Search

Bu sistematik incelemede kanser tedavisi alan çocuklarda yoga uygulamalarının incelenmesi amaçlanmıştır. Kanser tedavisi alan çocuklarda yoga uygulamaları ile ilgili 2009-2020 yılları arasında yapılan çalışmaları belirlemek için “Science Direct, Medline/Pubmed, Cochrane” veri tabanları taranmıştır. Tarama yapılırken, “çocuk/adölesan/pediatrik, kanser, yoga terapi ve zihin-beden uygulamaları/terapileri” anahtar sözcükleri kullanılmıştır. Anahtar kelimelerle yapılan araştırma sonucunda 209 makaleye ulaşılmıştır. İncelenen makalelerde kriterlere uyan 7 çalışma incelemeye alınmıştır. Bu sistematik incelemede “Kanser tedavisi alan çocuklarda yoga uygulamalarının etkinliği nasıldır?” ve “Kanser tedavisi alan çocuklarda yoga uygulamaları hangi semptomlara yönelik uygulanmaktadır?” soruları belirlendi. İncelenen makalelerde yoganın pediatrik onkoloji hastalarına uygulanabilir olduğu bulunmuştur. Yoganın yaşam kalitesi, yorgunluk, anksiyete, uyku kalitesi, fiziksel aktivite seviyesi, motor beceri ve psikolojik durum üzerine etkileri incelenmiştir. Yapılan çalışmalarda çocukların fonksiyonel mobilitesinde, kaba motor fonksiyon algısında, esnekliğinde ve fiziksel aktivitelerinde artış gözlenmiştir. Yoga, pediatrik onkoloji hastaları için yaşam kalitesini olumlu yönde etkileyen güvenli bir fiziksel aktivitedir., This systematic review is aimed to investigate yoga interventions in children receiving cancer treatment. “Science Direct, Medline/Pubmed, Cochrane” databases were searched to determine the studies conducted between 2009-2020 on yoga practices in children receiving cancer treatment. In the review, “Child / Adolescent/ Pediatric, Cancer, Yoga Therapy and Mind-Body Interventions/Therapies” keywords used. From the reviewed articles, seven studies that met the criteria were included. In this systematic review, "How is the effectiveness of yoga practices in children receiving cancer treatment?" and "For which symptoms are yoga practices applied in children who receive cancer treatment?" questions were determined. In studies, yoga was found to be applicable to pediatric oncology patients. The effects of yoga on quality of life, fatigue, anxiety, sleep quality, physical activity level, motor skills, and psychological status were investigated. There was an increase in functional mobility, gross motor function perception, flexibility, and physical activities of children in studies. Yoga is a safe physical activity for pediatric oncology patients, which positively affects the quality of life.

Kemoterapiyle ilişkili periferik nöropati, kanser tedavisinde kullanılan kemoterapik ajanların yol açtığı ciddi bir yan etkidir. Alınan kemoterapi kürleriyle giderek kötüleşen nöropati semptomları periferik sinir sisteminin duyu-motor-otonom bölgelerine hasar verebilmektedir. Bu derlemenin amacı kanser tedavisi alan çocuklara bakım veren hemşirelerin kemoterapiyle ilişkili periferik nöropati değerlendirmesindeki rolüne dikkat çekmektir. Kemoterapiyle ilişkili periferik nöropatinin ellerde-ayaklarda uyuşma, karıncalanma, kas/eklem ağrıları, yanma hissi, periferik reflekslerde azalma ve konstipasyon gibi belirtileri vardır. Bu belirtiler çocukların günlük yaşamını ve yaşam kalitelerini olumsuz yönde etkilemektedir. Kemoterapi ile ilişkili periferik nöropati görülme sıklığı kanserin tipine ve kullanılan kemoterapik ajana bağlı olarak değişmektedir. Vinkristin, sisplatin, taksan bazlı kemoterapik ajanların periferik nöropati geliştirdiği bilinmektedir. Kemoterapi tedavisi tamamlandıktan sonra bazı kemoterapik ajanların neden olduğu periferik nöropatiler azalsa da bazı ilaçların neden olduğu periferik nöropati bulguları uzun süre devam etmektedir. Hemşirelerin periferik nöropatiye yol açan kemoterapi ajanlarını bilmesi önemlidir. Hematoloji ve onkoloji servisinde çalışan pediatri hemşirelerinin, çocukların periferik nöropati semptomlarını nesnel olarak değerlendirebilecek ölçme araçlarından faydalanmaları gerekir. Nöropati değerlendirmesi hemşirelik bakımında bir rutin haline gelmelidir. Türkiye’de henüz kemoterapiyle ilişkili periferik nöropatiyi iyi bir şekilde değerlendiren bir ölçüm aracı bulunmamaktadır. Periferik nöropatiyi değerlendiren ölçüm araçlarının dilimize kazandırılması, hemşirelerin periferik nöropatinin semptomlarını (el ayaklarda karıncalanma, düğme ilikleme, merdiven inip çıkmada güçlük, yürürken sendeleme gibi duyusal, fonksiyonel ve otonom semptomlar, kas gücü ve derin tendon reflekslerinde azalmayı içeren fizik muayene bulguları) bilmesi ve nöropati değerlendirme araçlarıyla nöropatiyi değerlendirmesi önemlidir. Periferik nöropatinin yönetilmesinde farmakolojik yöntemlerin yanı sıra akupunktur, refleksoloji, masaj, ayak banyosu, kriyoterapi, scrambler terapi, progresif kas gevşeme egzersizleri, fiziksel aktivite gibi birçok farmakolojik olmayan yaklaşım bulunmaktadır ancak kanıtlar halen yetersizdir. Nöropatinin değerlendirilmesi ve yönetimi için klinik temelli çalışmalara ihtiyaç vardır.

Background: The evaluation of peripheral neuropathy in children receiving Vincristine treatment is challenging. This study examined the Turkish validity and reliability of the Total Neuropathy Score-Pediatric Vincristine (TNS-PV) measurement tool, which can measure Vincristine-induced peripheral neuropathy symptoms in children with cancer. Methods: A total of 53 children aged 5–17 years who received Vincristine treatment in two pediatric hematology-oncology centers participated in the study. Data was collected using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the Common Terminology Criteria for Adverse Events (CTCAE), the Wong-Baker FACES Pain Scale, and the Adolescent Pediatric Pain Tool (APPT). The correlation between the TNS-PV total score and other scales and the inter-rater reliability coefficient was evaluated. Findings: Of the children, 81.1% were diagnosed with ALL and 13.2% with Ewing Sarcoma. Cronbach's alpha values of form A and B of the TNS-PV scale were 0.628 and 0.639, respectively. As the cumulative Vincristine dose increased, the children's scores on TNS-PV were higher. A moderate and significant positive correlation was found between the TNS-PV form A total score and the worst subjective symptoms a, b (A), strength, tendon reflexes, and autonomic / constipation (r = 0.441, r = 0.545, r = 0.472, r = 0.536, p < 0.01). Discussion: The TNS-PV form B total score was found to have a moderate level, significant correlation with CTCAE sensory neuropathy score and Wong-Baker FACES Pain Scale, and a high level, significant positive correlation with CTCAE motor neuropathy score. Application to practice: The TNS-PV is valid and reliable for measuring Vincristine-induced peripheral neuropathy in practice in Turkish children 5 years and older.

Background and Aims: Evaluation of chemotherapy-induced peripheral neuropathy has gained importance in symptom management of pediatric patients with cancer. The aim of this study is to perform the Turkish validity and reliability study of the Pediatric-Modified Total Neuropathy Score (Ped-mTNS).Methods: A methodological, descriptive, and cross-sectional design was used in the study. Forty children who were aged between 5 and 18 and were treated for cancer and 40 age- and gender-matched healthy children (control group) were included in the study. The mean scores of the items on the Ped-mTNS were compared, and item-total score correlations were evaluated. Cronbach’s alpha coefficient of the Ped-mTNS was calculated for internal consistency.Results: Cronbach’s alpha value of the scale was found as .709 in the study. The item-total correlations of the scale items ranged from 0.260 to 0.658. The mean score of cancer patients on the Ped-mTNS was found as 4.4±3.8. The Ped-mTNS scores of children with cancer indicated more deficits than those of the control group. In the evaluation of children in the patient and control groups, a difference was found in terms of light touch sensation, which is one of the sensory symptoms in the items of the Ped-mTNS, and pin sensibility and strength, which are among clinical symptoms. The Ped-mTNS was determined to be a valid and reliable measurement tool for children with cancer who are aged between 5 and 18 in the Turkish population.

Aim: To evaluate perceptions of parents of children with cancer about medications errors. Materials and Methods: The sample of the study with a cross-sectional descriptive design consisted of parents of 100 children with cancer who received chemotherapy treatment. "The Parents’ Perceptions of Drug Application Security,” “The Methods Used by Parents to Protect Their Children from Medication Errors,” and “The Parents’ Willingness and Attitudes Toward Collaboration with Health Care Professionals" was used to collect research data. Results: It was found that 7% of the parents confronted with a real medication error; of these, 3% medication errors occurred in the form of wrong drug administration. It was also determined that 68% of the parents thought about the possibility of a medication error occurring during their children treatment. The parents responded as “yes” with the corresponding percentage to the following statements: “I always ask the nurse check whether the drug that he/she will administer on my child is the right drug” (37%), “I trust doctors/nurses, so I do not check them” (61%), and “If I encounter with a wrong drug administration, I definitely report it to the relevant authorities” (92%). Conclusions: The participant parents' awareness of the methods to protect their children from medication errors was found to be inadequate in some applications, but adequate in some others. It was also determined that they were willing to cooperate with health care professionals against medication errors.

Distraction methods such as virtual reality and cold vibration device are recommended during intravenous interventions. Few studies have focused on the impact of nonpharmacological interventions on intravenous insertion success.A randomized controlled study evaluated effect of virtual reality and cold vibration device application on first-attempt intravenous insertion success and procedure-related pain, fear, and anxiety during intravenous insertion in children. Children aged 4 to 10 years (N = 150) undergoing peripheral intravenous catheterization insertion in the pediatric emergency department were randomized to 1 of 3 groups: virtual reality, cold vibration (Buzzy), and control group. Distraction technique of talking and asking questions of children was used in control group. Primary outcome was first-attempt intravenous insertion success; secondary outcomes were procedure-related pain, fear, and anxiety. Study data were collected using Difficult Intravenous Access score, Emotional Appearance Scale for Children, Wong-Baker Faces Pain Rating Scale, Color Analog Scale, Children's Anxiety Meter-State, and Child Fear Scale. Data were analyzed using chi-square test, Fisher exact test, and Kruskal-Wallis test.There were no significant differences in first-attempt intravenous insertion success rates (virtual reality = 47.2%, Buzzy® = 50%, control = 46.9%), preprocedural emotional appearance scores, and procedure-related pain and anxiety scores. There was no difference between groups for vital signs before, during, and at fifth minute of procedure.Virtual reality and Buzzy may decrease procedure-related fear in children during intravenous insertion. This research has shown that pediatric emergency nurses can reduce pain and anxiety by talking to children, and simple distractions such as asking questions are as effective as more technological ones.

Background During the COVID-19 pandemic, parents and children have experienced stress and fear, and the attitudes of parents toward COVID-19 need to be explored. Purpose This study aimed to develop the Parental Attitude Scale-Protecting Children during COVID-19 (PAS-CV19S) and assess its psychometric properties. This study also aimed to determine the relationship between parental attitudes about COVID-19 and fear of COVID-19. Design and methods In this methodological and correlational study, parents of children ages 6 to 18 years old were included (N = 402). The PAS-CV19S was developed for this study. The study collected data using an online sociodemographic form, a fear of COVID-19 scale, and the PAS-CV19S. The Cronbach alpha coefficient, confirmatory factor analysis, and explanatory factor analysis were used to assess the validity and reliability of PAS-CV19S. Pearson correlation analysis was used to examine the relationship between the fear of COVID-19 scale and the PAS-CV19S. Results The PAS-CV19S is a valid and reliable scale consisting of three factors (general health, mental health, and preventive behaviors) as subdimensions. The Cronbach alpha of the PAS-CV19S overall was 0.90; the Cronbach alphas for the general health, mental health, and preventive behaviors subdimensions were 0.78, 0.80, and 0.92, respectively. There was a significant negative correlation between fear of COVID-19 and the mental health subdimension. Conclusion and practice implications This study sheds light on parental attitudes about protecting their children from COVID-19. The fear of COVID-19 of parents did not affect attitudes other than mental health. Parental concerns and attitudes about COVID-19 need to be discussed to protect children.

Purpose The purpose of this study was to examine the effect of the applications of external cold and vibration and blowing soap bubbles during phlebotomy in children aged between 3 and 6 years. Design This study is a randomized controlled trial. Methods The sample was obtained using block randomization. Children were divided into three groups: “external cold and vibration group,” “blowing soap bubbles group,” and “control group.” Children, their parents, the nurse, and the researcher rated the children's pain during phlebotomy. Findings A statistically significant difference between groups was found on pain scores. Pain scores were lower in the groups of external cold and vibration, and blowing soap bubbles than the control group. Conclusions The methods of external cold and vibration and blowing soap bubbles had a pain relieving effect in children aged between 3 and 6 years during phlebotomy.

Purpose: This observational study carried out to determine the incidence of poor nutritional status and symptom burden in children undergoing chemotherapy treatment. Methods: The research data collected from 187 children between the ages of 7-18 at pediatric hematology -oncology units in Izmir. The data of the study collected with Screening Tool for Risk of impaired Nutritional Status and Growth (STRONGkids), and the Memorial Symptom Assessment Scale (MSAS). Results: Patients reported a mean (SD) of 14.1 (8.1; range, 1-30) symptoms, and 43.9% were underweight. According to the STRONGkids, 62% had a high risk for malnutrition. The incidence of all symptoms increased as the Z-score of the patients worsens. There was a significant positive correlation between mean symptoms and STRONGkids malnutrition risk score, and Z-score (p < .001). Conclusion: Most of the patients were at high risk of malnutrition. It observed that chemotherapy treatment led to malnutrition. The patients with high risk for malnutrition according to the STRONGkids and severe malnutrition according to the Z-score experienced more symptoms.

Purpose: This study aimed to evaluate the Turkish validity and reliability of the revised version of the Cancer Patients Needs Questionnaire (rCPNQ-T) for parents whose children with cancer.Materials and methods: This methodological study conducted on 142 parents of children with cancer in Turkey’s southeast region. Data were collected with sociodemographic form and the rCPNQ-T.Results: The parents’ average age was 33.2±6.9 and most of them were a mother. Their children’s average age was 6.1±3.6, 72.5% diagnosed with acute lymphocytic leukemia (ALL). According to expert opinions, the content validity index was found to be 0.87, the total Cronbach's α coefficient of the questionnaire was 0.94, and the Cronbach's α coefficient of the sub-dimensions was ranged from 0.77 to 0.92.Conclusion: The validity and reliability analyses showed that the rCPNQ-T is a valid and reliable measurement questionnaire, accepted as 4 dimensions (informational, emotional, psychosocial, and practical needs) and 26 items. This scale can be used to determine the parents’ needs of children with cancer., Amaç: Bu çalışmanın amacı kanserli çocukların ebeveynleri için kanserli hasta gereksinimleri soru formu revize versiyonunun (rKHGSF-T) Türkçe geçerlik ve güvenirlik çalışmasını yapmaktır.Gereç ve yöntem: Metodolojik çalışma, Türkiye'nin güneydoğu bölgesinde kanserli çocuğa sahip 142 ebeveyn ile yapıldı. Veriler sosyodemografik form ve rCPNQ-T ile toplandı.Bulgular: Ebeveynlerin yaş ortalamasının 33,2±6,9 ve çoğunun anne olduğu belirlendi. Çocukların yaş ortalamasının 6,1±3,6 ve %72,5'inin akut lenfositik lösemili (ALL) olduğu saptandı. Uzman görüşlerine göre soru formunun kapsam geçerlilik indeksinin 0,87, anketin toplam Cronbach's α katsayısının 0,94, alt boyutlarının Cronbach's α katsayısının ise 0,77-0,92 arasında olduğu saptandı. Sonuç: Geçerlilik ve güvenilirlik çalışmasına göre rCPNQ-T’nin, 4 alt boyut (bilgi, duygusal, psikososyal ve uygulama gereksinimi) ve 26 madde olarak geçerli ve güvenilir bir soru formu olduğu belirlenmiştir. Bu ölçme anketi kanserli çocukların ebeveynlerinin gereksinimlerini belirlemek için kullanılabilir.

Amac: Bu calisma, hemsire-ebeveyn desteginin cocuk kliniklerinde yatan cocuk hastalarin ebeveynlerinin stresine etkisinin belirlenmesi amaciyla gerceklestirilmistir. Yontem: Arastirma tanimlayici, iliskisel ve kesitsel tasarimda bir calismadir. Arastirmanin orneklemini, bir universite hastanesinin cocuk kliniklerinde Mart 2018 – Mart 2019 tarihleri arasinda, cocuklari 3 gunden uzun suredir akut veya kronik hastalik nedeniyle yatarak izlenen, bilgilendirilmis yazili onam alinan ebeveynler olusturmustur (n=178). Arastirma verilerinin toplanmasinda, sosyo-demografik veri toplama formu, Hemsire-Ebeveyn Destegi Olcegi ve Anne-Baba Stres Olcegi Kisa Formu kullanilmistir. Bulgular: Hastanede yatan cocuklarinin yas ortalamasi 6.2±5.3 olup, %61.8’i erkek, %69.7’si akut bir hastalik nedeniyle izlenmektedir. Ebeveynlerin yas ortalamasi 34.1±7.3 olup, %83.7’si annedir. Ebeveynlerin Hemsire-Ebeveyn Destegi Olcegi puan ortalamasi 80.8±17.4 olup, Anne-Baba Stres Olcegi puan ortalamasi 80.0±23.7’dir. Ebeveynlerin stres duzeyleri ile hemsire-ebeveyn destegi duzeyleri arasinda negatif yonde dusuk duzeyde bir iliski, stres duzeyleri ile hemsire ebeveyn destek olceginin bilgi verme ve iletisim alt boyutu ile negatif yonde dusuk duzeyde bir iliski, duygusal destek alt boyutu, saygi destegi alt boyutu, kaliteli bakim verme alt boyutu ile negatif yonde cok dusuk duzeyde iliski saptanmistir. Sonuc: Ebeveynlerin, destek duzeylerinin yuksek, stres duzeylerinin ise orta duzeyde oldugu gorulmustur. Hemsire-ebeveyn destegi azaldikca stres duzeyinin arttigi saptanmistir. Pediatri hemsirelerinin ebeveynlere verdigi destegin, ebeveynlerin stresini azaltacagi, ebeveyn-cocuk etkilesimini olumlu etkileyecegi dusunulmektedir. Destekleyici hemsirelik bakimini gelistirmeye yonelik arastirmalarin planlanmasi, pediatri hemsirelerinin farkindaliklarinin arttirilmasi onerilmektedir.

Purpose: Port needle insertions are painful and distressing for Pediatric Hematology-Oncology patients. Virtual Reality (VR) can be used during needle-related procedures in these patients. This study aimed to investigate the effect of VR distraction during access to the venous port with a Huber needle in reducing needle-related pain, fear, and anxiety of children and adolescents with cancer. Methods: This randomized controlled study used a parallel trial design guided by the CONSORT checklist. The sample of children (n = 42) was allocated to the VR group (n = 21) and the control group (n = 21). Port needle related pain was assessed using the Wong-Baker Faces Pain Rating Scale after the procedure. Before and after the port needle insertion procedure, anxiety and fear assessed using self-and parent-report using the Children & rsquo;s Anxiety Meter and Child Fear Scale. The primary outcome was the patient-reported pain scores after the procedure and fear and anxiety scores before and after the procedure. Pain, anxiety, and fear scores of the two groups and within groups were analyzed and also Spearman correlation analysis was used. Results: Self-reported pain scores of patients in the VR and control group were 2.4 +/- 1.8 and 5.3 +/- 1.8, respectively. This study found a statistically significant difference between groups in pain scores (p < .001). A statistically significant difference was found between groups according to the self-and parent-reported fear and anxiety scores after the procedure. Self-reported fear scores in the VR and control group were 0.8 +/- 0.9, 2.0 +/- 1.0, self-reported anxiety scores were 2.9 +/- 2.0, 5.4 +/- 2.0, respectively (p < .001). Conclusion: Virtual reality is an effective distraction method in reducing port needle-related pain, fear, and anxiety in Pediatric Hematology-Oncology patients. ClinicalTrials.gov NCT04093154.

Aim: Oral care is a standard practice used to reduce ventilator-associated pneumonia in intensive care units and in the treatment of chemotherapy-induced oral mucositis. This research examines the oral care practices of pediatric nurses. Materials and Methods: This is a descriptive and cross-sectional study. Its sample was composed of 90 nurses working in the pediatric services of a university hospital in western Turkey from March to December 2016. the research data was collected using a sociodemographic data form and the Oral Care Practices Information Form. Results: of the nurses, 62.2% had received oral care education. There were statistical differences in oral diagnosis in terms of clinic, work shift, the making of oral diagnoses before each oral care practice, oral care frequency and the number of patients with impaired oral mucosal integrity (p

This study examined the effect of problematic Internet use, social appearance anxiety, and social media use on nursing students' nomophobia levels. This study was conducted with 755 undergraduate nursing students. Sociodemographic data were evaluated using percentages and means. The effect of problematic Internet use, social appearance anxiety, and social media use on nomophobia levels was assessed by simple linear regression analysis. The mean age of participants was 21.4 +/- 1.3; 82.5% were female, and 59.7% (n = 450) had adequate incomes. According to the regression analysis, nomophobia levels have a strong, positive, and significant relationship with the variables of problematic Internet use (beta = .39, P < .000), social appearance anxiety (beta = .27, P < .001), and social media dependency (beta = .28, P < .001). Examining the correlation between nursing students' problematic Internet use, social appearance anxiety, and social media use levels, nomophobia levels had a positively moderate relationship with problematic Internet use (r = 0.259, P < .001), social appearance anxiety (r = 0.320, P < .001), and social media use levels (r = 0.433, P < .001). There is a direct correlation between nomophobia levels and the variables of problematic Internet use, social appearance anxiety, and social media use.

Aim: Prevention of infiltration/extravasation (I/E) in pediatric patients is important. This study has examined the effect of an education program, which aims to prevent and manage pediatric I/E, on I/E rates in pediatric patients. Materials and Methods: This is a semi-experimental study with a single group pre-test/post-test design. A sample of 79 nursing staff and 289 IV catheters of 150 pediatric patients was investigated. Pediatric I/E training was given to the nurses and the effectiveness of the training program and I/E rates before and after the training were evaluated. Results: Compared to the pre-education phase, there was a significant increase in the mean scores of the nurses’ knowledge in the posteducation phase (t: 7,328; p

Aim and objectives Virtual reality (VR) can be used during painful procedures in children. The aim of this study was to evaluate the effects of two different VR methods on procedure-related pain, fear and anxiety of children aged 5-12 years old during blood draw. Methods This randomised controlled study used parallel trial design guided by the CONSORT checklist, see Supporting Information. The sample of children (n = 136) was allocated to the VR-Rollercoaster (n = 45), VR-Ocean Rift (n = 45) and control group (n = 46) using blocked randomisation. The primary outcome was pain scores after the blood draw and fear and anxiety scores before and after the blood draw. Before the blood draw, fear and anxiety scores were assessed using self-report and reports from the parents and the researcher using the Child Fear Scale and Children's Anxiety Meter. After the blood draw, level of pain experienced was assessed using the Wong-Baker Faces Pain Rating Scale and the fear and anxiety levels experienced by the children during the blood draw were re-evaluated. Results Pain scores were found to be lower in the VR-Rollercoaster group and the VR-Ocean Rift group. A statistical difference was found between groups according to self-, parent- and researcher-reported fear and anxiety scores after blood draw. While being in VR-Rollercoaster and VR-Ocean Rift group reduced children's fear and anxiety, being in the control group increased fear levels by 20% and anxiety levels by 34.1%. Conclusions VR is an effective method in reducing procedure-related pain, fear and anxiety in children aged 5-12 years old during blood draw. Relevance to clinical practice Evidence-based guidelines and protocols should be created for nonpharmacological methods such as VR for procedural pain and anxiety in children.

EgeUn###, Central line–associated bloodstream infections (CLABSIs) are still a major cause of morbidity and mortality in pediatric hematology-oncology patients in many countries. This cross-sectional study was a retrospective review of CLABSI in inpatient pediatric hematology-oncology cases with long-term central venous catheter at the Pediatric Hematology Department from January 2013 to June 2014. Characteristics of CLABSI events in pediatric patients with hematologic malignancies and related nonmalignant hematologic conditions are documented. CLABSI developed in 61.8% (n = 21) of the 34 hospitalized patients included in the study. The CLABSI rate was 7.8 per 1,000 inpatient central venous catheter days. Coagulase-negative staphylococci was the predominant pathogen in 47.6% of the patients with CLABSI. The high rate of CLABSI requires prevention strategies to reduce CLABSI immediately. This study provides guidance in prioritizing strategies for reducing rates of infection. © 2019 by Association of Pediatric Hematology/Oncology Nurses.

Purpose The objective of this study was to evaluate children's postoperative symptoms at home after outpatient surgery through nurse-led telephone counseling and the effects of the nurse-led telephone counseling on parents’ state–trait anxiety scores. Design and Methods In this prospective randomized controlled study, nurse-led telephone counseling was provided every day to parents in the intervention group until they came for the follow-up visit. Parents of children (n = 54) ages 3–17 years who had undergone outpatient surgery for appendicitis, cholecystectomy, or ovarian cysts were eligible to participate in the study. On the first postoperative day and at the follow-up visit, the Spielberger State–Trait–Anxiety Inventory (STAI) was administered to parents who were randomly allocated to the intervention (n = 24) and control groups (n = 30). Results The parents reported on postoperative symptoms such as pain, activity levels, excretion, sleep, nutrition, and wound infection. While there was no difference in STAI scores for parents between the groups at the first postoperative day, there was a significant decrease in STAI scores in the intervention group versus the control group, with parents in the intervention group reporting lower anxiety scores. Practice Implications Our results suggest that nurse-led telephone counseling is effective at reducing anxiety in parents of children after outpatient surgery.

Purpose The aim of this study was to evaluate the effects of the virtual reality (VR) and external cold and vibration methods on pain scores in children aged 7 to 12 years during phlebotomy. Design A randomized controlled study. Methods The sample of children (n = 121) was allocated to the groups (group 1, VR; group 2, external cold and vibration; group 3, control) by blocked randomization. Pain scores were assessed after the phlebotomy using self-report, parent's reports, report from the nurse who attempted the phlebotomy, and researchers' report with the Wong-Baker FACES scale. Findings Pain scores were determined to be lower in groups 1 and 2. Although there was no difference between the groups 1 and 2, a statistically significant difference was found between groups 1 or 2 and group 3 based on all pain scores. Conclusions Results suggest that VR and external cold and vibration are effective in reducing the pain in 7- to 12-year-old children during phlebotomy. VR can be used safely for the pain management of children who are growing up in the age of technology.

ObjectiveWhen patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with “unrealized potential” for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.MethodWe distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p< 0.001) and not having received training (p= 0.02; only 22% received training). How “developed” a country is negatively predicted spiritual care provision (p< 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.

BackgroundAlthough staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision.MethodsA cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancer patients.ResultsSeven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p

Purpose Pain is very common among pediatric cancers. This study aimed to assess the reliability and validity of the Turkish version of the Adolescent Pediatric Pain Tool (APPT). Methods In this methodological study, language validity and content validity of the words in the third section of the scale, which was administered to children with cancer, were tested using the Q-sort method. The APPT was used to measure test-retest reliability once for each of the 1st, 2nd and 3rd weeks of the chemotherapy protocols for 30 children. A reliability test was conducted using the APPT for 96 children with cancer. Results The number of words included in the third section of the APPT was reduced to 56 following the completion of the language and content validity using the Q-sort method. In the test-retest method, results from the three measures taken showed that the intra-class correlation coefficient was good. The internal consistency of the scale was also good (α = .78) in terms of the total number of body areas marked on body outline diagram, pain severity, pain intensity ratings, total number of word descriptors, and total number of sensory, affective, evaluative and temporal word descriptors. Correlations were found between the total number of body areas marked on the body outline diagram and the total number of word descriptors (r = .53), the pain severity and pain intensity ratings (r = .95), and the total number of word descriptors (r = .38). Conclusions The Turkish version of the APPT was determined to be valid, reliable and easy to use for pediatric cancer patients.

Purpose To compare standardized flushing methods with aseptic non-touch technique; (1) Manually prepared syringes (2) Single-use prefilled flush syringes. Method Forty-eight PHO patients with Hickman or Port catheters were recruited to participate in a prospective, randomized study. Standardized flushing methods with aseptic non-touch technique (ANTT) using single-use pre-filled flush syringes (intervention group) or manually prepared syringes (control group) also included the pulsatile technique, use of 10-mL syringe size with 0.9% NaCl for flushing, flushing once a day, flushing training of the nurses. The effects of standardized flushing methods on occlusion and CLABSI evaluated. Results Of the patients in the intervention group, 8.7% (n: 2) had catheter occlusion , while this rate was 20.0% (n: 5) in the control group. Of the patients in the intervention group, 8.7% (n: 2) had CLABSI, while this rate was 36.0% (n: 9) in the control group. While there was no difference in occlusion, there was a difference between the groups in terms of CLABSI development. In the intervention group, CLABSI rate was 1.9/1000 per catheter-days, in the control group CLABSI rate was 10.1/1000 per catheter-days. In the intervention group, occlusion rate was 1.9/1000 per catheter-days, in the control group, occlusion rate was 5.6/1000 per catheter-days. Conclusion Standardized flushing and single-use prefilled flush syringes are effective in reducing CLABSI rates in PHO patients.