and other part of developing world. Background: Nonprovision of safe drinking water and sanitation measures, non-implementation of adequate vaccination strategies and emergence of multidrug resistant salmonella strains is responsible for why typhoid fever is till now remaining an important health problem in some parts of world and the disease is even becoming more complex. Objective: This study was conducted in a tertiary care centre to find out the clinico-epidemiological profile of patients admitted with typhoid fever. Design: Cross sectional observational study. Subjects: 460 Widal positive typhoid fever pediatric cases admitted from 1 st June 2016 to 30 th November 2016. Methods: Both clinical and laboratory data of all the patients were retrieved, compiled and analyzed. Results: Out of 460 patients 238(51.74%) were males and 222 (48.26%) were females. Fever (100%), vomiting (49.13%), diarrhea (30.21%), cough (30.0%) and hepatomegaly (73.26%) were commonly observed.Response to injection Ceftriaxone was excellent.355(77.17%) patients responded to Ceftriaxone alone and 99 (21.52%) patients needed addition of oral Azithromycin.Average hospital stays in our study ranged from 3-9 days. Conclusion: In the present series typhoid fever accounted for 10.94% of pediatric admissions. Though mortality has significantly reduced typhoid fever continues to be an important cause of hospitalization in pediatric population.High incidence among lower age group indicates high endemicity and emphasizes the need of widespread use of vaccination.

Introduction: Congenital anomalies are a major cause of neonatal mortality and morbidity both in developed and developing countries. It accounts for 8-15% of perinatal deaths and 13-16% of neonatal deaths in India. Aims and Objective: This study was done to determine the proportion and changing pattern of congenital anomalies in live newborns and to study the associated maternal and perinatal risk factors. Materials and Method: This is a hospital based cross-sectional descriptive study and was conducted in Bankura Sammalini Medical College and Hospital, West Bengal India during the period July 2016 to December 2017. Results: During his period 31989 babies were born, of which 598 had congenital malformations, making the prevalence 1.86%. Distribution of malformation was predominant among males than in females (66.7 vs. 32.6%; p < 0.05). Discussion: The predominant system involved was musculo-skeletal system followed by cardiovascular and genitourinary system. Congenital anomalies were more likely associated with low birth weight, prematurity, multiparity, consanguinity and caesarean delivery. Various maternal risk factors were studied as well as the role of early preventive interventionalstrategies. Conclusion: Public awareness is to be created and early prenatal diagnosis and management of common anomalies is highly recommended.

Introduction: Typhoid fever is estimated to have caused 26.9 million cases and 5.74 lakhs deaths worldwide in 2010. It remains a major public health problem in India and other part of developing world. Background: Nonprovision of safe drinking water and sanitation measures, non-implementation of adequate vaccination strategies and emergence of multidrug resistant salmonella strains is responsible for why typhoid fever is till now remaining an important health problem in some parts of world and the disease is even becoming more complex. Objective: This study was conducted in a tertiary care centre to find out the clinico-epidemiological profile of patients admitted with typhoid fever. Design: Cross sectional observational study. Subjects: 460 Widal positive typhoid fever pediatric cases admitted from 1 st June 2016 to 30 th November 2016. Methods: Both clinical and laboratory data of all the patients were retrieved, compiled and analyzed. Results: Out of 460 patients 238(51.74%) were males and 222 (48.26%) were females. Fever (100%), vomiting (49.13%), diarrhea (30.21%), cough (30.0%) and hepatomegaly (73.26%) were commonly observed.Response to injection Ceftriaxone was excellent.355(77.17%) patients responded to Ceftriaxone alone and 99 (21.52%) patients needed addition of oral Azithromycin.Average hospital stays in our study ranged from 3-9 days. Conclusion: In the present series typhoid fever accounted for 10.94% of pediatric admissions. Though mortality has significantly reduced typhoid fever continues to be an important cause of hospitalization in pediatric population.High incidence among lower age group indicates high endemicity and emphasizes the need of widespread use of vaccination.

A 12-year-old Hispanic female presents to the local emergency room with seizures and severe hypertension. Over the past year, she gained 15 kilograms, with no changes in her appetite or level of physical activity, yet she stopped growing in height. Her BMI increased from 21.9 to 29 kg/m 2 . She was recently diagnosed with type 2 diabetes mellitus and was treated with metformin and diet modification. Her mother noticed that she was more impatient and irritable in the last 4-5 months. Significant findings on her physical exam included severe acne (face, chest, and back); acanthosis nigricans; hirsutism; wide purple striae on legs, abdomen, trunk; facial plethora; fat pads in supraclavicular, temporal, and dorsocervical areas; scattered petechiae on arms and shins; proximal muscle weakness; tinea versicolor; candida albicans; Tanner V pubic hair and Tanner II breast development. Her blood pressure remained N 90% for age-height, even with treatment with three antihypertensive medications. Alarmed by the severity of her hypertension along with concomitant development of rapid onset weight gain, diabetes, and numerous physical changes in a young girl, the emergency room doctor suspected Cushing syndrome and referred the child to a pediatric endocrinologist. Following is a brief overview of Cushing syndrome and the integral role of the pediatric nurse in the care of these children.

Purpose: Postoperative pain (POP) is a common outcome of surgical interventions among children. Identifying POP contributing factors can help identify children who are at risk for POP and facilitate POP management. The aim of the study was to determine the predictors of POP based on the Theory of Unpleasant Symptoms. Design and methods: This descriptive-correlational study was conducted in 2018-2019 on 153 children purposively recruited. Data were collected using a personal characteristics questionnaire, the Coping Strategies Questionnaire, the Child Pain Anxiety Symptoms Scale, and a Visual Analogue Scale for Pain. The SPSS software (v. 21.0) was used for data analysis. Results: Twelve participants were excluded and final data analysis was done on the data obtained from 141 participants. Most of participants were male (65.2%), underwent abdominal surgery (53.2%), and experienced POP (86.5%). Their age mean was 8.58±2.23. Linear regression analysis revealed that the physiological factors of heart rate, preoperative pain, and surgery duration as well as the psychological factors of anxiety and coping strategies were significant predictors of POP among children. All these factors collectively explained 34% of the total variance of POP. Situational factors (such as age, gender, and ethnicity) had no significant effects on POP. Conclusions: Heart rate, preoperative pain, surgery duration, anxiety and coping as predictive factors of POP can be considered when designing effective POP management strategies. Practice implications: The findings provide a better understanding about the predictors of POP and can be used to develop pain management among children.

Background: A plethora of studies evaluated home-visiting programs like Nurse-Family Partnership (NFP) broadly. Still, the mechanisms behind changes in mothers and children are scarcely considered. Aim: Pro Kind, the German NFP adaption, investigated the process of change in effective program variables, which are maternal perceived social support and parental self-efficacy (PSE) as coping resources for dealing with general stress within an ecological framework. Design: Longitudinal randomized controlled trial. Methods: Between 2006 and 2012 Pro Kind’s effectiveness was evaluated in mothers and children from pregnancy until the children’s second birthday. Altogether N=755 at-risk first-time mothers referred to the project. The treatment group (TG, n=394) received home visitation, while the control group (CG, n=361) solely had access to standard community services. Results: Structural equation modeling revealed a protective effect of social support as an environmental resource on gene...

Background: Acute respiratory infection (ARI) is one of the leading public health challenges among children in low-and middle-income countries. Child mortality due to ARI is disproportionately higher in African regions. In Ethiopia, an encouraging progress in the reduction of ARI was observed until 2010, however, since then the national prevalence is unchanged. There is limited information for the persistently higher prevalence of the infection. Therefore, the aim of this study was to determine regional variations and identify factors associated with the infection. Methods: This study used data from the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016. The analysis used information from 10,006 children. A twolevel logistic regression analysis was used to consider the cluster random effect. Results: Out of 10,006 children included, 15.9%, 8.9%, and 8.8% reported cough, short rapid breaths, and chest complaint respectively two weeks before the survey, making the overall prevalence of ARI 8.8%. Children aged six to 11 years (adjusted odds ratio (AOR)=1.466, 95% CI: 1.143-1.881), and 12 to 23 (AOR=1.390, 95%CI: 1.109-1.742), small birth size (AOR=1.387, 95%CI), and animal dung as cooking fuel (AOR=1.904, 95%CI: 1.152-3.146) are significantly associated with higher odds of ARI in the final multilevel modeling. The AOR (95%CI) for ARI for differing levels of altitude were: 1000 to 2000, 1. 805 (1.403-2.483); 2000 to 3000, 1.882 (1.427-2.483); above 3000, 2.24 (1.023-4.907). Conclusion: ARI is still a significant public health problem in Ethiopia among children underfive, with a huge variation in the burden across the regional states. Age of children, birth size, household cooking fuel, and altitude above sea level were important variables. Therefore, regional governments, health-care workers and concerned organizations should give emphasis to minimize ARI and the consequences associated with the disease.

Purpose: Postoperative pain (POP) is a common outcome of surgical interventions among children. Identifying POP contributing factors can help identify children who are at risk for POP and facilitate POP management. The aim of the study was to determine the predictors of POP based on the Theory of Unpleasant Symptoms. Design and methods: This descriptive-correlational study was conducted in 2018-2019 on 153 children purposively recruited. Data were collected using a personal characteristics questionnaire, the Coping Strategies Questionnaire, the Child Pain Anxiety Symptoms Scale, and a Visual Analogue Scale for Pain. The SPSS software (v. 21.0) was used for data analysis. Results: Twelve participants were excluded and final data analysis was done on the data obtained from 141 participants. Most of participants were male (65.2%), underwent abdominal surgery (53.2%), and experienced POP (86.5%). Their age mean was 8.58±2.23. Linear regression analysis revealed that the physiological factors of heart rate, preoperative pain, and surgery duration as well as the psychological factors of anxiety and coping strategies were significant predictors of POP among children. All these factors collectively explained 34% of the total variance of POP. Situational factors (such as age, gender, and ethnicity) had no significant effects on POP. Conclusions: Heart rate, preoperative pain, surgery duration, anxiety and coping as predictive factors of POP can be considered when designing effective POP management strategies. Practice implications: The findings provide a better understanding about the predictors of POP and can be used to develop pain management among children.

En contexte de cancer avancé pédiatrique, c'est-à-dire quand les traitements visant le cancer ne sont pas efficaces, les soins offerts aux patients ont une visée palliative pour limiter les symptômes et optimiser la qualité de vie (QdV). Pour orienter ces soins, il est nécessaire de connaître et mesurer ce qui est important pour les jeunes dans cette situation. Malheureusement, il existe très peu d'outils disponibles. L'objectif de cet article est de décrire le processus de développement d'une nouvelle méthode d'évaluation de la QdV qui s'adresse spécifiquement au contexte de cancer avancé pédiatrique, le programme Advance QoL. Trois études précédentes réalisées dans notre équipe ont permis d'identifier sept domaines de QdV importants auprès de cette population et de développer l'outil Advance Quality of Life (QoL)-version parents/soignants. L'étude en cours vise à développer des versions autorapportées de l'outil Advance QoL pour les enfants (8-12 ans) et les adolescents (13-18 ans) atteints de cancer avancé. À l'issue de cette étape, l'outil Advance QoL sera disponible en trois versions (parents/soignants, enfants et adolescents) qui seront testées dans des études de validation. L'évaluation régulière de la QdV des jeunes atteints de cancer est un processus central dans le but de définir des cibles pour l'activité soignante et devrait être réalisée tout au long de la trajectoire, incluant le cancer avancé.

School difficulties are common in children cancer survivors and may be prognostic for the success of the patient social reintegration after the disease. Here, we carry out a narrative review of the literature from 2001 to 2022 to assess the school difficulties of these patients, the predictive factors of these difficulties, and the possible long-term consequences. We punctuate this review the practical point-of-view of a teacher dedicated to our hospital, who works with children with chronic diseases such as cancer. Therefore, we expose possible barriers and solutions to improve the scholar reintegration and limit the impact of cancer on the academic achievement.

Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and VassarStats.net programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likeli...

To describe the quality of care for children in emergency departments (ED) as perceived by the nursing staff, and to compare the quality of care for children in a pediatric ED and in a general ED and to identify care quality factors that predict nursing staff's satisfaction with pediatric care in an ED. Design and Methods: A cross-sectional survey study was performed using the 41-item Children Revised Humane Caring Scale (CRHCS) to collect data (n = 147) from acute hospitals' pediatric EDs and general EDs in November 2015. The data were analyzed using descriptive statistics and multiple linear regression. Results: Nurses evaluated the quality of professional practice to be high. Children were treated in a respectful and friendly fashion, and received help when needed. The nurses perceived a lack of human resources in the studied EDs. Nurses in pediatric EDs gave more positive evaluations of the quality of care for children than nurses in general EDs. Positive assessments of professional practice, interdisciplinary collaboration and human resources by nursing staff predicted higher satisfaction with the quality of ED care for children. The quality of children's care seemed to be higher in the pediatric ED than in the general ED. Key predictors of quality in children's care are professional practices of nursing staff, interdisciplinary collaboration and adequate human resources. Practice Implications: In EDs, children should be treated by nursing staff and facilities designated for them. Pediatric nursing and teamwork skills should be maintained in the training of nurses.

Introduction: Incidence of renal and bladder stones is increasing worldwide and many children presenting with pain abdomen are diagnosed to have renal calculi. There is high rate of recurrence of stones in children if full clearance is not achieved or metabolic evaluation is not performed. We analyzed the clinical profile of the children diagnosed to have Urolithiasis and admitted in pediatric ward of our institute over the period of 2 years (Jan 2015 to Dec 2016) Methods: We conducted an Observational study done in Children <15 years diagnosed to have Urolithiasis based on Ultrasound findings and admitted in pediatric ward of Velammal medical college hospital, Madurai, Tamilnadu between January 2015 to December 2016. A total of 30 children were enrolled in this study and their demographic details, clinical presentation, investigations and management were analyzed. Results: Pediatric urolithiasis was more common in boys (75%) with colicky pain abdomen (90%) as the predominant presenting symptom. Most of the children presented during the summer months. They had associated complications like urinary tract infection, hydronephrosis and Pelviureteric junction obstruction. Ureter was the commonest site of urolithiasis (18/30) and most of the children responded to medical management. The children who presented with recurrent symptoms during this study period were evaluated and diagnosed to have some underlying metabolic or genetic disorder. Conclusion: Rising incidence of renal stones with acute colicky pain in pediatric age group is a worrisome problem as it causes school absenteeism and mental stress to the entire family. Urolithiasis in children needs complete evaluation to rule out underlying metabolic disorder. Complete evaluation of the underlying etiology is essential to prevent recurrence and further complications.

Introduction: Incidence of renal and bladder stones is increasing worldwide and many children presenting with pain abdomen are diagnosed to have renal calculi. There is high rate of recurrence of stones in children if full clearance is not achieved or metabolic evaluation is not performed. We analyzed the clinical profile of the children diagnosed to have Urolithiasis and admitted in pediatric ward of our institute over the period of 2 years (Jan 2015 to Dec 2016) Methods: We conducted an Observational study done in Children <15 years diagnosed to have Urolithiasis based on Ultrasound findings and admitted in pediatric ward of Velammal medical college hospital, Madurai, Tamilnadu between January 2015 to December 2016. A total of 30 children were enrolled in this study and their demographic details, clinical presentation, investigations and management were analyzed. Results: Pediatric urolithiasis was more common in boys (75%) with colicky pain abdomen (90%) as the predominant presenting symptom. Most of the children presented during the summer months. They had associated complications like urinary tract infection, hydronephrosis and Pelviureteric junction obstruction. Ureter was the commonest site of urolithiasis (18/30) and most of the children responded to medical management. The children who presented with recurrent symptoms during this study period were evaluated and diagnosed to have some underlying metabolic or genetic disorder. Conclusion: Rising incidence of renal stones with acute colicky pain in pediatric age group is a worrisome problem as it causes school absenteeism and mental stress to the entire family. Urolithiasis in children needs complete evaluation to rule out underlying metabolic disorder. Complete evaluation of the underlying etiology is essential to prevent recurrence and further complications.

Background : Hyperbilirubinemia is the most frequent clinical condition that occurs in neonates identified by yellow discoloration of the skin and other tissues. It is caused by elevations of bilirubin level as the effect of increased breakdown of red blood cells, impaired conjugation of indirect bilirubin, and incomplete bilirubin excretion. This study was conducted to discribe the characteristics of neonates with hyperbilirubinemia. Methods : This study used descriptive quantitative method which took retrospective data from medical record of neonates with hiperbilirubinemia in 2014. The population of this study was neonates which were born in the perinatology division at Dr. Hasan Sadikin General Hospital, Bandung. The variables collected were gender, gestational age, weight birth, general condition ad treatment options. The collected data were tabulated and presented by percentage and in the form of a table. Results : One hundred and seventy four of 230 medical records of neonate...

Among adults, trait anger, patterns of anger expression, and stress have been associated with blood pressure (BP). Less apparent is the effect of these variables on BP in overweight and obese children. To characterize the relationships between these psychological variables and BP, the authors conducted a secondary analysis of data from 73 overweight and obese 9-to 11-year-old children. Findings indicate a positive correlation between trait anger and systolic BP (SBP). Regression results indicate that the overall model significantly predicted SBP by explaining 15.4% of the variance and that trait anger was a significant predictor of SBP.

The purpose of this study was to determine if there is a difference between temperature readings obtained using two different electronic temperature devices: one measuring temporal artery temperature (TAT) and one measuring rectal temperature (RT). A comparative single-group design was used with each participant acting as his or her control. The sample consisted of 47 pediatric patients between 3 and 36 months of age. Data analysis revealed no statistically significant differences between TAT and RT; however, concerns related to statistical significance versus clinical significance are discussed.

Introduction: Adolescents' mutually good relationship with others enhances their empowerment. The aim of this study was to analyze the interaction between adolescents with type 1 diabetes and others. Methods: In this study, the interaction of adolescents with type 1 diabetes was investigated through content analysis. Sixteen adolescents, aged 13 to 18 years old with type 1 diabetes with at least a year past their diagnosis, participated in the present study. Data was collected through semistructured interviews. After each interview, data were transcribed and analyzed with the help of members of the research team. Each interview guided the next interview, that is, the interview questions were altered based on the previous interview data. Field note was another instrument for data collection. Results: Demographic findings of this study indicated that the adolescents' mean age was 16 years, 37.5% were female and 62.5% were male, and 37.5% of adolescents resided in Tehran and the rest in other provinces. Six themes emerged from this study including, relationship with family, relationship with others, lack of dependence on others, normal behavior with others, sense of power when compared with others and keeping up appearances, along with 20 subthemes. Conclusions: The present study showed that Iranian adolescents strongly tend to participate in selfcare and treatment. People's reactions and rational behaviors as well as their support along with preserving independence lead to adolescents' effective communication.

This investigation extended prior work by determining if stress and body mass index (BMI) contributed independently to tumor necrosis factor-α (TNF-α) levels among prepubescent Latino children and if sex and family history of type 2 diabetes mellitus (T2DM) modified these relationships. Data were collected in South Florida from 112 nondiabetic school-aged Hispanic children, of whom 43.8% were obese (BMI ≥ 95th percentile) and 51.8% presented with a family history of T2DM. Stressful life events were assessed via parental report using a life events scale. Plasma TNF-α levels were determined with enzyme-linked immunosorbent assay. The relative contributions of stress and BMI with TNF-α levels and the potential interaction effects of sex and family history of T2DM were analyzed with multiple linear regression analyses. Stress and BMI each accounted for a significant proportion of the unique variance associated with TNF-α. The association between stress and TNF-α was not modified by sex or family history of T2DM. These findings implicate BMI and stress as independent determinants of TNF-α (an inflammatory cytokine and adipocytokine) among Latino children. Future investigations should examine the potential roles of exercise, nutritional status, age, and growth hormone in explicating the relationship between TNFα production and psychosocial distress and risk for infection among obese children.

Método: Estudio descriptivo, en el que participaron pacientes pediátricos que acudieron al Centro de Salud de Pontedeume entre los meses de marzo y abril de 2010. Los datos fueron recogidos mediante un cuestionario formado por 14 preguntas, cumplimentado durante una entrevista semiestructurada con el niño y su acompañante, previo consentimiento verbal, acompañada de presentación la presentación de diferentes fotografías. Resultados: El perfil de los 112 respondientes era de una niña, de entre 3-5 años, que acudía acompañada de su madre a la consulta de niño sano, en turno de mañana, no habiendo estado nunca hospitalizada. La mayoría de niños entrevistados prefieren enfermeras mujeres, jóvenes, que llevan uniforme de trabajo completo de color azul, a ser posible con dibujos. Los distintos tipos de vestimentas son el primer paso en la relación asistencial e influyen en la confianza generada en nuestros pacientes y familiares.

Post-infection illness caused by Coronavirus 2019 leads teenagers to change their health behaviors for staying healthy as previously. This descriptive qualitative research aimed to describe the self-care experiences of teenagers with post-coronavirus 2019 conditions. Participants were purposefully selected based on specific criteria: adolescents diagnosed by a physician as having postcoronavirus 2019 condition, experiencing these symptoms for at least four weeks, and having no other chronic illnesses. The research was conducted at two hospitals in Ubon Ratchathani Province. Data were collected through in-depth interviews and field notes, which were the primary tools used in this research. Thematic analysis was conducted concurrently with data collection until data saturation was reached, including a total of 7 participants, from February 2023 to May 2024. The study concluded that the self-care practices of adolescents who had been affected by the postcoronavirus 2019 condition evolved into chronic symptom management. The results were categorized into two main themes. The first theme, " Life facing the consequence of COVID-19," included subthemes of changes in life and impact on emotional and mental well-being. The second theme, "Finding ways to manage chronic symptoms," included subthemes of discovering health care methods and managing and coping with symptoms independently. These findings help pediatric nurses understand the specific self-care experiences of adolescents with post-coronavirus 2019 conditions. This evidence may be utilized to create nursing care guidelines for this group and provide insight for future research.

Background: Children were significantly impacted during COVID-19 surges, especially with highly transmissible variants like Delta. This study explored caregivers' experiences of children with COVID-19 in hospital isolation rooms, focusing on psychological and practical challenges. Methods: Qualitative methods were used to describe the experiences of caregivers of children with COVID-19. Data were collected through in-depth interviews and from field and observation notes to capture reflections, ideas, and meanings. Content analysis was used to generate themes until saturation was reached with seven participants. The study was conducted at the Queen Sirikit National Institute of Child Health (QSNICH) in Bangkok, Thailand. Results: The research identified three main themes: 1) caregiving in close proximity and handling everything, 2) difficulties and laborious efforts, and 3) emotional experiences and barriers to communication. These themes reflected the practical challenges of managing care with limited support, restricted visitation, and the inability to leave the isolation room, which were collectively summarized as 'caring in confinement'. Conclusion: Insights from this research are crucial for both academic discourse and practical applications. They serve as a foundation for knowledge management practices and inform policy development to enhance pediatric care strategies during health crises. Supporting caregivers and assisting pediatric nurses can improve health outcomes for children during infectious disease outbreaks. This preparation enhances the readiness of pediatric nurses and health care personnel for new health emergencies.

Opekline kože jedne su od vrlo cestih povreda kod djece svih uzrasta, a jedne od najcescih kod manje djece. Ovisno o nacinu nastanka, povrsini zahvacenosti i duljini kontakta s toplinskim izvorom, opekline ponekad dovode do velikih metabolickih promjena i pojacanog neuroendogenog odgovora organizma, pa govorimo o opeklinskoj bolesti. Prema dubini opecene povrsine opekline svrstavamo u opekline I., II., III. i IV. stupnja. Osim dubine, procjena opeklinske bolesti ovisi i o zahvacenoj povrsini. Za procjenu velicine opecene povrsine koriste se razna pravila ili sheme, modificirane za djecu, jer osim dijelove tijela uzimaju u obzir I godine starosti. Tako je, uzimajuci u obzir specificnosti djecje dobi, težina opeklina kod djece podijeljena u tri kategorije: lake, umjerene i teske. Opekline I. i II. stupnja uglavnom se lijece konzervativno, za razliku od opeklina III. stupnja koje zahtijevaju operativno lijecenje, u cilju uklanjanja nekroticnog tkiva. No potreba da se ekscizija ucini do...

This final report describes the rationale, goals and activities of a federally funded project that was designed to develop a model intervention program for hospitalized chronically ill children between birth and five years. The focus of the program was to promote optimal emotional development: attachment, separation, individualization, and socialization. A multidisciplinary team consisting of a pediatrician, a psychologist, child development specialists and volunteers worked together with 46 children and their families. The children were provided with play activities, peer interactions, and a consistent daily caretaker. Parents joined as partners in working with their children, and hospital staff responded with enthusiasm, participation, and an increased number of referrals to the program. The program developed a curriculum with print materials, slides and videotapes for hospital personnel, covering the major areas of emotional and cognitive development, information on how to work with parents and siblings, and helpful approaches to commonly encountered problems. This report also includes a description of challenges encountered by the project, information about the study group at the beginning and end of the intervention, and a review of dissemination and continuation activities. Appendices include: (1) Project devised/adapted measures; (2) Presentations; and (3) Publications.

Management is one of the most significant human beings' attempts in human social life. Human societies are composed of a set of organizations with various purposes, each of which carries out a task. The society achieves the desired aims when all organizations obtain organizational objectives by performing tasks and plans. The most significant factor for obtaining effective goals is management in all organizations. Studies have been carried out on the subject of lived experience in recent years; however, no studies have been conducted on the lived experience of exceptional school principals. Therefore, the current study tried to formulate the lived experience of the principals of exceptional schools in the country with a qualitative approach in a phenomenological study in order to investigate the experience of the principals of these schools from the management of these schools. Obviously, doing the present study can reveal the point of views of the principals working in this position and allow the authorities of the Exceptional Education Organization to take more helpful steps within the framework of laws in order to promote the management quality of exceptional schools. Therefore, the main objective of this research is to answer the following questions: "what is the lived experience of school principals from management in these exceptional schools and what are its themes?" Principals of exceptional school, compared to regular schools, should have very suitable and corrective management because of the intense activities and problems they encounter at school with students and parents, as well as due

Vamos a cuidar con juguetes? RESUMO RESUMO RESUMO RESUMO RESUMO Diante da importância do brinquedo no cotidiano da criança hospitalizada, o estudo buscou identificar a percepção da equipe de enfermagem quanto o preparo de crianças e adolescentes para procedimentos hospitalares em um hospital Universitário de Aracaju. Utilizou-se pesquisa exploratória com abordagem qualitativa com a equipe de enfermagem da unidade pediátrica. Constatou-se que os profissionais não executavam as técnicas com os brinquedos em suas atividades diárias, embora conheçam a importância de tal recurso. Pelas evidências, faz-se necessário a inserção do brinquedo terapêutico no plano de assistência de enfermagem pediátrica. Cuidar com brinquedos é um dos meios mais eficientes de assistir uma criança hospitalizada.

Background and Objective: Many adolescents have a strong desire to establish fruitful relationships, but they are often incapable of interacting and communicating with others. Therefore, the aim of this article is to investigate the effect of coping skills on self-control and self-efficacy in refraining from risky behaviors among adolescents. Methodology: Since the main question of this study is whether self-control and self-efficacy in refraining from risky behaviors are influenced by a specific type of coping skills (problem-focused, emotion-focused, and avoidance), a causal-comparative research method was used. In order to conduct the study, 120 students were randomly selected and asked to complete the self-control questionnaire, self-efficacy to refrain from risky behaviors, and the coping skills questionnaire. Findings: The results of MANOVA analysis showed that coping skills (problem-focused, emotion-focused, and avoidance) have an effect on self-efficacy and its components, but do not have an effect on self-control to refrain from risky behaviors. Conclusion: Lack of life skills leads to low self-efficacy in adolescents, and this factor makes adolescents unable to resist peer pressure and life problems. In a way, low self-control and self-efficacy affect risky behaviors by making them unable to postpone pleasures.

Estudo experimental para aferição do potencial hidrogeniônico (pH) dos antimicrobianos ceftriaxona sódica, cloridrato de vancomicina, metronidazol, penicilina G potássica e sulfato de amicacina, após reconstituição, diluição com NaCl 0,9% (SF) e soro glicosado 5% (SG), em oito momentos distintos e sob condições cotidianas de luminosidade e temperatura ambiente de unidade hospitalar não climatizada. O objetivo deste estudo foi verificar alterações no comportamento ácido-básico das soluções, indicativas de instabilidade química ou relacionadas a complicações da terapia intravenosa. Nos 186 valores de pH analisados, não foram identificadas variações maiores que 1,0 valor nem alterações físicas visíveis a olho nu. Todas as soluções tiveram pH menor que 7 e não houve diferença considerável para a prática clínica segundo o diluente. As médias dos valores de pH após a diluição em SF e SG, do cloridrato de vancomicina, metronidazol e sulfato de amicacina constituem fator de risco para o des...

OBJECTIVES: this study was aimed at developing and validating a checklist of preoperative pediatric interventions related to the safety of surgical patients. METHOD: methodological study concerning the construction and validation of an instrument with safe preoperative care indicators. The checklist was subject to validation through the Delphi technique, establishing a consensus level of 80%. RESULTS: five professional specialists in the area conducted the validation and a consensus on the content and the construct was reached after two applications of the Delphi technique. CONCLUSION: the &quot;Safe Pediatric Surgery Checklist&quot;, simulating the preoperative trajectory of children, is an instrument capable of contributing to the preparation and promotion of safe surgery, as it identifies the presence or absence of measures required to promote patient safety.

The objective of this experimental study was to measure the pH of antibiotics administered by intravenous infusion - ceftriaxone sodium, vancomycin hydrochloride, metrodinazole, penicillin G potassium and amikacin sulfate - after reconstitution with sterile water and dilution with NaCl 0.9% or dextrose 5% in water, according to temperature and luminosity of the environment. The results showed that variation in the drugs&#39; pH was less than 1.0 value and that some antibiotics remained acidic after dilution and maintained this chemical profile in all situations studied, suggesting that the studied environmental factors did not change the solutions&#39; acid base characteristic. Some pH values measured characterize risk for the development of chemical phlebitis and infiltration, and it is important for clinical practice to emphasize the profile of intravenous solutions of antibiotics, considering method of dilution, and time to infusion.

Estudo de abordagem qualitativa que objetivou identificar como alunos de graduação percebem a integralidade do cuidado da criança no seu processo de aprendizagem, em um Curso de Bacharelado em Enfermagem do interior paulista. Entrevistou-se 89 alunos em junho e dezembro de 2009. Os dados coletados foram analisados mediante análise de conteúdo, sendo identificadas quatro temáticas. A integralidade é vista como cuidado inteiro, envolvendo criança, família, condições de vida, meio ambiente. A instituição de ensino propõe inserção precoce do aluno na realidade; este desmistifica o ideal de cuidado, deparando-se com o real. O professor instiga o aluno a refletir sobre sua prática, para que esta faça sentido e também sejam apreendidos o saber e o fazer relacionado à integralidade do cuidado à criança.

The current focus on reducing the risk of osteoporosis and skeletal fractures in later life has placed an emphasis on the role of calcium in building strong bones during childhood and adolescence. Recent National Institutes of Health (NIH) Consensus Development Conference recommendations for optimal calcium intake encourage increased intake. Strategies to enhance optimal calcium intake in children and adolescents include dietary choices and the use of supplements.

Objective: Type 1 diabetes significantly affects children physical, emotional, social, and academic wellbeing, reducing their Quality of Life (QoL) and potentially causing psychological problems. This study evaluates the QoL in children aged 10-16 with type 1 diabetes in Yazd. Materials and Methods: In this analytical cross-sectional study, 75 children with type 1 diabetes who visited healthcare clinics in Yazd were assessed. Data were collected using a demographic questionnaire and the Pediatric QoL Inventory (PedsQL), QoL questionnaire, evaluating four subscales: physical, emotional, social, and academic performance. Data were analyzed using SPSS-24 software. Results: The highest QoL score was in the physical dimension (mean: 8.51 (± 7.04)), while the lowest was in academic performance (mean: 4.02 (± 3.75)). A significant relationship was found between gender and academic performance (girls: 2.43 (± 1.58), boys: 1.93 (± 1.04)) (P= 0.021). HbA1C levels significantly correlated with academic (P= 0.028) and social (P= 0.013) dimensions. Parental education (father: P= 0.007, mother: P= 0.047) and employment status (father: P= 0.039, mother: P= 0.025) were also associated with QoL and academic performance. Conclusion: Type 1 diabetes particularly impacts the academic and social dimensions of QoL in children, potentially leading to long-term psychological consequences. Further research should explore therapeutic, educational, and familial interventions to enhance their QoL.

This work aimed to investigate obstacles and facilitators for carrying out Kangaroo Mother Care (KMC) across Italian NICUs. Design and methods: A survey that investigated Unit's characteristics, policies toward parents and KMC practice and policies was carried out. Data from 86 NICUs (80.4%) was collected. Descriptive statistics and Multiple Regression Models were computed. Results: Eighty-one NICUs provided KMC. These NICUs had a less restricted parental access policies (chi 2 = 7.373, p = .007). More than the 70% of the units did not have adequate facilities for parents. KMC daily length was positively predicted (R 2 = 0.18, F = 7.91, p = .001) by repeated sessions and documentation of KMC. The implementation of KMC is characterized by different barriers and facilitators that determine the parent's possibility to provide KMC. Structural factors (e.g., adequate space and facilities) can support families in providing KMC. A unique result of this survey is that KMC documentation on medical records appears critical for improving its practice. Practice implications: Although most of the Italian units provide KMC as a routine practice, improving its practical support would be beneficial to its implementation. A more formalized approach to KMC may strengthen staff habits to consider KMC like a standard care treatment.

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The present study was taken up to evaluate the mode of transmission and clinical profile of HIV in children. It was a cross sectional observational study which included HIV seropositive children of less than 15 years age who presented to the pediatrics department with various clinical manifestations and also symptomatic children who accompanied the parents and siblings to ART centre and were found to be seropositive on screening. 442 HIV positive children were enrolled in the study. The mean age of presentation was 8.63±2.9 years. Vertical transmission was the probable mode of transmission in 97.7% children. Prolonged fever and cough more than 1 month were the commonest presenting clinical features. 79% of enrolled children were malnourished. Tuberculosis was the commonest opportunistic infection. Awareness of clinical spectrum of HIV helps in early screening and intervention.

Published online: 18 August 2019 Background and Aim: Venipuncture is a common iatrogenic procedure and a great source of pain in children who attend to hospital. The aim of the present study was comparing the effect of playing a riddle and music on the severity of pain perception during venipuncture. Materials and Methods: In this clinical trial, a total of 243 children aged 7 to 9 years were allocated to the trial and control groups by a blocked randomization method in Amir Kabir hospital of Arak. A visual riddle was played before and during venipuncture for one trial group and a visual music was played for another trial group via a same tablet. In all groups, venipuncture was performed with a 22-gauge cannula by a nurse in a similar place. Severity of pain was measured using the Wong-Baker scale and the mean differences was compared through Kruskal-Wallis test. Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1397.061 has been approved by research ethics ...

Background & Aim: Multiple Sclerosis (MS) is an incurable disease that requires proper self-management. This study aimed to compare the effects of peer-led and nurse-led selfmanagement programs on the self-management of patients with MS . Materials & Methods: This randomized clinical trial study was performed on 81 patients with MS, who were members of the comprehensive treatment center for special diseases affiliated to Birjand University of Medical Sciences in 2018, selected by convenience sampling. First, the participants completed the demographic characteristics form and the selfmanagement scale, and then attended self-management programs held by an experienced nurse in four nurse-led groups and a peer in four peer-led groups. The intervention was carried out in the form of six sessions (1.5 hours) held once a week. Notably, the selfmanagement scale was completed by all subjects immediately and two months after the intervention . Results: In this study, no significant difference...

The main aim of the study was to assess the effectiveness of breast feeding on reduction of pain related behaviors among infants during immunization. A quasi experimental post-test only control group design was adapted for present study. A purposive sampling technique was used to select 40 infants (20 each in experimental and control group) at primary health centers at Mangalore. The data was collected by using modified behavioral observational scale. Descriptive and inferential statistics were used to analyse the data. According to modified behavioral observational scale the breastfed infants in experimental group 99% showed mild behavioral response to pain, whereas infants in the control group 55% and 45% showed moderate and severe behavioral response to pain. This study concluded that breastfeeding is effective in reducing pain related behaviors among infants during immunization.

Pain management in the neonatal intensive care unit (NICU) continues to be a major challenge for the care team. Despite all the advances in scientific knowledge, the treatment of pain in neonates is still neglected in many centers, with important biopsychosocial implications. Bioethical reflections on this subject are practically non-existent in the current literature and several studies have pointed out the importance of inclusion and active parental participation in pain management and decision-making for neonates hospitalized in the NICU. This article aims to stimulate bioethical reflections on health care by the nursing team for this vulnerable population, with regard to pain, with a view to improving care and humanizing hospital care.

Stroke is a major cause of sequelae and mortality worldwide. The aim of the study was to investigate the perception of the influence of the COVID-19 pandemic on stroke. The methodology used was observational, longitudinal and of a mixed approach, within the line of research within the Social Sciences and Epistemology in Health. Data was collected in two private hospitals in 2022. Patients diagnosed with acute ischemic stroke, their families, doctors and nurses took part in the study. A data collection form and interviews were used for each participant semi-structured. Quantitative data was analyzed using SPSS software, and qualitative data using IRAMUTEQ. Data was collected from a total of 19 patients, 19 family members, 19 doctors and 19 nurses. Among the results found, the average age of the patients was 72± 13 years and 52.6% were male, 57.9% were married and 68.5% had at least a high school education. As for the qualitative data, stress was considerably prevalent in interviewees' perceptions (patients, family members and doctors and nurses), contributing to the study patients' strokes, rather than the "COVID disease" itself.

This study investigated sleep, television, computer habits, and obesity in school-age children. This was a cross-sectional self-report survey of 1260 children in grade 4 (mean age, 10.1) living in southern Sweden (49.1% boys). The heights and weights of 1097 (87.1%) of the children were recorded. Descriptive statistics, bivariate analyses, and multiple logistic regression were employed. The median length of self-reported sleep on weeknights was 9.5h. Approximately 40% of the children reported receiving &lt;9h of sleep. The median bedtime was 9PM (21:00). On weekends, the median bedtime was 1 h later, and they delayed getting up by 1.5h. The median time spent watching TV and using a computer was 1 h each. The prevalence of being overweight (including obesity) was 18%. Insufficient sleep (&lt;9h) was associated with being overweight, watching TV, or using a computer for two or more hours each day, difficulty falling asleep, and being tired at school. School-age children who receive le...