The effect of facilitated tucking and white noise on stress and sleep of newborns receiving nasal continuous positive airway pressure.

OBJECTIVE: To investigate the effects of facilitated tucking and white noise on stress and sleep in neonates receiving nasal continuous positive airway pressure (CPAP). METHOD: This study was conducted as a randomised controlled experimental study of neonates receiving nasal CPAP in neonatal intensive care units. The study sample consisted of 108 newborns (facilitated tucking (n = 36), white noise (n = 36) and control (n = 36)) receiving nasal CPAP support in the NICU. The neonates' sleep parameters were recorded by actigraphy for 24 h. Data were collected using the Neonatal Descriptive Information Form, the Sleep Tracking Form and the Neonatal Stress Scale. Percentage, mean, chi-squared and one-way ANOVA were used for data analysis. RESULTS: It was found that 50.9% of the newborns were female, their mean gestational age was 33.54 ± 3.38, their mean height was 43.56 ± 5.12, and their mean weight was 2139.23 ± 827.82. The total sleep time of the neonates in the facilitated tucking and white noise group increased by 3 h, their sleep efficiency increased by 20% and their mean stress scores decreased (p < 0.05). CONCLUSION: Facilitated tucking and white noise each showed a similar improvement in sleep duration and sleep efficiency and a reduction in stress scores in neonates receiving nasal CPAP. Close monitoring of sleep in this population and supportive care practices are recommended. PRACTICE IMPLICATIONS: The findings of this study may help to reduce sleep problems and stress levels in the clinical care of neonates in the NICU through developmental nursing practices.

Psychosocial conditions of children after liver transplant: Post-traumatic stress, depression, and anxiety.

AIM: This study aimed to determine psychosocial conditions, post-traumatic stress, depression, and anxiety of children who underwent a liver transplant. METHOD: This is a relational descriptive study, which was conducted between March 2019 and December 2020 in the Inonu University Liver Transplantation Institute Pediatric Liver Transplant Clinic. The "Child Information Form," "Child Post-Traumatic Stress Reaction Index," "State-Trait Anxiety Inventory for Children-Trait Form," and "Children's Depression Inventory" were used to collect data. The study was conducted with 71 children who had a previous liver transplant. RESULTS: Of the participating children, 56.3% were girls, 63.4% continued their primary school education after the transplant, 32.5% were diagnosed with cirrhosis, 39.4% received the transplant in 2017, 32.4% received it from the mother, and 25.4% received it from a cadaveric donor. Although it had been at least 3 years since the transplant, 47.9% exhibited moderate and 43.7% severe post-traumatic stress responses. There was a significant negative relationship between the age of children with a liver transplant and trait anxiety and post-traumatic stress responses (path coefficients ß = -0.268, p = 0.002; ß = -0.166, p = 0.023, respectively). There was a significant positive relationship between anxiety and post-traumatic stress responses of the children after the transplant and there was a statistically significant relationship between the path coefficients (ß = 0.750; p < 0.001). CONCLUSION: Children who underwent a liver transplant had post-traumatic stress disorder, depression, and trait anxiety.

A follow up study on the effects of massage on preterm infants: A randomized controlled research.

BACKGROUND: Preterm infants who leave the intrauterine environment early are deprived of tactile stimuli. This affects the physical, emotional and social developments of infants and their physical growth parameters such as weight, height and head circumference negatively. AIM: This research was conducted to determine the effects of massage on the development of preterm infants. MATERIAL-METHOD: This research was conducted as randomized controlled research with two groups (massage-control). The infants in the intervention group received massage for 30 days. Height, weight and head circumference values of the infants were recorded on days 5, 10, 20 and 30. Amount of feeding was recorded before intervention, on day 15 after intervention and on day 30 after intervention. Discharge times of the infants were recorded according to groups. RESULTS: A significant difference was found in height and weight of the preterm infants on days 20 and 30 when compared with the control group. Discharge time of the infants in the massage group was found to be 10 days shorter on average when compared with the control group. Significant difference was also found between day 15 and 30 in terms of amount of feeding. CONCLUSION: Massage was found to have significant effects on physical growth parameters such as height, weight and head circumference. It was found that massage increased amount of feeding and weight intake in infants and decreased discharge time. In this case, hospital cost per infant may be reduced.

The effect of anxiety and depression levels of children with celiac disease on quality of life.

PURPOSE: This study was conducted to examine the effect of anxiety and depression levels on quality of life in children with celiac disease. DESIGN AND METHOD: This descriptive and correlational study was conducted with 98 children diagnosed with celiac disease who applied to the pediatric outpatient clinic of a university hospital in Eastern Anatolia between September 2021 and August 2022. Data were collected using the State-Trait Anxiety Scale, Depression Scale, and Quality of Life Scale through face-to-face interviews conducted by the researchers. Percentage distribution, mean, independent samples t-test, Pearson correlation analysis and regression analysis were used to analyze the data. RESULTS: It was found that 62% of the participant children were female and their mean age was 11.69 ± 4.15 years. The mean scores of state anxiety, trait anxiety, depression and quality of life of children with celiac disease were 42.46 ± 5.42 (high), 43.83 ± 7.08 (high), 23.37 ± 4.79 (high) and 43.67 ± 19.67 (low), respectively. Regression analysis revealed that anxiety had a statistically significant relationship with quality of life. CONCLUSIONS: It was found that children with celiac disease experienced high levels of depression and anxiety along with physical functionality and psychosocial health problems and this negatively affected their quality of life. It is recommended that children with celiac disease should be followed up and supported psychosocially. PRACTICE IMPLICATIONS: That healthcare professionals can contribute to reducing the depression and axienty and improving the quality of life by strengthening the social support systems of childrens with celiac disease.

The effects of massage therapy and white noise application on premature infants' sleep.

AIM: Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing. MATERIALS AND METHODS: This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Sanliurfa Mehmet Akif Inan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40). RESULTS: The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants. CONCLUSION: In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.

Development study of 2-5 age Technology Addiction Scale (TAS).

PURPOSE: Although it is known that technology use increases in early childhood, no measurement tool has been found to examine technology addictions in children in this period. In this study, the development and validation process of the Technology Addiction Scale (TAS), which can be used to evaluate the technology addiction of children 2-5 years, is described. DESIGN: The sample of the study consists of 308 children 2-5 years living in one of the big cities of Turkey. METHODS: Item-total correlation coefficients, Cronbach Alpha reliability analyzes, explanatory and confirmatory factor analyses, and normality analyzes were used in the evaluation of the research data. FINDINGS: As a result of the analyzes made, the validity and reliability of the 9-item 2-factor (impulsiveness and implicit attitude) TAS scale have been proven. The Cronbach alpha value of the impulsiveness factor was calculated as 0.865, the Cronbach alpha value of the implicit attitude factor was calculated as 0.840, and the total Cronbach alpha value of the scale was 0.90. These Cronbach alpha values show an acceptable level of reliability. CONCLUSIONS: According to the results of the validity and reliability analyzes, it can be said that TAS can be used as a reliable scale.

Effect of Yakson touch and mother's voice on pain and comfort level during nasal CPAP application in Turkey: A randomized controlled study.

PURPOSE: This study was conducted to evaluate the effects of Yakson touch and mother's voice on pain and comfort levels of preterm infants during nasal CPAP application. DESIGN AND METHODS: The study was conducted as a randomized experimental study with a control group. It included 124 premature infants (mother's voice group = 31, Yakson touch group = 31, mother's voice+ Yakson touch group= 31, control group = 31) of 28-37 weeks of age who had nasal CPAP application in the NICU of a state hospital in souteastern Turkey between April 2019 and August 2020. While the infants in the experimental group received mother's voice, Yakson touch, and mother's voice+ Yakson touch procedures before, during and after nasal CPAP application, the infants in the control group received nasal CPAP application without extra intervention. "Newborn Infant Pain Scale (NIPS)" and "Premature Infant Comfort Scale (PICS)" were used to collect data. RESULTS: Further analysis revealed that the Yakson Touch was the most beneficial intervention for reducing NIPS scores and PICS scores during and after nasal CPAP application in the experimental groups, followed by mother's voice + Yakson touch and lastly mother's voice. CONCLUSION: Yakson touch and mother's voice+Yakson touch methods, are effective in neonatal pain and comfort management during and after the nasal CPAP application.

The effect of therapeutic touch and music rest on sleep parameters in children with liver transplantation.

PURPOSE: This study was conducted to evaluate the effect of therapeutic touch and music rest on the sleep of children with liver transplantation. DESIGN AND METHODS: The data of the study were collected between February 2021 and November 2021. The study was completed with 50 patients included in the therapeutic touch and music rest groups. Therapeutic touch and music practices were applied for three consecutive days, once a day and 20 min. Before and after the practices, the 24-h sleep of the children was evaluated with actigraphy. RESULTS: It was determined that the time in bed, total sleep time, and sleep efficiency of the children in the therapeutic touch group increased after the procedure. On the other hand, it was determined that the time in bed, and total sleep time increased, and the onset latency decreased after the procedure in the children in the music rest group. It was determined that the effects of therapeutic touch and music rest applications on sleep parameters after the procedure were similar. CONCLUSION: It has been determined that therapeutic touch and music rest applications have an improving effect on the sleep of children with liver transplantation. PRACTICE IMPLICATIONS: Music rest and therapeutic touch, which are non-pharmacological methods that do not increase the burden of the liver, can be used by health professionals to support the sleep of children with liver transplantation.

The effects of the posttraumatic stress and general health status on paediatric burns and their sleep habits.

BACKGROUND: Burns are serious injuries that can require hospitalization and have physical and emotional sequelae. Sleep disturbance can occur after trauma as evidenced by posttraumatic stress symptoms such as re-experiencing of a trauma with repetitive dreams, memories and flashbacks. This area has been minimally examined with pediatric burn survivors; therefore, the aim of this study was to investigate the effects of posttraumatic stress and general health on sleep habits of pediatric burn survivors from. METHOD: This is a correlational descriptive study. Its sample included 7-18-year-old inpatients at the burn clinic of a university hospital from January to November 2019. This study used the Posttraumatic Stress Disorder Reaction Index, the General Health Questionnaire (12) and the Children's Sleep Habits Questionnaire for data collection. RESULTS: Of the participants, 58.6% were male, 46.5% were primary school students, and 62.6% had no diseases other than their burns. 20.2% of the children had epilepsy, 14.2% had diabetes and 3% had pneumonia. Of the child burn victims, 45.5% were brought to the hospital because of contact with fire. All of them had first-degree burns, 59.6% had second-degree burns, and 80.8% had third-degree burns. After their burns, infections developed in 20.2% during trauma and in 43.4% during burn treatment. A structural equation model indicated that the child burn victims' general health perceptions did not significantly affect their sleep habits (p > 0.05). A significant correlation was found between the children's posttraumatic stress disorder and their sleep habits (p < 0.05). Posttraumatic stress disorder explained 7.2% of their sleep habits. A positive and significant correlation was found between the children's general health perceptions and posttraumatic stress disorder (r = 0.74, p < 0.05). CONCLUSION: Burns of any kind can cause posttraumatic stress, sleep disorders and impairment of health status in children.

The effect of three different methods applied during peripheral vascular access in prematures on pain and comfort levels.

PURPOSE: This research was carried out to determine the influence of kangaroo care, fetal position, and swaddling on pain and comfort levels in preterm infants during peripheral vascular access. DESIGN AND METHODS: The study was conducted as a randomized experimental study with a control group. It included 148 premature infants (kangaroo group = 37, swaddling group = 37, fetal position = 37, control group = 37) of 32-37 weeks of age who had peripheral vascular access in the NICU of a state hospital in eastern Turkey between December 2019 and June 2020. While the infants in the experimental group received kangaroo care, fetal position, and swaddling procedures during and after peripheral vascular access, the infants in the control group received conventional peripheral vascular access without extra intervention. "Newborn Infant Pain Scale (NIPS)" and "Premature Infant Comfort Scale (PICS)" were used to collect data. Data were analyzed using percentile, chi-square and ANOVA tests. RESULTS: Further analysis revealed that the fetal position was the most beneficial intervention for reducing NIPS scores and boosting PICS scores during and after peripheral vascular access in the experimental groups, followed by kangaroo care and lastly swaddling. CONCLUSION: It was discovered that kangaroo care, fetal position, and swaddling were useful in lowering discomfort and boosting comfort levels in premature infants during and after peripheral vascular access. PRACTICE IMPLICATIONS: Kangaroo care, fetal position and swaddling methods can be used in clinical practice in order to reduce the pain level and increase the comfort level during and after peripheral vascular access in prematures.

The effect of perceived social support on the psychosocial status of parents whose child had liver transplantation.

BACKGROUND: The aim of this study was to describe parental psychosocial outcomes following paediatric liver transplantation and the relationship between parental psychosocial outcomes and social support. METHOD: This is a correlational, descriptive study conducted between April 2021 and October 2021 in the paediatric hepatology polyclinics of the liver transplantation institute of a university hospital. The SPSS 25 and AMOS 23 package programmes were used to perform data analyses. RESULTS: Data analysis revealed that the parents' social support level was low (44.6 ± 14.8), while their levels of trait anxiety (51.5 ± 4.8) and loneliness (48.5 ± 5.4) were high, and their depression level was moderate (26.4 ± 5.8). Established structural equation modelling demonstrated that the social support parents received had a significant effect on their levels of loneliness (ß = -0.88; p < 0.001), trait anxiety (ß = -0.37; p < 0.001), and depression (ß = -0.44; p < 0.001). CONCLUSION: The authors conclude that in parents of children who have had a liver transplant, increased levels of perceived social support result in decreased levels of anxiety, loneliness, and depression. PRACTICE IMPLICATIONS: The authors recommend that healthcare professionals can contribute to reducing the anxiety, loneliness and depression in parents of paediatric liver transplant recipients by strengthening their social support systems.

The Effect of Circular and Oscillating Breast Massage on the Amount of Breast Milk Produced: An Innovative Method.

Background: In addition to suffering stress and anxiety owing to being separated from their babies, mothers whose babies are hospitalized in neonatal intensive care units suffer breastfeeding problems. Moreover, their breast milk production may decrease over time. Objective: Examining the effect of circular and oscillating breast massage on the amount of breast milk produced. Materials and Methods: This randomized controlled experimental study used a pretest-posttest model. The participants included 120 mothers (experimental group: 60, control group: 60) who went to a breast milk pumping unit of a hospital between December 1, 2017, and July 31, 2019. A circular and oscillating breast massage device was used to massage both breasts for 10 to 15 minutes, three times a day, for 3 days, and milk production was measured daily. The sociodemographic characteristics, perceptions regarding breast massage, and daily breast milk amounts of the mothers were collected. Results: The average age of the mothers that participated in the study was 30.21 ± 5.58 years; the average birth week of their babies was 32.31 ± 4.10 weeks. There were no significant differences in the mothers' amounts of milk production before the procedure in the experimental and control groups. In the study group, milk production increased by 7.92%, 5.25%, and 5.02% on days 1, 2, and 3 of the procedure, respectively. The mothers' total amount of milk production before and after the procedure (3 days) increased by 22.28%. Significant differences were found between the study groups on days 1, 2, and 3 and the total amount of milk produced after the procedure. Conclusion: Our study found circular and oscillating breast massage increased the amount of breast milk produced and decreased breast pain and swelling. Similar studies on the clinical use of this treatment should be conducted in line with the results of this study.

Effect of Postpartum Yoga on Breastfeeding Self-Efficacy and Maternal Attachment in Primiparous Mothers.

Objective: This study was conducted to determine the effect of yoga practice on the breastfeeding self-efficacy and maternal attachment of primiparous mothers in the postpartum period. Methods: This study was performed in a quasi-experimental model with pretest and posttest control groups. The domain of the study was formed with women with 20-40-day-old babies enrolled in two Family Health Centers. One hundred and twenty-four women participated in the study. The Individual Identification Form, Breastfeeding Self-Efficacy Scale, and Maternal Attachment Scale were completed by the experimental and control groups. The experimental group engaged in 60 minutes of postpartum yoga practice 2 days a week for 8 weeks in the company of the researcher. Results: After yoga practice, there was a statistically significant increase in the breastfeeding self-efficacy and improvement in the maternal attachment of the experimental group (p < 0.05). The corresponding increase and improvement of the mothers in the control group were less than those of the mothers in the experimental group (p < 0.05). Conclusion: This study finds that it is beneficial for both the mother's and the baby's physical and psychological health for health professionals to teach mothers to practice yoga, which positively affects breastfeeding and maternal attachment in the postpartum period.

The relationship between the care burden and quality of life of parents who have children with hematological problems and their perceived social support.

PURPOSE: The purpose of this study was to examine the interrelationship of the caregiver burden, perceived social support, and quality of life of parents who have children with hematological problems. DESIGN AND METHODS: The design and methods included a descriptive study with 141 parents of children with hematological problems. The introductory information form, the Zarit Burden Interview (ZBI), multidimensional scale of perceived social support (MSPSS), and the EUROHIS-QOL.8 (WHOQOL-8) scale were used as data collection tools. The data obtained were analyzed using descriptive statistics and structural equation models. RESULTS: As a result of the conducted correlation analysis, it was determined that there was a positive correlation between parents' perceptions of social support and their quality of life, and a negative correlation between their perceptions of social support and the caregiver burden (p < 0.05). As a result of the structural equation model, it was determined that the social support received by the parents had a significant effect on their caregiver burden (ß = -0.40; p < 0.05), and their quality of life (ß = 0.42; p < 0.05). CONCLUSIONS: The conclusion formed was that it can be said that parents' perceptions of social support affect their caregiver burden and quality of life. Parents with high perceptions of social support perceive the burden of caregiver to be low and their quality of life to be high. PRACTICE IMPLICATIONS: The practice implications are that healthcare professionals can contribute to reducing the caregiver burden and improving the quality of life of parents, by strengthening the social support systems of parents with sick children.

The effect of Neurolinguistic Programming practices on organizational citizenship behaviour of nurses: A randomized controlled study.

AIM: The aim of this study is to evaluate the effect of Neurolinguistic Programming practices on organizational citizenship behavior in nursing. BACKGROUND: Neurolinguistic Programming practices are used for different purposes in many areas, and they can also be used to contribute to the acquisition of organizational citizenship behaviour. METHODS: The research is a randomized controlled trial. The sample of the study consisted of 180 nurses. The data of the study were collected through structured face-to-face interviews conducted with the nurses in the sample group, Neurolinguistic Programming training group, standard training and control groups between January and April 2020 after Neurolinguistic Programming training was received by the researcher. The Chi-squared test and the analysis of variance (ANOVA) were used to analyze the collected data. RESULTS: A statistically significant difference was found in the total score of the organizational citizenship behaviour in the Neurolinguistic Programming training group compared with the standard training group and the control group (p < .05). CONCLUSIONS: The use of Neurolinguistic Programming practices can be an effective method for nurses to gain organizational citizenship behaviour. Neurolinguistic Programming practices can be used to achieve the desired goals, especially for the acquisition of informing and participation, tolerance and conscientiousness behaviours. IMPLICATIONS FOR NURSING MANAGEMENT: Organizational citizenship behaviour exhibited by employees is very important for organisations. With this behaviour, nurses can improve all processes, from the quality of care services they provide to patients, to satisfaction. Findings of this study may be used to increase work satisfaction of nurses and to improve the quality of services received by patients.

A Comparison of Two Different Tactile Stimulus Methods on Reducing Pain of Children During Intramuscular Injection: A Randomized Controlled Study.

INTRODUCTION: Pediatric patients in the emergency department often require intramuscular injection procedures, which may lead to pain, fear, and anxiety. The purpose of this study was to test a novel nonpharmacological intervention to reduce needle-related pain in the pediatric emergency department. METHODS: The study was conducted as a parallel-group, randomized controlled design. The study population consisted of 159 children aged 7 to 10 years cared for in the emergency department who received an intramuscular injection of ampicillin/sulbactam. The children were randomly assigned to Palm Stimulator, ShotBlocker, or control groups. The children's preprocedure fear levels were evaluated using the Children's Fear Scale, and their perceived pain levels during the procedure were evaluated using the Faces Pain Scale-Revised and Visual Analog Scale. Parents and observers also completed the pain level scores. RESULTS: According to all raters (child, parent, and observer), the Palm Stimulator group had the lowest mean Faces Pain Scale-Revised score averages (P < .001). The Visual Analog Scale score averages of the children in the Palm Stimulator group (Visual Analog Scale: M = 27.94, standard deviation = 19.13) were statistically significantly lower than the ShotBlocker (Visual Analog Scale: M = 46.07, standard deviation = 24.96) and control group (Visual Analog Scale: M = 53.43, standard deviation = 29.01) score averages (F = 14.94, η2 = 0.16, P = .001). DISCUSSION: The results of this study support the effectiveness of the Palm Stimulator to reduce perceived pain in children during intramuscular injection administration in the pediatric emergency department.

The effect of online solution-focused support program on parents with high level of anxiety in the COVID-19 pandemic: A randomised controlled study.

AIM: The aim of this study was to determine the anxiety levels of parents with children aged 3-6 years because of the Coronavirus Disease 2019 (COVID-19) pandemic and to examine the effects of Solution-Focused Support Program (SFSP) applied to parents with a high level of anxiety. METHODS: The study was conducted as a parallel-group, randomised controlled design. The sample of the study consisted of 77 parents who were randomly assigned to the experimental and control groups (control group n = 40; intervention group n = 37). One session of online SFSP was applied to the intervention group each week and 4 sessions were applied in total. No intervention was applied to the control group. The data were collected using introductory information form and State-Trait Anxiety Inventory (STAI). Statistical Package for the Social Sciences (SPSS) programme and Analysis of Moment Structures (AMOS) 23 application were used in the analysis of the data. Structural Equation Modeling (SEM) was used to examine a hypothesised model that SFSP has both direct and indirect effects on the anxiety levels of parents. RESULTS: The state and trait anxiety mean scores of the intervention group decreased compared with the pre-intervention mean scores after the implemented programme. While this difference between state anxiety scores was statistically significant (P ≤ .001), the difference between trait anxiety scores was not statistically significant (P > .05). There was no statistically significant difference between the pre-test and post-test STAI total scores of the control group. CONCLUSIONS: In the study, it has been found that SFSP applied to parents with a high level of anxiety is an effective method in reducing the state anxiety levels of parents.

Behaviours and experiences of nurses during the COVID-19 pandemic in Turkey: A mixed methods study.

AIM: The aim of this work is to present behaviours and experiences of nurses in Turkey during the current coronavirus pandemic. BACKGROUND: The coronavirus pandemic leads to difficulties for most health care workers, especially for nurses who mostly accompany patients and are on the front line. METHODS: In the study, a parallel mixed pattern converging quantitative and qualitative research methods was used. RESULTS: The model revealed that 41 years old or older, diabetic, female, single professionals, working in the pandemic department took more personal measures. Five main themes appeared regarding the experiences of the nurses during the pandemic period: (1) psychological and mental strain; (2) personal protective equipment; (3) organizational, physical, and social strains; (4) change in professional values; (5) turning the crisis into an opportunity. CONCLUSIONS: Personal measures are associated with the risk status. There is a need to protect nurses with significant measures by providing psychosocial support, meeting their basic needs, and preventing all complications likely to occur due to increasing workload. IMPLICATIONS FOR NURSING MANAGEMENT: More efforts should be made to ensure good work, fair treatment, no tolerance for discrimination, and equal compensation conditions.

The effects of the COVID-19 pandemic on children's lifestyles and anxiety levels.

OBJECTIVE: This study was conducted to determine the effects of the coronavirus disease 2019 (COVID-19) pandemic on children's lifestyles and anxiety levels. METHODS: This study was designed as a descriptive, cross-sectional online questionnaire survey. RESULTS: Of the children, 91.9% reported that the pandemic had an important effect on their lifestyle. Children stated that they experienced changes in terms of nutrition, sleep, television-internet use, social activity, coursework time, and school success due to the pandemic. IMPLICATION FOR PRACTICE: It was determined that the COVID-19 pandemic caused changes in children's routines, and the children experienced moderate or high levels of anxiety. Primary healthcare providers should increase their attention to these issues to protect and improve children's mental health during the pandemic period.

The Effects of a Therapeutic Play/Play Therapy Program on the Fear and Anxiety Levels of Hospitalized Children After Liver Transplantation.

PURPOSE: This study was conducted to analyze the effects of a therapeutic play/play therapy (TP/PT) program on anxiety levels and fear of medical procedures in children with liver transplant. DESIGN: The study had a pretest-posttest quasi-experimental design. METHODS: Sixty-five children aged between 6 and 12 years were included in this study. A children's information form, the State-Trait Anxiety Inventory for Children, and the Medical Procedure Fear Scale were used for data collection. FINDINGS: The application of the TP/PT program resulted in a statistically significant decrease in the children's anxiety levels and fears about medical procedures (P = .001). CONCLUSIONS: The TP/PT program had a positive effect on the children's fear and anxiety levels regarding certain medical procedures. Pediatric nurses can use the TP/PT program to reduce children's anxiety and fears about medical procedures.