Öznur Tosun

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.

Investigation of the Relationship Between Peer Victimization and Quality of Life in School-age Adolescents

OBJECTIVE: This research aims to investigate the relationship between peer victimization and quality of life in school‐age adolescents. METHODS: In the study, a total of 332 seventh‐ and eighth‐grade students, who agreed to participate in the research and studying at secondary schools subsidiary of Provincial Directorate for National Education in the Province of Giresun, Turkey, were included in the study. The approval of ethics committee, permission of Provincial Directorate for National Education, and written and verbal consent of the students, who were participated in the research, were obtained. Personal Information Form, Olweus Bully/Victim Questionnaire, and Kiddo‐KINDL Adolescent Quality of Life Scale was used for data collection. RESULTS: Considering the quality of life of adolescents according to the peer victimization, the mean physical well‐being, mental well‐being, family, friends, and disease sub‐scale scores and the mean total score in the quality of life scale was found to be higher in adolescents not involved any bullying/victimization, and the difference was found to be significant (p < 0.05). CONCLUSION: In this study, it was concluded that peer victimization is widespread in Turkey, males are more prone to bullying, and peer victimization has a negative impact on quality of life.

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.