Psychometric properties of the Turkish version of the Readiness for Hospital Discharge Scale-Parent Form (Ped-RHDS).

BACKGROUND: An objective evaluation of parents' perceived readiness for the discharge of their child from hospital may aid in the prevention of readmission and rehospitalization. This study examined the validity and reliability of the Turkish version of the Readiness for Hospital Discharge Scale-Parent Form (Ped-RHDS) for children in Turkey. METHODS: The parents of 160 children planned for discharge from the pediatric surgery and pediatric departments were included. Cronbach's α, exploratory factor, confirmatory factor, item-total correlation, and criterion validity analyses of the Turkish Ped-RHDS were performed. RESULTS: The Turkish Ped-RHDS has 26 items in 5 factors explaining 52.212% of the total scale variance. The scale had a Cronbach's alpha of 0.842. In exploratory and confirmatory factor analyses, item factor loadings were higher than 0.30 and comparative fit and goodness of fit indices were 0.96 and 0.93, respectively. In criterion-based validity, total Ped-RHDS score weakly correlated with scores on the Post-Discharge Coping Difficulty Scale (r = -0.164; p = 0.039). Item-item total score correlations for the Turkish Ped-RHDS were between 0.329 and 0.532. CONCLUSION: The Turkish Ped-RHDS is valid and reliable as a parent-reported instrument for the assessment of hospital discharge readiness in children and parents. PRACTICE IMPLICATIONS: Healthcare professionals can use this assessment tool to measure parental and child discharge readiness before children are discharged from hospital. The Turkish Ped-RHDS should be integrated into discharge readiness assessment as standard practice in the discharge of pediatric patients.

Psychometric Properties of the Turkish Version of the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes

Objective: Resilience in diabetes refers to the capacity overcome diabetes-related challenges to achieve favorable psychosocial and health outcomes. Despite the known benefits of resilience in adolescents with type 1 diabetes mellitus (T1DM), there tends to be more emphasis on risk factors in research and practice. This study evaluated the psychometric properties of the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes (DSTAR-Teen) in Turkey. Methods: This descriptive, methodological study was conducted between October 2020 and May 2021. The Turkish DSTAR-Teen was administered to 120 adolescents with T1DM, and the data were evaluated using Cronbach's alpha coefficients, factor analyses, test-retest correlation, and item-total score correlations. Results: The Turkish DSTAR-Teen has 12 items in two factors that explained 50.64% of the total variance. Confirmatory factor analysis revealed goodness-of-fit and comparative fit indices of 0.92 and 0.95, respectively. The total Cronbach's alpha value of the scale was 0.85. Item-total score correlations ranged from 0.49 to 0.74 (p<0.001). Conclusion: Our analyses showed that the Turkish DSTAR-Teen is a valid and reliable instrument in Turkish adolescents with T1DM. The Turkish DSTAR-Teen can be used to evaluate strengths and resilience associated with diabetes management in adolescents with T1DM in Turkey.

Effect of Left and Right Semi-Elevated Side-Lying Positions on Feeding Performance of Preterm Infants.

OBJECTIVE: To determine the effect of right and left semi-elevated side-lying positions on the feeding performance and skills of bottle-fed preterm infants. DESIGN: A single-group, crossover experimental study. SETTINGS: Level 3 NICU of a training and research hospital in Istanbul. PARTICIPANTS: A total of 60 preterm infants born at 24 to 36 6/7 weeks gestation. METHODS: We collected data using an infant information form, feeding observation form, and the Turkish version of the Early Feeding Skills Assessment (EFS-Turkish). For each infant, we collected data for two feeds: one in the right and one in the left semi-elevated side-lying position. RESULTS: We found no difference between the right and left semi-elevated side-lying positions in the volume or percentage of food taken (p = .582 and p = .625, respectively), feeding duration (p = .901), or feeding efficiency (p = .423). We observed no significant differences between feedings in the left and right semi-elevated side-lying positions in mean EFS-Turkish total score (p = .251) or subscale scores (p > .05). CONCLUSION: Neonatal nurses can feed preterm infants in both directions of the semi-elevated side-lying position when following evidence-based feeding guidelines.

The Effect of Training on Neonatal Nurses' Knowledge about Transitioning Preterm Infants to Oral Feeding.

BACKGROUND: Neonatal nurses require knowledge of evidence-based interventions that can be utilized for supporting oral feeding skills in preterm infants. Little is known about the impact of education/training programs on neonatal nurses' knowledge of this topic. PURPOSE: This study was conducted to determine the effect of a training program about evidence-based interventions for the transition to and support of oral feeding in preterm infants on the knowledge levels of neonatal nurses. METHODS: We conducted a pretest-posttest studywith 73 neonatal nurses in a research and training hospital. Participants completed a demographic information form and their knowledge about oral feeding in preterm infants was assessed before and after a 240-min training about the transition to oral feeding and evidence-based therapeutic interventions to promote preterm infants' oral feeding skills. RESULTS: Posttest scores evaluated at 1 week (81.6 ± 6.8) and 1 month (79.5 ± 6.5) after the training were significantly higher than pre-test scores (66.8 ± 6.9) (p < 0.001). CONCLUSION: Neonatal nurses showed higher levels of knowledge about evidence-based interventions for supporting oral feeding skills in preterm infants at 1 week and 1 month after the training program compared to their knowledge before training. IMPLICATIONS FOR PRACTICE: Providing training to neonatal intensive care nurses on the transition to oral feeding in preterm infants will increase their level of knowledge and ensure that oral feeding interventions for preterm infants can be implemented using evidence-based therapeutic methods.

The Evaluation of Oral Feeding in Preterm Infants: Turkish Validation of the Early Feeding Skills Assessment Tool.

OBJECTIVE: The Early Feeding Skills Assessment Tool (EFS) is a valid and reliable tool for evaluating preterm infants' oral feeding skills and readiness during the transition to oral feeding. There is currently no instrument with tested validity and reliability available to evaluate the oral feeding skills and readiness of preterm infants in Turkey. The aim of this study was to fill the need for such an instrument for use in the Turkish population by adapting and validating the EFS for the assessment of Turkish preterm infants during the transition to oral feeding. MATERIAL AND METHODS: This methodological, cross-sectional study included 107 preterm infants. Validity of the EFS-Turkish was tested with linguistic, content, and construct validity analyses, and its reliability was tested using internal consistency and item analyses. RESULTS: A panel of experts confirmed the content validity of the items in the EFS-Turkish (content validity index = 0.97). Cronbach's alpha for the total instrument was 0.95, supporting its internal consistency reliability. Item-total correlations ranged from 0.58 to 0.83 (P < .001). Confirmatory factor analysis confirmed the established EFS structure of 19 items and 5 factors. The tool demonstrated good model fit statistics (χ2/df = 2.24; P < .001). CONCLUSION: The EFS-Turkish is a valid and reliable instrument for use in neonatal intensive care units to evaluate the feeding skills of preterm infants during the transition to oral feeding. The use of the EFS-Turkish is recommended to facilitate the safe and successful development of preterm infants' oral feeding skills and to plan evidence-based initiatives.

Turkish Neonatal Nurses' Knowledge and Practices Regarding the Transition to Oral Feeding in Preterm Infants: A Descriptive, Cross-sectional Study.

PURPOSE: Neonatal nurses play an important role in preterm infants' safe and successful transition to oral feeding. Little is known about neonatal nurses' knowledge and practices regarding the transition to oral feeding in preterm infants. The aim of this study was to determine neonatal nurses' knowledge levels and clinical practices related to the process of transitioning preterm infants to oral feeding. DESIGN AND METHOD: This descriptive cross-sectional study was conducted with 275 neonatal nurses working in the neonatal intensive care units of 9 different hospitals in Istanbul, Turkey. Data were collected using a participant demographic form and a questionnaire about the neonatal nurses' knowledge and practices regarding oral feeding. RESULTS: The mean knowledge score of the nurses in this study was 64.7 out of 100 (SD = ±8.7; range = 40-87.5). Rates of correct responses were particularly low for items related to cue-based feeding, interventions to promote oral-motor development, non-nutritive sucking, and infant positioning for oral feeding. All of the NICU nurses participating in the study did not use the protocols developed for transitioning preterm infants to oral feeding. CONCLUSIONS: Nurses need knowledge and practical training on evidence-based therapeutic interventions that promote oral feeding skills in preterm infants during the transition to oral feeding. The use of protocols developed for transitioning preterm infants to oral feeding is limited in NICUs. PRACTICE IMPLICATIONS: In order to facilitate safe and successful feeding, nurses should improve their knowledge and practical skills regarding the transition to oral feeding and evidence-based therapeutic interventions for preterm infants.

Reducing Pain and Fear in Children During Venipuncture: A Randomized Controlled Study.

BACKGROUND: Venous blood sampling is a common procedure in the hospital setting and cause significant pain and stress for children. AIM: This study was conducted to determine and compare the effects of balloon inflation, ball squeezing, and coughing methods on levels of pain and fear during venipuncture in children aged 7-12 years. DESIGN: Experimental, randomized controlled study. SETTING: The study was conducted at a state hospital in Turkey between March and July 2017. PARTICIPANTS/SUBJECTS: The study population comprised children 7-12 years of age who were subjected to venous blood sampling in the phlebotomy unit of a state hospital. The study sample included 120 children for a confidence interval of 95% and statistical power of 80%. METHODS: The children were assigned to one of four groups (balloon inflation, ball squeezing, coughing, and control groups), each including 30 participants. The children's pain and fear were rated before and after the procedure by the children themselves, their parents, and a researcher using the Wong-Baker FACES Pain Rating Scale and Children's Fear Scale, respectively. RESULTS: Mean scores for pain and fear after the procedure were lower in all intervention groups compared with the control group (p = .001). There was no statistical difference in pain or fear scores between the intervention groups; however, the children in the coughing group had the lowest scores for both pain and fear. CONCLUSION: Balloon inflation, ball squeezing, and coughing were all effective in reducing pain and fear associated with venipuncture in children aged 7-12 years. These are simple, rapid, and cost-effective methods that nurses can implement during venipuncture with minimal equipment and preparation.

What do Neonatal Nurses Know and Feel About Pain Management During Retinopathy of Prematurity Examination: A Qualitative Research.

AIM: The purpose of this study was to determine feelings, pain-related knowledge, and pain management-related practices of neonatal intensive care nurses during the retinopathy of prematurity examination. METHOD: The descriptive qualitative research design was used. In the study, the individual in-depth interviews were conducted with nurses by using the interview form with semi-structured open-ended questions. The data were evaluated by using the MAXQDA12. RESULTS: Two main themes were formed as "neonatal pain" and "retinopathy of prematurity examination" in line with the thematic analysis. In the study, it was determined that the nurses were able to limitedly identify the pain-induced physiological and behavioral symptoms in newborns, could not evaluate the symptoms and levels of pain by using pain scales with proven validity and reliability. The results indicated that the nurses provided the care based on their observations rather than evidence-based knowledge in the pain management. CONCLUSION: Nurses should be informed through evidence-based training programs and supported to transfer the acquired knowledge into practice. And the results emphasizes that the subject of pain and pain management should be inserted in nursing education cirruculum.

Rehospitalization of preterm infants according to the discharge risk level.

PURPOSE: The rehospitalization rate of preterm infants is between 22 and 52% within the first year after discharge. The purpose of this study was to investigate the rehospitalization of preterm infants within 2 months following discharge, considering the level of risks originating from the infant, parents, and the social factors. DESIGN AND METHODS: The sample was composed of 238 preterm infants and their parents. The data were collected with a Descriptive Information Form, the Post-Discharge Infant Follow-up Form, and the Neonatal Discharge Assessment Tool (N-DAT). Before discharge, the preterm infants were evaluated in terms of risky discharge via N-DAT consisting of the subscales Medical, Competencies, Risk factors, Resources, and Parenting. Discharge was determined as low, moderate, and high risk according to N-DAT total score. Two months after the discharge, rehospitalization of the infants was assessed. The data were evaluated via chi-square, Mann-Whitney U-test, and Fisher's exact test. RESULTS: In the study, 39.9% of the preterm infants were rehospitalized within the 8 weeks following the discharge, with medical and/or surgical reasons. Medical problems such as pneumonia and acute bronchiolitis were ranked as the first cause for rehospitalization. As expected, according to the N-DAT scores, the rates of rehospitalization of infants who had been discharged with intermediate and high risk levels were found to be higher (p < .001) than the rates of those with low risk levels. Also, N-DAT Medical, Competencies, Risk factors, Resources, and Parenting subscale scores of the infants who were rehospitalized with medical problems were found to be higher at a statistically significant level than infants who were not rehospitalized (p < .001). PRACTICE IMPLICATIONS: Nurses can help to minimize rehospitalization of infants by parental education, telephonic counseling, frequent observation, and home care support.

Validity and reliability of the Neonatal Discharge Assessment Tool.

PURPOSE: To investigate the reliability and validity of the Neonatal Discharge Assessment Tool (N-DAT) designed to assess risk factors related to infants' and parents' readiness for discharge to home. DESIGN AND METHODS: The sample was composed of 238 high-risk preterm infants, born at gestational age of 24 to 37 weeks, and their parents. High scores on the N-DAT indicated higher risk for discharge of preterm infants and their parents. Psychometric analyses of the N-DAT included content validity, internal consistency reliability, and construct validity. RESULTS: Content validity of the N-DAT items was supported by experts (content validity index = .98). Internal consistency reliability was supported by a Cronbach's alpha for the total instrument of .94. N-DAT total and subscale score correlations ranged from .42 to .89. Known-groups analysis indicated that infants born at <31 weeks' gestation and infants who were rehospitalized during 8 weeks after discharge had significantly higher N-DAT total and subscale scores than infants born at ≥31 weeks or not rehospitalized. Also, mothers who reported experiencing problems with infant care at home had significantly higher N-DAT Competencies subscale scores than mothers who did not report problems. PRACTICE IMPLICATIONS: The N-DAT is a reliable and valid instrument to evaluate the risks related to discharge of preterm infants so that nurses can provide parents with the necessary knowledge, skills, and resources they need prior to discharge.