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Trials: The study aimed to investigate the effect of virtual reality interventions on relieving pain and anxiety in children and adolescents receiving cancer treatment. A search that involved Cochrane Library (comprising Cochrane Central Register of Controlled Trials (CENTRAL)), PubMed, ProQuest, MEDLINE, Web of Sciences, Science Direct, and Scopus electronic databases covering the records from January 1, 2000 up to May, 2023 was conducted to determine randomized controlled trials that could be included in our study. The results of the search were limited to "anxiety and pain, adolescents, children, virtual reality, cancer." Of the 160 articles that were reached during the search, seven were found eligible based on inclusion criteria. Hedges' g effect size was calculated for each article. Random effects model was used to test effect sizes and moderator variables. The registration number of this meta-analysis on PROSPERO is CRD42022304737. The outcomes were pain and anxiety. Compared with standard care, virtual reality had a medium and significant effect on anxiety (g = 0.60, 95% CI: [- 1.05 - 0.15]) and pain (g = - 0.667, 95% CI: [- 1.08- -0.24]). In addition, age has been identified as an important moderator in the use of virtual reality in pain management. This meta-analysis shows that virtual reality applications are effective interventions for reducing pain and anxiety in the field of pediatric oncology. However, it is necessary to carry out randomized controlled trials that have large samples for evidence-based virtual reality applications in pediatric oncology., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Cancer can have various psychosocial effects on children and young adults. Technology-based psychosocial interventions are increasingly popular in paediatric oncology for psychosocial health., Objective: The objective of this study is to investigate the effectiveness of technology-based psychosocial interventions applied to children, adolescent and young adults undergoing cancer treatment., Methods: Eight electronic databases including PubMed, Cochrane Library (including Cochrane Central Register of Controlled Trials [CENTRAL]), CINAHL Plus with Full Text, PsycINFO, MEDLINE, ProQuest, Science Direct and Scopus were searched to identify eligible randomised controlled trials from 1 January 2010 up to 9 April 2021. Search results were limited to 'children, adolescent and young adults' 6-24 years undergoing cancer treatment. Randomised controlled studies in which technology-based psychosocial interventions were applied were examined. Of 4,927 articles, 12 articles met the inclusion criteria. Hedges' g effect size was computed for each study. Effect sizes and moderator variables were tested using random-effects models. This study is registered with PROSPERO, number CRD42020177787., Results: The outcomes were anger, anxiety, coping, depression, distress, quality of life and resilience. Compared with standard care, technology-based psychosocial interventions had a large effect and significantly on anger (g = -1.327, 95% CI: [-2.43, 0.22], anxiety (g = -0.89, 95%CI: [-1.34, -0.18], and depression (g = -1.05, 95% CI: [-1.65,-0.46]. Also, it was found that the duration of interventions had a significant moderator and effect size of the distress and resilience outcomes increased as the duration increased., Conclusion: This meta-analysis demonstrated that technology-based psychosocial interventions served as an effective intervention as it appears to have implications reducing anger, anxiety and depression in paediatric oncology. Nevertheless, randomised controlled studies with larger samples still needed to establish evidence-based psycho-oncological interventions for paediatric oncology. Future research should develop interventions more graduated by duration., (© 2021 John Wiley & Sons Ltd.)

Background: Simulation is an important learning-teaching tool for integrating theory and practice in nursing education., Objective: The aim of this study was to develop and to conduct the validity and reliability of a self-evaluation scale for simulation laboratory practices (SES-SLP) with undergraduate nurses., Methods: The study sample consisted of 220 undergraduate nursing students. Data were collected using a Descriptive Characteristic Form (DCF) and the 23-item Self-Evaluation Scale for Simulation Laboratory Practices (SES-SLP)., Results: Cronbach's alpha value of the scale was 0.94. The scale comprised of two subscales: the developing factor (19 items) and the challenging factor (4 items). All items showed a statistically significant correlation (p < 0.05)., Conclusions: The SES-SLP is a valid and reliable scale that can be used to evaluate students' learning experience for simulation laboratory practices., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Parents need to constantly monitor their children with inherited metabolic diseases (IMDs) and have difficulty coordinating care. The aim of this descriptive study was to determine the symptoms and problems in children with IMDs and factors affecting caregiver burden. The study was conducted in a pediatric hospital. The study sample consisted of 47 mothers of children with IMDs. Data were collected using a descriptive characteristics form (DCF), a data collection form related to symptoms and problems (DCFSP), and a caregiver burden inventory (CBI). The most common specific problems were hepatomegaly (36.2%), developmental delay (27.7%), and muscle weakness (14.9%). Mothers' CBI mean total score was 30.23 ± 19.65. Mothers whose children were partially or completely dependent had significantly higher scores than others. Mothers who expressed the family income status as "an expenses more than income" had higher CBI scores. Understanding the problems of children with IMD and factors effecting caregiver burden of mothers can help health-care professionals to identify patients' and their families' needs and facilitate the development of nursing interventions for effective care and reduction of caregiver burden. These results can be used to improve the nursing care of children with IMDs and their families.

Sedentary lifestyles and unhealthy nutrition, in particular, cause childhood obesity. The purpose of this semi-experimental research is to determine the changes in body mass index, self-concept, and healthy lifestyle behaviours of children during a training programme to prevent obesity. Children 9 and 15 years old were included from two public secondary schools. A total of 1609 students completed the study in the intervention and control groups (1022 vs 587, respectively). The training programme for the intervention group at the schools had three sessions in 12 weeks and was about obesity, body mass index (BMI) calculation, a healthy lifestyle and coping with stress. Data was collected through a sociodemographic data form, healthy lifestyle behaviours data form, Piers-Harris Children's Self-Concept Scale and weight-height measurements during the first and last weeks of the programme (except for the sociodemographic form). Before training, BMI's of children in the intervention group were higher than in the control group (19.61 ± 3.8 vs 19.00 ± 3.5, respectively). The gap between BMI scores of the groups was narrowed after the training (p > 0.05). The mean score on the Self-Concept Scale increased in the intervention group after the training (63.21 ± 9.5) as compared to before the training (61.16 ± 10.4); whereas in the control group, there were no differences found (p = 0.908). In the intervention group, the number of children who had breakfast after the training (81.1%) increased compared to before the training (74.1%) (p = 0.001). The trainings were provided to students to increase healthy nutrition, physical activity and to decrease sedentary lifestyles., Competing Interests: Conflict of interest: The authors declare no conflict of interest., (© 2020 the Author(s), licensee AIMS Press.)

Technology-based applications in the health field have been increasing in recent years. Since they attract adolescents' attention, technology-based applications can be used in health-promoting interventions. This systematic literature review was conducted to determine the effect of technology-based programmes in changing adolescent health behaviors. In the literature review, 16 randomized controlled empirical studies with full text published in English between 2011 and 2016 in the PubMed and Science Direct databases were investigated. The sample of the studies investigated under the scope of this study consisted of adolescents in the age range of 12-24 years. The intervention time was determined to be a minimum of two weeks and a maximum of 24 months. When the resulting studies were examined, the model was used in some of the studies. The intervention methods used for adolescents were generally presented as informing, counseling services, protection, behavioral change development, self-assessment, goal development and problem-solving. It was observed that the majority of the studies were Internet and computer-based, and some were mobile phone-based. In 56.25% of the studies, the development in the studied health behaviors was found to be significant. In addition, 62.5% of the adolescents stated that they were satisfied with technology-based programmes. In the studies, some of the difficulties in the use of technology included the participants' withdrawing from the research, their having difficulties in accessing the website, and other technical problems. The use of technology in health promotion is becoming widespread, especially among adolescents, which increases the success of behavioural change. However, further randomized controlled studies are needed in the field to increase evidence-based knowledge.

Objective: This experimental randomized controlled trial will be to examine the impact of a technology-based psychosocial motivation program on children and families who are being followed up on a diagnosis of cancer., Methods: The research is based on the "Transactional Model of Stress and Coping." This study will be conducted on children with leukemia, aged 9-18 years, and their parents, who will be followed in the consolidation treatment phase in the hematology wards and outpatient clinic of a university hospital. Data collection will consist of the children's and parents' descriptive characteristic form, the Spielberger State Anxiety Inventory for Parents, the State-Trait Anxiety Inventory for Children, the Pediatric Cancer Coping Scale, the Pediatric Quality of Life Inventory, and process evaluation forms. A 10-week program will be implemented for the children in the intervention group through web-based training, coaching interviews and counseling via video mobile calls, mobile messages and children's stories, progressive muscle relaxation and breathing exercises, and imagination interventions. During the same period, parents will also receive web-based training, coaching sessions, counseling, mobile messages, and progressive muscle relaxation exercises., Results: It is thought that after the intervention the stress level of the child and the family will decrease, the coping skills of the children will improve, and their quality of life will increase., Conclusions: It is thought that the treatment process can be affected positively by providing psychosocial support to children and their families who receive cancer treatment., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Ann & Joshua Medical Publishing Co. Ltd.)

Problem: Little is known about the emotional reactions of children who have migrated to another country fleeing a war in their home., Purpose: This descriptive study was conducted to compare the emotional indicators and anxiety levels of Syrian children who have migrated to Turkey following the war with anxiety levels of Turkish children., Methods: The study has been completed with 125 children who migrated from Syria and 168 children who are living in Turkey. The demographic data form, the Spielberger state and trait anxiety inventory (STAI) and Koppitz Draw-A-Person test were used for data collection., Findings: The average ages of Syrian and Turkish children who participated in the study are 9.14 ± 1.11; 8.89 ± 0.76, respectively. Emotional indicators such as impulsivity, anxiety, and anger appear more frequently in Syrian children's drawings compared to the drawings of Turkish children. State anxiety scores were 47.44 ± 8.09 in Syrian children and 32.16 ± 10.46 in Turkish children. Trait anxiety scores were 49.08 ± 7.98 in Syrian children and 39.76 ± 8.58 in Turkish children. The STAI score of Syrian children was higher compared to the score of Turkish children., Conclusions: Anxiety scores of children who have migrated are significantly higher than those of children residing in their country of origin. The physical and psychological evaluation of children who have witnessed warfare and have migrated is an important nursing initiative., (© 2019 Wiley Periodicals, Inc.)

Purpose: The study was conducted to examine the effects of a preoperative preparation program on children and their parents in a pediatric surgery outpatient clinic., Design: A quasiexperimental design was used., Methods: Seventy-three children and their primary caregivers were included in the study (intervention = 36, control = 37). Data collection tools included the Characteristics of Children and Caregivers Data Form, the PedsQL Health Care Parental Satisfaction Scale, the State Anxiety Inventory, and the children's Koppitz Human Figure Drawing Test. Data were collected on the day before surgery and the day of surgery. The program comprised verbal and written information about the process that was given to families and children, and a medical play doll was used for therapeutic communication with children in the intervention group., Findings: The satisfaction level of parents in the intervention group was found to be significantly higher than in the control group (intervention = 100, control = 50; P < .05). During the preoperative and discharge periods, the anxiety scores of parents in the intervention group were significantly lower than the control group (P < .05). According to the Koppitz Drawing Test, the children in the control group's emotional state was higher than the intervention group regarding impulsiveness, anxiety, and anger on discharge (P < .05)., Conclusions: The preoperative preparation program was found to have a positive effect on the children and their parents. Nurses should use drawings of children as a therapeutic communication technique to evaluate the emotions of children., (Copyright © 2017 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Objective: The majority of problems and symptoms occur in the gastrointestinal system in children with cancer. Parents have difficulty in coping with the nutritional problems and changing routines of children and need support in this respect. This study aimed to assess the nutritional problems of children with cancer and the information needs of their parents., Methods: This descriptive study was performed among children with cancer aged 3-18 years and their parents ( n = 69). The data were collected through a data collection form developed by the researchers based on the literature., Results: The most prominent nutritional problems experienced by children were loss of appetite (85.5%), nausea (84.1%), vomiting (81.2%), fatigue (79.7%), and mucositis (66.7%). According to the parents, the factors causing these nutritional problems in children were physiological factors (100%) and the foods given to children in the hospital (65.2%). The parents mostly needed information about food-drug interactions (58.0%), food-disease interactions (52.2%), foods that children with neutropenia should avoid or should eat (neutropenic diet) (46.4%), and frequency of nutritional intake (36.2%)., Conclusions: This study has shown that most children experience at least one nutritional problem, and the parents need comprehensive and regular information about nutrition. Pediatric oncology nurses have a significant responsibility in the evaluation, education, and monitoring of these children., Competing Interests: There are no conflicts of interest.

Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches., Competing Interests: There are no conflicts of interest.

The incidence of childhood cancers has been gradually rising worldwide. The rate of leukemia, which is the most common cancer type in childhood, has been increasing as well. In recent years, multiple chemotherapeutic agents, radiotherapy and bone marrow transplantation have been using in leukemia treatment. Children receiving treatment for leukemia may experience many symptoms due to the disease and its treatment. These concurrent symptoms may have a complex relationship. The aim of this paper is to review and compile current literature data related to symptom clusters used to explain multiple symptoms that occur in a complex structure due to leukemia and its treatment. Symptom clustering is used in oncology nursing to explain the complex relationship among multiple symptoms and to find out the effects that symptoms have on each other and patient outcomes. There are generally two statistical approaches to modeling symptom clusters. One is to establish the symptom clusters by grounding on clinical experiences, while the other is to establish them according to the results of statistical analysis and then clinical experiences. With the latter method, symptom clusters can be established more objectively and more number of symptoms can be assessed. In the literature, there are four instruments available for the measurement of a large number of symptoms in children. It is important to increase use of symptom clusters in nursing care for a better understanding of the relationship among multiple symptoms experienced during leukemia treatment, a more effective symptom management, and a more holistic care., Competing Interests: There are no conflicts of interest.

Background: After-school programs represent a promising opportunity to assist adolescent girls' in attaining adequate physical activity. Although evaluating the process of intervention implementation is important for determining if an intervention was delivered and received as intended, comprehensive information about process evaluation methods and results are rarely reported. The purpose of this article was to evaluate the reach, dose, and fidelity of a 90-minute after-school physical activity club offered 3 days a week. The club is 1 of 3 components included in a 17-week intervention designed for 5th-8th grade girls, the majority of whom were of minority and/or low socioeconomic status., Methods: A total of 24 schools (12 intervention; 12 control) and 56-67 girls per school (total N = 1519 girls) were included in the Girls on the Move group randomized controlled trial. At the beginning of each of 3 academic years (2012-2015), 8 schools per year were randomized to receive either the intervention (n = 4) or control condition (n = 4). To evaluate the club, data collected via surveys from girls, club coaches and managers, and process evaluators were analyzed. To evaluate the opportunity for physical activity provided by the coaches and managers, process evaluators used an observation tool based on the System for Observing Fitness Instruction Time and Academic Learning Time - Physical Education. Girls wore accelerometers every other week during the club time., Results: Mean attendance was 41 % with the average attendance in year 3 being higher than rates for years 1 or 2. Mean moderate-to-vigorous physical activity time was 21.85 minutes measured via accelerometry and 21.81 minutes observed by process evaluators. Satisfaction with the intervention was high. For the most part, process evaluators perceived the club was delivered as planned and reflected constructs of the Health Promotion Model and Self-Determination Theory. Areas contributing to success included using incentives and offering a variety of activities. Issues negatively impacting implementation included managing behavioral problems, having limited space for moderate-to-vigorous physical activity, dealing with inclement weather, and getting coaches to actively participate in all physical activities with the girls., Conclusions: This process evaluation provides important information to guide future school-based physical activity intervention delivery. Barriers to implementation have been identified. Ways to overcome them warrant consideration when designing physical activity interventions. Research is needed to test innovative approaches for enhancing attendance and increasing girls' moderate-to-vigorous physical activity in after-school programs., Trial Registration: ClinicalTrials.gov Identifier NCT01503333 . Registered 23 December, 2011.

Purpose: The aim of this study was to evaluate content and construct validity of a Turkish language version of the Bates Wound Assessment Tool (BWAT) as well as its internal consistency and interrater reliability., Subjects and Setting: The study was conducted in 13 intensive care units that included patients with pressure ulcers; the units were located in a university hospital in Central Anatolia, Turkey. The sample comprised 70 nurses and 20 patients who have stage II, III, and IV pressure ulcers., Methods: Data were collected between January and April 2011. Content validity was measured using the Davis Technique. The BWAT was scored by 2 groups, nurses with expertise in wound care and staff nurses. An expert nurse and a ward nurse conducted pressure ulcer evaluation on the same patient consecutively in order to determine interrater reliability. We also measured internal consistency via the Cronbach α., Results: The content validity agreement rate was 0.82. The interrater reliability of the instrument was 0.82; its internal consistency calculated via the Cronbach α was 0.85., Conclusion: The findings of this study support the Turkish language version of the BWAT as possessing content validity, interrater reliability and internal consistency.

Smoking and alcohol drinking in adolescents cause significant problems in most countries. The aim of this cross-sectional descriptive study was to determine the prevalence, causes, risk factors, and preventive factors for cigarette and alcohol use in adolescents. The sample included 1,133 students enrolled in grades 9-12. Data were collected using a descriptive data form, the Psychological Resilience and Adolescent Development Scale, and the Family Environment Scale. Most adolescents stated that stress and psychological problems were the causes of smoking and alcohol use. Preventive factors were indicated as developing skills for saying "no," good coping skills, and peer groups not using cigarettes. The Psychological Resilience and Adolescent Development Scale mean score for cigarette and alcohol use was significantly higher than for nonuse. The Family Environment Scale mean score for cigarette and alcohol use was significantly lower than for nonuse.

Background: Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses., Objective: This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties., Materials and Methods: It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis., Results: Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues., Conclusions: Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

This research was conducted to assess the effect of a weight management program in Turkish school children with overweight and obesity. Forty one students formed the intervention group while 40 students formed the control group in two elementary schools. Students in intervention group were given seven training sessions in a period of 2.5 months. Concurrently, parents were given two trainings and consultancy. The Body Mass Indices (BMIs) of the intervention group at the third measurement were decreased (p < .05) significantly when compared to the control group. The findings suggest use of school-based weight management programs starting from elementary school.