Hamide Nur Çevik Özdemir

Pediatrik cerrahi süreçlerinde çocuklar kaygı ve korku gibi olumsuz duygular yaşayabilmekte ve bu durum hem çocuk hem de aile için psikososyal açıdan zorlayıcı olabilmektedir. Bu duyguların azaltılması, cerrahi sürecin daha etkili yönetilmesi açısından önemlidir. Pediatri hemşireliği uygulamalarında kaleydoskop, müzik ve sanal gerçeklik gibi çeşitli nonfarmakolojik girişimler çocukların kaygısını azaltmak için kullanılmaktadır. Son yıllarda terapötik mizah ve hastane palyaçosu uygulamaları da çocukların stresle başa çıkmasına yardımcı olan etkili yöntemler arasında yer almıştır. Mizah ve oyun temelli etkileşimler çocuklarda kaygı, korku ve ağrının hafifletilmesine, tedaviye uyumun artırılmasına ve hastane deneyiminin daha olumlu hale gelmesine katkı sağlamaktadır. Bu bölümde pediatrik cerrahide terapötik mizahın kapsamı, hastane palyaçosu uygulamalarının etkileri ve pediatri hemşireliği bakımına olan katkıları ele alınmıştır. Children undergoing pediatric surgical procedures may experience negative emotions such as anxiety and fear, which can create psychosocial challenges for both the child and the family. Reducing these emotions is essential for the effective management of the surgical process. In pediatric nursing practice, various nonpharmacological interventions such as kaleidoscopes, music, and virtual reality are commonly used to decrease anxiety. In recent years, therapeutic humor and hospital clown interventions have also emerged as effective methods that support children in coping with stress. Humor and play based interactions help reduce anxiety, fear, and pain, promote adaptation to treatment, and contribute to a more positive hospital experience. This section examines the scope of therapeutic humor in pediatric surgery, the effects of hospital clown interventions, and their contributions to pediatric nursing care.

Bu araştırma 5-12 yaş grubu çocuklarda kan alma işlemi sırasında yağmur çubukları ve kaleydoskop kullanımının ağrı, anksiyete ve ebeveyn memnuniyeti üzerine etkisini belirlemek amacıyla deneysel olarak yapıldı. Bu araştırma 1 Nisan-1 Temmuz 2022 tarihleri arasında Türkiye'nin doğusundaki bir ilin üniversite hastanesinin çocuk polikliniği kan alma ünitesinde paralel gruplarla yürütülen randomize kontrollü bir çalışmadır. Örneklem dahil edilme kriterlerini karşılayan I. Deney Grubu (Yağmur Çubuğu) 35, II. Deney Grubu (Kaleydeskop) 35 ve Kontrol Grubu 35 olmak üzere toplam 105 çocuk ve ebeveyni ile gerçekleştirildi. Araştırma verilerinin toplanmasında “Çocuk Anksiyete Skalası- Durumluluk” ve “Wong-Baker Yüzler Ağrı Ölçeği” kullanıldı. Çalışmada, CONSORT yönergelerine bağlı kalındı. Çocukların öz bildirimine, ebeveyn ve araştırmacının raporuna göre ağrı puan ortalamaları I. Deney Grubu ve II. Deney Grubunda Kontrol Grubuna göre anlamlı derecede daha düşük bulundu (p0.05), işlem esnasında kaygı puan ortalamaları açısından anlamlı fark olduğu bulundu (p<0.05). Yağmur çubuğu ve kaleydeskop kullanımının, çocuklarda kan alınması sırasında hissedilen ağrı ve kaygı düzeyini azaltmada etkili olduğu belirlendi.

Aims: Circumcision is a surgical procedure that causes pain, anxiety, and fear in children. This study aimed to examine the effectiveness of immersive virtual reality (IVR) and music on anxiety, fear, and pain levels of children during circumcision surgery. Methods: This randomized controlled trial included boys aged 6-8 years who were circumcised at a university hospital between September 2022 and July 2023. Using stratified block randomization, the sample group’s children were split into three groups: music (n=24), IVR (n=24), and control group (n=24). The Wong-Baker Faces Pain Rating Scale, the Children’s Anxiety Meter Scale, the Children’s Fear Scale, and a Participant Information Form were used to gather the data. Descriptive statistics, t tests, analysis of variance and Duncan and Bonferroni adjustments were used to examine the data. Results: Children in the IVR and music groups experienced much less worry and dread during and after circumcision than those in the control group. The mean pain scores of the experimental groups during and after circumcision were significantly lower than those of the control group. Fear, anxiety, and pain levels were significantly different in the IVR group compared to the other groups (p

Objectives: Social isolation is an important public health issue that is becoming increasingly prevalent among adolescents today. Recognizing the risk of social isolation in children and adolescents during their developmental years can contribute to the prevention of depression and anxiety disorders, as well as risky behaviors such as suicide and substance abuse. Valid and reliable measurement tools are needed to assess social isolation in adolescents. There is a lack of surveys to identify gaps in social isolation among Turkish adolescents. This study aims to adapt the Social Isolation Questionnaire (QIS) scale, which was developed for adolescents, to Turkish culture and to evaluate its psychometric properties. Methods: This descriptive and methodological study was conducted between July and November 2024 with 1922 adolescents. Data were collected using an introductory information form, the QIS, and the UCLA Loneliness Scale. In the evaluation of the data, explanatory and confirmatory factor analysis, Cronbach’s alpha, split-half, item–total score correlation, and test–retest analysis were used. Results: The average age of the adolescents was 13.97 ± 1.67 years (min = 12, max = 17). A total of 50.6% of the adolescents were male and 49.4% were female. A total of 81.2% of the adolescents had a nuclear family structure. Exploratory factor analysis revealed a three-factor structure explaining 55.97% of the variance. The factor loadings were greater than 0.30, and all fit indices were greater than 0.90. The total Cronbach’s α value of the scale was 0.83, while the values for the subdimensions ranged from 0.73 to 0.75. Conclusions: The Turkish version of the QIS is a valid and reliable measurement tool for assessing social isolation in adolescents. This questionnaire can be used by health professionals and researchers to identify adolescents at risk of social isolation and plan appropriate mental health interventions. This questionnaire can be used in studies focusing on adolescent mental health and well-being, contributing to the development and implementation of strategies in line with the Sustainable Development Goals.

The Effect of Practices by Caregiver Mothers of Children with Tracheostomies at Home on the Occurrence of Pressure Ulcers - Journal of Pediatric Emergency and Intensive Care Medicine

This study aimed to examine the developmental trends and research focus of the child and family-centered care literature through a bibliometric analysis of articles published between 1990 and 2023. The bibliometric analysis method was used in the study. Data were obtained from the Web of Science Core Collection and Scopus databases. Bibliometric analysis and visualization were conducted using the R language, along with the bibliometrix and openxlsx libraries and the biblioshiny interface. The study included citation, co-occurrence, co-authorship, co-word analysis, and trend topic analysis. Between 1990 and 2023, a total of 1.613 publications related to child and family-centered care were published. Of these publications, 1.598 were original research articles, and the majority (%95) were written in English. The United States was the country with the highest number of publications and the most co-authorship collaborations. Collaborating countries included Canada, Brazil, Iran. Journal of Pediatric Nursing was the most prolific journal (n=149). The author with the highest number of publications on the topic was Shields (n=23). The most cited works related to child and family-centered care were by Gorski (2021), Kerr (2002), and Snow (2009). The institution producing the most publications on the topic was McGill University. In trend topic analysis, key terms such as ‘‘family-centered care’’, ‘‘nursing’’, ‘‘parents’’, ‘‘child’’, and ‘‘child-centered care’’ emerged. Child- and family-centered care research is widespread in developed countries but lacks interdisciplinary collaboration, particularly outside pediatric intensive care units. Future studies should promote co-authorship and international cooperation, providing healthcare professionals and researchers with insights into unexplored areas and opportunities for collaboration.

This study examines the effects of virtual reality (VR) and tablet-based mobile applications (TBMA) in teaching heart anatomy to middle school students. A randomized-controlled trial was conducted in which 84 middle school students were divided into three groups: VR (n = 28), TBMA (n = 28), and control (n = 28). The students' knowledge levels regarding heart anatomy were assessed before and after the applications. In addition, the student's metacognitive awareness and satisfaction levels were measured after the TBMA and VR applications. The participants' opinions regarding the applications were evaluated using qualitative analysis techniques. Descriptive statistics, variance analysis, and t tests were used to analyze quantitative data, and Colaizzi's education method was prepared sevenfold to examine qualitative data. A significant increase in heart anatomy knowledge levels was observed in the distribution of VR and TBMA. However, no significant difference was found between the groups (p > 0.05). In addition, while the metacognitive awareness of heart anatomy was higher in the students in the VR group, the students in the TBMA group were more satisfied with the learning process. Students stated that learning heart anatomy with VR and TBMA methods was fun, informative, and enjoyable and that such applications should be used more in classes. This study reveals that technology-supported teaching methods can positively affect students' learning processes while teaching heart anatomy. More comprehensive research should be conducted with randomized-controlled and mixed-method studies in different age groups and various course subjects to evaluate the sustainability and effectiveness of technology-based applications.

This study aimed to investigate the mediating role of psychological resilience in examining the effects of spiritual well-being on the caregiver burden of parents of children with tracheostomy. This descriptive, cross-sectional, and correlational study was conducted with 109 parents of children with tracheostomy. The three-factor spiritual well-being scale, the caregiver burden scale for family caregivers, and the brief resilience scale were used for data collection. The study adhered to the strengthening the reporting of observational studies in epidemiology guidelines. Descriptive statistics, t tests, variance analysis, and relationship analysis were used in the data analysis. A significant, negative, and moderate relationship exists between the caregiver burden and the brief resilience scale (p < 0.05). There is a negative relationship between the anomie sub-dimension of the spiritual well-being scale and caregiver burden, and a positive and moderate relationship with resilience (p < 0.05). Psychological resilience affects caregiver burden via the anomie subscale. Programs can be developed to alleviate the caregiving burden and enhance the spiritual well-being of parents with children who have tracheostomies, taking into account the importance of psychological resilience.

Preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing represents a significant advancement in treating inherited hematological disorders, particularly thalassemia major. This technology enables the birth of healthy children who can serve as compatible stem cell donors for their affected siblings. Turkey is a world leader in both PGD+HLA typing technology and hematopoietic stem cell transplantation from savior siblings born through PGD+HLA typing. This study investigated the experiences of Turkish parents who underwent successful savior sibling procedures using preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing and then successful hematopoietic stem cell transplantation, from this savior sibling, for the treatment of their thalassemia major child. The research aimed to understand the medical, psychological, and socio-cultural dimensions of this complex process within the Turkish healthcare context. A qualitative study using descriptive phenomenological approach was conducted. In-depth interviews were performed with 16 parents, who successfully completed PGD+HLA matching and subsequent successful stem cell transplantation process from this savior sibling to their thalassemia child. Data were analyzed using Colaizzi's seven-step method and MAXQDA 20.0 software. Analysis revealed six main themes: Disease Stage, Treatment, Recovery Process, Social Family, Support Systems, and Recommendations. Parents reported significant emotional challenges but demonstrated unexpected resilience. Religious and cultural factors played nuanced roles, with most parents viewing the process as compatible with their beliefs. Economic burden, prolonged hospitalizations, and geographical access to treatment centers emerged as key challenges. Extended family support and healthcare professional guidance were identified as crucial support mechanisms. The study highlights the complex interplay between advanced medical technologies and traditional values in Turkish society. Findings emphasize the need for comprehensive, culturally sensitive support systems and long-term follow-up for families. Results suggest implementing multidisciplinary care teams and developing specialized support programs for families undergoing savior sibling procedures.