Background: Preschool-age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children. Objective: To determine the effectiveness of the mobile-type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents. Design: This study used a three-group, randomized controlled trial prepost design. Setting(s): This study was conducted in the pediatric ward of three general hospitals in Korea. Participants: A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention. Methods: Hospitalized preschool-age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper-based intervention, whereas the control group received the usual intervention. Participants' outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention. Results: Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups. Conclusions: Using the SKH app is easy to attract the interest of preschoolage children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future. Clinical Relevance: It is thought to contribute to the prevention of preschool-age children's safety incidents in pediatric wards.
Aims The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease. Design A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals. Methods To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13–19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010–December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log‐likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two‐step method. Results The physical symptoms experienced by adolescents with moyamoya disease were ‘limb weakness’ – the most common – followed by a ‘headache,’ ‘difficulty in speech,’ and ‘nausea/vomiting.’ A total of five symptom clusters were derived: cluster 1 was characterized by ‘limb weakness’; cluster 2 participants were asymptomatic or experienced ‘convulsions’; cluster 3 experienced ‘difficulty in speech’ and ‘facial paralysis’; cluster 4 is prone to ‘dizziness’ and ‘pins and needles’; and cluster 5 displays ‘headaches’ and ‘nausea/vomiting’. Conclusion This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents. Impact These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.
Purpose: This study aimed to identify the mediating and moderating effects of mindset and psychological collectivism, respectively, on the relationship between grit and nursing intention for children with emerging infectious diseases, including coronavirus disease 2019 (COVID-19), among pediatric nurses.Methods: We conducted a crosssectional descriptive study with 230 pediatric nurses.Results: Grit directly impacted mindset (β=.27, p<.001) and nursing intention (β=.20, p=.001). The direct effect of mindset on nursing intension (β=.28, p<.001) and the indirect effect of grit on nursing intension via mindset (β=.08, p<.001) were significant. Accordingly, mindset mediated the effect of grit on nursing intention. The effects of grit and psychological collectivism (β=.19, p=.003), respectively, on nursing intention were significant. However, the interaction between grit and psychological collectivism was not significant. Thus, psychological collectivism did not moderate the effect of grit on nursing intention.Conclusion: The findings demonstrate the importance of pediatric nurses' grit and mindset on their intended care for patients in critical situations. Cultivating a gritty culture and developing interventions to enhance nurses' personality traits associated with their performance will be crucial, and such measures are especially salient for pediatric nurses to face the new adjustments required in the era of COVID-19.
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