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Chen T, Chen Q, Lin Z, Ye J. Family participatory clown therapy in venipuncture in hospitalized children: A non-randomized controlled trial. PLoS One 2024; 19:e0305101. [PMID: 39052600 PMCID: PMC11271897 DOI: 10.1371/journal.pone.0305101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/18/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE To explore the effectiveness of family participatory clown therapy in venipuncture in hospitalized children. METHODS We recruited 104 children aged 3 to 6 years for a non-randomized controlled trial from March to December 2022. All participants required peripheral venepuncture infusions for treatment. The children were assigned to either the control group (n = 52) or the experimental group (n = 52).Standard care was utilized in the control group. In the experimental group, two clown nurses and a parent provided family participatory clown therapy for 35-45 minutes per child before, during, and after venipuncture. We assessed children's pain (FLACC and W-B FPS), anxiety (VAS-A), medical fear (CFS), crying incidence, compliance, parental anxiety (S-AI), and parental satisfaction. RESULTS At venipuncture, the FLACC score was lower in the experimental group (4.46±2.053) compared to the control group (5.96±2.441), the W-B FPS score was also lower in the experimental group (4.96±2.392) than in the control group (6.35±2.266), with a statistically significant difference (P<0.05).The children in the experimental group had lower levels of anxiety, medical fear, crying, and parental anxiety than the control group. In addition, child compliance and parent satisfaction were higher in the experimental group than in the control group, with statistically significant differences (P<0.05). CONCLUSION Family participatory clown therapy can reduce pain, anxiety, medical fear, and crying during venipuncture in children. It can also improve venipuncture compliance, reduce parental anxiety, and increase parental satisfaction.
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Affiliation(s)
- Tianyu Chen
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian, China
| | - Qiying Chen
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Zhenhua Lin
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Jingfang Ye
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian, China
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Alvarenga WDA, da Cruz IEC, Leite ACAB, Machado JR, Dos Santos LBPA, Lima RAGD, Nascimento LC. "God gives me hope!": Hospitalized children's perception of the influence of religion in coping with chronic illness. J Pediatr Nurs 2024; 77:13-20. [PMID: 38471371 DOI: 10.1016/j.pedn.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE The mechanism of the impact of religion on health is still unclear, especially in children and adolescents with chronic illness who live in religious contexts. This study aimed to understand the influence of religion on coping with chronic diseases from the perspective of hospitalized children and adolescents diagnosed with cancer, type 1 diabetes mellitus and cystic fibrosis. DESIGN AND METHODS Qualitative descriptive research used photo-elicitation interviews with 35 Brazilian children and adolescents with cancer, type 1 diabetes mellitus and cystic fibrosis, aged between 7 and 17 years old. A thematic analysis approach was used to analyze qualitative data. RESULTS Participants were diagnosed with cystic fibrosis (14.3%), cancer (57.1%), and type 1 diabetes mellitus (28.6%) and 82.9% had a religious affiliation. Three themes were constructed: finding strength and support in the relationship with the divine, religion as an important source of meaning, and religious practice as a promoter of well-being. These themes demonstrate that children and adolescents themselves perceived their illness as a journey through which their faith grew. CONCLUSIONS This research shows the influence of religion on the positive coping of chronic illness, being a source of strength and support from the relationship with the divine, as well as offering a source of meaning, purpose and well-being based on religious practices. PRACTICE IMPLICATIONS This study supports clinical practice, based on the recognition of the patient as a religious and spiritualized person who has spiritual beliefs and needs that are capable of influencing treatment.
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Affiliation(s)
| | | | - Ana Carolina Andrade Biaggi Leite
- University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil; Public University of Navarre, Spain
| | - Júlia Rezende Machado
- University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil.
| | | | - Regina Aparecida Garcia de Lima
- University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil.
| | - Lucila Castanheira Nascimento
- University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil.
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Demetriou EA, Boulton KA, Bowden MR, Guastella AJ. Adjustment and homesickness in hospitalised children: A systematic review. Clin Psychol Rev 2024; 110:102431. [PMID: 38626645 DOI: 10.1016/j.cpr.2024.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
Children can experience significant distress during hospitalisation, as a result of the treatment process and due to psychosocial factors impacting their adjustment to the hospital environment. Such factors can contribute to negative outcomes for the child. Despite this, limited research focus has been placed on understanding the psychosocial factors that contribute to a child's distress to inform support strategies that can improve the experience of hospitalisation across paediatric conditions. The objectives of this review were to synthesise the qualitative and quantitative literature on psychosocial factors associated with hospital adjustment and to identify risk and protective factors that influence the adjustment process. The literature search (1980 to February 2024: CINAHL / Embase / Medline / PsychINFO and Web of Science databases) identified thirty-four studies. Poor hospital adjustment, anxiety, depression and homesickness, were reported by the majority of hospitalised children. Several demographic and psychosocial factors were identified in the quantitative synthesis to contribute to poor adjustment. Child age, temperament, attachment style, past negative hospital experiences, homesickness and fear cognitions, were all associated with adjustment to the hospital environment. Homesickness was identified as a particularly understudied and important construct. Theoretical and methodological considerations are discussed, and recommendations made for future research that can further support inpatient children and their families.
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Affiliation(s)
- Eleni Andrea Demetriou
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Kelsie Anne Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Michael Russell Bowden
- Mental Health Branch, NSW Health; Sydney Children's Hospitals Network; Discipline of Psychiatry, Westmead Clinical School and The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Adam John Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia.
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Pattabi A, Nazarene A, Varghese S, Hassan SM, Nashwan AJ, Patil SK, Singh K. Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar. Front Pediatr 2024; 12:1279033. [PMID: 38774295 PMCID: PMC11106397 DOI: 10.3389/fped.2024.1279033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/24/2024] Open
Abstract
Background "Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. Aim This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. Methods This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. Results A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. Conclusion The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.
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Affiliation(s)
- Amudha Pattabi
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Ananth Nazarene
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | - Sejo Varghese
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdulqadir J. Nashwan
- Department of Nursing Education and Practice Development, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Surekha Kiran Patil
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
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Ayan G, Şahin ÖÖ. Effect of therapeutic play based training program on pre- and post-operative anxiety and fear: A study on circumcision surgery in Turkish Muslim children. J Pediatr Urol 2023:S1477-5131(23)00194-8. [PMID: 37202291 DOI: 10.1016/j.jpurol.2023.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/29/2023] [Accepted: 04/26/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Developmentally appropriate pre-surgical educational programs can help alleviate the anxiety of both children and parents. As one of the most common pediatric surgical procedures is circumcision; and they may experience anxiety and fear before and after this surgical procedure, this study is considered to make an important contribution to the literature. OBJECTIVE This study aimed to examine the effect of therapeutic play based training program on pre- and post-operative anxiety and fear levels of children aged 8-11 years who would undergo circumcision. STUDY DESIGN This was a quasi-experimental study that consisted of a pre- and post-intervention and control groups; and concluded with 60 children aged 8-11 years (intervention group: 30 and no intervention/control group: 30). Child and Parent Information Form, Childhood Anxiety Sensitivity Index (CASI) and Fear for Medical Procedures Scale (FMPS) were used as data collection tools. Children in the intervention group applied a "therapeutic play-based training program" 2 h before they underwent circumcision surgery. Therapeutic toys used in the educational program has designed by researchers. RESULTS After the training program, children in the intervention group obtained lower CASI (preop t = 6.383, p < .001; postop t = 8.763, p < .001) and FMPS (preop t = 6.331, p < .001; postop t = 9.366, p < .001) total mean scores than those in the control group. DISCUSSION This study was concluded that the therapeutic play based training program used to prepare children for circumcision surgery was effective in reducing their pre- and post-operative anxiety and medical fears. Considering that male circumcision is a religious and cultural necessity in Turkey, further studies can also examine whether the anxiety and medical fear scores differ in study groups that include children who are not Muslim or live in a different country, and whether the training program will be effective in reducing their anxiety and medical fears. CONCLUSIONS A therapeutic play based training program can be used to prepare children for circumcision in the preoperative period.
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Affiliation(s)
- Gülbahar Ayan
- Pediatric Clinic, Karabuk Provincial Health Directorate, Safranbolu State Hospital, Karabuk, Türkiye
| | - Özlem Öztürk Şahin
- Department of Pediatric Nursing, Faculty of Heath Sciences, Karabuk University, Karabuk, Türkiye.
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Ogihara H. Development and validation of the Distracting Ingenuity Promotion Scale for paediatric nurses to support the psychological outcomes of paediatric patients and their families: A survey-based cross-sectional cohort study. Nurs Open 2022; 9:1653-1666. [PMID: 35274821 PMCID: PMC8994938 DOI: 10.1002/nop2.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/24/2021] [Accepted: 01/30/2022] [Indexed: 11/24/2022] Open
Abstract
Aim To develop and validate the Distracting Ingenuity Promotion Scale (DIPS) for paediatric nurses. Design Cross‐sectional study using anonymized self‐administered questionnaires. Methods From July–November 2013, paediatric nurses working in the wards or outpatient departments in 39 medical institutions in Japan were enrolled in the survey. Data were analysed using the Student's t‐test, Mann–Whitney U test and analysis of variance test. Exploratory and confirmatory factor analyses were performed to validate the factors in the DIPS. Cronbach's α was used to calculate the reliability of the DIPS. Results The DIPS included five subscales comprising 21 items. The goodness‐of‐fit indices for confirmatory factor analysis had a Comparative Fit Index of 0.923 and a Root Mean Square Error of Approximation of 0.059 and fulfilled the standard external validity criteria. Cronbach's α was 0.707–0.826 for each subscale and 0.895 for the overall scale.
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Affiliation(s)
- Hiroyuki Ogihara
- Pediatric Nursing, Faculty of Nursing, Ashikaga University, Ashikaga, Tochigi, Japan.,Graduate School of Science and Technology, Gunma University, Kiryu, Gunma, Japan
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Dewi MM, Nurhaeni N, Hayati H. The effect of storytelling on fear in school-age children during hospitalization. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 37184322 DOI: 10.4081/pmc.2021.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Indexed: 11/23/2022] Open
Abstract
Hospitalization places children in conditions that may nurture fears of new surroundings, strangers, and unknown actions. Storytelling can be administered as a distraction from the fears that a child experiences during treatment. This study aims to determine the effectiveness of storytelling against fear due to hospitalization in school-age children admitted to the hospital. This study used a quantitative approach with a pre-experimental design and the method used was nonequivalent control group pretest-posttest design. Subjects in this study consisted of two groups namely the intervention and the control groups. The total number of respondents was n=32 and located at the Maternity and Children Hospital in Indonesia. Bivariate analysis showed that storytelling intervention had a significant relationship with the fear of hospitalization among the hospitalized school-age children (p-value=0.001< 0.05). Also, there was a significant difference between the fear score in the intervention and the control groups (p-value=0.001<). Therefore, applying storytelling in the nursing intervention of pediatric patients in hospitals can be recommended to minimize the fear in children.
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Yin Y, Win ASS, Aung NN, Myo O, Swe KK. Experiences of family caregivers caring for critically ill children hospitalized in a pediatric intensive care unit: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:121-127. [PMID: 31433371 DOI: 10.11124/jbisrir-2017-003935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW OBJECTIVE This review aims to synthesize the best available evidence on the experiences of family caregivers in caring for their critically ill children who have been hospitalized in a pediatric intensive care unit. INTRODUCTION The participation of family caregivers in providing health care for critically ill children is increasingly important. Family caregivers are defined as adult family members, including parents and siblings, and are often described as hidden patients, as their health can be neglected when caring for others. Understanding how family caregivers of critically ill children describe their experience will be beneficial in providing family-centered care to these children. INCLUSION CRITERIA This review will consider studies that include adult family caregivers caring for children hospitalized with critical illness in pediatric intensive care units. Any family with a child experiencing a life-threatening illness that may result in significant morbidity or mortality will be considered. Studies that disclose the physical, psychosocial, financial and spiritual experiences of family caregivers will be considered with no geographical limitation. Only English-language studies will be included, with no date limitation. METHOD MEDLINE, CINAHL, PsycINFO, Embase, ProQuest Dissertations and Theses, Scopus, ASSIA, SciELO, and Google Scholar will be searched for relevant papers following the completion of the three-step search process. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Meta-aggregation will be performed, and a ConQual presented.
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Affiliation(s)
- Yin Yin
- Military Institute of Nursing and Paramedical Sciences, Yangon, Myanmar
- The Yangon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Aye Su Su Win
- Military Institute of Nursing and Paramedical Sciences, Yangon, Myanmar
- The Yangon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Ni Ni Aung
- Military Institute of Nursing and Paramedical Sciences, Yangon, Myanmar
- The Yangon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Ohnmar Myo
- Military Institute of Nursing and Paramedical Sciences, Yangon, Myanmar
- The Yangon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Kyawt Kyawt Swe
- Military Institute of Nursing and Paramedical Sciences, Yangon, Myanmar
- The Yangon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
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