Search Results (65)

Background/Objectives: The use of digital technologies among children and adolescents has been increasing exponentially, raising concerns about the potential impacts on physical, mental, cognitive, educational, and social development. Understanding these effects is key to informing clinical and educational practices and public policies that promote digital wellbeing in childhood and adolescence. The main objective of this study was to map the latest available scientific evidence on the patterns of digital technology use by children and adolescents and its main impact, identifying risk factors, opportunities, and strategies for promoting digital wellbeing. Methods: A rapid review was carried out following the Joanna Briggs Institute (JBI) guidelines. Quantitative, qualitative, and mixed studies published between 2020 and 2025, in Portuguese or English, that addressed the use of digital technologies by children and adolescents were included. The assessment of methodological quality was based on JBI’s Critical Appraisal Tools. Results: Ten studies from diverse contexts showed an association between excessive screen time and risks of sedentary lifestyles, sleep disorders, anxiety, depression, attention difficulties, and low academic performance. Occasional benefits arose with adult mediation and educational use; parental mediation and socioeconomic background were key factors. Conclusions: The use of digital technologies is a complex and multifactorial phenomenon that requires integrated approaches; the promotion of digital literacy, public policies for equitable access to quality digital resources, and longitudinal and intercultural studies are recommended to clarify causal relationships and adapt interventions to local contexts. Full article

Background/Objectives: The high sensitivity of paediatric nurses directly influences the quality of nursing care provided to patients. The purpose of this study is to present the most frequent issues faced by paediatric nurses in their everyday work and their responses to difficult situations at work, define the actions applied when a difficult situation occurs, and assess the level of stress and other factors influencing the level of stress experienced by paediatric nurses. Methods: This study was conducted using an original survey form and a standardised psychological questionnaire based on the Perceived Stress Scale (PSS-10) for paediatric nurses. Results: The study involved 416 paediatric nurses and indicated a medium level of stress among the nurses. The median stress level, calculated as the sum of answers to questions based on the PSS-10, was 18 (16.0 ÷ 20.0), and the mean was 17.9 (min–max = 1–30). The median Sten score was 6 (5.0 ÷ 7.0), and the mean Sten score was 5.94 (min–max = 2–9). Nurses aged 21–30 years, who live in a city, have a Bachelor of Science in Nursing or a Master of Science in Nursing, and work ≥ 61 h a week and 161–250 h a month experience a higher level of stress. Factors such as choosing which child to help first, spending a great deal of time filling out medical documentation, obtaining a sick child’s consent to perform nursing procedures which the child does not understand, involving the minor in decision-making, impolite or offensive behaviour from a sick child or their parents, ineffective nursing and treatment methods, providing care against the opinion/views of a sick child or their parents, difficulties in or a lack of understanding of the situation of a sick child and their family, performing nursing procedures that can cause the child pain, and the inability to fulfil a sick child’s request increase the level of stress experienced by paediatric nurses. When a difficult situation occurs at work occurs, the nurses usually meet and talk about the situation with someone close (72.4%) or engage in other activities to avoid thinking about the situation (66.6%). They consult a psychologist/psychotherapist very rarely (9.6%) and a psychiatrist extremely rarely (4.6%). Conclusions: Polish paediatric nurses were found to experience a medium level of stress. Since paediatric nurses are exposed to stress, providing them with psychological care is important. The level of perceived stress is dependent on the nurse’s age, place of residence, and education, as well as weekly and monthly working durations. Paediatric nurses experience many difficult situations in their everyday work that influence their stress levels. Management should pay special attention to difficult workplace situations faced by paediatric nurses and implement regular actions to reduce the levels of stress experienced. Full article

Celiac disease (CeD), also known as gluten enteropathy, is an immune-mediated inflammatory enteropathy triggered by intolerance to gluten. It presents with a spectrum of symptoms, including both gastrointestinal and extraintestinal manifestations, as well as neurological symptoms. A review of the literature indicates that 10–22% of patients with CeD present with neurological symptoms. The objective of this study is to assess the influence of a gluten-free diet (GFD) on brain bioelectrical activity and neurological symptoms in children with CeD. Methods: The study was conducted using a multidisciplinary approach, encompassing a comprehensive array of clinical data gathered alongside laboratory test results, questionnaires, and electroencephalogram (EEG) assessments. The study population included 85 children: 18 newly diagnosed cases of CeD patients (NDC), subsequently reassessed after 6 months on a GFD as a celiac disease on diet (CDD); 27 CeD patients on a GFD for over 12 months (CDD2); and 40 healthy individuals in the comparison group (CG). Results: It was observed that over half of the NDC group exhibited neurological symptoms, particularly headaches. Following a six-month period on a GFD, there was a notable reduction in symptom severity. In comparison to the CG, the NDC patient group exhibited a higher prevalence of abnormalities in EEG recordings (p = 0.032), including focal sharp waves or slow waves. Conclusions: The results demonstrate that a GFD has a positive impact on the neurological condition of children with CeD. The clinical improvements correspond with EEG normalization, which supports the hypothesis that dietary intervention plays a role in mitigating CeD-associated neurological dysfunction. Full article

Background/Objectives: Parents who accompany their children with a complex chronic illness until their death experience a unique situation, with vulnerabilities, specific needs and enormous suffering. The aim of the study was to describe the lived experience of parents who accompanied their children with a complex chronic illness until their death, in a paediatric palliative care setting. Methods: We opted for a qualitative methodology, with a descriptive phenomenological orientation. Phenomenological interviews were carried out with nine intentionally selected mothers, with the support of a paediatric palliative care hospital team. The procedural phases of van Kaam’s method, modified by Moustakas, were used to analyse the data. Results: An understanding of the essential structure of the phenomenon is revealed in a description made up of three essential themes: ‘facing the harbinger of illness’; ‘living (together) with a sick child’; and ‘starting again without ever forgetting: living with an absent child’, the latter being the subject of this article. Conclusions: The participants attribute a self-transforming meaning to their lived experience of accompanying their children. Nurses will be able to access the lived experience of these mothers and improve their intervention in the process of their children’s illness, as well as in their bereavement process. There are also contributions to research and teaching in palliative care in the area of child and paediatric health. Full article

This study was undertaken to structure and validate a Multi-Professional Family Support Programme that was collectively developed at a Neonatal Intensive Care Unit (NICU). This is participative research of the action-research category with a qualitative–quantitative approach conducted at a University Hospital in the southeast of Brazil with the participation of their multi-professional staff. The study was done in four interdependent stages, adapted from the method proposed by Thiollent (2011): organisation, structuring, validation, and diffusion. Qualitative data were analysed following Bardin’s (2016) Content Analysis Technique and presented in categories and sub-categories. The evaluation instruments followed the evaluation criteria proposed by Pasquali (2010). In the analysis of quantitative data, Cronbach’s Alpha coefficient was used to verify reliability, Fleiss’ Kappa coefficient for measuring agreement, and the Content Validity Index for relevance and representativeness. The programme was built collectively and is based on the Family-Centred Care model. Cronbach’s Alpha reached values above 0.90, which is excellent reliability. There was varying agreement between substantial/perfect and significant (k = 0.68–1.00; p < 0.001), and all the evaluation criteria were considered relevant and representative (CVI > 90.0%). The programme and its guiding technologies were structured and validated with high levels of reliability, agreement, relevance, and representativeness. Full article

Background/Objectives: It is well known that there are differences in the academic and employment preferences of nursing students once they have completed their undergraduate studies in nursing. These preferences are largely influenced by students’ affinity for certain thematic areas over others. Therefore, the objective of this study was to identify the employment and academic preferences of third- and fourth-year Nursing Degree students at the University of Las Palmas de Gran Canaria (ULPGC). Methods: A cross-sectional, descriptive observational study was conducted among nursing students across three campuses of the ULPGC (Canary Islands, Spain). An online questionnaire was used to collect various sociodemographic and academic variables, as well as preferences across ten thematic areas. Descriptive and bivariate inferential analyses were performed, along with a correlation analysis among the areas. Results: The areas of highest preference were “Emergency Nursing”, “General Nursing”, and “Family and Community Nursing”. The areas of lowest preference were “Other Areas (teaching, management, research)”, “Mental Health and Psychiatric Nursing”, and “Geriatric Nursing”. Three clusters of closely correlated areas were identified: cluster 1 (Intensive and Critical Care Nursing, Emergency and Emergency Nursing and Operating Theatre and Anaesthesia Nursing), cluster 2 (Obstetric-Gynaecological Nursing–Midwifery, Paediatric Nursing and Mental Health and Psychiatric Nursing) and cluster 3 (remaining areas). A significant proportion of students expressed intentions to pursue postgraduate studies. Conclusions: Strategies should be implemented to enhance students’ preferences in the areas of “Mental Health and Psychiatric Nursing” and “Geriatric Nursing”, which are areas where there is a high demand for nurses. It is also necessary to increase their interest in research, management, and teaching. This study was not registered. Full article

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department. Aim: To explore paediatric emergency nurses’ perceptions of medication administration errors. Method: A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant’s consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan. Results: The participants’ discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered. Full article

Objectives: This study aims to determine the association between parental competence (warmth, demandingness, and parental education in fortitude and in privacy) and pornography use. Methods: This study presents cross-sectional data from an ongoing international study (YOURLIFE Project) about the opinions and lifestyles of adolescents with respect to affectivity, love, and sexuality. Adolescents (N = 2516) aged 12–15 from Chile, Mexico, Peru, and Spain were included. Multiple logistic regressions were performed to analyze the association between family assets (parental demandingness, warmth, and parental fortitude and privacy education) and pornography use. Results: The results indicated an association between parental warmth and pornography use among boys and girls. Furthermore, privacy education was highly associated with less pornography use only in girls. Parental demandingness and parental fortitude education were not associated with pornography use. Conclusion: Our findings suggest that new educational perspectives including privacy issues should be considered within programs for pornography use prevention among adolescents. Parents should incorporate these variables when discussing pornography with their adolescents and not only focus on filters or demandingness. Full article

Background/Objectives: The complexity of care requires systematic documentation to fully understand its relationship with medical complexity and its impact on patient outcomes. The Nursing Minimum Data Set (NMDS) plays a crucial role by capturing essential nursing data, enabling a detailed analysis of care and its impact on outcomes, such as length of stay (LOS). However, despite its potential, the use of NMDS in paediatric care remains limited. This study aims to explore the association between nursing and medical complexities and LOS in paediatric patients. Methods: A descriptive, retrospective, monocentric study will be conducted. The data will be collected through a nursing information system (Professional Assessment Instrument (PAIped)) and the hospital discharge register of patients admitted to the paediatric department in 2022 in an Italian university hospital. Conclusions and Expected Results: The use of PAIped will allow for the description of the complexity of care and enable an analysis of its relationship with medical complexity and LOS. Full article

Background: Febrile seizures are a common form of convulsions in childhood, with poorly known cellular mechanisms. The objective of this pioneering study was to provide qualitative and quantitative ultrastructural research on the large neuronal perikarya in the cerebellar dentate nucleus (DN), using an experimental model of hyperthermia-induced seizures (HSs), comparable to febrile seizures in children. Methods: The study used young male Wistar rats, divided into experimental and control groups. The HSs were evoked by a hyperthermic water bath at 45 °C for 4 min for four consecutive days. Specimens (1 mm³) collected from the DN were routinely processed for transmission electron microscopy studies. Results: The ultrastructure of the large neurons in the DN affected by hyperthermic stress showed variously pronounced lesions in the perikarya, including total cell disintegration. The most pronounced neuronal lesions exhibited specific morphological signs of aponecrosis, i.e., dark cell degeneration (‘dark neurons’). In close vicinity to the ‘dark neurons’, the aponecrotic bodies were found. The findings of this qualitative ultrastructural study correspond with the results of the morphometric analysis of the neuronal perikarya. Conclusions: Our results may constitute interesting comparative material for similar submicroscopic observations on large DN neurons in HS morphogenesis and, in the future, may help to find potential treatment targets to prevent febrile seizures or reduce recurrent seizures in children. Full article

Objective: The aim of our study was to investigate whether a 1-month-long milk-free diet results in a reduction in faecal calprotectin (FC) and faecal-zonulin-related proteins (FZRP) in children with milk-protein-induced allergic proctocolitis (MPIAP). Materials and methods: This is a single-centre, prospective, observational cohort study involving 86 infants with MPIAP, aged 1–3 months, and 30 healthy controls of the same age. The FC and FZRP were marked using the ELISA method (IDK^® Calprotectin or Zonulin ELISA Kit, Immunodiagnostik AG, Bensheim, Germany). The diagnosis of MPIAP was confirmed with an open milk challenge test. Results: FFC and FZRP proved useful in evaluating MPIAP treatment with a milk-free diet, and the resolution of allergic symptoms and a significant (p = 0.0000) decrease in the concentrations of both biomarkers were observed after 4 weeks on the diet. The FC and FZRP concentrations were still higher than in the control group. A high variability of FC concentrations was found in all the study groups. An important limitation is the phenomenon of FZRP not being produced in all individuals, affecting one in five infants. Conclusions: FC and FZRP can be used to monitor the resolution of colitis in infants with MPIAP treated with a milk-free diet, indicating a slower resolution of allergic inflammation than of allergic symptoms. The diagnosis of MPIAP on the basis of FC concentrations is subject to considerable error, due to the high individual variability of this indicator. FZRP is a better parameter, but this needs further research, as these are the first determinations in infants with MPIAP. Full article

Background: Eye-tracking technology could be used to study human factors during teamwork. Objectives: This work aimed to compare the visual attention (VA) of a team member acting as both a team leader and managing the airway, compared to a team member performing the focused task of managing the airway in the presence of a dedicated team leader. This work also aimed to report differences in team performance, behavioural skills, and workload between the two groups using validated tools. Methods: We conducted a simulation-based, pilot randomised controlled study. The participants included were volunteer paediatric trainees, nurse practitioners, and neonatal nurses. Three teams consisting of four team members were formed. Each team participated in two identical neonatal resuscitation simulation scenarios in a random order, once with and once without a team leader. Using a commercially available eye-tracking device, we analysed VA regarding attention to (1) a manikin, (2) a colleague, and (3) a monitor. Only the trainee who was the airway operator would wear eye-tracking glasses in both simulations. Results: In total, 6 simulation scenarios and 24 individual role allocations were analysed. Participants in a no-team-leader capacity had a greater number of total fixations on manikin and monitors, though this was not significant. There were no significant differences in team performance, behavioural skills, and individual workload. Physical demand was reported as significantly higher by participants in the group without a team leader. During debriefing, all the teams expressed their preference for having a dedicated team leader. Conclusion: In our pilot study using low-cost technology, we could not demonstrate the difference in VA with the presence of a team leader. Full article

Background: Measuring and interpreting vital signs in pediatric patients recovering from anaesthesia, particularly those up to 36 months old, is challenging. Nurses’ decision-making regarding the level of monitoring must balance patient safety with individualized care. This study aimed to explore the perceptions of critical care nurses and registered nurse anesthetists regarding their experiences and actions when making decisions about vital sign monitoring for children in post-anesthesia care units (PACUs). Methods: A qualitative study utilizing the critical incident technique was conducted. Interviews were performed with a purposeful sample of 17 critical care nurses and registered nurse anaesthetists from two hospitals. Results: Nurses reported that the rationale for decisions concerning the need for vital sign monitoring in children was both adequate and inadequate. Actions were taken to adjust the monitoring of vital signs, optimizing conditions for assessment and ensuring the child’s safe recovery. Conclusions: The complexity of accurately monitoring children makes it challenging for nurses in the PACU to adhere to guidelines. Evidence-based care and safety are compromised when technology has limitations and is not adapted for paediatric use, leading to a greater reliance on experience and clinical assessment. This reliance on experience is crucial for reliable assessment but also entails accepting greater risks. Full article

Background: Burns are a common and severe medical emergency requiring immediate specialized care to minimize damage and prevent complications. Burn severity depends on depth, extent, and location, with more complex care needed for burns on critical areas or extensive burns. Nursing is essential in burn management, providing immediate care, adapting treatments, managing pain, preventing infections, and offering emotional support for recovery. The study aims to analyse the epidemiological and clinical characteristics of burns treated at the Hospital Emergency Department of the Hospital Complex of Cáceres (Spain) from January 2018 to December 2022. It looks at factors like gender, age, hospital stay duration, emergency type (paediatric or adult), main diagnosis, skin thickness, burn degree, affected body areas, percentage of body surface area burned, and treatment types. It also investigates how treatment varies by gender, age, skin thickness, and burn severity. The relevance of this research lies in the fact that periodic epidemiological studies are essential to monitor changes in diseases, evaluate the effectiveness of interventions, detect outbreaks quickly, update knowledge on risk factors, and guide health policy decisions. This ensures an adapted and effective response to the needs of the population. Methods: Retrospective, observational study that analysed burn cases treated at the Hospital Complex of Cáceres (Spain) 2018–2022. Inclusion criteria were based on ICD-10 codes for burns, excluding severe cases not treated in this service. Data were analysed using descriptive statistics, Student’s t-tests, Chi-square tests, and ANOVA. Results: 220 patients surveyed, with a mean age of 47 years and 60.9% male. Most burns (95.5%) affected the external body surface, with a mean hospital stay of 7.86 days. Medical treatment was provided to 75.5% of patients, and 24.5% required surgical intervention. Significant differences in treatment procedures were observed according to age, skin thickness, and burn degree. Older patients had more procedures and longer hospital stays. Excision and transfer procedures were more common in full-thickness and severe burns. Conclusions: The findings align with previous research on burn demographics and treatment approaches. Treatment differences by age and burn severity highlight the need for tailored interventions. The study underscores the importance of comprehensive burn management, including psychological support for improved long-term outcomes. Further research could explore the impact of socio-economic factors on burn incidence and treatment. This study was not registered. Full article

Aim: This research study aims to determine nurses’ alarm fatigue (AF) levels in paediatric critical care units in two governmental hospitals and to examine the significant differences in the mean between nurses’ attributes, nurses’ working environment, and nurses’ alarm management with the level of fatigue caused by the alarm. Background: In recent years, AF has become a significant and growing concern among nurses. However, in the Saudi Arabian paediatrics context, the impact of AF on nurses working in intensive care units remains unexplored. Method: A descriptive cross-sectional survey was conducted using a non-probability purposive sampling method. Data were collected from 216 nurses in two governmental hospitals through self-administered questionnaires comprised of four sections: individual attributes, work environment, alarm management, and AF scale. Data analysis: The Statistical Package of Social Science (SPSS) was used to analyse the data, and ANOVA was utilised to describe the sample’s demographic characteristics and determine any differences. Results: Most participants were female, held a bachelor’s degree, and were aged 31 to 35. Of the participants, 62.5% reported experiencing a medium level of AF, 29.2% reported a low level, and 8.3% reported a high level. Participants expressed that recurrent false alarms disrupt patient care and decrease trust in alarm systems. Significant differences in AF levels were observed based on marital status and the percentage of non-actionable alarms. Conclusions: Nurses working in paediatric critical units with high rates of false alarms, the frequent de-activation of alarms, and decreased trust in alarm systems are more likely to experience AF. Addressing AF is crucial for patient safety; nurse training on alarm management, the collaboration between biomedical and nursing staff, and technological advancements can help mitigate this issue. Implications for Practice: To minimise the adverse effects of AF, policymakers, biomedical experts, and nursing administrators must establish comprehensive policies and protocols concerning alarms. These measures aim to ensure secure and efficient care for the well-being of patients and nurses. Full article