BACKGROUND:Clustered care is a core component of individualized developmental care (IDC) in neonatal intensive care units (NICUs). However, the absence of standardized, evidence-based guidance results in variability in nursing practices, potentially compromising developmental stability and care quality. This study aimed to develop, validate, and pilot an evidence-based Clustered Care Practice Guide to support standardized nursing care in NICUs. METHODS:This methodological study followed a de novo guideline development approach (April 2022-June 2025). Multiple data sources were integrated, including a PRISMA-guided and PROSPERO-registered systematic review, a descriptive survey with 122 NICU nurses, clinical observations in two university hospitals, and five focus group interviews with 35 nurses. Synthesized evidence was translated into structured recommendations. Content validity was evaluated by 33 multidisciplinary experts using the Davis technique, and methodological quality was assessed according to AGREE II criteria. A pilot implementation was conducted to evaluate feasibility and clinical applicability. RESULTS:The final guide comprised 55 items across five sections. All items demonstrated acceptable content validity (I-CVI ≥ 0.78), with excellent overall validity (S-CVI/Ave = 0.96). The guide met AGREE II standards. Pilot testing with five nurses and subsequent evaluation by 25 nurses indicated high acceptability, with 95.8% rating the guide as effective and useful. Thematic analysis revealed improved clinical decision-making, workflow organization, professional confidence, and standardization of care practices. CONCLUSION:The Clustered Care Practice Guide demonstrates strong methodological rigor and high clinical applicability. It offers a structured, evidence-based framework to standardize clustered care and enhance developmentally supportive practices in NICUs.
OBJECTIVES:This study mapped nursing-related pediatric medication safety research and examined publication trends, author, country, and source productivity, citation patterns, thematic structures, and comparatively less visible topics within the retrieved corpus. METHODS:This descriptive bibliometric analysis included Web of Science Core Collection records retrieved on April 3, 2026. Of 570 records identified, 292 original research articles met the eligibility criteria. Author keywords were audited and standardized before descriptive, thematic, trend-topic, multiple correspondence, and co-occurrence analyses using Bibliometrix and VOSviewer. RESULTS:The articles were published between 1976 and 2026; 2026 was a partial year through April 3. The compound annual growth rate for 1976-2025 was 6.19%. Mean citations per article and co-authors per document were 19.62 and 5.60, respectively. Publication output increased after 2020 and peaked at 28 articles in 2024. Pediatrics and Journal of Pediatric Nursing were the most productive sources. After cleaning, 577 author keywords were retained; 67 occurring in at least three articles were included in conceptual analyses. Medication errors, pediatrics, patient safety, nursing, and medication safety were the most prominent concepts. Medication preparation and administration safety, care transitions, home medication safety, and family education were comparatively less visible. CONCLUSION:Within the corpus retrieved through the nursing-related search strategy, publication output increased substantially but remained geographically and thematically uneven. Topic visibility may have been influenced by the search strategy and author-keyword practices. Future research should strengthen nursing- and family-centered approaches across the medication-use continuum, particularly in care transitions, home medication safety, and systems-based prevention.
OBJECTIVES:This study was conducted to determine the effect of the SENSE® program applied to preterm infants during their stay in the neonatal intensive care unit (NICU) on maternal stress, anxiety, and depressive symptoms among mothers. METHODS:This quasi-experimental pre-post study included 21 mother-infant pairs in the SENSE® group and 25 in the control group. The data collection instruments used were the Demographic Information Form, the Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU), the State-Trait Anxiety Inventory (STAI), and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS:The mean total PSS: NICU score of the experimental group in the post-test was found to be statistically significantly lower than that of the control group (p = 0.039; p < 0.05). The mean STAI score of the experimental group in the post-test was found to be statistically significantly lower than that of the control group (p = 0.020; p < 0.05). The mean EPDS score of the experimental group in the post-test was found to be statistically significantly lower than that of the control group (p = 0.019; p < 0.05). CONCLUSION:This study found lower levels of stress, anxiety, and depression in the experimental group. These findings suggest that participation in the SENSE® program may be associated with improved psychological well-being among mothers of preterm infants; however, given the quasi-experimental design and baseline differences between groups, a causal effect cannot be established. IMPLICATIONS FOR CLINICAL PRACTICE:Integrating the SENSE® program into NICU care may be associated with reduced maternal stress, anxiety, and depression. TRIAL REGISTRATION:www. CLINICALTRIALS:gov (Identifier: NCT06354517).
INTRODUCTION:Hazardous child labor is an important cause of preventable injury requiring emergency care. In the occupied West Bank, children as young as 11 work in agricultural settlements under hazardous conditions beyond Palestinian labor law enforcement. Emergency nurses are often the first healthcare professionals to assess these injuries, identify safeguarding concerns, and initiate care, yet their experiences remain absent from the literature. METHODS:This qualitative descriptive study employed semi-structured interviews with 19 emergency nurses purposively recruited from six hospitals across three West Bank regions between March and August 2025. Data were analyzed using Braun and Clarke's reflexive thematic analysis with NVivo support. RESULTS:Four interconnected themes described nurses' experiences: severe occupational injuries requiring emergency care; hidden psychological suffering beyond physical wounds; navigating system barriers within emergency care; and the emotional burden of emergency nursing for working children. DISCUSSION:Emergency nurses witness repeated, preventable occupational injuries among working children while navigating resource constraints, absent referral pathways, and jurisdictional barriers. The emotional burden is significant, yet nurses demonstrate resilience through faith, peer support, and advocacy. CONCLUSION:Findings suggest that emergency departments should develop protocols for screening child labor, trauma-informed care, safeguarding referral pathways, and psychological support for nursing staff. Emergency nurses are uniquely positioned to identify, treat, and advocate for working children, but require institutional support to fulfill this role.
Purpose To examine caregivers' perceived importance of topics regarding pediatric obesity management (POM) and explore their expectations and preferences regarding family navigation (FN). Design and methods In this cross-sectional, mixed-methods study, caregivers of 6-to-17-year-olds with a BMI ≥ 97th percentile completed a survey to assess their perceived importance of topics regarding POM, including knowledge and skill needs regarding healthier food/drinks, physical activity/exercise, family support/behaviour, and weight management goals. A sub-set completed individual interviews to explore their expectations and preferences regarding FN for POM. From 2022 to 2024, data collection occurred at two POM clinics in Calgary and Mississauga, Canada, within a randomized controlled trial. To examine differences between caregivers' knowledge and skill needs, the paired t-test or Wilcoxon test was used. Inductive/manifest content analysis was used to analyze interview data, with convergent mixed methods used to integrate quantitative and qualitative data. Results Overall, 108 caregivers completed the survey; data analysis included interviews with 52 caregivers. Survey data showed that caregivers' knowledge needs exceeded skill needs for healthier food/drinks, physical activity/exercise, and total knowledge/skills (all p < 0.01). Caregivers attended clinic appointments seeking support to change behaviours; however, competing commitments limited their ability to attend regularly. Participants preferred to meet navigators more often than monthly, both as a family and parent only, and expected navigators to serve as facilitators and supporters to identify available community resources. Conclusions Caregivers reported that FN could support families in accessing community resources and connect them with medical and healthcare providers to promote behaviour change and improve their children's mental health. Practice implications Caregivers expect to receive support to overcome barriers that reduce access to health services for managing pediatric obesity in clinics. Interventions that include family navigators as facilitators and supporters to help families in addressing barriers can enhance pediatric obesity management engagement in clinic appointments.
PURPOSE:This study investigated the short-term effects of a mobile game application developed for children with Chronic Kidney Disease (CKD) on knowledge, health-related beliefs, attitudes, and clinical parameters. DESIGN AND METHODS:This randomized controlled trial included 64 children with CKD (32 per group). A mobile game tailored for children aged 11-14 years was developed. Data were collected using a Data Collection Form, Clinical Parameters Follow-up Form, Information Form on Chronic Renal Failure, Healthy Lifestyle Belief Scale for Adolescents, and the Child's Attitude Toward His/Her Disease Scale. RESULTS:Mean ages were 12.78 ± 1.21 and 12.65 ± 1.31 years in the experimental and control groups, with no significant demographic differences (p > 0.05). Children using the mobile game showed significantly higher knowledge, healthy lifestyle belief, and disease attitude scores at 1 and 3 months than controls (p < 0.05). No significant between-group differences were found in blood pressure or pulse rate (p > 0.05). Initial differences in iron-binding capacity and potassium did not remain significant after correction. Usability was high (score: 276.18 ± 2.71/280). CONCLUSIONS:The intervention was associated with short-term improvements in knowledge, healthy lifestyle beliefs, and attitudes toward CKD; given the absence of an attention-matched control and confounding of modality with educational dosage, findings should be interpreted as association rather than established effectiveness. No significant effects were observed on clinical parameters. The internally developed knowledge instrument lacks formal factor-analytic or criterion validation. PRACTICE IMPLICATIONS:Pediatric nurses can support disease management in children with CKD by incorporating mobile game-based educational tools into routine care, recognizing that current evidence supports short-term educational benefit rather than established clinical effects.
PURPOSE:The aim of this study was to examine the experiences of individuals diagnosed with idiopathic scoliosis regarding body image, social life, and brace use. DESIGN:This study was conducted using a descriptive qualitative design with a phenomenological approach. SETTINGS AND PARTICIPANTS:The study was carried out with 15 participants who attended the scoliosis outpatient clinic of a Physical Therapy and Rehabilitation Training and Research Hospital. Participants were recruited using purposive sampling. METHODS:Data were collected through semi-structured individual interviews and analyzed using Colaizzi's seven-step phenomenological analysis method. The COREQ checklist was used to guide the reporting of the findings. RESULTS:Four main themes were identified: (1) Changing Body, Fragile Emotions, (2) Under Observation: The Social Imprints of Scoliosis and Bracing, (3) Living with Armor, and (4) The Need for Connection: Strengthening through Support. The findings revealed that participants experience scoliosis and brace use as a multi-layered process in which physical, emotional, and social dimensions are closely intertwined. PRACTICE IMPLICATIONS:The findings indicate that psychosocial needs in adolescent idiopathic scoliosis care are closely related to emotional awareness and communication processes. In pediatric nursing practice, peer-based and communication-focused approaches may support individuals with adolescent idiopathic scoliosis' adaptation and coping. CONCLUSIONS:Participants experience disturbances in body image, concerns about social visibility, and physical-emotional strain associated with scoliosis and brace use. Over time, some participants come to perceive the brace as a protective and functional element, while seeking support plays a decisive role in their coping processes.
PURPOSE:This study evaluated the effects of cartoon character-printed bands on fear, stress, pain, and physiological parameters in children. DESIGN:A randomized controlled trial was conducted. METHODS:This single-center study included 42 children (aged 7-10 years) undergoing burn dressing. Participants were randomly assigned to an intervention group (cartoon character-printed band, n = 21) or a control group (standard dressing, n = 21). Data were collected using the Children's Fear Scale, Wong-Baker Faces Pain Rating Scale, Perceived Stress Scale for Children, and monitoring of vital signs. Outcomes were assessed before and after the procedure and analyzed using mixed between-within ANOVA. RESULTS:Significant group × time interactions were found for fear (F = 56.178, p < .001, \eta^2 = 0.584), stress (F = 83.997, p < .001, \eta^2 = 0.677), and pain (F = 48.338, p < .001, \eta^2 = 0.547), showing substantial reductions in the intervention group. Additionally, the intervention group demonstrated a significant increase in oxygen saturation (p < .001, \eta^2 = 0.411) and a decrease in heart rate (p < .001, \eta^2 = 0.312). No significant differences were observed in body temperature or respiratory rate. CONCLUSIONS:Cartoon character-printed bands appear to be a promising, low-cost, and easily applicable non-pharmacological nursing intervention. Integrating these distraction-based materials into routine care may help reduce procedural distress and support selected physiological outcomes in this sample. IMPLICATIONS FOR PRACTICE:This intervention has the potential to be incorporated into standard pediatric nursing care without requiring additional training or equipment. CLINICAL TRIAL REGISTRATION:NCT07313735.
PURPOSE:This study aimed to examine the associations among diabetes technology satisfaction, self-efficacy, and quality of life in adolescents with Type 1 Diabetes (T1D). DESIGN AND METHODS:This descriptive, cross-sectional study included 235 adolescents with T1D registered at Family Health Centers in a provincial center in Turkey's Western Black Sea Region. Data were collected using the Diabetes Technology Questionnaire (DTQ), the Diabetes Management Self-Efficacy Scale, and the Kiddo-KINDL Quality of Life Scale. RESULTS:The mean HbA1c was 9.05 ± 1.38%. Insulin pump (±CGM) users demonstrated significantly higher technology satisfaction (118.9 vs. 90.3; F = 47.23, p < .01), better self-efficacy (58.3 vs. 76.4; F = 18.42, p < .01; lower scores indicate higher self-efficacy), and higher quality of life (112.3 vs. 92.5; F = 21.87, p < .01) compared to the MDI + SMBG group. Hierarchical regression identified self-efficacy as the strongest predictor of quality of life (β = -0.39, p < .001), followed by DTQ score (β = 0.30, p < .001). The model explained 37.2% of total variance, with modifiable psychosocial factors contributing 28.0%. Female adolescents showed lower self-efficacy and quality of life than males (p < .01). CONCLUSION:Self-efficacy emerged as the strongest independent predictor of quality of life, surpassing demographic, clinical, and technology-related variables. Advanced diabetes technology use was consistently associated with more favorable psychosocial outcomes. APPLICATION TO PRACTICE:Pediatric nurses should integrate self-efficacy-enhancing strategies and gender-sensitive psychosocial support into diabetes education, while advocating for equitable access to advanced technologies.
PURPOSE:This phenomenological study explored mothers' caregiving experiences for children with special needs, focusing on stigmatization and how they make sense of these experiences in daily life. DESIGN AND METHODS:A descriptive phenomenological study was conducted with 15 mothers serving as primary caregivers of children with moderate to severe autism spectrum disorder and/or intellectual disability. Participants were recruited through purposive criterion sampling. Data were collected through semi-structured interviews and analyzed using Colaizzi's seven-step phenomenological method. RESULTS:Four themes emerged: motherhood experience and identity transformation, caregiving burden and continuous responsibility, stigmatization and social interaction, and future-related concerns and coping. Mothers described caregiving as a continuous responsibility extending beyond physical care and involving substantial invisible labor and mental load related to planning, monitoring, anticipating risks, and coordinating care. Their experiences were marked by physical and emotional exhaustion, social isolation, and stigma. Concerns about their children's future, particularly who would care for them after their death, emerged as a major source of anxiety. Spousal support, peer relationships, and rehabilitation services were identified as important coping resources. CONCLUSIONS:Caring for a child with special needs is a multidimensional experience characterized by invisible labor, constant vigilance, social challenges, and uncertainty about the future. Nursing care should address not only the child's needs but also mothers' psychosocial burden. RELEVANCE TO CLINICAL PRACTICE:Nurses should assess mothers' less visible cognitive and emotional caregiving demands, including constant vigilance, care coordination, social restrictions, and future uncertainty, to better understand their needs and provide appropriate support.
BACKGROUND:Adolescents with asthma often experience inadequate disease knowledge, limited social support, and poor self-management, which may adversely affect asthma control and quality of life. Online peer support programs offer a promising approach to complement conventional asthma education by addressing both educational and psychosocial needs. AIM:To examine changes in adolescents' asthma knowledge, social support-seeking behaviors, and asthma self-management following participation in an online peer support program. METHODS:A one-group quasi-experimental pretest-posttest study was conducted among 50 adolescents (12-16 years) with physician-diagnosed asthma attending two outpatient pulmonary clinics in Egypt. Participants completed validated questionnaires assessing asthma knowledge, social support-seeking behaviors, and asthma self-management before and after an 8-week nurse-supervised online peer support program delivered through WhatsApp and Microsoft Teams. RESULTS:Significant improvements were observed following the intervention. Mean asthma knowledge scores increased from 25.98 ± 4.19 to 39.40 ± 1.34 (p < .001), social support-seeking behavior scores increased from 13.90 ± 1.72 to 29.34 ± 1.69 (p < .001), and asthma self-management scores increased from 5.10 ± 2.19 to 15.10 ± 0.99 (p < .001). Significant positive correlations emerged between asthma knowledge and social support-seeking behaviors (r = 0.465, p < .001), asthma knowledge and self-management (r = 0.311, p = .02), and social support-seeking behaviors and self-management (r = 0.582, p < .001). CONCLUSIONS:Participation in the online peer support program was associated with significant improvements in asthma knowledge, social support-seeking behaviors, and asthma self-management.
Background Children with congenital gastrointestinal malformations often have complex conditions that require long-term treatment and care, which can negatively impact their physical and mental well-being as well as their families, who play a crucial role throughout their treatment and management. Purpose This study aimed to determine the current state of family disease management, the difficulties in managing disease in children with congenital gastrointestinal malformations, and the associated risk factors. Design and methods This was a cross-sectional descriptive study including 127 family members of children with congenital gastrointestinal malformations. Data were collected using a subscale of the Family Management Measure (FaMM), the Zarit Caregiver Burden Interview, the Feetham Family Functioning Survey (FFFS), and the Perceived Social Support Scale (PSSS). Result The family disease management and disease management difficulties for children with congenital gastrointestinal malformations were at a moderate level, and caregiver burden was also at a moderate level. Surgical history, family residence, family function, and caregiver burden were the main factors influencing family disease management in the children with Congenital Gastrointestinal Malformations. Conclusion The family management capacity for children with congenital gastrointestinal malformations needs to be improved. It is multi-influenced by surgical history, family residence, family function, and caregiver burden. Nursing staff should integrate caregiver burden assessment, family function support, and social resources to develop family-centered interventions. Through targeted education, personalized follow-up, and active caregiver engagement in the rehabilitation journey, family management can be facilitated, disease management difficulties reduced, and long-term health outcomes ultimately enhanced.
AIM:To evaluate the effectiveness of the Family Program "CARE" (Caring, Assisted, Redesign, Education) in maintaining nutritional status, environmental sanitation, and family function with stunted children, with the primary outcome focused on improving the child's linear growth. METHODS:This study used a quasi-experimental pre-post-test design with a control group among 56 children aged 12-60 months with stunting status (26 stunted children for intervention and 30 children in the control group). The research implemented the Family Program CARE (P-CARE) intervention for a period of 30 days. Parameters measured included environmental sanitation, family care function, oral health, and nutritional status. Data analysis was performed using a paired t-test to identify differences between the pre- and post-intervention periods. RESULTS:Children who received the P-CARE intervention showed a mean increase in height (H) of 1.43 cm. Within-group analyses demonstrated a significant improvement in HAZ-Height-for-Age z-score (0.563 ± 1.903, p = 0.003), while favorable changes were also observed in WAZ-Weight-for-Age z-score (0.104 ± 1.385). However, adjusted ANCOVA analyses showed that HAZ and WAZ did not remain statistically significant after controlling for covariates. In contrast, the between-group comparison showed a significant difference in WHZ (Weight-for-Height Z-score) between the control and intervention groups (p < 0.001). CONCLUSION:The Family Program CARE (P-CARE) demonstrated promising improvements in several child and family health indicators among children with stunting. Although improvements were observed in selected outcomes, not all anthropometric indicators remained statistically significant after adjusted analyses. These findings support the potential role of family-centered, community-based interventions as a comprehensive strategy for addressing stunting in children.
AIM:This study examines how children with a sibling who has a tracheostomy perceive family dynamics and express their emotional experiences through drawings. METHOD:A qualitative descriptive design using methodological triangulation was employed. Data were collected using an "Information About the Child and The Drawing Form", the Marmara Sibling Jealousy Scale-Short Form, and family drawings accompanied by narratives. Thematic analysis was conducted. RESULTS:Fourteen children (mean age = 11.5 years) participated, and the mean scale score was 31 ± 8.3. Five themes were identified: meaning of colors, expression of the sick sibling, expression of family members, self-expression, and communication. Jealousy-related expressions were identified in 8 of 14 drawings, including some children with low scale scores, suggesting differences between quantitative and qualitative findings. Drawings and narratives reflected perceived exclusion, unmet needs for parental attention, communication difficulties, emotional distance, and a desire for greater family support and interaction. Fathers were frequently depicted as important family figures. CONCLUSION:Self-report measures alone may not fully capture the emotional experiences of healthy siblings. Combining drawings with narrative provided a broader understanding of children's perceptions of family relationships, communication, and sibling experiences in families of children with tracheostomy. IMPLICATIONS FOR PRACTICE:Healthy siblings' emotional needs may be overlooked in families of children with tracheostomy. Drawings can serve as supportive communication tools to explore feelings of exclusion, need for attention, communication difficulties, and sibling jealousy. Pediatric nurses should include healthy siblings in family-centered care and provide opportunities for emotional expression and psychosocial support.
OBJECTIVE:To examine the associations between symptom clusters and quality of life (QoL) in pediatric liver transplant recipients. DESIGN AND METHODS:From June 2022 to June 2023, a cross-sectional study was conducted with 129 pediatric liver transplant recipients (mean age: 4.1 years old) at 3 tertiary hospitals in Guizhou Province, China. QoL and symptom clusters were measured using the validated Chinese version of Pediatric Quality of Life Inventory Measurement Models and the Modified Transplant Symptom Occurrence and Symptom Distress Scale, respectively. The data were analyzed using the Pearson correlation and linear regression. RESULTS:The mean QoL score was 70.05 ± 19.37. Pearson correlation revealed that neurological system-related (r = -0.560 to -0.282, p < 0.05), digestive system-related (r = -0.522 to -0.160, p < 0.05), and medication-related (r = -0.648 to -0.344, p < 0.05) symptom clusters were negatively correlated with the overall QoL scores and all dimensions. Linear regression showed that the child's primary disease diagnosis (β = -0.157, p = 0.038) and neurological- (β = -0.436, p < 0.001), digestive- (β = -0.326, p < 0.001), and medication-related symptom clusters (β = -0.161, p = 0.025) were significant predictors of QoL (adjusted R2 = 0.385, p < 0.001). CONCLUSIONS:The QoL of pediatric liver transplant recipients was sub-optimal and warranted clinical attention. The neurological-, digestive-, and medication-related symptom clusters are significant predictors of QoL. Nursing care including assessment and management of these key symptom clusters may be considered to improve the well-being of children after liver transplantation. IMPLICATIONS TO PRACTICE:These findings highlight the need for routine screening of symptom clusters in pediatric liver transplant recipients and for developing targeted nursing interventions to manage co-occurring symptoms, thereby improving health-related quality of life in this population.
BACKGROUND:Children with medical complexity (CMC) often require highly individualized care environments in everyday living settings. Nurses play key roles in coordinating care and optimizing these environments; however, their specific practices have not been fully elucidated. PURPOSE:This study aimed to clarify nursing practices for optimizing care environments for CMC in everyday living settings. DESIGN AND METHODS:A qualitative interpretive description study was conducted with nurses from hospitals, home-visit nursing agencies, and community-based services in Japan. Participants were recruited using purposive and snowball sampling between July 2023 and February 2024. Semi-structured interviews explored nurses' experiences of optimizing care environments for CMC. Data were analyzed using reflexive thematic analysis. RESULTS:Seventeen female nurses with a mean of 16 years (SD = 5.4) of CMC-related care experience participated. Five themes were identified: (1) supporting autonomous decision-making by CMC and their families; (2) organizing daily living environments for safety, comfort, and holistic well-being; (3) fostering family empowerment; (4) preparing service environments to improve service quality and support; and (5) organizing community environments for safe and sustainable living. PRACTICE IMPLICATIONS:Nurses play key coordinating roles in optimizing multidimensional care environments through collaboration with families and multidisciplinary teams. These practices may inform community-based nursing interventions, strengthen family empowerment and decision-making, and support integrated care systems that promote safe and sustainable living for CMC and their families.
BACKGROUND:Rumination includes maladaptive forms, such as brooding, and potentially adaptive forms, such as positive rumination. Families navigating the chronic physical decline and lifelong rehabilitation needs of children with Duchenne muscular dystrophy (DMD) may be susceptible to such thought patterns. We examined associations between maternal rumination, maternal well-being, and children's motor function and balance. METHODS:Forty-one children with DMD (6-17 years) and their mothers (24-43 years) participated. A consecutive convenience sampling strategy was used. Maternal rumination was measured with the Ruminative Responses Scale (RRS)-short form and the Positive and Negative Rumination Scale (PNRS); well-being with the Warwick-Edinburgh Mental Well-being Scale-short form. Child function and balance were assessed using the Motor Function Measure-32 and Pediatric Functional Reach Test. RESULTS:Spearman correlations showed that maternal well-being was negatively associated with RRSsf Brooding and Total Rumination scores and positively associated with the PNRS Positive Rumination total score (p < 0.05). The PNRS Enjoy Happiness subscale was positively associated with children's motor function and balance (p < 0.05). A greater number of siblings with disabilities was associated with higher scores on the PNRS Negative Attribution subscale (p < 0.05). CONCLUSION:These cross-sectional findings indicate a dual pattern of associations between maternal cognitive strategies and study outcomes in DMD: maladaptive brooding was associated with lower maternal well-being and was more pronounced with longer caregiving duration, whereas positive rumination was associated with better mental well-being and with higher child motor function. IMPLICATIONS TO PRACTICE:Given the correlational design, these associations underscore the potential value of integrating caregiver psychosocial screening into long-term rehabilitation models.
INTRODUCTION:The aim is to adapt the CPS into Turkish and evaluate its psychometric properties specifically among mothers of hospitalized neonates. METHODS:This cross-sectional study included 149 mothers at a university hospital NICU. Cross-cultural adaptation followed Beaton et al.'s five-stage framework. Psychometric evaluation included internal consistency (Cronbach's α and McDonald's ω), confirmatory factor analysis (CFA) using both maximum likelihood on Pearson correlations and unweighted least squares on polychoric correlations, convergent and discriminant validity, and criterion-related validity with the Barrett-Lennard Relationship Inventory empathy subscale. RESULTS:The Turkish CPS demonstrated excellent internal consistency (α = 0.961, ω = 0.911). The two-factor model showed excellent fit under polychoric-ULS estimation (CFI = 0.99, RMSEA = 0.001, SRMR = 0.046), and all standardized factor loadings exceeded 0.75. However, the one-factor and two-factor models showed almost identical fit, and the two subscales were highly overlapping, indicating that discriminant validity between them was not established. Significant positive correlations with empathy scores provided support for criterion validity. CONCLUSION:The Turkish CPS demonstrates strong internal consistency and provides initial evidence for model fit in the NICU; however, discriminant validity between the two subscales was not supported, and the total score may be more appropriate than subscale-level interpretation. The findings support the cross-cultural applicability of Swanson's Theory of Caring and emphasize the necessity of using polychoric-based CFA methods for ordinal nursing data. IMPLICATIONS TO PRACTICE:The Turkish CPS provides pediatric nurses and researchers with a brief, theory-based tool to assess maternal perceptions of professional caring in the NICU.
BACKGROUND:Early infancy is a critical period for gross motor development. Although tummy time is widely recommended, evidence regarding whether the support surface influences its developmental benefits is limited. METHODS:This randomized controlled trial included 30 healthy infants aged 0-6 months, who were randomly allocated to a playmat group (n = 15) or a mattress group (n = 15). Both groups performed supervised, age-adjusted tummy time three times daily for two weeks. Gross motor development was assessed before and after the intervention using the Denver Developmental Screening Test. RESULTS:Gross motor scores significantly improved in both groups. The playmat group increased from 5.20 ± 1.14 to 7.13 ± 1.06, while the mattress group increased from 5.07 ± 1.16 to 6.80 ± 1.21. Between-group comparison showed a significantly greater improvement in the playmat group (mean difference = 0.20, 95% CI 0.01-0.39; p = 0.041; Cohen's d = 0.78). CONCLUSION:Structured tummy time improved gross motor development in infants aged 0-6 months, with greater improvement observed on a playmat than on a mattress. IMPLICATIONS FOR PRACTICE:Pediatric nurses should recommend supervised age-appropriate tummy time on firm, flat, and stable surfaces and provide practical guidance to parents regarding safe positioning, frequency, duration, and infant tolerance. This low-cost intervention can be integrated into infant developmental education in primary healthcare and home environments.
PURPOSE:This study was conducted to examine the relationship between parents' levels of awareness of child abuse and their cognitions regarding abuse. METHOD:This descriptive study was conducted with 386 parents of children aged 4-6 years who visited 8 family health centers in Sivas province, Türkiye. Data were collected using the Demographic Information Form, the Child Neglect and Abuse Awareness Scale, and the Child Abuse Beliefs Scale, and were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation analysis in SPSS 23.0. RESULTS:While mothers constituted 80.8% of the participants, 70.5% of the parents had not previously received training on child neglect and abuse. The mean score on the Parental Abuse Awareness Scale was 53.69 ± 6.15, while the mean score on the Abuse-Related Cognitions Scale was 38.38 ± 8.93, indicating a moderate level. The awareness level showed a significant difference according to the number of children and place of residence, the cognition level showed a significant difference according to maternal and paternal educational status, the child's sex, income level, the mother's employment status, and previous training on child neglect and abuse (p < 0.05). Additionally, a weak positive significant correlation was found between awareness and cognition levels (r = 0.249; p < 0.001). CONCLUSION:It was determined that parents' child abuse awareness and cognition levels are affected by various factors, and as abuse awareness increases, cognitive distortion levels also increase. PRACTICE IMPLICATIONS:It is recommended to organize training programs aimed at improving parents' awareness and cognition levels regarding abuse and neglect.
