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    A study protocol to develop virtual reality software in the care management of patients in intensive care
    (Wiley, 2025) Terzi, Banu; Duzkaya, Duygu Sonmez; Uysal, Gulzade; Yalniz, Nazik
    BackgroundThe use of virtual reality is increasing in nursing to ensure patient safety and to improve the quality of care in the education of nurses.AimTo develop a virtual reality software for intensive care patient care management and to investigate the effect of this software on novice intensive care nurses.Study DesignThis study protocol contains a randomized controlled experimental design research. The nurses will be divided into control (n = 34) and study groups (n = 34) by randomization. The research will be conducted in four steps: (1) according to Kolcaba's Comfort Theory, the protocol for care management of an intensive care patient will be prepared and transferred to the virtual reality software, (2) the nurses in both groups will be given theoretical training, (3) a routine orientation training programme will be applied to the nurses in the control group, and those in the study group will be given virtual reality goggles. (4) Tools such as a 'Clinical Practice Skills Observation Form and Knowledge Level Questionnaire' and 'Problem-Solving Inventory', 'Clinical Decision-Making Scale in Nursing', 'State Anxiety Inventory' and 'Satisfaction Level Questionnaire' will be applied to both groups before commencing the theoretical training, 1 week after the application and in the first month of the application.ResultsThis protocol describes an experimental study aiming to test the impact of virtual reality software on novice intensive care nurses in the care management of an intensive care patient.ConclusionsThe results and recommendations will be shared after the study is completed.Relevance to Clinical PracticeWithin the scope of the research, the virtual reality software to be developed for the care management of an intensive care patient will provide important contributions to the development of nurses' problem-solving and clinical decision-making skills and reduce state anxiety levels in orientation to the intensive care unit (ICU).
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    Awareness of child abuse and neglect among students
    (Kare Publ, 2022) Uysal, Gulzade; Bozkurt, Gulcin; Duzkaya, Duygu Sonmez
    Objectives: This descriptive study was conducted to determine the level of awareness of child abuse and neglect (CAN) among students at a private university in Istanbul, Turkey. Methods: The study sample comprised 1533 students from all faculties and colleges of the university selected using the stratified sampling method. A demographic information form and the Child Abuse and Neglect Awareness Scale (CANAS) were used to collect the study data. Results:The findings revealed that 30.5% of the students had received some instruction about CAN and 72.9% indicated that they wanted lectures on CAN to be added to the curriculum. The mean total score of the CANAS and the mean scores of the physical abuse, emotional abuse, and neglect subscales were statistically significantly higher among female students (p<0.05). The physical abuse and neglect subscale scores of students who had formal education on abuse were higher than those of students who had not (p<0.05). Conclusion:The female students and those who had received instruction about abuse had greater awareness of abuse and neglect. Broader coverage in the curriculum may increase the awareness of all students and help to enhance public understanding.
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    Determining the Difficulties of Parents with Children in Home Care Who Were Discharged from Intensive Care
    (Galenos Publ House, 2024) Bozkurt, Gulcin; Duzkaya, Duygu Sonmez; Uysal, Gulzade; Yakut, Tulay; Karakul, Atiye
    Introduction: This study was performed to determine the difficulties experienced by parents with children in home care who were discharged from intensive care. Methods: A phenomenological qualitative method was used to determine the difficulties experienced by the parents. The sample of the study consisted of parents (n=22) whose children met the inclusion criteria and needed home care. The data were analyzed in the MAXQDA qualitative data analysis program in accordance with Colaizzi's seven-stage method. Results: The average age of the children in the study group was 85.63 +/- 58.40 months. 56.7% of them were male. 40% of the children were followed up with a diagnosis of neurological disease. All children discharged from the intensive care unit had tracheostomy. 95.4% of them used home-type mechanical ventilators, and 95.3% were fed enterally. In line with the data obtained from the interviews of the parents, it was determined that there were difficulties in terms of feelings about discharge, physical conditions for home care, family relationship, social relationship, difficulty in physical care, inadequacy in support systems and financial status. Conclusion: The home care of children, who are dependent on medical technology and discharged from intensive care, is mostly performed by their families. Children dependent on medical technology should be supported by home care personnel to avoid potential risks.
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    Effect of short film video and video-based education on fear, pain, and satisfaction of children undergoing day surgery
    (Elsevier Science Inc, 2024) Bozkul, Gamze; Karakul, Atiye; Duzkaya, Duygu Sonmez; Dilsen, Sahika
    Purpose: This study aims to determine the effect of introducing the operating room environment with different informative multimedia methods to pediatric patients aged 7-12 in the preoperative period in day surgery on fear, pain, and patient satisfaction in three different groups comparatively.Design and methods: This randomized controlled study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The sample of children was allocated to the Short Film Group (n:30), Video Based Education Group (n:30) and Control Group (n:30). Fear, pain, and satisfaction were measured.Results: The age distribution of the children in the study was 7.57 +/- 1.25 years in the short film group, 7.27 +/- 0.52 years in the video-based education group, and 7.57 +/- 2.27 years in the control group. There was no significant difference between the groups in terms of demographic status, fear, and vital signs before the procedure. Fear, pain, and satisfaction levels of children in short film groups were lower than video-based education groups.Conclusion: The result of this research reveals that preoperative short film education in children is more effective than video-based education in reducing fear, pain, and satisfaction levels. This intervention could be an effective method to improve outcomes. Nurses can increase children's comfort by using educational programs that attract children's attention.Practice implications: Healthcare team members working in pediatric surgical units can use the short film method, which is effective, easy, and applicable in the field, to reduce pain and fear in the preoperative period and increase satisfaction in children undergoing day surgery.(c) 2023 Elsevier Inc. All rights reserved.
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    Effect of Two Bathing Methods on Physiologic Parameters in Pediatric Intensive Care
    (Sage Publications Inc, 2022) Oz, Ozgul; Uysal, Gulzade; Duzkaya, Duygu Sonmez
    To determine the effect of traditional and disposable bed baths performed in the pediatric intensive care unit (PICU) on the physiologic parameters of children. This research was conducted as a randomized controlled trial with children who were monitored in the PICU. It was found that the pulse and blood pressure immediately after the bath were higher for both bath applications and was the lowest 30 minutes after the bath (p < .05). Children who used traditional baths had a lower body temperature than those who used the disposable bed bath after bathing for the second day. Oxygen saturation averages were found that within the group to be the highest 30 minutes after bathing methods (p < .05). Both bathing methods applied in the PICU had a positive effect on physiologic parameters. It may be recommended to regularly perform the most appropriate bathing for patients with stable hemodynamics in PICUs.
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    Effect of using a kaleidoscope projector and matching cards on fear and vital signs in children aged 3-6 years receiving inhaled medication
    (Wiley, 2025) Korkmaz, Burcu; Karakul, Atiye; Duzkaya, Duygu Sonmez
    AimThe aim of this study was to investigate the effect of the use of projector kaleidoscope and matching card on children's fear and physiological parameters in children aged 3-6 years receiving inhaled medication.MethodsThis randomised controlled study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The sample of children was allocated to the projector kaleidoscope group (n = 38), matching card group (n = 38) and control group (n = 38). Fear and vital signs were measured.ResultsIn the study, the mean age of the children in the projector kaleidoscope group was 4.39 +/- 1.10, the mean age of the children in the matching card group was 4.34 +/- 0.96 and the mean age of the children in the control group was 4.28 +/- 1.18. There was a statistically significant difference between the post-test scores of the Children's Fear Scale in the evaluation of parents and nurses according to the groups of children. There was a statistically significant difference between the respiratory post-test scores according to the groups of children. It was observed that the mean heart rate of the control group participants was higher than that of the children in the matching card group. There were no statistically significant differences in the post-test saturation values among the groups of children.ConclusionIt was observed that the projector kaleidoscope and matching card reduced fear and prevented increased respiratory rate in children receiving inhaler medication. In addition, it was determined that matching card had more effect on heart and respiratory rate than projector kaleidoscope.
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    Effects of ShotBlocker® and the Helfer skin tap technique on pain and fear experienced during intramuscular injection among children aged 6-12 years in pediatric emergency units: A randomized controlled trial
    (Elsevier Sci Ltd, 2024) Duzkaya, Duygu Sonmez; Karakul, Atiye; Akoy, Iremrem; Andi, Senem
    Background: In pediatric emergency units, intramuscular injection is one of the most common procedures that cause pain and fear in children. Reducing pain and fear is important for patient comfort. Objective: This randomized controlled experimental study aimed to determine the effects of ShotBlocker (R) (R) and the Helfer skin tap technique on the pain and fear experienced by children aged 6-12 years during intramuscular injection in pediatric emergency units. Methods: This study was conducted from April 2022 to October 2023 among 177 children aged 6-12 years. ShotBlocker and the Helfer skin tap technique were applied during intramuscular injection among children in the intervention groups (ShotBlocker group: n = 59, Helfer skin tap technique group: n = 59), while children in the control group received routine injections. (n = 59). The levels of pain and fear were measured. Results: In the analysis of the age distribution of the children, the average age of the Helfer skin tap technique group was found to be 8.54 +/- 2.00 years; ShotBlocker group, 8.46 +/- 1.99 years; and control group, 9.19 +/- 2.01 years. There was a significant difference in the post-intervention Wong-Baker Pain Scale and Child Fear Scale scores based on the evaluation of the children, parents, and observer nurses between the groups (p < 0.05). The pain and fear scores of the ShotBlocker group were lower than those of the control group (p < 0.05). Conclusions: ShotBlocker is more effective in reducing pain than the Helfer skin tap technique among children receiving intramuscular injection. These cheap and easy-to-use methods are recommended for use in emergency units.
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    Effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by children during vaccination: A randomized controlled trial
    (Elsevier Science Inc, 2024) Duzkaya, Duygu Sonmez; Uysal, Gulzade; Siktas, Ozge; Karakul, Atiye; Acikgoz, Ayfer
    Purpose: Vaccination is an invasive procedure that causes pain. Uncontrolled pain negatively affects all aspects of life, including health. This study aimed to determine the effects of the Helfer skin tap technique and Buzzy (R) application on the levels of pain and fear experienced by 4-year-old children during measles-mumps-rubella (MMR) vaccination. Methods: This study adopted a randomized controlled experimental design. The study sample consisted of 96 children (Helfer skin tap technique group: n = 32, Buzzy (R) group: n = 32, control group: n = 32) who received MMR vaccination. Children in the Buzzy (R) and Helfer skin tap technique groups received their respective interventions before and after vaccine injection, while children in the control group received routine vaccine injection. Results: Based on the parents' and nurse's observations, the pain and fear scores after vaccine injection were lowest in the Buzzy (R) group and highest in the control group. Based on the children's assessments, the pain scores after vaccine injection were lower in the Buzzy (R) group than in the Helfer skin tap technique group. Conclusion: Buzzy (R) application and the Helfer skin tap technique have beneficial effects on children's pain and fear during MMR vaccination. Buzzy (R) application is more effective in reducing pain and fear during vaccine injection in children than the Helfer skin tap technique.
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    Emotions and difficulties experienced by parents of children with autism: A qualitative study
    (Wiley, 2024) Uysal, Gulzade; Karakul, Atiye; Duzkaya, Duygu Sonmez
    RationaleThis study was performed to determine the difficulties experienced by the parents of children with autism.MethodsA qualitative method was used to determine the difficulties experienced by the parents. The sample of the study consisted of parents with 24 children with autism who met the inclusion criteria. The data were analysed by the MAXQDA qualitative data analysis programme in accordance with Colaizzi's seven-stage method.ResultsTotal of 5 themes and 29 codes were gathered in line with the data obtained from the interviews. Five main themes of the interviews emerged; emotions experienced by parents; adaptation to family life; difficulty in social relationships; limited opportunity for entertainment/activity and financial difficulty. Parents whose income were less than or equal to their expenses particularly stated that they had economic difficulties in the transportation of their children to places such as hospitals/schools/special education.ConclusionIn accordance with the findings of this study, it was determined that almost all of the parents with a child diagnosed with autism experienced sadness, denial, shock, depression, self-blame in the period when their children were first diagnosed, and later accepted the disease. In addition, it was detected that parents had difficulties in family relations, social relations, entertainment/activity and economic aspects.
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    Evaluation of Enteral Nutrition Applications in Pediatric Intensive Care Units in Türkiye
    (Galenos Publ House, 2025) Yakut, Tulay; Duzkaya, Duygu Sonmez; Uysal, Gulzade
    Objective: Enteral nutrition practices in pediatric intensive care units (PICUs) in T & uuml;rkiye and all around the world are mostly performed in accordance with an expert opinion due to the inadequacy of evidence- based practices. Therefore, different approaches are observed in enteral nutrition applications. This research aimed to evaluate the enteral nutrition practices in PICUs in T & uuml;rkiye. Materials and Methods: The research was carried out through the online survey database between February 2021 and June 2021 by reaching 73 out of 93 PICUs according to the 2019 data of the Ministry of Health of the Republic of T & uuml;rkiye. The clinical identification form and the clinic's evaluation form for enteral nutrition practices were prepared by the researcher and expert opinion was taken. The data were analyzed with the SPSS 21.0 program. Results: As a standard, the first preferred method was the gastrointestinal tract (98.6%) followed by the intermittent feeding method (93.2%). The commonly used criteria to evaluate enteral feeding tolerance included gastric residual volume (GRV), vomiting, increased abdominal pressure, and diarrhea. 61.6% of PICUs routinely measured GRV in patients who were on enteral feeding, whereas 31.5% did not routinely measure it but measured GRV only in patients with signs of intolerance. The frequency of GRV measurement was 50.7% in patients who were on intermittent feeding, and it was performed before each feeding. Conclusion: It was determined that the routine GRV control was frequently performed in enterally fed patients in PICUs, and the first preferred enteral feeding method was the intermittent gastric route. However, it is noteworthy that the use of written enteral nutrition protocols in PICU was insufficient. In accordance with these findings, we recommend implementing practices to encourage the use of the enteral nutrition protocol in the PICU.
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    Global trends in technology-dependent children, home care, and parental discharge education: A bibliometric analysis using Biblioshiny
    (Elsevier Science Inc, 2024) Azizo, Fatma; Terzi, Banu; Duzkaya, Duygu Sonmez
    Background: Parents of technology-dependent children constitute a different population in society and face diverse problems during caregiving. Methods: This study aimed to identify and visualize studies conducted from 1990 to 2024 on technologydependent children, home care, and parental discharge education and determine global trends. A descriptive and bibliometric study design was employed. Data were obtained from the Web of Science Core Collection database, and bibliometric analyses were performed with performance analysis, visualization, and mapping using the Biblioshiny interface in the R software. Screening yielded a total of 157 publications. A total of 138 publications were included. Findings: The keywords frequently used by the authors included home care, technology-dependent children, palliative care, home mechanical ventilation, child, family, and pediatric. Co-author keywords with moderate centrality and density are home mechanical ventilation (Betw = 106.47), technology-dependent (Betw = 106.47), home mechanical ventilation (Betw = 106.47). Each article had 4.41 co-authorships, with an international co-authorship rate of 6.52 %. Conclusions: This study provided important data on studies focusing on technology-dependent children, home care, and parental discharge education. Application to practice: Since the number of studies in the field is small, the findings of this study are essential in guiding researchers about gaps in the literature. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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    The effect of mobile game training designed for asthmatic children on asthma management and quality of life
    (Elsevier Science Inc, 2024) Karakul, Atiye; Duzkaya, Duygu Sonmez; Bozkul, Gamze; Capanoglu, Murat
    Purpose: This study aimed to examine the effect of mobile game training designed for children with asthma on inhaler use skills, asthma symptoms and treatment needs, and quality of life. Design and methods: This randomized controlled study was conducted between April and October 2023 at Pediatric Asthma and Allergy Clinic in Turkey. The sample of the study consists of a total of 74 children diagnosed with asthma, including the Mobile game (n: 37) and the Control group (n: 37). In the study, a mobile game was developed for children with asthma between the ages of 8 -12. In collecting research data; Child and Parent Information Form, Inhaler Use Skill Evaluation Form, Asthma Symptom and Treatment Need Scoring (Asthma Symptom Score [ASS], Rhinitis Symptom Score [RSS] and Total Symptom Score [TSS]), DISABKIDS Asthma Scale were used Results: There was no significant difference between the groups in terms of the demographic status of the children ( p > 0.05). It was determined that the average inhaler use skill score and DISABKIDS asthma scale Child/Parent score average of the children in the mobile game group were higher than the control group ( p < 0.05). When the children's final follow-up ASS, RSS and TSS total scores were examined; It was determined that there was a statistically significant difference between the children in the mobile game and control groups (p < 0.05). Conclusions: As a result of this study, it was determined that mobile game training designed for children is an effective method in increasing children's ability to use inhaler medications, reducing asthma symptoms and treatment needs, and improving quality of life. Practice implication: Nurses can improve children's quality of life by using mobile game training programs that attract children's attention. (c) 2024 Published by Elsevier Inc.
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    The effect of watching videos using virtual reality during operating room transfer on the fear andanxiety of children aged 6-12 undergoing inguinal hernia surgery: A randomized controlled trial
    (Elsevier Science Inc, 2023) Uysal, Guelzade; Duzkaya, Duygu Sonmez; Bozkurt, Gulcin; Akdag, Melike Yilmaz; Akca, Selen Ozakar
    Background: Being in a hospital and undergoing a surgical intervention are very stressful for the children and their parents. It is critical to keep the pain, fear and anxiety of children at a minimum level during this period in order to have a better process.Purpose: The aim of this study was to evaluate the effect of watching videos using virtual reality on fear and anxiety of children aged 6-12 years old during operating room transfer for inguinal hernia surgery. Methods: This prospective and randomized controlled study used parallel trial design guided by the CONSORT checklist. The study was conducted with two groups: the group that watch videos using virtual reality group and the control group. Data were collected using follow-up forms; the Children's State Anxiety Scale and the Children's Fear Scale.Results: Children in the virtual realty group had lower anxiety and fear scores than the children in the control group (p < 0.05). Evaluation of the in-group measurements demonstrated that the fear and anxiety scores of the children in the virtual reality group decreased after the transfer compared to that of the pre-transfer, while the children in the control group experienced higher fear and anxiety scores (p < 0.05).Conclusion: Virtual reality is an effective method to reduce fear and anxiety in children aged 6-12 years old during their transfer to the operating room.Implications for practice: Evidence-based protocol and guidelines should be developed for nonpharmacological methods such as virtual reality for procedural fear and anxiety in children.(c) 2023 Elsevier Inc. All rights reserved.
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    THE IMPACT OF COLD SPRAY AND ICE APPLICATION DURING INTRAVENOUS ACCESS ON PAIN AND FEAR IN CHILDREN AGED 7-15 YEARS IN THE PEDIATRIC EMERGENCY UNIT: A RANDOMIZED CONTROLLED TRIAL
    (Elsevier Science Inc, 2024) Celik, Elif Gunal; Duzkaya, Duygu Sonmez
    Introduction: Many strategies have been developed to prevent procedural pain in pediatric emergency units, where nurses play a vital role in ensuring patient comfort. Easy -touse and inexpensive nonpharmacologic analgesic methods are important in emergency units. This study was conducted to determine the effect of cold spray and ice applied during venipuncture on the level of fear and pain in children aged 7 to 15 years. Methods: This was a randomized controlled experimental study of 96 children between the ages of 7 and 15 years (cold spray group, ice group, and control group) who were scheduled to have venous access in the pediatric emergency clinic and met the sampling criteria. Results: Evaluations of the children, parents, and observers in the groups found a statistically significant difference between the pain and fear scores after the intervention compared with the preintervention (P < .001). The pain and fear scores of the children in the control group were higher than the scores of those in the spray and ice groups (P < .001); the pain and fear scores of the children in the spray group were lower than the scores of the children in the ice group and statistically significant (P < .001). Discussion: In conclusion, cold spray applied during intravenous access in children aged 7 to 15 effectively reduces pain and fear and should be used in the emergency unit.
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    Turkish validity and reliability of the universal mental health literacy scale for adolescents (10-14 years): A methodological study
    (Wiley, 2024) Uysal, Guelzade; Semerci, Remziye; Sengun, Rukiye; Duzkaya, Duygu Sonmez
    RationaleMental health literacy enables adolescents to acquire information that will accompany them in their future lives and to define their attitudes and behaviors.Aims and ObjectivesThis study evaluated the Turkish validity and reliability of the Universal Mental Health Literacy Scale for Adolescents (10-14 years).MethodsThis is a methodological, correlational, cross-sectional, and descriptive study. The study was conducted with 223 adolescents. Data were collected by 'Information Form' and 'Universal Mental Health Literacy Scale for Adolescents.' Exploratory Factor Analysis, Confirmatory Factor Analysis, and Pearson Correlation analysis were used to assess the validity and reliability of the UMHL-A.ResultsItem Content Validity Index (I-CVI) scores ranged from 0.94 to 0.96, while the Scale Content Validity Index (S-CVI) was 0.95. For 'Help-seeking and Stigma dimensions' chi 2/df = 3.347, NFI = 0.804, IFI = 0.854, TLI = 0.778, CFI = 0.849, RMSEA = 0.103. For 'Knowledge of Mental Health and Knowledge of Mental Illnesses dimensions' chi 2/df = 1.959, NFI = 0.731, IFI = 0.847, TLI = 0.774, CFI = 0.837, RMSEA = 0.066. The internal consistency and time stability were affirmed by a Hotelling T-square value of 15.241 and an F-test result of 27.793.ConclusionsThis study reveals that the Turkish validity and reliability of the Universal Mental Health Literacy Scale for Adolescents is a valid and reliable tool for assessing mental health literacy among adolescents. The UMHL-A scale is a valid tool to evaluate critical aspects of mental health literacy in adolescent populations and can be used in both research and clinical practice in mental health education and intervention. It is recommended that the Turkish version of the Universal Mental Health Literacy Scale should be used to determine resilience in adolescents.