Purpose The purpose of this study was to review studies investigating the effect of bereavement care provided for parents in the neonatal intensive care unit.
Methods We conducted a literature review of databases (MEDLINE, Embase, Cochrane Library, and CINAHL) for studies published in English and four databases (RISS, KISS, NANET, and KoreaMed) for Korean studies. The selection criteria included original articles that evaluated the parents’ perceptions or responses to bereavement care provided in the neonatal intensive care unit. Of 889 articles from the initial screening, 66 articles underwent full-text review and five articles were finally selected for analysis.
Results None of the studies was conducted in Korea. Only one study used a randomized control trial design. The forms of bereavement care reviewed included a provision of a memory package, grief information, and emotional and/or social support from peers or health care providers. The effectiveness of bereavement care was measured by including grief, social support, and depression.
Conclusion Bereavement care can be considered to be beneficial for relieving grief reactions and enhancing the personal growth of bereaved parents. Future research should assess the needs of bereaved parents in Korea. Nurses may play a role in developing the bereavement care for parents.
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Purpose The purpose of this study was to review pain alleviation intervention for Korean pediatric inpatients with reference to Kolcaba’s Theory of Comfort.
Methods Whittemore and Knafl’s integrative review methods were used. Articles published in Korean or English were identified through electronic search engines and scholarly web sites. Scientific, peer-reviewed articles published between 2006 and 2019 were included in this review. Twenty-seven articles that met the inclusion criteria were analyzed.
Results Among the 27 selected studies, three were descriptive, while 24 were interventional studies related to pain alleviation interventions. Pain alleviation interventions showed three attributes: identifying pain triggers and the child’s response to pain, effective strategies for pain relief, and nurses’ competence in pain management.
Conclusion The three attributes of pain alleviation interventions using the theory of comfort shown in this study were identified as important factors for obtaining evidence-based data on how to enhance the comfort of hospitalized pediatric patients. In addition, the attributes of pain alleviation interventions should be considered for hospitalized pediatric patients and their family members.
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Purpose This study aimed to characterize the relationship between parental stress and nurses’ communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU).
Methods The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents’ perceptions of nurses’ communication ability and styles were measured using a questionnaire.
Results The average scores for parental stress and nurses’ communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses’ perceived verbal communication ability. Higher scores for nurses’ verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby’s appearance and behaviors, and treatments in the NICU.
Conclusion The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.
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Purpose This prospective study was conducted to determine the incidence and related characteristics of respiratory medical device-related pressure ulcers (MDRPU) in children admitted to a pediatric intensive care unit (PICU).
Methods The participants were 184 children who were admitted to the PICU of P University Hospital from April 2016 to January 2017. Data were collected on the occurrence of respiratory MDRPU and characteristics regarding the application of respiratory medical devices.
Results Respiratory MDRPU occurred in 11.9% of participants (58.3%: stage I ulcers, 37.5%: mucosal ulcers). The devices associated with respiratory MDRPU were endotracheal tubes (54.2%), high-flow nasal cannulas (37.5%), and oximetry probes (8.3%). Respiratory MDRPU associated with an endotracheal tube were significant differences according to the site and strength of fixation, the use of a bite block and adhesive tape, skin dryness, and edema. In high-flow nasal cannulas, significant differences were found according to the site of fixation, immobility after fixation, and skin dryness.
Conclusion The occurrence of respiratory MDRPU is significantly affected by the method and strength of fixation, as well as skin dryness and edema. Therefore, appropriate consideration of these factors in nursing care can help prevent respiratory MDRPU.
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Purpose This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors.
Methods The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, x2 test, t-test, and logistic regression analyses.
Results The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age (x2=14.10, p=.007), admission type (x2=7.40, p=.007), use of physical restraints (x2=26.11, p<.001), RASS score (x2=14.80, p=.001), need for oxygen (x2=5.31, p=.021), use of a mechanical device (x2=9.97, p=.041), feeding (x2=7.85, p=.005), and the presence of familiar objects (x2=29.21, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002).
Conclusion Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.
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Purpose This study was conducted to assess the knowledge and performance of developmentally supportive positioning for premature infants (DSPP) among neonatal intensive care unit (NICU) nurses.
Methods The participants in this study were 131 nurses working in the NICU at five university hospitals in Daejeon and the city of Cheong-ju. The collected data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0.
Results NICU nurses’ average DSPP knowledge score was 24.7 out of 33.0, and their average DSPP performance score was 3.2 out of 4.0. A statistically significant positive correlation was observed between knowledge and performance of DSPP (r=.32, p<.001).
Conclusion To improve the level of NICU nurses’ knowledge and performance of DSPP, educational programs should be developed and their effectiveness should be verified.
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Purpose The purpose of this study was to examine the paternal stress and nursing support as perceived by fathers of high risk infants admitted to Neonatal Intensive Care Units (NICU).
Methods The study participants included 88 fathers of high risk infants in NICUs. Their parental stress and nursing support were measured using a self-report questionnaire.
Results The parental stress level of the fathers was 3.57 of a possible 5. Among the parental stress items, ‘Relationship with infant and parental role’ had the highest scores. The perceived nursing support level was a relatively high, 3.90 on a 5-point scale. The lowest score was for the item ‘showed concern about my well-being.’ The parental stress was lower in fathers with low income, higher in fathers in nuclear families and when the infants’ condition was serious.
Conclusion The findings indicate that fathers of high risk infants experience intense parental stress. Thus when designing care to provide support for these fathers and their infants, it is necessary to encourage the fathers’ engagement, provide information on how to respond to the baby, and include supportive care to the fathers.
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PURPOSE The patient's perspective in the assessment of quality of care has become increasingly important. The purpose of this paper was to introduce the concept of 'QUality Of care Through patient's Eyes (QUOTE)', to analyze the papers using QUOTE through an integrative review method, and to present the attributes of the QUOTE evaluation. METHODS Data were collected from electronic databases.
Inclusion criteria were publication in English from 1997 to 2013, as a peer-reviewed research article, with an empirical study focused on QUOTE. Thirty two papers met the criteria and were analyzed. RESULTS QUOTE had been applied to various groups of patients such as those with various diseases since 1997 in the Netherlands. Four themes were retrieved from synthetic analysis of the thirty-two papers using QUOTE; 1) acceptance of individuation of the patient and family, 2) evaluation of diverse nurses' competencies, 3) evaluation of quality of nursing environments, and 4) participation of patient in the whole process of evaluation. CONCLUSION The strengths of QUOTE are that it attempts to overcome the conceptual and methodological problems associated with evaluation of quality of care. Our results imply that QUOTE evaluation could be an effective strategy to improve care of patients in clinical setting.
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PURPOSE This study was done to identify the effectiveness of the 'intervention - mother's recorded song' on low-birth weight infants in an neonatal intensive care unit (NICU). METHODS This study was conducted with a nonequivalent control group pre-posttest quasi-experimental design and the participant group was low-birth weight infants who were admitted to the NICU. Forty-eight infants, 24 in each from two groups, the experimental and control group, participated in the study. RESULTS For physical response according to vital signs, there were no significant statistical differences in heart rate, respiration rate and pulse oximetry saturation between the experimental group and the control group. For behavioral state, there was a significant statistical difference between the experimental and control group. CONCLUSION The study results indicate that the intervention using mother's song had some significance as a nursing intervention with positive impacts. Such an intervention can help pediatric nurses improve infants' stabilization of their vital signs and behavioral states. By showing the effectiveness of such an intervention, the results of this study provide further evidence-based information in developing the practice of pediatric nursing.
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Since 1990, descriptive studies about the concept of client advocacy have been published in the health journals.
However, empirical studies of the concept are still lacking.
There are not enough bases to apply the concept of client advocacy in nursing practice. The purpose of this paper is to encourage empirical research about client advocacy by clarification of the concept and to discusses application of the theory in child healthcare. The literature was reviewed that empirical studies on client advocacy conducted after the year 2000. The changing trends in the client advocacy concept was examined; it was changed from the philosophical concept to nursing action and changed from individual advocacy to collective advocacy, with the rise of the self advocacy concept. The research trends on client advocacy evolves from descriptive study to quasi-experimental study and instrument development study, with diversification and expansion of research methods, advocates, clients and settings. The advocacy role of the nurse in child healthcare is significant due to the child's lack of self determination ability. In ill child care, the application of individual advocacy is potent, while in healthy child care, collective advocacy, policy advocacy, and social advocacy is effective.
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PURPOSE This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. METHODS Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. RESULTS Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers.
Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. CONCLUSION Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.
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PURPOSE This study was done to provide basic data for developing nursing interventions to enhance quality of life of pediatric patients with cancer (children and adolescents) by examining the quality of life and related factors. METHODS Participants were 134; 67 pediatric patients and 67 parents. The PedsQL(TM) 3.0 Cancer Module was employed to measure quality of life in the participants. The related factors included general and clinical characteristics of the participants. RESULTS Mean score for quality of life in the patients was 75.07, and mean score for patient quality of life as perceived by their parents was 64.40. Among the quality of life subscales, treatment anxiety had the highest score whereas nausea had the lowest score. Mean score in adolescent patients (13-18 years of age) was 71.62, lower than the 78.04 for child patients (8-12 years of age).
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, Hyejung Lee
, Shin-Jeong Kim
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