Purpose This study aimed to identify the effects of nurse’s knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management and provide the primary data necessary for the efficient intravenous injection management of hospitalized children.
Methods This study was a descriptive study design with 141 nurses who perform pediatric intravenous therapy care at eight hospitals in the S, C, D, and S regions. Data were collected from September 1, 2023, to September 30, 2023.
Results Nursing performance of pediatric intravenous injection management was significantly positively correlated with knowledge (r=.44, p<.001) and self-efficacy (r=.19, p=.022). Nurses’ knowledge (β=.42, p<.001) and self-efficacy (β=.22, p=.004) of pediatric intravenous injection management and care were identified as significant predictors of nursing performance thereof, with these two factors explaining 21.9% of the variance.
Conclusion This study found that knowledge and self-efficacy of pediatric intravenous injection management are significant predictors of the practice of intravenous care among pediatric nurses. Therefore, considering these factors, education and intervention programs should be developed to enhance pediatric nurses' knowledge and self-efficacy regarding intravenous injection management.
Purpose With the recent increase in interest in patient safety, prevention of falls in hospitalized children has become important. This study aimed to identify the incidence rate of falls among hospitalized children and explore fall-related characteristics.
Methods This retrospective descriptive study analyzed the medical information of 18,119 patients aged <18 years admitted to a general hospital in South Korea from electronic medical records and fall event reports between January 1, 2018, and September 30, 2023. The study variables included the general and clinical characteristics of the fall group and fall-related characteristics of the fall events. This study employed descriptive statistics and a chi-square test using IBM SPSS version 26.0.
Results Among the patients, 82 fall events were identified. Therefore, the fall incidence rate was 4.5 falls per 1,000 patients. Furthermore, a statistically significant difference was found concerning the type of injury sustained between children >1 year old and those <1 year old, and most cases had no damage or bruises. More cases were found in which falls occurred two days after hospitalization in winter and summer than on the day or the day after hospitalization, which was a statistically significant difference. In addition, fall prevalence was higher between 8 am and 4 pm, and when no caregiver was present. Conclusion: Based on the results of this study, education and interventions to prevent fall events in infants and toddlers should persist throughout hospitalization, and it is necessary to guide continuous management and observation of the caregivers.
Purpose This study was conducted to investigate nurses’ perceptions and performance of family-centered care (FCC) at a children’s hospital in Sri Lanka and to explore the feasibility of implementing FCC in the context of the Sri Lankan healthcare system.
Methods A convergent, parallel, mixed-methods design was applied to understand Sri Lankan nurses’ perspectives on FCC. In total, 157 nurses working at a large teritagy children’s hospital responded to a self-report survey and 18 nurses participated in focus group interviews.
Results Of the factors of FCC, family participation in caring for children received the highest score (4.09±0.51) for perceptions, and information-sharing received the highest score (3.54±0.55) for performance. The qualitative data revealed the following five themes: (a) importance of the family in caring for children; (b) helping families during children’s hospitalization; (c) taking steps to implement FCC, even with imperfect knowledge; (d) barriers in the current situation; and (e) suggested strategies to promote FCC.
Conclusion Participants endorsed the concept of FCC and demonstrated some aspects of it in their day-to-day practice. The results indicate a clear knowledge deficit and several challenges, which need to be addressed to effectively implement FCC.
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Purpose This study was conducted to design services for improving the quality of care of hospitalized children with acute diseases.
Methods The service design process had four phases: discovery, definition, development, and delivery. The participants were 23 mothers of hospitalized children with an acute disease, and seven nurses and three doctors working at a pediatric hospital. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics.
Results The participants reported needs for explanations about the treatment, skillful nursing, and environmental improvements. The concept of the services was familiarity and enjoyment, aimed at solving the problems of unfamiliarity and boredom. A six-guideline was presented for improving the quality of care of hospitalized children with acute diseases: improvement of awareness, development of educational materials, improvement of skills, environmental improvements, play activities, and evaluations of user satisfaction.
Conclusion These findings indicate that nursing services should deliver familiarity and enjoyment to hospitalized children and their families. The findings of this study emphasize that the service design methodology can be used to improve the quality of care of hospitalized children with acute diseases.
Purpose The purpose of this study was to develop content for safety education to prevent hospital safety accidents among hospitalized children and to investigate the status of safety education performed by nurses.
Methods First, the Delphi method was used, with 18 experts, to develop educational contents for preventing safety accidents. Second, an exploratory survey was performed of the actual status of safety education for preventing safety accidents among hospitalized children using a questionnaire developed based on the Delphi method. The participants of this study were 159 nurses with at least 6 months of
work experience.
Results The educational content developed through the Delphi method for preventing safety accidents among hospitalized children contained seven domains (falls, injury, electric shocks/burns, suffocation/aspiration, poisoning/abuse, kidnapping, medical devices) with 44 topics. The item mean of nurses'perceptions of the importance of child safety education was 4.18, and the actual performance score was 3.72, which was a statistically significant difference (t=11.58, p<.001).
Conclusion These seven comprehensive domains of accident prevention education for hospitalized children are expected to be useful for interventions to support the safety of hospitalized children.
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Purpose This study aimed to compare the quality of nursing care as perceived by registered nurses and mothers of hospitalized children in South Korea.
Methods This was a descriptive study that recruited 70 mothers of hospitalized children and 70 nurses in pediatric units in university hospitals as participants. The quality of pediatric nursing care was measured using importance and performance scores for 19 items describing various elements of nursing care. The collected data were analyzed using descriptive statistics and the independent t-test.
Results The hospitalized children mothers’mean importance scores were significantly higher than those of the nurses (t=2.94, p=.004). However, there were no significant differences in the mean performance scores of nurses and mothers (t=0.91, p=.363) or between nurses’and mothers’perceptions of quality of nursing care, with the exception of a significant difference for the quality of explanations (t=2.78, p=.006). The quality of explanations was assessed more positively by nurses than by mothers.
Conclusion This study suggests that when developing strategies to improve the quality of nursing care in pediatric wards, ensuring that pediatric nurses provide detailed explanations should be considered as a way to improve the quality of nursing care in pediatric units.
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Purpose The aim of this study was to test whether maternal uncertainty and the general characteristics of mothers and children influenced maternal coping.
Methods In this cross-sectional study, 190 mothers whose children had been admitted to the pediatric ward of a general hospital completed self-report questionnaires during their children’s hospitalization. The questionnaires assessed the general characteristics of the mothers and children, maternal uncertainty, and maternal coping. Multiple regression analysis was used to test the research model.
Results In the multivariable model, help from one’s spouse (t=3.10, p=.002), religion (t=2.68, p=.008), overall ambiguity (t=2.64, p=.009), and family income (t=2.33, p=.021) were associated with higher coping scores.
Conclusion This research model presents possible guidelines for pediatric nurses to provide comprehensive and accurate information on children's illnesses and treatments for mothers of children hospitalized in general hospitals. In particular, nurses should pay more attention to mothers who are not receiving help from their spouses, are not religious, and have a low family income.
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Results Regression analysis showed that the model’s explanatory power was 37%. Safety policy and procedure, safety priority, disaster experience, and knowing a place of refuge were factors affecting the perception of safety nursing activities for children during hospitalization.
Conclusion Findings show that safety policy and procedures and safety priority are major factors that affect the perception of safety nursing activities and indicate that effective education programs on safety policy and procedure and safety priority are necessary to improve the perception of safety nursing activities.
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Purpose This paper is a report on the concept analysis of family-centered care for hospitalized children.
Methods The concept analysis approach of Walker and Avant was used. A search of multidisciplinary literature published between 1960 and 2016 was undertaken using the keyword ‘family centered care’ or ‘family centered nursing’ combined with hospitalized children. Attributes, antecedents, and consequences were inductively derived from the citations analyzed (n=19).
Results The attributes of family-centered care included (1) family respect, (2) collaboration, (3) family support, and (4) information sharing. These attributes are influenced by the ‘willingness of family to participate’, ‘competency and willingness of staff,’ and ‘institution policy and system.’ Additionally, family-centered care does significantly impact ‘the health of the children’, ‘family empowerment’ and ‘work satisfaction and self-confidence of staff’.
Conclusion Family-centered care of hospitalized children as defined by the result of this study will contribute to the theoretical foundation for application in pediatric nursing practice.
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Purpose Fatigue in mothers of hospitalized children is an important component for her child’s health. This study was done to identify factors influencing fatigue in mothers of hospitalized children.
Methods A descriptive correlation study design was used. Participants were 157 mothers of hospitalized children in a university hospital located in one city. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression.
Results Mean score for fatigue in mothers of hospitalized children was 2.11±0.53. There were significant differences in scores for fatigue in these mothers according to education, sleep satisfaction, and family support. Multiple regression analysis showed that the important factors related to fatigue in mothers of hospitalized children were parenting stress (β =.44), hours of sleep (β =-.25), and age (β =-.21). These factors explained 38% of the total variance.
Conclusion Research results suggest that nursing interventions for mothers of hospitalized children are needed in order to improve the comfort and health of the mothers and facilitate the recovery of their child.
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Purpose Involvement of families in rounds is one strategy to implement patient- and family-centered care to help families get clear information about their child, and be actively involved in decision making. The purpose of this paper was to identify the major concepts of family-centered rounds for hospitalized children.
Methods We searched five electronic databases for relevant articles and used Whittemore and Knafl’s integrative review methods to synthesize the literature. Articles published between June 2003 and January 2016 were reviewed and through full text screening 24 peer-reviewed articles were found that met the selection criteria for this review.
Results Through in-depth discussion and investigation of the relevant literature, four overarching components emerged: (a) cognition of parents and medical staff, (b) effective communication, (c) collaboration of family and medical staff, and (d) coaching of medical staff.
Conclusion For successful family-centered rounds positive cognition is important. Appropriate communication skills and consideration of multi-cultural family can lead to effective communication. Offering consistent and transparent information is important for collaboration between family and medical staff. Prior education on family-centered rounds is also important. Four major components have been identified as basic standards for implementing family-centered rounds for hospitalized children.
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Purpose The purpose of this study was to develop an instrument that evaluated QUality Of care Through patients’ Eyes for hospitalized child (QUOTE-Child), and examine the validity and reliability.
Methods Preliminary items were reviewed through expert content validity and face validity. To test the validity and reliability of the instrument, the data were collected from 221 care givers of hospitalized children. Data were analyzed using exploratory factor analysis, Pearson correlation coefficient, Cronbach’s alpha and Spearman-Brown coefficient.
Results Factor analysis yielded 19 items in four factors including 1) respect, 2) explanation, 3) kindness, and 4) skillfulness, with a cumulative explanatory variance of 70.68%. For criterion-related validity, a significant positive relationship was found between quality of care and pediatric family satisfaction. For internal consistency reliability, the Cronbach’s α was .93 (importance) and .95 (performance) for the overall instrument. The half split reliabilities were .86, .95 (importance) and .92, .97 (performance). The Cronbach’s α of 110 data was .92 (importance) and .94 (performance).
Conclusion Researchers and practitioners can use this instrument to systematically assess quality of care for hospitalized children and identify areas of support for hospitalized children and their family.
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PURPOSE This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. METHODS A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. RESULTS Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. CONCLUSION The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.
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PURPOSE The purpose of this paper was to explore the meaning of parent participation (PP), to clarify the concept of PP as a benefit to children and their families, and to increase understanding of PP in pediatric nursing practice. METHODS Walker and Avant's approach to concept analysis was used. A search of multidisciplinary literature published between 1994 and 2012 was undertaken using the keyword, 'parent participation' combined with hospitalized children.
Attributes, antecedents and consequences were inductively derived from the citations analyzed (n=30). RESULTS PP was identified as having three attributes: Negotiation, Performing caring activity, Providing individualized care. Antecedents of PP were 'Parents & pediatric nurses' attitudes', 'Children's age', 'Children's conditions'. Consequences of PP were 'Effective partnership', 'Mutual empowerment'. CONCLUSION Parent participation as defined by the results of this study should contribute a foundation for theory development in pediatric nursing practice.
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PURPOSE Humor is an important part of life. Humor has many benefits as an intervention for hospitalized children. Humor is one strategy that pediatric nurses can use to help children cope with illness and hospitalizations. The purposes of the study were to 1) review the definition of humor, 2) identify methods and skills in using humor as an intervention, 3) identify the effects of humor as an intervention, and 4) suggest further research. METHOD The design was a descriptive study with literature review. Previous studies were identified by searches of MEDLINE, CHNIAL, PUBMED and ProQuest. RESULTS Humor has positive physiological, psychological, social and communicative effects on patients and humor has a positive effect on the immune system. CONCLUSION The main point identified from this study suggests that humor as a nursing intervention be developed for nurses to use with children who are hospitalized.
Further research is needed to develop programs for humor as an intervention for health promotion and disease prevention in children.
PURPOSE The purpose of this study was to develop a program promoting self-esteem and to determine the effectiveness of the program for hospitalized school-aged children. METHOD The sample group consisted of 68 hospitalized children in a University Hospital located in Busan. The experimental group was given the program and feedback was obtained 3 times up until the day of discharge. Data were analyzed using t-test and 2-way ANOVA with the SPSS program package. RESULT There was a significant difference between experimental and control groups in self-esteem. CONCLUSION It was found that the program promoting self-esteem in school aged children was effective. The program, which was based on learning theory, was shown to be an effective and strong method to promote adjustment in hospitalized school-aged children.
PURPOSE The purpose of this study was to explore the fatigue of the mothers of the hospitalized children's mothers in descriptive study. METHOD Two hundred eighty three mothers who take care of the hospitalized children in three University hospitals were enrolled from June, 1 to October, 30, 2003. Data were collected using a questionnaire titled "Symptom Table on Fatigue Perception" designed by the Fatigue Research Committee of Japan, consisted of a total 30 items categorized into three sub-dimensions: the physical, the psychological and the neuro-sensory. SPSS was used for the analysis of data with 0.05 of significance. RESULT 1) The mean average fatigue score of subjects was 1.94(SD:.48): the physical fatigue revealed the highest value with a mean of 2.19(SD:.57), followed by psychological fatigue with a mean score of 1.85(SD:.52), neuro-sensory fatigue with a mean of 1.79(SD:.51). 2) With the respect to the general characteristics of hospitalized children and mothers, there were statistically significant differences in the mothers' fatigue perception by the child sex(t=-2.697, p=.008), the character of child(F=9.032, p=.000), the child condition compared to pre-hospitalization(F=3.523, p=.031), with or without support in domestic households(t=-1.981, p=.049), the amount of sleeping time(t=2.704, p=.007), and with or without of night-time sleep disturbance because of the child hospitalization(t=2.082, p=.038). CONCLUSION These results suggest that health care professional need to be aware of the persistent presence of the maternal fatigue related to the child hospitalization and the factors worsen the degree of the fatigue.
This study was done to evaluate the need and satisfaction for nursing care of the families with their hospitalized children. The data were collected through the questionnaire from March 15, 2002 to April 7. Subjects were the 103 families caring for their hospitalized children at pediatric ward in two university hospitals in Daegu. The nursing need instrument was developed by Seo(1999) and modified by the researcher of this study based on the classification of nursing care area(nursing assessment, direct nursing, education and counseling, and facilities and environment).
The nursing satisfaction instrument was developed by Wandelt & Ager(1974) and modified by Park(1994) based on classification of nursing care area (psychosocial care, physical care, general care, professional care, and communicative care). The results are summarized as follows: 1. The scores in the nursing need showed in the Direct nursing(3.41 +/- .42), Facilities and Environment(3.38 +/- .46), Education and Counseling (3.35 +/- .40), and Nursing Assessment(3.14 +/- .41) area in order. 2.The scores in the nursing satisfaction showed in the Psychosocial care(3.70 +/- .74), Commu- nicative care(3.60 +/- .72), General care(3.42 +/- .76), Professional care(3.38 +/- .82), and Physical care(3.32 +/- .70) area in order. 3.General characteristics of families which influence on the satisfaction showed a significant difference according to their educational(F=5.63, p=.001) and economical level(F=4.47, p=.006), and hospitalized experience(t=2.30, p=0.02). 4. There was no correlation between the nursing need and the nursing satisfaction.
The purpose of this study was to identify therapeutic play need and the degree of the nurses's therapeutic play performances perceived by hospitalized children's mothers, and then to compare the difference between the degree of the need and perceived performances. The subjects of this study consist of 121 hospitalized children's mothers. A questionaire for this study was 29 item likert type 4 point scale developed on the basis of literature review, hospitalized children's mother interview and researcher's clinical experiences. Data was analyzed by Paired t-test, t-test, ANOVA & Duncan's comparison. Results of this study are summarized as follows : 1. The degree of the therapeutic play need was measured to be high (3.20). The degree of perceived therapeutic play need by five components were followed as : physiologic suffering relief & enhancing play (3.39), growth & development facilitating play (3.26), instructional play (3.24), emotional well-being promoting play (3.18) and providing play tool & environment(2.97). 2.The degree of the nurse's therapeutic play performances perceived by mothers was measured to be low (1.60). The degree of perceived performances of the therapeutic play by the five components were followed as : physiologic suffering relief & enhancing play (1.87), instructional play (1.74), emotional well-being promoting play (1.64), providing play tool & environment (1.44) and growth & development facilitating play (1.42). 3. The difference between the degree of the therapeutic play need and nurese's perfor mances perceived by hospitalized children's mothers were significant statistically (t= 38.54, p=.0001). Also, five components of therapeutic play were significant statistically (p=.0001). Therapeutic play has unique benefits among health care intervention for children.
These findings will help in building of the theoretical framework of therapeutic play and enhancing the quality of nursing care for hospitalized children. Therapeutic play program for hospitalized children according to child growth & development and physiologic status are recommended to be developed.
Nurses working with families who has a hospitalized child are aware of the complexity of the tasks and stresses they deal with new setting of environment. The challenge is to assess the family coping activity that require the most immediate intervention for the effective nursing care for child and family. This study describe the family coping inventory for the clinical guidance to identify a family coping with stressors. The purpose of this study was to look at the factors related to the family's coping activity when the child was hospitalized. The data were collected with a questionnaire between July and August, 1999, in a sample of 106 families who have hospitalized child. Family coping was assessed using Family Crisis Oriented Personal Evaluation Scale(F-COPES). Data was analyzed using correlation coefficent and analysis of variance. Positive correlation was found between social support, reframe with mobilizing the family to acquire and accept help in sub-domain of family coping. Strongest correlation existed between the family's spiritual support and total family coping. The type of diagnosis, the level of family income, religion, and child's age were significantly different in family coping.
The result show that the family coping is affected by the characteristics of child and family, as well as the factors of coping activity. Therefore, early assessment of family coping skill and activity is important to the prevention of problem with function toward wholeness as a unit and child's well being. It can be used with a broad range of child's hospitalization process. It also serve as a nursing record and planning tool for documenting issues that may become priorities for future interventions.
The main purpose of this study is to identify nursing needs of parents who have hospitalized child. Research design is a descriptive survey. The subjects for the study were 79 parents who have hospitalized child at a pediatric ward of one of the general hospital attached to a university in J city. The data was collected by researchers using a structured questionnaire. The questionnaire was Liken type 5 point scale, composed of 5 categories with 61 items. The data was analyzed by SPSS/PC. The results of the study were as follows : 1) Mean score of nursing needs of subjects were 3.93 at 2nd day of admission and 3.99 at 7th day of ad mission. 2) Among the categories, the highest nursing need at the 2nd day and 7th day of admission was 'direct nursing', in desending order, 'facilities and environment', 'education and counseling', 'nursing assessment'. The lowest nursing need was 'reference'. 3) Differences between the nursing needs of subjects at 2nd day and 7th day were as follows ; (1) By categories, there was a significant difference only in the 'reference' category(t=2.74, P=.008).
(2) By items, there were significant differences in items of 'to check necessary materials(t=2.31, P=.024)', 'to understand family function and family relationship(t=2.12.
P=.041), 'to set up study room(t=2.22, P=.030)', and 'to mediate parent's meeting group(t=3.89, P=.000)'. The above result indicated that nursing needs of parents with hospitalized child were above average, especially very high in items about disease process, and items directly associated with treatment and nursing care. So, nurses have to focus on information about the patient's state of disease, treatment, test and procedure, and in efficiently giving direct nursing care to implement more effective care for the hospitalized children and their parents. And some future research is needed to identify the difference of degree of nursing needs of parents with hospitalized child according to admission duration using a different sample and a longer sampling interval.
PURPOSE This study was done to analyze children's play during hospitalization. METHOD Data were collected from 36 play situations of hospitalized children, ages 2 to 6, hospitalized at 4 general hospitals, one in each city, Seoul, Suwon, Daejeon and Daegu. All observations were made in pediatric units during free-play periods. Each child was observed for 5 minutes at each observation and observed three times at each play session. RESULTS: Of the children, 83.3% played on the bed. Play partners were mainly mothers. While 75.0% of children actively took part in play activity and 70.0% played with joy, 63.9% of play partners were more passive in the play. The most frequent play material was a small toy.
The level of play was early stage of social and cognitive play, and dramatic play was observed in a few children over the age of 3 years. The play activities were conversional play, reflections of therapeutic procedures, imagination, and exploratory play. In the conversional play, children converted hospital equipments into play materials. CONCLUSION It is recommended that health care team members should pay attention and actively participate in play of hospitalized children in order to help them have some control over the stress of the situation.
, Mi-Young Choi
, Jina Oh
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