The efficacy of finger puppets, distraction cards and kaleidoscope for reducing anxiety in children undergoing day surgery.

AIM: This study was conducted to determine the efficacy of finger puppets, distraction cards and kaleidoscope for reducing anxiety in children aged 6-12 years who undergoing day surgery in Turkey. METHODS: The study was conducted using the "pre-post test unmatched group model", one of the quasi-experimental methods. The study was conducted between April 2023 and January 2024 with children aged 6-12 years who were admitted to the pediatric clinic of a hospital for day surgery in the Southern Marmara region of Turkey. A total of 85 children (including 20 children in the control group, 22 children in the finger puppet intervention group, 21 children in the distraction cards intervention group, and 22 children in the kaleidoscope intervention group) who were hospitalized in the pediatric clinic. RESULTS: It was determined that there was a statistically significant difference between the pre- and post-intervention the Modified Yale Preoperative Anxiety Scale Child Form (m-YPAS) sub-dimension and total mean scores of the children in the kaleidoscope, finger puppet and distraction cards groups, while there was no difference in the control group children. CONCLUSION: Kaleidoscope, finger puppet and distraction cards interventions were found to be effective in reducing preoperative anxiety in children and contributed to the national and world literature. It is recommended that further studies be conducted on the effectiveness of the three methods and that other variables that may affect the child's anxiety be addressed. CONTRIBUTION TO NURSING PRACTICE: This finding can be interpreted as significant and positive in demonstrating that anxiety induced by surgical procedures in children can be effectively managed with non-pharmacological methods.

Development and psychometric analysis of a pediatric cancer survivors Psychosocial Late Effects Scale (PCSLES).

PURPOSE: Although the physiological late effects of childhood cancer survivors are more obvious, appropriate assessment of psychosocial effects is needed. Therefore, it was aimed to develop a scale to evaluate psychosocial late effects in cancer survivors and to test its validity and reliability. DESIGN AND METHODS: This methodological study was conducted with 100 children and adolescents who survived were collected at the oncology center in the south of Türkiye in 2022. Data were collected with the "Personal Information Form" and "Pediatric Cancer Survivors Psychosocial Late Effects Scale (PCSLES)" IBM SPSS 24.0 and IBM AMOS 24.0 software programs were used for data analysis, and descriptive statistics were used to analyze numeric variables. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. RESULTS: The factorial analysis was used to test the structural validity of the scale. A four-factor structure consisting of 17 items was developed. The Cronbach's alpha coefficient for "1" was 0.89, "2" was 0.87, "3" was 0.80, "4" was 0.82 and the total score was 0.92. Fit indices resulting from the study were χ2/SD: 1.497, root mean square error of approximation (RMSEA): 0.071, goodnessof-fit index (GFI): 0.85, comparative-of-fit index (CFI): 0.94, and normed fit index (NFI): 0.85. CONCLUSION: The scale is a valid and reliable scale that can be used to determine psychosocial late effects in pediatric cancer patients. PRACTICE IMPLICATIONS: Utilizing the PCSLES can assist in identifying the psychosocial symptoms of child survivors/adolescents and facilitate the planning of appropriate interventions.

Therapeutic communication skills level among students undertaking the pediatric nursing course and the associated influencing factors.

AIM: The present study to determine the level of therapeutic communication skills among the students undertaking the pediatric nursing course and explore the associated influencing factors. METHODS: This descriptive cross-sectional study was conducted with 140 nursing students who took the pediatric nursing course. Data were collected using a Nursing Student Information Form and the Therapeutic Communication Skills Scale for Nursing Students. The mean and percentage calculations, t-test, ANOVA test, and regression analysis were conducted to analyze the correlations between the participants' descriptive characteristics and their mean scores on the scales. RESULTS: The participants' mean scores obtained on the total Therapeutic Communication Skills Scale for Nursing Students and all of its subdimensions were observed to have a statistically significant correlation with variables such as gender, grade point average, willingness to select the nursing department, satisfaction with the nursing department, difficulty in establishing communication, perceived ability to establish social relations, difficulty in communicating with a child, perception of childhood life, experience with child care, fondness for children, interest in playing therapeutic games with children, and perceived ability to communicate with children. In Model 1, certain descriptive characteristics (satisfaction with the nursing department, difficulty in communicating with a child, experience with child care, interest in playing therapeutic games with children, and perceived ability to communicate with children) explained 52.4% of the therapeutic communication skills scores of the pediatric nursing students and were statistically significantly. CONCLUSIONS: In this study, it was determined that some of the descriptive characteristics of the students who took the pediatric nursing course had a significant effect on their therapeutic communication skills. IMPLICATIONS FOR PRACTICE: In order to develop the therapeutic communication skills of students undertaking a pediatric nursing course, it is necessary to support these students with a standard curriculum that includes student-centered, innovative, and interactive educational methods, such as role play, case analysis, and video-based learning. It is also recommended to conduct comparative studies on different educational approaches for nursing students undertaking pediatric nursing courses or meta-analyses to evaluate the effectiveness of such approaches.

Psychometric Properties of the Turkish Version of the Nurse Spiritual Therapeutic Scale for Oncology Patients and Caregivers.

This study evaluated the Turkish version of the Nurse Spiritual Therapeutic Scale for assessing oncology patients' and caregivers' needs. It involved 200 participants from July 2022 to May 2023. The scale demonstrated high validity (content validity index = 0.97) and good internal consistency (Cronbach's alpha = 0.879). Factor analysis revealed a 20-item single-factor structure with satisfactory representation (factor loadings: 0.29-0.89). Item-total score correlations indicated moderate to strong relationships (0.236-0.761). The model showed a good fit (goodness-of-fit indices > 0.90). The Turkish version of the scale is valid and reliable for assessing oncology patients' and caregivers' spiritual care needs.

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.

Investigation of psychometric properties of Turkish version of nursing students' attitudes and beliefs towards Childhood Obesity Scale.

AIM: This study aimed to evaluate the Turkish psychometric properties of The Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale. METHODS: The study was conducted with 219 nursing students. The data were obtained with the 'Information Form' and the 'Attitudes and Beliefs of Nursing Students Towards Childhood Overweight. Strengthening the Reporting of Observational Studies in Epidemiology guidelines was implemented in the study. RESULT: Original scale was created using the Attitudes Towards Obese Person Scale (ATOP) and the Beliefs About Obese Persons Scale (BAOP). ATOP consists of 13 items and two sub-dimensions (self-concept, social relationships) in a 5-point Likert type that evaluates nursing students' attitudes towards childhood obesity. BAOP is 5-point Likert-type and consists of 6 items that evaluate nursing students' beliefs on childhood obesity. When the item-total score correlations were examined in the study, two items showing a negative correlation in the "ATOP" were removed. Cronbach's alpha was 0.80 for the ATOP and 0.83 for the BAOP. In the exploratory EFA and confirmatory CFA factor analyses, the factor loading of all items was >0.40 for both scales. CONCLUSION: It was determined that Turkish psychometric properties of the Nursing Students' Attitudes and Beliefs towards Childhood Obesity Scales were valid and reliable.

Development and psychometric analysis of a Pediatric Oncology Nurses' Educational Needs Scale.

BACKGROUND/OBJECTIVES: It is important to determine the educational needs of pediatric oncology nurses in order to maximize and implement nursing care interventions. Therefore, this study aims to develop a valid and reliable measurement tool to determine pediatric oncology nurses' educational needs and examine its psychometric properties. DESIGN/METHODS: This methodological study was conducted with 215 pediatric oncology nurses in Turkey between December 2021 and July 2022. Data were collected with the "Nurse Information Form" and "Pediatric Oncology Nurses' Educational Needs Scale." IBM SPSS 21.0 and IBM AMOS 25.0 software programs were used for data analysis, and descriptive statistics were used to analyze numeric variables. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. RESULTS: The factorial analysis was used to test the structural validity of the scale. A five-factor structure consisting of 42 items was developed. The Cronbach's alpha coefficient for "Illness" was .978, "Chemotherapy and Side Effect" was .978, "Another Therapy and Side Effect" was .974, "Palliative Care" was .967, "Supportive Care" was .985, and the total score was .990. Fit indices resulting from the study were χ2 /SD: 3.961, root mean square error of approximation (RMSEA): 0.072, goodness-of-fit index (GFI): 0.95, comparative-of-fit index (CFI): 0.96, and normed fit index (NFI): 0.95. CONCLUSION: The Pediatric Oncology Nurses' Educational Needs Scale is a valid and reliable scale for pediatric oncology nurses to determine their educational needs.

Psychometric characteristics of the Turkish version of the pain flexibility scale for children with cancer.

PURPOSE: This study was conducted to evaluate the validity and reliability of the Pain Flexibility Scale for children with cancer in Turkey. DESIGN AND METHOD: This was a methodological-descriptive-correlational study conducted on 211 children with cancer. Data were collected using the information form and Pain Flexibility Scale for children with cancer. The data were evaluated using explanatory and confirmatory factor analysis, Cronbach's alpha, split-half, item-total score correlation, and test-retest analysis. RESULTS: The explained variance rate of the scale, in which factor analysis confirmed the two-dimensional structure, was 85.31%. The factor loads were greater than 0.30, and all fit indices were greater than 0.90. In addition, RMSEA was less than 0.080 and was significant. The total Cronbach's alpha value of the scale was 0.82, and the Cronbach's alpha values of its sub-dimensions were 0.82 and 0.79. CONCLUSIONS: The Pain Flexibility Scale for children with cancer is a valid and reliable measurement tool for the Turkish sample. PRACTICE IMPLICATIONS: Pain Flexibility Scale facilitates the development of psychological interventions based on acceptance, which can enable children with cancer to cope more successfully with pain.

Predicting the Healthy Lifestyle Behaviors of Turkish Adolescents Based on their Health Literacy and Self-Efficacy Levels.

PURPOSE: The effects of Turkish adolescents' self-efficacy and health literacy on their health behaviors are examined in this study. DESIGN AND METHOD: This study employed a descriptive cross-sectional design with a sample population of 440 adolescents between the ages of 13 and 18 years old. The data were collected using a demographic data form and analyzed according to the Self-Efficacy Scale for Children, the Health Literacy Scale, and the Adolescent Lifestyle Profile. RESULTS: The regression analysis found that the self-efficacy and health literacy levels of adolescents predicted their healthy lifestyle behaviors (F = 141.813, p = 0.000). The self-efficacy and health literacy levels explained 41.9% of the healthy lifestyle behaviors of the subjects, with regression coefficients for self-efficacy and health literacy of 0.545 and 0.185, respectively. Self-efficacy among adolescents significantly predicted all the sub-dimensions of healthy lifestyle behaviors, such as health responsibility, physical activity, nutrition, positive life view, interpersonal relations, stress management, and spiritual health. Similarly, the health literacy levels predicted all the sub-dimensions except for physical activity and stress management. CONCLUSIONS: In this study, the adolescents' self-efficacy levels and their health literacy levels significantly explained their health behaviors. This finding suggests that increasing the self-efficacy and health literacy levels of adolescents should be increased to develop positive health behaviors among today's youth. PRACTICE IMPLICATIONS: Nurses should identify strategies to increase self-efficacy and health literacy among adolescents to protect and improve adolescent health behavior.

Nurses' Attitudes Towards Death and Their Effects on Spirituality and Spiritual Care.

This study aimed to determine the effect of nurses' attitudes towards death on spirituality and spiritual care. This is a descriptive and correlational study. There was a moderate correlation between the total score on the Spirituality and Spiritual Care Rating Scale and the total and subdimension scores on the Attitude Towards Death Scale. It was found that the scores on the subdimensions of objective acceptance, escaping/acceptance and fear of death explained 41.7% of nurses' perceptions of spirituality and spiritual care. For holistic nursing care, it is very important that nurses are aware of their patients' spiritual needs and are capable of providing supportive spiritual service without regard for their own attitudes towards or spiritual thoughts about death.

Assessment of Turkish oncology nurses' knowledge regarding COVID-19 during the current outbreak in Turkey.

PURPOSE: To assess Turkish oncology nurses' knowledge regarding novel coronavirus (COVID-19) during the current outbreak in Turkey. METHODS: This descriptive study was carried out with the 185 oncology nurses between April and May 2020 in Turkey. Research data were collected through online survey using "Nurse Information Form" and "Nurse Information Scale for COVID-19." Multilinear regression analysis was used in determining the factors affecting oncology nurses' information regarding COVID-19. RESULTS: According to the data delivered from 185 oncology nurses, 57.7% of the participants had an undergraduate degree, 74.1% were working in adult oncology units, and 52.4% of them were working as clinical nurses, 48.1% of the nurses received education for COVID-19 (51.9% did not receive) and 70.3% followed and read the COVID-19 Guidelines published by the Ministry of Health (29.7% did not follow guidelines). Using multiple regression analysis, a model based on the relationship between the variables was created. In the model, the descriptive characteristics of the oncology nurses and their experiences of COVID-19 were found to explain 29.1% of their knowledge level for COVID-19. Nurses' education level, the presence of a relative diagnosed with COVID-19, and following the COVID-19 guidelines were found to statistically significantly affect the knowledge levels of COVID-19. CONCLUSION: These findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.

The Effect of Fatigue-Related Education on Pediatric Oncology Patients' Fatigue and Quality of Life.

The identification of cancer-related fatigue as a clinical problem in pediatric oncology is an important phenomenon, and there are limited number of studies about raising the awareness of pediatric oncology patients and their parents. Fatigue-related education for patients and their parents before and during cancer treatment reduces the fatigue levels of patients. This study aims to analyze the effect of fatigue-related education for pediatric oncology patients aged 7-12 and their parents on their fatigue and quality of life. This study was conducted with 80 children with cancer and their parents who were assigned to either the control group (n = 40) or the experimental group (n = 40). The experimental group received a fatigue-related educational program. The data were collected three times: prior to the program, 3 months later, and 6 months afterwards. Multidimensional variance analysis, the Bonferroni adjusted t test and regression analysis were used to analyze the data. A significant difference was found among the experimental and the control group for total mean scores and the mean scores of subdimensions of the Scale for the Assessment of Fatigue-Child Form in terms of the interactions of group, time, and group*time (p < 0.05). Significant differences were found among the experimental and control groups' mean scores on the Scale for the Quality of Life-Child and Parents Form in terms of the interactions of group, time, and group*time (p < 0.05). Fatigue-related education is an effective education model as a way to reduce fatigue and increase the quality of life of children with cancer. The use of fatigue-related education by nurses in pediatric oncology clinics will have positive effects on children and their parents.

Psychometric properties of the Turkish version of the Emotional Eating Scale for children and adolescents.

This methodological-descriptive-sectional study was performed to assess the validity and reliability of the "Emotional Eating Scale Adapted for Use in Children and Adolescents (EES-C)" scale in Turkey. The sample group of the study was composed of 576 children and adolescents. The data were obtained by using the demographic data collection form and "Emotional Eating Scale Adapted for Use in Children and Adolescents (EES-C)". Cronbach's alpha values for the scale and its subscales were 0.90, 0.86, 0.76 and 0.71; respectively. Item-total correlations for the scale changed between 0.57 and 0.99 (p<0.001). The indices of Model Fit were determined to be Root Mean Square Error of Approximation (RMSA)=0.051, Goodness of Fit Index (GFI)=0.91 and Comparative Fit Index (CFI)=0.97. According to our results, it has been shown that the scale is a valid/reliable instrument to detect the emotional eating of Turkish children and adolescents. EES-C is a convenient tool for professionals to manage and prevent the emotional eating problems.

Psychometric Properties of Turkish Version of Pediatric Daytime Sleepiness Scale (PDSS-T).

PURPOSE: The aim of the research was to evaluate the psychometric properties of the Pediatric Daytime Sleepiness Scale-Turkish Version (PDSS-T). METHODS: The researchers chose a study sample of 522 grade 5-11 students. Data were collected using a demographic data collection form and the PDSS-T. RESULTS: Cronbach α for the scale was .79 and Kaiser-Meyer-Olkin coefficient was .78. Item-total correlations for the scale varied between .53 and .73 (p < .001). The indices of model fit were determined to be the root mean square error of approximation at .07, the goodness of fit index at .97, and the comparative fit index at .97. CONCLUSIONS: The study's results showed that PDSS-T is a valid and reliable instrument for detecting Turkish-speaking children's and adolescents' daytime sleepiness. PDSS-T is convenient for professionals to prevent and manage daytime sleepiness.

Effects of perceived smoking-cancer relationship and cardiovascular health attitudes on childrens' views of smoking.

BACKGROUND: This study was conducted with the aim of determining how students' perceived smoking-cancer relationship and cardiovascular health attitudes affect childrens' views of smoking. MATERIALS AND METHODS: The sample of this descriptive-cross sectional study comprised 574 subjects between the ages of 11-15. The data were collected using the Children's Cardiovascular Health Promotion Attitude Scale and the Children's Decisional Balance Measure for Assessing and Predicting Smoking Status. Correlation and logistic regression were used for analysis. RESULTS: It was determined that a statistically significant relationship exists between the attitudes of children towards smoking and their ideas about the relationship of smoking with cancer, which is negative and low (r=-0.223). There was also a statistically significant relationship between their attitudes towards cardiovascular health and their attitudes towards smoking, again at a low level (r=0.257). It was determined that children with ideas about smoking and cancer were 9.4 times less likely to have positive/negative attitudes towards smoking, while positive attitudes towards cardiovascular health made negative attitudes towards smoking 3.9 times less likely. CONCLUSIONS: It was determined that the attitudes of students towards cardiovascular health and their perceptions of smoking and cancer reduced the positive perceptions towards smoking.

Developing a scale for quality of life in pediatric oncology patients aged 7-12--children and parent forms.

BACKGROUND: This study was planned in an attempt to develop a scale for the quality of life in pediatric oncology patients aged 7-12, with child and parents forms. MATERIALS AND METHODS: In collecting the study data, we used the Child and Parent Information Form, Visual Quality of Life Scale, Scale for Quality of Life Pediatric Oncology Patients Aged 7-12 and the Scale for the Quality of Life in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. RESULTS: In this study, the total Cronbach alpha value of the parent form was 0.96, the total factor load being 0.54-0.90 and the total variance explained was 82.5%. The cutoff point of the parent form was 93 points. The total Cronbach alpha value for the child form was 0.96, with a total factor load of 0.55-0.91 and the total variance being explained was 78.3%. The cutoff point of the child form was 65 points. CONCLUSIONS: This study suggests that the Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 Child and Parents Forms are valid and reliable instruments in assessing the quality of life of children.

Developing scales for the assessment of fatigue in Turkish pediatric oncology patients aged 13-18 and their parents.

BACKGROUND: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatric oncology patients aged 13-18 and also for their parents. MATERIALS AND METHODS: In collecting the study data, we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 for Parents. We also used Pearson correlation analysis, Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. RESULTS: In this study, the total Cronbach alpha value of the parent form was 0.99, the total factor load was 0.72-0.94 with 95% the total variance being explained. The cutoff point of the parent form is 73 points. The total Cronbach alpha value of the child form was 0.99, the total factor load was 0.82-0.95, with 89.4% of the total variance being explained. The cutoff point of the child form was 75.5 points. CONCLUSIONS: This study suggests that the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 for Parents are valid and reliable instruments in assessing the fatigue symptoms of children in Turkey.

Symptom frequency of children with cancer and parent quality of life in Turkey.

BACKGROUND: This research was planned with the aim of determining the effect of symptom frequency of children with cancer on the quality of life of their parents. MATERIALS AND METHODS: In gathering the research data, the Child and Parent Information Form, the Symptom Evaluation Form and the Family Version of Life Quality Scale in Cancer Patients were used. Evaluation was made by using percentage calculations, Kruskal Wallis test, Bonferroni adjusted t-test and Bonferroni adjusted Mann-Whitney U test. The significance level was accepted as 0.005. RESULTS: Some 37.6% of the participant children were female and 62.4% were male, with an average age of 10.2 ± 4.5. While 41.0% were newly diagnosed, 46.2% were in remission and 12.8% was in relapse. Highly significant differences were detected according to the symptom frequency with parent physical and psychological health, social anxiety, and spiritual wellness sub-dimensions, as well as total point averages. CONCLUSIONS: It is thought that following up the symptoms that might develop depending on cancer diagnosis and treatment and implementing nursing initiatives aimed at reducing the symptoms, knowing the importance of life quality, maintaining measures aimed at life quality and planning initiatives to increase the life quality will play a key role in maintaining and developing the health of Turkish paediatric oncology patients and their parents.

Developing a scale for the assessment of fatigue in pediatric oncology patients aged 7-12 for children and parents.

BACKGROUND: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatric oncology patients aged 7-12 as well as for their parents. MATERIALS AND METHODS: In collecting the study data, we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach Alpha coefficient, Factor Analysis and ROC Analysis for the study data. RESULTS: In this study, the total Cronbach alpha value of the parent form was 0.95, the total factor load was 0.52-0.95 and the total variance being explained was 85.7%. The cutoff point of the parent form was 82 points. The total Cronbach alpha value of the child form was 0.98, the total factor load was 0.71-0.94 and the total variance being explained was 84.7%. The cutoff point of the child form was 75 points. CONCLUSIONS: This study suggests that our scales for the assessment of fatigue in pediatric oncology patients aged 7-12 and their parents are valid and reliable instruments.