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Objective:To investigate parents′ proxy-assessment post-operative pain intensity of orthopedic children, and to analyze the relevant influencing factors.Methods:Using the purposive sampling method, 200 children and their parents who met the inclusion and exclusion criteria were mainly selected in pediatric orthopedics of Children′s Hospital of Soochow University from August to December in 2020. A general information questionnaire and the Wong-Baker Facial Pain Rating Scale (WBFP) were used to survey.Results:One hundred and ninety-five questionnaires were effectively recovered. Nearly 44.6%(87/195) and 28.7%(56/195), 36.9%(72/195) and 5.1%(10/195), 8.2%(16/195) and 1.0%(2/195) of parents reported (using WBFP Rating Scale) moderate to severe pain intensity of 1 d, 2 d and 3 d after surgery and the Cohen′s Kappa coefficient with child′s self-report which ranged from 0.556 to 0.631 were all higher than child-nurse (Cohen′s Kappa coefficient ranged from 0.318 to 0.406). The results of multiple linear regression analysis showed that using painkillers by children entered in the regression equation, which could explain the variation of 13.5% ( R 2=0.135). Conclusions:The self-report of the children was in good agreement with the assessment of the pain intensity by the parental agent, and the assessment of the pain intensity was affected by the painkillers used by the children. Therefore, medical institutions and personnel should create a supportive environment that values the positive role of parents to promote the management of children′s post-operative pain.
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The paper reviewed the application of child life in the care of children with acute leukemia in recent years, including related overviews, application effects, shortcomings and prospects in the process. The purpose is to provide references for further improving the application of child life in children with acute leukemia.
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Objective:To investigate parents′ knowledge and attitude toward post-operative pain management in pediatric orthopedics and analyze influencing factors.Methods:A total of 170 parents of 6 to 16 years old children who underwent selective surgeries and were hospitalized because of limb fracture were conveniently selected in Children′s Hospital of Soochow University from April to December in 2019, They were investigated using the general data questionnaire, Pain Management Knowledge and Attitudes Questionnaire.Results:There were 167 parents completed questionnaires in our study. The mean score of parents′ knowledge, general attitude and negative attitude to pain medication were 15.0(3.00), 24.0(4.00) and 17.0(3.00) respectively. There were statistical differences between different educational levels of parents′ knowledge ( χ2 value was11.599, P=0.021), as well as different age of parent′s general attitude ( χ2 value was 7.053, P=0.029). Spearman-related results showed that parents′ cognition was positively correlated with general attitudes ( r value was 0.394, P<0.01). Conclusions:The majority of parents are at moderate to high level of knowledge, general attitude and negative attitude to pain medication. Pediatric nurses should pay more attention to parents′ knowledge deficit of and negative attitude toward pain assessment tools and pain-drugs to develop targeted educational intervention programs for promoting parental involvement.
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Objective To understand the negative emotion in primary caregivers of early diagnosed children with acute leukemia. Methods By purposive sampling, 17 cases were selected and investigated by semi-structuredinterviews. Colaizzi principles were used to analyze the data. Results Three themes were extracted:complex emotional response, too many concerns and weak support system. Conclusions The primary caregivers of children with acute leukemia at the early stage of diagnosis have negative emotions such as anxiety and fear, and suffer from psychological and economicpressures.Nurses should provide disease-related nursing skills training and personalized psychological care,and call for the establishment of the social support system and online communication platformto really meet their needs and alleviate the burden of care in order to better meet the follow-up treatment and care of children.
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Objective@#To investigate the dynamic changes of quality of life and its influencing factors in children with acute lymphoblastic leukemia during chemotherapy.@*Methods@#A total of 134 children who were diagnosed with acute lymphoblastic leukemia were selected. The demographic questionnaire and Pediatric Quality of Life InventoryTM General Core Module were completed in children at three different time points during chemotherapy (the first month, the third month, and the sixth month of chemotherapy).@*Results@#There were significant differences in the quality of life between children with acute lymphoblastic leukemia (t=-23.117-209.225, P<0.01). Multiple factors analysis showed that the factors influencing the quality of life of children at the first month of chemotherapy were age (t=-10.413, P=0.000) , and family emotional support (t=2.231, P=0.027) ; the factors at the third month of chemotherapy included age (t=-12.439, P=0.000) , whether the child was the only child (t=2.267, P=0.025) , education level of primary caregiver (t=2.091, P=0.038) , and family emotional support (t=5.374, P=0.014) ; the factor at the sixth month of chemotherapy were age (t=-11.254, P=0.000) , and family emotional support (t=2.184, P=0.035) .@*Conclusions@#The total quality of life and the scores of all dimensions of children with acute lymphoblastic leukemia were lower and showed dynamic changes. Age and family emotional support were continuing factors influencing quality of life. Medical staff should take targeted interventions according to the characteristics of the quality of life of children at different ages, and guide and help parents and children to establish good family emotional support and improve their quality of life.
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Objective To explore the work experience after the change of professional role of the new head nurse in pediatrics,and to provide a basis for development of a more scientific training program in the future.Methods A total of 12 cases of pediatric new head nurses were interviewed by semistructured interview.The NVivol0.0 software was used to supervise,excavate and seek data.The data were analyzed by the Colaizzi phenomenological methodology.Results Four themes were extracted including role maladjustment,difficult to cope with stress,achievement of self growth,and expectation of the nursing department.Conclusions The new head nurse in pediatrics is under great pressure,the nursing managers should pay more attention to their growth process,provide timely support and conduct regular pre job training for them,so that they can adapt to the head nurse's positions as soon as possible,so as to ensure the quality and safety of nursing.
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Objective To explore the lived experience of children with acute leukemia about acupoint therapy during chemotherapy, so as to provide the theoretical and practice evidence for development of more scientific nursing measures. Methods Totally 14 children with acute leukemia participated in half-structured interviews regarding their experience of acupoint therapy.The NVivo 10.0 software was used to supervise, excavate and seek data.The data were analyzed by the Co1aizzi phenomenological methodology. Results Five themes were extracted including benefit sense,a sense of accomplishment of self-fulfilling, a sense of attachment to medical, sigh with emotion the magic of traditional Chinese medicine and bearable mild discomfort. Conclusions The experience of children with acute leukemiais positive feelings for the most part, nursing staff should listen to them and give corresponding nursing according to specific circumstances in order to improve the quality of nursing.
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Objective To construct nursing needs scale for school-age children with acute leukemia (AL) during lumbar puncture by using Delphi technique.Methods A certain number of experts were chosen for consulting to form a consulting scale.Two-round consultations were conducted and the results were analyzed.Results The effective response rate of the experts' questionnaire for 2 rounds was 100％ (17/17).The specialist group authority coefficient was 0.85.The coordination coefficients for 2 rounds were 0.437 and 0.516 respectively (P ＜ 0.01).The nursing needs scale for school-age children with AL during lumbar puncture comprised of 5 first-level indicators and 30 second-level indicators.Conclusions This scale can scientifically and quickly evaluate the nursing needs of school-age children with AL during lumbar puncture,it provides a research tool to develop individualized interventions with demand as the direction.
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Objective To explore the experience of mothers who provide the first direct breast-feeding for preterm infants in hospital. Methods Using qualitative phenomenological research methods, eleven mothers who provided the first direct breast-feeding for preterm infants in hospital participated in semi-structured interviews. Results Four themes were concluded: the motivation of direct breast feeding in hospital, the lack of experience in breastfeeding, the psychological experience of breastfeeding, and the breast feeding health guidance for premature infants in the hospital expected by mothers. Conclusions Mothers who provide premature infants the first direct breast-feeding in hospital were facing many problems ,there is an urgent need to develop the hospital health guidance , to provide effective social support, helping them transit to direct breastfeeding smoothly and safely after discharge.
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Objective We aimed to explore the real experience of parents of children with acute leukemia during lumbar puncture,so as to provide the theoretical and practice evidence for development of individualized nursing measures.Methods Twenty parents of children with acute leukemia participated in semi-structured interviews regarding their experience of lumbar puncture.The data were colected and analyzed by the Colaizzi phenomenological methodology.Results Three themes were extracted including heavy psychological burden,lack of related knowledge of lumbar puncture and demand of multipolarity.Conclusions Attention should be paid closely to parents of children with acute leukemia during lumbar puncture.The individualized nursing measures should be taken by medical workers in order to truly meet their needs,make them stay in a good state and cooper-ate with medical workers to complete the treatment of children.