Taboo words in pediatric oncology: Communication experiences of nurses and physicians with dying children and their families.

PURPOSE: Despite the numerous benefits of effective communication between patients, families, and healthcare professionals, there are still substantial barriers and communication challenges. This study investigated the experiences of nurses and doctors working in different pediatric hematology-oncology units in Turkey communicating with children and their parents about end-of-life issues. METHOD: This qualitative study was conducted with twenty-four physicians and nurses. A descriptive phenomenological approach was used. Data were analyzed using Braun and Clarke's six-step reflexive thematic analysis. The MAXQDA software was used to facilitate data management. RESULTS: The findings revealed three main themes describing end-of-life communication experiences of physicians and nurses: Avoiding communication with a dying child, Everyone knows but nobody talks, and Complicating aspects of the setting. CONCLUSIONS: Communication with dying children and their families is essential. However, multiple barriers remain for healthcare providers to do so. That issue burdens the child and their family more during the end-of-life, which is already a challenging experience to handle. Healthcare professionals need urgent training in communication with the dying children and their families.

Comparison of Heparin and Saline for Prevention of Central Venous Catheter Occlusion in Pediatric Oncology: A Systematic Review and Meta-Analysis.

OBJECTIVE: The management of central venous catheter (CVC) occlusion remains an area without clear evidence-based guidelines. Studies have been conducted that compare the use of heparin and normal saline for reducing thrombosis, but the evidence is not strong enough to suggest a significant advantage of one over the other. Therefore, the study aimed to assess the effectiveness of heparin and normal saline flushing in preventing CVC occlusion in pediatric patients with cancer. DATA SOURCES: A comprehensive search was conducted in PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Embase, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov platform using specific keywords. The search was conducted until March 2022. Five randomized controlled trials are included in this study. CONCLUSION: Five studies with a total of 316 pediatric cancer patients met the inclusion criteria. The studies were found to be heterogeneous due to variations in the types of cancer, heparin concentration, flushing frequency of CVCs, and methods used to measure occlusion. Despite these differences, there was no significant difference in the effect of flushing with heparin and normal saline in preventing CVC occlusion. The analysis revealed that normal saline is as effective as heparin in preventing CVC occlusion among pediatric cancer patients. IMPLICATIONS FOR NURSING PRACTICE: This systematic review and meta-analysis demonstrated that there is no significant difference between the use of heparin and normal saline flushing in preventing CVC occlusion among pediatric cancer patients. Considering the potential risks of heparin, the use of normal saline flushing may be recommended to prevent CVC obstruction.

Desires vs. conditions: A qualitative study exploring the factors affecting the place of death of child with cancer in Turkey.

OBJECTIVE: The purpose of this study was to describe factors affecting the place of death of children with cancer at the end of life. METHODS: The descriptive phenomenological approach was used. Eighteen mothers who lost their children to cancer participated in in-depth interviews. Data were analysed using MAXQDA software version. Codes and categories were developed inductively from participants' narratives. RESULTS: The factors affecting the place of death of children were categorised into two main themes: (1) desires and (2) conditions. Most of the mothers reported that their deceased children wanted to be with their families at the end of life and they wanted to go home. The conditions related to health services were defined as the barriers to the death of their children in the places of death preferred by the mothers. CONCLUSION: The desire to be close to the child was the main factor affecting the parents' decisions. The findings revealed the prevailing circumstances in the death place decision beyond parental desires. These were the child's health conditions, physical conditions of hospitals, and the lack of home care and paediatric palliative care services, which were factors related to the system, and the lack of other options for parents.

[Patients of Turkish origin in an institutional psychiatric outpatient service]. / Patienten türkischer Herkunft in der psychiatrischen Institutsambulanz.

Germany has changed to a multicultural society within the last decades, similar to other industrial countries in Europe. The health system has not yet adapted to this situation and there is a need for better treatment of migrants with specialized programs. It is important to create consciousness about the situation of migrants and their requirements. The Westphalian Center Bochum as part of the Ruhr-University Bochum offers a specialized care project for people derived from Turkey and has a culture competent outpatient service. The results of this care project are presented along an evaluation of 115 Turks, who were treated within the year 2006.