Emine Erdem

Depression, Anxiety, Hopelessness, and Social Support Levels of the Parents of Children With Cancer

When a child is diagnosed with cancer, family members are affected both socially and psychologically. This study was conducted to determine the depression, anxiety (state and trait), hopelessness, and perceived social support levels of 94 parents of children with cancer followed up at a university hospital. Data were collected using a questionnaire form and included descriptive characteristics, Beck Depression Inventory, Multidimensional Scale of Perceived Social Support, State—Trait Anxiety Inventory, and The Hopelessness Scale. A positive relationship was found between depression and hopelessness scores and between state and trait anxiety scores for both mothers and fathers. Also, a negative relationship was found between social support and depression scores and between hopelessness and social support scores. Apart from fathers, a positive relationship between depression and trait anxiety scores and a negative relationship between state anxiety and hopelessness scores were found in mothers. Based on these results, it seems that it would be highly beneficial to provide psychological and social support and social support groups to help parents cope with these problems.

Daily physical activity in low-risk pre-term infants: Positive impact on bone strength and mid-upper arm circumference

Background: Prevention of pre-term osteopenia is important because it results in ventilator dependency, fractures in long bones, softening of the ribs or respiratory failure due to bone breaks in newborns. Aim: The aim of this study was to evaluate the changes in bone strength and anthropometric indices of very low birth-weight (VLBW) pre-term infants undergoing daily physical activity. Subjects and methods: Forty VLBW and low-risk pre-term infants (n intervention group = 20, n control group = 20) with a birth weight of 800–1600 g and gestational age of 26–32 weeks were recruited. Pre-term infants in the control group were provided with standard nursing care whereas those in the intervention group received a daily physical activity programme in addition to standard nursing care during the study. Before and after the study, anthropometric indices and tibial speed of sound (SOS) values were measured. Results: In this study the tibial SOS values were found to be increased in the intervention group (p < 0.001) and decreased in the control group (p = 0.002). The increase in percentage of the mid-upper arm circumference of infants was significantly higher in the intervention group than in the control group (p < 0.001). Conclusion: A daily physical activity programme increased SOS values of the tibia and mid-upper arm circumference in VLBW pre-term infants.

Pain in New born and Nursing Management

It is determined that first nociceptors (pain sensing receptors) occur in the perioral region at 7 weeks of intrauterine life, spread in the rest of face, the palms of the hands and feet at 11 weeks, with arms and legs at 15 weeks, all cutaneous and mucosal surfaces at 20 weeks. Distribution of nociceptive nerve endings in the skin of neonates was determined to be similar in density to an adult . In addition, pain in neonates is transmitted by unmyelinated C fibers. These fibers transmit impulses slowly. It starts second or seconds later than a painful stimuli and continues for minutes to increase in size. Pain transmitted by this fiber is perceived as dispersed, continuous, dull and burning. Therefore, anatomical, physiological and biochemical structures enabling the perception of pain are present in neonates and are sufficient for the transmission of painful stimuli. In this direction, the necessity of making researches on neonatal pain experience has been raised.

O-153 The Effect Of Aromatherapy, Music Therapy And Vibration Applications On Neonatal Stress And Behaviours

Background and aims It is important for physicians and nurses at neonatal units using advanced technology to understand neonatal behaviours and to support newborns by complementary care applications. This randomised controlled study was conducted experimentally to determine the effect of aromatherapy (with lavender+sweet almond oil), music therapy (Traditional Turkish Music) and vibration application (with electric toothbrush) on neonatal stress and behaviours. Methods The study was conducted in a university hospital in Kayseri, Turkey. Totally 80 preterm infants assigned randomly to 4 groups as control, aromatherapy, music therapy and vibration application. Data were collected with questionnaire form, Brazelton Newborn Behavioural Assessment Scale (BNBAS) and Newborn Stress Evaluation Form (NSEF). On the first, third and fifth days, BNBAS and NSEF were applied both pre- and post-intervention application continued one session/day for five days. Data were analysed with two-way analysis of variance for the repeated measurements, Student-Newman-Keuls tests. Results Of the preterm infants, there was significant difference between measurement times in mean BNBAS scores (p < 0.001) and between measurement times (p = 0.003), group-time interactions (p < 0.001) and between groups (p = 0.040) in mean NSEF scores. Mean of differences between pre- and post-intervention of BNBAS and NSEF scores of complementary care application groups were higher than control group (p = 0.001, p = 0.040) and the source of the difference was the control group. Conclusions Aromatherapy, music therapy and vibration application decreased stress in newborns and favourably affected the behaviours of newborns. Complementary care applications (especially aromatherapy, music therapy) by physicians and nurses in neonatal units may be recommended.

Increasing awareness of protection from sexual abuse in children with mild intellectual disabilities: An education study

Sexual abuse is an important problem for children and particularly those with intellectual disabilities. Increasing awareness of sexual abuse could help these children to protect themselves from such a potential encounter. The study was conducted to raise awareness about sexual abuse in children with intellectual disabilities with 15 children who had mild intellectual disabilities as a pre-posttest experimental design. Informative pictures, designed according to age and intellectual level, suitable stories linked with these pictures and homework, were used in an educational setting. It was determined that there was a significant difference relating to the scores for all the subjects before and after the assignment (p<0.05). After education, awareness of them in protecting from a possible sexual abuse increased with protection educations for intellectual disabilities children, as desired.

A Comparison of Aggression and Self-injury Among Type 1 Diabetic and Healthy Adolescents: A Sample From Turkey

Background: Adolescents tend to have risky behaviors like aggression and self‐injury due to the age period characteristics. The risk of aggression and self‐injury may increase in adolescents with the addition of chronic diseases. Objectives: This study was conducted descriptively to determine and compare the aggression and self‐injury in those with type 1 diabetes mellitus (T1DM) and healthy counterparts. Methods: The study sample consisted of 60 adolescents with T1DM followed up in the child endocrinology polyclinic of a university hospital and 319 healthy counterparts, 15–18 aged, at 9th–12th grade at high school. In the study, the permission of the institution, Ethical Committee, the parent and adolescent consent, the data were collected using a questionnaire form, Aggression Questionnaire (AQ) and Inventory of Statements About Self‐injury (ISAS). The descriptive statistics, Shapiro‐Wilk, Mann‐Whitney U, Student t, Chi‐square, Spearman correlation tests were used for analyzing data. Results: The mean scores of AQ all subscales and the total scale of healthy adolescents were higher than adolescents with T1DM (p < 0.05). Mean ISAS scores of adolescents with T1DM were higher than the healthy ones (p > 0.05). The mean scores of autonomic function, social function and ISAS were positively moderately correlated with the mean scores of total aggression in both healthy and diabetic adolescents (p < 0.05). Conclusions: Considering the age period characteristics, training about anger‐stress management and effective communication skill to adolescents and their parents may be recommended by health professionals.

Osteopenia among Preterm Newborns and Nursing Care

Incidence of preterm birth has been increasing since 1980s. Despite this increase in the incidence, survival rate of preterm newborns has been going up although it changes depending on gestational age. It is stated that such critical diseases that progress slowly as sensory losses, neurological disorders, developmental deficits, respiratory failures, bone mineral problems occur despite decreasing number of health problems that develop rapidly thanks to the increasing rate of preterm survival rate. One of the bone mineralization problems seen in preterm newborns is osteopenia. Because osteopenia, described as poor bone mineralization, occurs during the last trimester of pregnancy and bone development period, it is often seen among preterm newborns and is thus termed as preterm osteopenia. As birth weight and gestation age of newborns reduce, incidence of preterm osteaopenia increases. In diagnosing preterm osteopenia, biochemical parameters and radiological tests are used. Preterm osteopenia may lead to fractures in long bones, respiratory insufficiency due to softening or fractures of ribs, inability to leave ventilator during newborn period as well as retardation of tooth development and short stature in future. Therefore, it is highly important to prevent preterm osteopenia. First intervention against preterm osteopenia is to prevent disease progress. Enabling preterm newborns to be fed with fortified breast milk or formula with calcium and phosphorous supplements may fail in preventing preterm osteopenia. Besides; osteopenia and osteopenia-related complications may be prevented by offering daily physical activities that have no adverse effects to preterm newborns who suffer from movement restrictions. It is suggested that nurses who are responsible for the protection, maintenance and development of health can make contributions to prevent osteopenia by assessing behaviors of the newborns with the health care team and providing nutritional supplements, proper treatment modalities and physical activity programs. Thus, undesired results including long hospital stay and repeated hospitalizations that will worsen general physical status of preterm newborns and will increase cost of health care can be avoided.

PS-258 Can The Expression Of Chronic Disease Given By Children Be Understood With Aesthetic Knowing?

Background and aims Aesthetic Knowing provides understanding human reactions towards disease, health, events. Study was conducted qualitatively to understand what chronic disease expressed to children with chronic diseases by intern nurses with Aesthetic Knowing. Methods Study was conducted with 25 intern nurses caring 25 children aged 9–18 years hospitalised at paediatric clinics of a university hospital in Turkey. Ethical approval and consent from students, children, parents were obtained. Aesthetic Knowing education was given to students prior to study. Students wanted children to express what it meant to have chronic disease by painting (8) or article-poem-letter (17) based on their preferences. Focus group interview was done to learn experiences of students, recorded and themes (meaning of chronic disease for children, benefits of Aesthetic Knowing, experiences of students about using Aesthetic Knowing in nursing, contribution of Aesthetic Knowing to nursing) were determined after content analysis. Results Opinions of students about chronic disease were; fear, anxiety, concern, stress, anger, pain, feeling of guilt, impact on routines, school lives, life styles, quality of life, social and psychological support needs, future uncertainty, limitations of disease (medications, diet). Opinions of students about benefits of Aesthetic Knowing and its usage in nursing were; entering inner world of children, understanding feelings of pain, anger, guilt, increasing empathy, trust relations, communication, provision of holistic care, improving quality of care, integrating family into care, noticing patient needs, providing patient self-expression. Conclusions Aesthetic Knowing is recommended to use in nursing education and patient care to understand children reactions and direct care.

PO-0865 The Aggression And Self- Injury Behaviours In Adolescents With Type 1 Diabetes Mellitus

Background and aims Adolescents tend to have risky behaviours like aggression and self-injury due to the age period charateristics. The risk of aggression and self-injury may increase in adolescents with the addition of chronic diseases. This study was conducted descriptively to determine and compare the aggression and self- injury in those with type 1 diabetes mellitus (T1DM) and healhty adolescents. Methods The study sample consisted of 60 adolescents with T1DM followed up in the child endocrinology polyclinic of a university hospital and 319 healthy adolescents,15–18 aged, at 9th-12th grade at high school. In the study, the permission of the institution, Ethical Committee, the parent and adolescent consent, the data were collected using a questionnaire form, Agression Questionnaire (AQ) and Inventory of Statements About Self-injury (ISAS). The descriptive statistics, Shapiro-Wilk, Mann-Whitney U, student t, Ki-kare, Spearman correlation tests were used for analysing data. Results The mean scores of AQ all subscales and the total scale of healthy adolescents were higher than adolescents with T1DM (p < 0.05). Mean ISAS scores of adolescents with T1DM were higher than the healthy adolescents (p > 0.05). The mean scores of autonomic function, social function and ISAS were positively moderately correlated with the mean scores of total aggression in both healthy and diabetic adolescents (p < 0.05). Conclusions Considering the age period characteristics, giving weight to sport (especially team sports), social and cultural activities and education about anger-stress management and effective communication skill to adolescents and their families in school may be recommended.