Introduction: Hospitalization can cause severe disruption in sleep. This study aimed to assess mother’s perception of sleep quality and related factors in hospitalized toddlers. Methods: A cross-sectional analytical study was carried out among 384 mothers of toddlers in pediatric medical ward. Convenience sampling technique was used to enrol the mothers of toddlers who met the inclusion criteria. Socio-demographic and clinical characteristics of the toddlers were collected from the mothers by interviewing them and also from medical record. Mother’s perception of sleep quality and related factors were assessed through Karolinska sleepiness scale (KSS) and Potential hospital sleep disruption and noises questionnaire (PHSDNQ) respectively. Data were analysed using frequency, percentage, chi-square test, spearman’s rank correlation and multiple regression with SPSS software version 20. Results: Mother’s perception of sleep quality in toddlers showed that 98.2% had poor sleep. Related factors were: 96.1% by nurse physician interruption, 93.0% by cleaning staff interruption, 89.1% by administration of medications, 86.7% by checking vital signs, 85.2% by noises, 79.7% by pain, 75.8% by feeling anxious, 75.0% by disturbance created by neighbouring child, 70.1% by alarms on equipment, 59.9% by staffs conversation, 52.6% by lighting in a hallway (or) room, 25.5% by drawing blood (or) other test, 20.3% by room temperature (warm/cold), 11.7% by continuous pulse oximetry, and 8.6% by poor ventilation. Age of the mother, type of respiratory support and duration of intravenous line days had relationship with sleep quality significantly. Conclusion: Mother’s perception of sleep quality of toddlers revealed that 98.2% had poor sleep.
Introduction: Bone marrow biopsy and aspiration (BMBA) are invasive and painful procedures used to diagnose and monitor hematologic and non-hematologic disorders. Music therapy is known as a non- pharmacological approach to pain and anxiety management. However, there is an inconsistent findings regarding the effectiveness of music intervention on pain and anxiety control. We conducted a systematic review to synthesize and analyze the available evidence. Methods: In this systematic review, Google Scholar, PubMed, Web of Science, Cochrane, Scopus, and SID (Scientific Information Database) databases were searched until December 2023. Randomized controlled trials (RCTs) and quasi-experimental studies in English were eligible. Following screening, 4 studies (3 RCTs and 1 quasi-experimental study) were included. For meta-analysis, pain outcomes were analyzed using 3 RCTs, and anxiety outcomes were analyzed using all 4 studies (3 RCTs and 1 quasi-experimental study). Risk of bias was assessed using Cochrane tools (ROB-2 for RCTs, ROBINS-I for non-randomized studies). Meta-analysis was performed using RevMan 5.3, with standardized mean differences (SMDs) and 95% confidence intervals calculated for pain and anxiety outcomes. Result: Four studies (257 patients) were included in the review. Meta-analysis of the data showed listening to music during the bone marrow aspiration and biopsy may reduce pain (SMD -1.05, 95% CI -1.63 to -0.48; 3 trails), and anxiety (SMD -0.31, 95% CI -0.56 to -0.07). However, the certainty of evidence for both outcomes was assessed as very low according to the GRADE approach, due to serious risk of bias, inconsistency, and imprecision. Conclusion: Pain and anxiety are common during BMBA. While music therapy has been studied, the evidence is of very low certainty, so no strong clinical recommendations can be made. More high-quality, large-scale studies with standardized methods are needed to determine if music therapy is effective.
Introduction: Technological advancements in healthcare have greatly enhanced patient care but may overshadow essential elements like empathy and compassion. The Theory of Communion-in-Caring (TCIC) addresses this concern by focusing on the relational and communicative dimensions of care, thereby promoting deep, empathetic connections between nurses and patients. This study explores the framework, pragmatic utility, and future direction of TCIC within contemporary healthcare. Methods: This study employs a qualitative theory-building approach that incorporates conceptual analysis, framework development, and pragmatic utility assessment. Existing caring theories, including Watson’s Human Caring, Leininger’s Culture Care, and Boykin & Schoenhofer’s Nursing as Caring, are examined to examine theoretical foundations. Pragmatic utility is evaluated through case studies of healthcare professionals who applied TCIC principles in clinical settings, with a focus on patient outcomes and satisfaction. Results: TCIC offers a transformative framework for patient care, prioritizing human connection and shared understanding. Nurses who applied TCIC principles reported enhanced patient relationships, increased patient satisfaction, and improved health outcomes. The theory’s emphasis on relational and communicative aspects of care distinguishes it from other caring models, offering a more holistic approach to nursing that addresses physical, emotional, and spiritual needs. Conclusion: TCIC with its unique focus on compassionate care, not only advocates for a shift from task-oriented nursing to a more relational and person-centered approach but also has the potential to revolutionize healthcare. As healthcare professionals increasingly recognize the value of empathy and human connection, TCIC can promote more holistic, compassionate, and patient-centered care.
Introduction: As the global population continues to age, ensuring older adults’ well-being and promoting healthy aging have become increasingly important. In this context, ageism has emerged as a growing public health concern. This study aimed to investigate the relationship between ageist attitudes and adverse childhood experiences among health sciences students. Methods: In this cross-sectional study, 1,064 undergraduate students from four universities in Turkey completed an online survey including a personal information form, the Ageism Attitude Scale (AAS; possible range 23–115, higher scores indicating more positive attitudes), and the Adverse Childhood Experiences Questionnaire (ACE-Q; possible range 0–10, higher scores indicating more ACEs). Group comparisons in ACE-Q scores by selected characteristics were conducted using independent samples t-test, and the association between AAS total score and ACE-Q total score was examined using Pearson correlation (two-tailed). Results: The mean (SD) scores were 66.29 (9.44) for the AAS and 0.85 (1.49) for the ACE-Q. The most commonly reported ACE item was psychological abuse (21.1%). Pearson correlation showed no significant association between AAS and ACE-Q scores (r=0.036, P=0.247). ACE-Q scores were significantly higher among participants living with an older adult and among those who did not wish to live with an older adult family member in the future (P<0.05). Conclusion: Students demonstrated moderately positive attitudes toward older adults, and approximately one in three participants reported at least one adverse childhood experience. Although AAS and ACE-Q scores were not significantly correlated, higher ACE-Q scores were observed in subgroups defined by living arrangements with older adults and future co-residence preferences.
Introduction: Although cognitive interviewing is an efficient method for assessing and enhancing the face validity of self-report instruments, the lack of a structured framework can limit its effectiveness. This study aims to introduce and apply Tourangeau’s Question-and-Answer Framework as a systematic guide for conducting cognitive interviews and enhancing face validity. Methods: This methodological study was conducted in two phases. First, Tourangeau’s theoretical framework comprising the four cognitive stages of comprehension, retrieval, judgment, and response was used to structure interview probes. Second, this framework was applied in a case study to improve the Nursing Talent Identification Scale. Cognitive interviews using think-aloud and verbal probing techniques were conducted with 20 first-year undergraduate nursing students selected via purposive sampling. Data were analyzed through qualitative content analysis explicitly guided by Tourangeau’s stages. Results: The application of Tourangeau’s framework enabled the precise identification and categorization of item-level issues. Analysis of the initial 95-item pool revealed problems primarily related to ambiguous wording and misinterpreted intent. Most issues were traced to the comprehension (16 items) and judgment (11 items) stages, leading to the revision of 20 items. For example, items with vague phrases (e.g., "relationships between components") or negative wording were clarified. Conclusion: Tourangeau’s framework provides a systematic approach to conducting cognitive interviews and improving face validity in healthcare research. Its application enhanced the Nursing Talent Identification Scale; however, the small, region-specific sample may limit generalizability. Future studies should apply this framework in larger and more diverse populations to strengthen its external validity and broader applicability.
