Journal of Pediatric Nursing-Nursing Care of Children & Families最新文献

{"title":"Caregivers' perceived importance of topics for managing pediatric obesity and their expectations and preferences regarding family navigation: a convergent mixed-methods study.","authors":"Najmeh Hamzavizarghani, Josephine Ho, Ian Zenlea, Marcus G O'Neill, Angela S Alberga, Rima Azar, Josie Geller, Nicholas L Holt, Tracy Lebel, Rhonda J Rosychuk, Jean-Eric Tarride, Laiba Azhar, Dinah Bear, Sharifa Beker, Rebecca Zafrani Miralles, Geoff D C Ball","doi":"10.1016/j.pedn.2026.08.050","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.050","url":null,"abstract":"<p><strong>Purpose: </strong>To examine caregivers' perceived importance of topics regarding pediatric obesity management (POM) and explore their expectations and preferences regarding family navigation (FN).</p><p><strong>Design and methods: </strong>In this cross-sectional, mixed-methods study, caregivers of 6-to-17-year-olds with a BMI ≥ 97th percentile completed a survey to assess their perceived importance of topics regarding POM, including knowledge and skill needs regarding healthier food/drinks, physical activity/exercise, family support/behaviour, and weight management goals. A sub-set completed individual interviews to explore their expectations and preferences regarding FN for POM. From 2022 to 2024, data collection occurred at two POM clinics in Calgary and Mississauga, Canada, within a randomized controlled trial. To examine differences between caregivers' knowledge and skill needs, the paired t-test or Wilcoxon test was used. Inductive/manifest content analysis was used to analyze interview data, with convergent mixed methods used to integrate quantitative and qualitative data.</p><p><strong>Results: </strong>Overall, 108 caregivers completed the survey; data analysis included interviews with 52 caregivers. Survey data showed that caregivers' knowledge needs exceeded skill needs for healthier food/drinks, physical activity/exercise, and total knowledge/skills (all p < 0.01). Caregivers attended clinic appointments seeking support to change behaviours; however, competing commitments limited their ability to attend regularly. Participants preferred to meet navigators more often than monthly, both as a family and parent only, and expected navigators to serve as facilitators and supporters to identify available community resources.</p><p><strong>Conclusions: </strong>Caregivers reported that FN could support families in accessing community resources and connect them with medical and healthcare providers to promote behaviour change and improve their children's mental health.</p><p><strong>Practice implications: </strong>Caregivers expect to receive support to overcome barriers that reduce access to health services for managing pediatric obesity in clinics. Interventions that include family navigators as facilitators and supporters to help families in addressing barriers can enhance pediatric obesity management engagement in clinic appointments.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"672-680"},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"invisible\" world of mothers of children with special needs: a phenomenological study of caregiving experiences and stigmatization.","authors":"Tuğba Demiroğlu Dost, Esma Özmaya, Gizem Ercan","doi":"10.1016/j.pedn.2026.08.067","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.067","url":null,"abstract":"<p><strong>Purpose: </strong>This phenomenological study explored mothers' caregiving experiences for children with special needs, focusing on stigmatization and how they make sense of these experiences in daily life.</p><p><strong>Design and methods: </strong>A descriptive phenomenological study was conducted with 15 mothers serving as primary caregivers of children with moderate to severe autism spectrum disorder and/or intellectual disability. Participants were recruited through purposive criterion sampling. Data were collected through semi-structured interviews and analyzed using Colaizzi's seven-step phenomenological method.</p><p><strong>Results: </strong>Four themes emerged: motherhood experience and identity transformation, caregiving burden and continuous responsibility, stigmatization and social interaction, and future-related concerns and coping. Mothers described caregiving as a continuous responsibility extending beyond physical care and involving substantial invisible labor and mental load related to planning, monitoring, anticipating risks, and coordinating care. Their experiences were marked by physical and emotional exhaustion, social isolation, and stigma. Concerns about their children's future, particularly who would care for them after their death, emerged as a major source of anxiety. Spousal support, peer relationships, and rehabilitation services were identified as important coping resources.</p><p><strong>Conclusions: </strong>Caring for a child with special needs is a multidimensional experience characterized by invisible labor, constant vigilance, social challenges, and uncertainty about the future. Nursing care should address not only the child's needs but also mothers' psychosocial burden.</p><p><strong>Relevance to clinical practice: </strong>Nurses should assess mothers' less visible cognitive and emotional caregiving demands, including constant vigilance, care coordination, social restrictions, and future uncertainty, to better understand their needs and provide appropriate support.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"661-671"},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cartoon character-printed band use during burn dressing on fear, stress, pain, and physiological parameters in children: A randomized controlled trial.","authors":"Rıdvan Akdoğan, Delal Aslan Özdemir, Özkan Sir","doi":"10.1016/j.pedn.2026.08.066","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.066","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effects of cartoon character-printed bands on fear, stress, pain, and physiological parameters in children.</p><p><strong>Design: </strong>A randomized controlled trial was conducted.</p><p><strong>Methods: </strong>This single-center study included 42 children (aged 7-10 years) undergoing burn dressing. Participants were randomly assigned to an intervention group (cartoon character-printed band, n = 21) or a control group (standard dressing, n = 21). Data were collected using the Children's Fear Scale, Wong-Baker Faces Pain Rating Scale, Perceived Stress Scale for Children, and monitoring of vital signs. Outcomes were assessed before and after the procedure and analyzed using mixed between-within ANOVA.</p><p><strong>Results: </strong>Significant group × time interactions were found for fear (F = 56.178, p < .001, eta^2 = 0.584), stress (F = 83.997, p < .001, eta^2 = 0.677), and pain (F = 48.338, p < .001, eta^2 = 0.547), showing substantial reductions in the intervention group. Additionally, the intervention group demonstrated a significant increase in oxygen saturation (p < .001, eta^2 = 0.411) and a decrease in heart rate (p < .001, eta^2 = 0.312). No significant differences were observed in body temperature or respiratory rate.</p><p><strong>Conclusions: </strong>Cartoon character-printed bands appear to be a promising, low-cost, and easily applicable non-pharmacological nursing intervention. Integrating these distraction-based materials into routine care may help reduce procedural distress and support selected physiological outcomes in this sample.</p><p><strong>Implications for practice: </strong>This intervention has the potential to be incorporated into standard pediatric nursing care without requiring additional training or equipment.</p><p><strong>Clinical trial registration: </strong>NCT07313735.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"617-627"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyberbullying toolkit for adolescent mental health: assessment and intervention in a YMCA summer camp population.","authors":"Lachelle Cruickshank, Gina L Schaar, Pam Miller","doi":"10.1016/j.pedn.2026.08.058","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.058","url":null,"abstract":"<p><strong>Introduction: </strong>Cyberbullying is a growing public health concern among adolescents aged 11-14 and is associated with increased anxiety, depression, social isolation, and reduced self-efficacy. With widespread internet and social media use among adolescents, exposure to online aggression is common. Traditional school-based prevention programs often fail to reach community-based youth settings such as summer camps, creating a gap in early intervention and skill-building opportunities. Strengthening awareness, empathy, and reporting self-efficacy is essential to promoting safer online peer interactions and protecting adolescent mental health.</p><p><strong>Methods: </strong>A structured cyberbullying educational toolkit was implemented over three weeks at a YMCA summer camp in the northeastern United States. The intervention included interactive workshops, role-play activities, and guided group discussions. A pretest-posttest design was used to evaluate changes in awareness, attitudes toward reporting, empathy, and self-efficacy. Thirteen adolescents aged 11-14 participated. Data were collected using a Likert-scale questionnaire administered before and after the intervention. Paired-samples t-tests and effect sizes were used to analyze changes.</p><p><strong>Results: </strong>Post-intervention findings demonstrated significant improvements across all measured domains. Participants showed increased awareness (p < .001, d = 3.20), improved attitudes toward reporting (p < .001, d = 2.19), enhanced empathy (p < .001, d = 1.97), and greater self-efficacy in addressing cyberbullying (p < .001, d = 1.69). All participants demonstrated measurable gains following the intervention.</p><p><strong>Conclusions: </strong>The cyberbullying educational toolkit was effective in improving key psychosocial outcomes among adolescents in a community setting. These findings support the use of structured, interactive, and community-based interventions to strengthen adolescents' capacity to recognize and respond to cyberbullying.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"600-608"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in adolescents' asthma knowledge, social support-seeking behaviors, and asthma self-management following an online peer support program.","authors":"Faten Mabrouk Nouh, Hasan Abualruz, Eba'a Da'san Barghouthi, Mohammed Qutishat, A H Salama, Hend Emara, Eman Saif Soliman Ashour, Samar F Mansour","doi":"10.1016/j.pedn.2026.08.057","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.057","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with asthma often experience inadequate disease knowledge, limited social support, and poor self-management, which may adversely affect asthma control and quality of life. Online peer support programs offer a promising approach to complement conventional asthma education by addressing both educational and psychosocial needs.</p><p><strong>Aim: </strong>To examine changes in adolescents' asthma knowledge, social support-seeking behaviors, and asthma self-management following participation in an online peer support program.</p><p><strong>Methods: </strong>A one-group quasi-experimental pretest-posttest study was conducted among 50 adolescents (12-16 years) with physician-diagnosed asthma attending two outpatient pulmonary clinics in Egypt. Participants completed validated questionnaires assessing asthma knowledge, social support-seeking behaviors, and asthma self-management before and after an 8-week nurse-supervised online peer support program delivered through WhatsApp and Microsoft Teams.</p><p><strong>Results: </strong>Significant improvements were observed following the intervention. Mean asthma knowledge scores increased from 25.98 ± 4.19 to 39.40 ± 1.34 (p < .001), social support-seeking behavior scores increased from 13.90 ± 1.72 to 29.34 ± 1.69 (p < .001), and asthma self-management scores increased from 5.10 ± 2.19 to 15.10 ± 0.99 (p < .001). Significant positive correlations emerged between asthma knowledge and social support-seeking behaviors (r = 0.465, p < .001), asthma knowledge and self-management (r = 0.311, p = .02), and social support-seeking behaviors and self-management (r = 0.582, p < .001).</p><p><strong>Conclusions: </strong>Participation in the online peer support program was associated with significant improvements in asthma knowledge, social support-seeking behaviors, and asthma self-management.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"642-651"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with armor: A qualitative study of body image, social life, and brace experiences in adolescents with idiopathic scoliosis.","authors":"Deniz Kaya Meral, Nihan Altan Sarıkaya, Deniz Öke","doi":"10.1016/j.pedn.2026.08.061","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.061","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the experiences of individuals diagnosed with idiopathic scoliosis regarding body image, social life, and brace use.</p><p><strong>Design: </strong>This study was conducted using a descriptive qualitative design with a phenomenological approach.</p><p><strong>Settings and participants: </strong>The study was carried out with 15 participants who attended the scoliosis outpatient clinic of a Physical Therapy and Rehabilitation Training and Research Hospital. Participants were recruited using purposive sampling.</p><p><strong>Methods: </strong>Data were collected through semi-structured individual interviews and analyzed using Colaizzi's seven-step phenomenological analysis method. The COREQ checklist was used to guide the reporting of the findings.</p><p><strong>Results: </strong>Four main themes were identified: (1) Changing Body, Fragile Emotions, (2) Under Observation: The Social Imprints of Scoliosis and Bracing, (3) Living with Armor, and (4) The Need for Connection: Strengthening through Support. The findings revealed that participants experience scoliosis and brace use as a multi-layered process in which physical, emotional, and social dimensions are closely intertwined.</p><p><strong>Practice implications: </strong>The findings indicate that psychosocial needs in adolescent idiopathic scoliosis care are closely related to emotional awareness and communication processes. In pediatric nursing practice, peer-based and communication-focused approaches may support individuals with adolescent idiopathic scoliosis' adaptation and coping.</p><p><strong>Conclusions: </strong>Participants experience disturbances in body image, concerns about social visibility, and physical-emotional strain associated with scoliosis and brace use. Over time, some participants come to perceive the brace as a protective and functional element, while seeking support plays a decisive role in their coping processes.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"609-616"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a mobile game application on knowledge and health-related beliefs in children with chronic kidney disease: A randomized controlled trial.","authors":"Gülzade Uysal, Duygu Sönmez Düzkaya, Atiye Karakul, Banu Terzi, Serkan Uçar, Nevin Uygur Bıçaklı, Berna Gürler Arı, Alev Yılmaz","doi":"10.1016/j.pedn.2026.08.060","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.060","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the short-term effects of a mobile game application developed for children with Chronic Kidney Disease (CKD) on knowledge, health-related beliefs, attitudes, and clinical parameters.</p><p><strong>Design and methods: </strong>This randomized controlled trial included 64 children with CKD (32 per group). A mobile game tailored for children aged 11-14 years was developed. Data were collected using a Data Collection Form, Clinical Parameters Follow-up Form, Information Form on Chronic Renal Failure, Healthy Lifestyle Belief Scale for Adolescents, and the Child's Attitude Toward His/Her Disease Scale.</p><p><strong>Results: </strong>Mean ages were 12.78 ± 1.21 and 12.65 ± 1.31 years in the experimental and control groups, with no significant demographic differences (p > 0.05). Children using the mobile game showed significantly higher knowledge, healthy lifestyle belief, and disease attitude scores at 1 and 3 months than controls (p < 0.05). No significant between-group differences were found in blood pressure or pulse rate (p > 0.05). Initial differences in iron-binding capacity and potassium did not remain significant after correction. Usability was high (score: 276.18 ± 2.71/280).</p><p><strong>Conclusions: </strong>The intervention was associated with short-term improvements in knowledge, healthy lifestyle beliefs, and attitudes toward CKD; given the absence of an attention-matched control and confounding of modality with educational dosage, findings should be interpreted as association rather than established effectiveness. No significant effects were observed on clinical parameters. The internally developed knowledge instrument lacks formal factor-analytic or criterion validation.</p><p><strong>Practice implications: </strong>Pediatric nurses can support disease management in children with CKD by incorporating mobile game-based educational tools into routine care, recognizing that current evidence supports short-term educational benefit rather than established clinical effects.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"628-641"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of quality of life in adolescents with type 1 diabetes: The role of diabetes technology satisfaction and self-efficacy.","authors":"Türkan Akyol Güner","doi":"10.1016/j.pedn.2026.08.063","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.063","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the associations among diabetes technology satisfaction, self-efficacy, and quality of life in adolescents with Type 1 Diabetes (T1D).</p><p><strong>Design and methods: </strong>This descriptive, cross-sectional study included 235 adolescents with T1D registered at Family Health Centers in a provincial center in Turkey's Western Black Sea Region. Data were collected using the Diabetes Technology Questionnaire (DTQ), the Diabetes Management Self-Efficacy Scale, and the Kiddo-KINDL Quality of Life Scale.</p><p><strong>Results: </strong>The mean HbA1c was 9.05 ± 1.38%. Insulin pump (±CGM) users demonstrated significantly higher technology satisfaction (118.9 vs. 90.3; F = 47.23, p < .01), better self-efficacy (58.3 vs. 76.4; F = 18.42, p < .01; lower scores indicate higher self-efficacy), and higher quality of life (112.3 vs. 92.5; F = 21.87, p < .01) compared to the MDI + SMBG group. Hierarchical regression identified self-efficacy as the strongest predictor of quality of life (β = -0.39, p < .001), followed by DTQ score (β = 0.30, p < .001). The model explained 37.2% of total variance, with modifiable psychosocial factors contributing 28.0%. Female adolescents showed lower self-efficacy and quality of life than males (p < .01).</p><p><strong>Conclusion: </strong>Self-efficacy emerged as the strongest independent predictor of quality of life, surpassing demographic, clinical, and technology-related variables. Advanced diabetes technology use was consistently associated with more favorable psychosocial outcomes.</p><p><strong>Application to practice: </strong>Pediatric nurses should integrate self-efficacy-enhancing strategies and gender-sensitive psychosocial support into diabetes education, while advocating for equitable access to advanced technologies.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"591-599"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing family disease management and disease management difficulties in children with congenital gastrointestinal malformations: The roles of caregiver burden, social support, and family function.","authors":"Qiuping Wang, Jiayi Hu, Qun Yu, Min Zhu, Chen He, Jin Yan, Xiaohua Ge","doi":"10.1016/j.pedn.2026.08.048","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.048","url":null,"abstract":"<p><strong>Background: </strong>Children with congenital gastrointestinal malformations often have complex conditions that require long-term treatment and care, which can negatively impact their physical and mental well-being as well as their families, who play a crucial role throughout their treatment and management.</p><p><strong>Purpose: </strong>This study aimed to determine the current state of family disease management, the difficulties in managing disease in children with congenital gastrointestinal malformations, and the associated risk factors.</p><p><strong>Design and methods: </strong>This was a cross-sectional descriptive study including 127 family members of children with congenital gastrointestinal malformations. Data were collected using a subscale of the Family Management Measure (FaMM), the Zarit Caregiver Burden Interview, the Feetham Family Functioning Survey (FFFS), and the Perceived Social Support Scale (PSSS).</p><p><strong>Result: </strong>The family disease management and disease management difficulties for children with congenital gastrointestinal malformations were at a moderate level, and caregiver burden was also at a moderate level. Surgical history, family residence, family function, and caregiver burden were the main factors influencing family disease management in the children with Congenital Gastrointestinal Malformations.</p><p><strong>Conclusion: </strong>The family management capacity for children with congenital gastrointestinal malformations needs to be improved. It is multi-influenced by surgical history, family residence, family function, and caregiver burden. Nursing staff should integrate caregiver burden assessment, family function support, and social resources to develop family-centered interventions. Through targeted education, personalized follow-up, and active caregiver engagement in the rehabilitation journey, family management can be facilitated, disease management difficulties reduced, and long-term health outcomes ultimately enhanced.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"652-660"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' practices in optimizing the care environment in everyday living settings for children with medical complexity.","authors":"Yumi Mizuochi, Yukako Shigematsu, Yoshitomo Fukuura","doi":"10.1016/j.pedn.2026.08.056","DOIUrl":"https://doi.org/10.1016/j.pedn.2026.08.056","url":null,"abstract":"<p><strong>Background: </strong>Children with medical complexity (CMC) often require highly individualized care environments in everyday living settings. Nurses play key roles in coordinating care and optimizing these environments; however, their specific practices have not been fully elucidated.</p><p><strong>Purpose: </strong>This study aimed to clarify nursing practices for optimizing care environments for CMC in everyday living settings.</p><p><strong>Design and methods: </strong>A qualitative interpretive description study was conducted with nurses from hospitals, home-visit nursing agencies, and community-based services in Japan. Participants were recruited using purposive and snowball sampling between July 2023 and February 2024. Semi-structured interviews explored nurses' experiences of optimizing care environments for CMC. Data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Seventeen female nurses with a mean of 16 years (SD = 5.4) of CMC-related care experience participated. Five themes were identified: (1) supporting autonomous decision-making by CMC and their families; (2) organizing daily living environments for safety, comfort, and holistic well-being; (3) fostering family empowerment; (4) preparing service environments to improve service quality and support; and (5) organizing community environments for safe and sustainable living.</p><p><strong>Practice implications: </strong>Nurses play key coordinating roles in optimizing multidimensional care environments through collaboration with families and multidisciplinary teams. These practices may inform community-based nursing interventions, strengthen family empowerment and decision-making, and support integrated care systems that promote safe and sustainable living for CMC and their families.</p>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"91 ","pages":"563-573"},"PeriodicalIF":2.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}