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

{"title":"Adolescents' experiences of living with type 2 diabetes mellitus: A scoping review","authors":"Eric Peprah Osei ,&nbsp;Ernest Owusu Antwi ,&nbsp;Emmanuel Ekpor ,&nbsp;Gideon Yaw Osei ,&nbsp;Amos Asante ,&nbsp;Gordon Etornam Dzotrah ,&nbsp;Michelle Danny Stampley Boakye","doi":"10.1016/j.pedn.2026.01.002","DOIUrl":"10.1016/j.pedn.2026.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus has emerged as a major public health concern among adolescents; however, existing research has largely emphasized biomedical outcomes, with comparatively limited attention to adolescents' lived experiences, emotional well-being, and coping strategies. This scoping review aimed to synthesize qualitative evidence on adolescents' experiences of living with type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>Six electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, Scopus, and Web of Science) were searched from inception to May 19, 2025, for peer-reviewed qualitative or mixed-methods studies involving adolescents aged 10–19 years with type 2 diabetes mellitus. Fifteen studies conducted across six countries met the inclusion criteria. The review was guided by the Social Ecological Model and adhered to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. An inductive thematic analysis of the quotations and narrative descriptions reported within the included studies was conducted following Braun and Clarke's framework to identify patterns related to adolescents' lived experiences.</div></div><div><h3>Findings</h3><div>Five key themes were identified: (1) initial diagnosis, awareness, and understanding of type 2 diabetes mellitus; (2) challenges in treatment, self-management, and lifestyle modification; (3) complications and health outcomes; (4) psychosocial and emotional impact; and (5) coping strategies and resilience.</div></div><div><h3>Discussion</h3><div>These findings underscore the multifaceted challenges adolescents face in managing type 2 diabetes mellitus and the need for supportive, developmentally appropriate approaches to improve their well-being.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 160-172"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979321","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":"Effect of nursing-led empowerment program on care burden and social isolation among caregivers having children with cerebral palsy: A quasi-experimental study","authors":"Halla Ali Abd El hie Ali Ph.D, MSN, BSc, RN ,&nbsp;Ayman Mohamed El-Ashry Ph.D, MSN, BSc, RN ,&nbsp;Fatma Sayed Abdelaziz Mohamed Ph.D, MSN, BSc, RN ,&nbsp;Dalia Ibrahem Mustafa Abdel-Azem Ph.D, MSN, BSc, RN ,&nbsp;Mahmoud M. Noureldeen ,&nbsp;Ahmed Abdellah Othman Ph.D, MSN, BSc, RN ,&nbsp;Eslam Reda Machaly Ph.D, MSN, BSc, RN ,&nbsp;Nahla Abdallah Abd El-Tawab Ph.D, MSN, BSc, RN","doi":"10.1016/j.pedn.2025.12.032","DOIUrl":"10.1016/j.pedn.2025.12.032","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy is a lifelong, non-progressive neurodevelopmental disorder that affects movement and posture, often resulting in long-term disability. Caregivers—most commonly mothers—assume primary responsibility for daily care and rehabilitation, which can lead to a high care burden and increased social isolation.</div></div><div><h3>Aim</h3><div>To evaluate the effect of a nursing-led empowerment training program on care burden and social isolation among caregivers of children with cerebral palsy.</div></div><div><h3>Methods</h3><div>A quasi-experimental pretest–posttest design was conducted with a convenience sample of 98 caregivers assigned to an intervention group (<em>n</em> = 49) or a control group (n = 49). Data were collected using the Caregiver Burden Inventory, the Revised UCLA Loneliness Scale, and the Family Empowerment Scale. The intervention group participated in a six-session nursing-led empowerment program over six weeks, while the control group received routine care. Outcomes were assessed before and after the intervention.</div></div><div><h3>Results</h3><div>Post-intervention, caregivers in the intervention group showed a significant reduction in care burden and loneliness scores and a significant increase in family empowerment scores (<em>p</em> &lt; 0.001 for all). The control group showed no significant changes in care burden or empowerment and a significant increase in loneliness scores (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The nursing-led empowerment program effectively reduced care burden and social isolation while enhancing empowerment among caregivers.</div></div><div><h3>Implications for practice</h3><div>Integrating structured nurse-led empowerment programs into routine pediatric and community care may improve caregiver well-being, strengthen family functioning, and enhance long-term care for children with cerebral palsy.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 88-98"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940153","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":"Multidisciplinary practices in pediatrics clinics: A meta-synthesis of qualitative research","authors":"Raheleh Sabetsarvestani ,&nbsp;Şerife Didem Kaya ,&nbsp;Emine Geçkil","doi":"10.1016/j.pedn.2026.01.003","DOIUrl":"10.1016/j.pedn.2026.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary practices play a crucial role in pediatric care settings. However, existing research is fragmented and often limited to specific clinical contexts, underscoring the need for a comprehensive synthesis of qualitative evidence across diverse pediatric settings.</div></div><div><h3>Purpose</h3><div>This study aims to systematically explore multidisciplinary practices in pediatric healthcare by synthesizing qualitative evidence.</div></div><div><h3>Methods</h3><div>We conducted a qualitative meta-synthesis of research published between 2000 and 2025. Our search encompassed three major electronic databases, namely Web of Science, Scopus, and PubMed. The primary keywords used were multidisciplinary team, pediatric clinics, and qualitative study. Initially, 306 records were identified, and after removing duplicates, 305 records remained. Subsequently, 177 full-text articles were assessed for eligibility. A total of 13 studies were included in the final meta-synthesis. Quality appraisal was performed, and no studies were excluded. Data were synthesized using thematic qualitative analysis.</div></div><div><h3>Results</h3><div>The results revealed a main theme: Navigating the complexities of multidisciplinary practices in pediatric care, encompassing three subthemes: the promise of multidisciplinary practices, the pitfalls of multidisciplinary practices, and drivers of success in multidisciplinary practices.</div></div><div><h3>Conclusion</h3><div>This study highlights the transformative potential of multidisciplinary practices in pediatric care, including empowering families, fostering professional growth, and improving system effectiveness. However, these benefits are often hindered by resource constraints, communication gaps, and role ambiguity. Strong leadership, structural support, and a shared vision are key to overcoming these challenges and ensuring high-quality, coordinated pediatric care.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 126-135"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953465","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":"Healthy lifestyle program based on a mobile serious game-extended version for childhood cancer survivors: Development and evaluation of user satisfaction","authors":"Kyung-Ah Kang ,&nbsp;In-Hye Song ,&nbsp;Han-Ho Kim","doi":"10.1016/j.pedn.2026.01.024","DOIUrl":"10.1016/j.pedn.2026.01.024","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to develop a Healthy Lifestyle Program Based on a Mobile Serious Game-Extended version (HLP-MSG<em><strong>e</strong>)</em> for childhood cancer survivors (CCSs) and evaluate the satisfaction level of a HLP-MSG<strong><em>e</em></strong>.</div></div><div><h3>Methods</h3><div>The HLP-MSG<strong><em>e</em></strong> for CCSs included 33 quests with 7 minigames in 7 healthy lifestyle subfactors (health responsibility, physical activity, nutrition, positive life perspective, interpersonal relationships, stress management, and spiritual health). Five experts validated the content, organization, and usability of the HLP-MSG<strong><em>e</em></strong>. A satisfaction survey consisting of 5-point Likert scales was answered by CCSs in South Korea aged 6–14 years old whose cancer treatment was terminated at least 12 months previously. Data were analyzed using means and standard deviations.</div></div><div><h3>Results</h3><div>“Healthy village-Acorn island” was named to an HLP-MSG<strong><em>e</em></strong>-based initial game called “Healthy village-Hope Island”. The content validity index score by experts ranged from 0.93 to 1.00, with a mean of 0.95. The mean score of satisfaction with the HLP-MSG<strong><em>e</em></strong> was 4.16 (SD = 0.68) out of 5.</div></div><div><h3>Conclusion</h3><div>HLP-MSG<em><strong>e</strong>,</em> a mobile serious game, is a health education modality that meets the learning needs of CCSs who recognize games as educational media and is an appropriate educational medium to increase the efficiency and continuity of self-directed health care.</div></div><div><h3>Implications for practice</h3><div>HLP-MSG<strong><em>e</em></strong> for CCSs intervention can contribute to a new paradigmatic approach to healthcare that maximizes the effectiveness of ongoing health self-management of CCSs. It can also be used as a platform to provide health education based on the human holism model, reflecting the multifaceted needs of CCSs including spirituality.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 286-296"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078318","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 tub bathing on stress, comfort, and physiological parameters in newborns","authors":"Necla Kasımoğlu PhD ,&nbsp;Sultan Beşiktaş Msc ,&nbsp;Ayşe Gürol PhD","doi":"10.1016/j.pedn.2026.01.032","DOIUrl":"10.1016/j.pedn.2026.01.032","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the effects of tub bathing on stress levels, comfort, and physiological parameters in newborns undergoing phototherapy.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted with 62 newborns receiving phototherapy in a university hospital neonatal intensive care unit (June 2024–June 2025). Infants were randomized to an experimental (tub bathing) or a control group. Physiological parameters, stress (Neonatal Stress Scale), and comfort (Neonatal Comfort Behavior Scale) were assessed at three time points: before, 15 min after initiation, and 15 min before completion of phototherapy. Data were analyzed using SPSS version 30.0.</div></div><div><h3>Results</h3><div>There were significant differences between the groups in terms of sex (<em>p</em> = .005, φ = 0.35) and gestational week (<em>p</em> = .045, φ = 0.36). Respiratory rate, heart rate, and oxygen saturation values in the experimental group were statistically higher compared with the control group (<em>p</em> &lt; .001, Cohen's d = 1.37–1.85). Mean scores of the Neonatal Stress Scale and Neonatal Comfort Behavior Scale revealed a significant decrease in stress and a significant increase in comfort in the experimental group (p &lt; .001, Cohen's d &gt; 1.40). The post-hoc power analysis indicated a test power of 1.00.</div></div><div><h3>Conclusion</h3><div>Tub bathing reduces stress levels, enhances comfort, and positively affects physiological parameters in newborns undergoing phototherapy. Therefore, it is recommended that nurses incorporate tub bathing as a safe and feasible nursing practice in neonatal care.</div></div><div><h3>Implications to practice</h3><div>Tub bathing is recommended as a standardized intervention to enhance physiological comfort in infants undergoing phototherapy. Additionally, involving parents in this process strengthens family-centered care and emotional bonding in the neonatal setting.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 338-345"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078317","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":"Assessing the relationship between pediatric nurses' three-dimensional work fatigue and ethical blindness levels","authors":"Dilek Uysal ,&nbsp;Selda Yildiz ,&nbsp;Dilek Eryürük","doi":"10.1016/j.pedn.2026.01.027","DOIUrl":"10.1016/j.pedn.2026.01.027","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric nurses face heavy workloads, long shifts, inadequate staffing, and the emotional demands of caring for vulnerable children, leading to physical, emotional, and cognitive fatigue. Such fatigue may increase the risk of ethical blindness, defined as difficulty in recognizing or responding to ethical issues. This study aimed to assess levels of work fatigue and ethical blindness and to examine their relationship.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional study was conducted in Turkey between April and August 2025. Data were collected using an anonymous online questionnaire including the Three-Dimensional Work Fatigue Inventory and the Workplace Ethical Blindness Scale. Analyses were performed with descriptive and inferential statistics.</div></div><div><h3>Results</h3><div>A total of 240 nurses participated, most aged 36–45 years with more than 11 years of experience. Overall, work fatigue was high, whereas ethical blindness was relatively low. Higher ethical blindness was observed among younger and less experienced nurses and those with lower professional satisfaction. Work fatigue was highest among pediatric intensive care nurses. Weak correlations were found between the routine dimension of ethical blindness and both physical and emotional fatigue.</div></div><div><h3>Discussion</h3><div>Professional motivation, voluntary career choice, and long-term experience may protect against ethical blindness. Workload regulation, motivational support, and structured ethics education are recommended to reduce fatigue-related risks and support ethical pediatric nursing care.</div></div><div><h3>Implications to practice</h3><div>Institutions should implement workload management strategies and integrate regular ethics education and reflective practices into professional development.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 353-362"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078434","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 bath applied in two different sequences on stress level and physiological parameters in term babies","authors":"Ayşe Dilan Koçak ,&nbsp;Sevil Inal","doi":"10.1016/j.pedn.2025.12.025","DOIUrl":"10.1016/j.pedn.2025.12.025","url":null,"abstract":"<div><h3>Background</h3><div>The sequence of neonatal bathing may significantly influence an infant's ability to maintain homeostasis. Traditional methods begin with the head, but deferring head washing to the final stage may reduce thermal loss and procedural distress.</div></div><div><h3>Purpose</h3><div>This study compared the effects of two swaddle bathing sequences head-first versus body-first on the stress levels and physiological parameters of term newborns.</div></div><div><h3>Design and methods</h3><div>This randomized controlled trial (RCT) included 104 term infants born in a Training and Research Hospital in Istanbul between July 18 and September 20, 2023. Infants were randomly assigned to Group 1 (head washed first, then body; <em>n</em> = 52) or Group 2 (body washed first, then head; n = 52). Stress levels, calming durations, and physiological parameters (body temperature, oxygen saturation, heart rate) were systematically analyzed.</div></div><div><h3>Findings</h3><div>Baseline measurements were similar between groups (<em>p</em> &gt; 0.05). During and after the procedure, Group 1 exhibited significantly higher stress levels (<em>p</em> &lt; 0.001) and longer calming times (<em>p</em> &lt; 0.001) than Group 2. Post-procedure body temperature and O₂ saturation were significantly lower (p &lt; 0.001), while heart rate was significantly higher (<em>p</em> = 0.001) in Group 1.</div></div><div><h3>Conclusion</h3><div>Washing the body before the head minimizes neonatal stress, accelerates recovery, and preserves physiological stability. Deferring head washing is recommended to enhance neonatal care (RCT ID: <span><span>NCT06166485</span><svg><path></path></svg></span>).</div></div><div><h3>Implications for practice</h3><div>These findings provide evidence-based guidance for neonatal nurses. Implementing a body-first sequence optimizes thermoregulation and minimizes procedural stress in term infants.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 50-57"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935729","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":"From the Nile to the global stage: A rapid bibliometric audit of Egyptian pediatric nursing visibility in SciVal (2000–2025)","authors":"Ahmed Loutfy ,&nbsp;Amina Elzeiny","doi":"10.1016/j.pedn.2026.01.008","DOIUrl":"10.1016/j.pedn.2026.01.008","url":null,"abstract":"","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Page 111"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953584","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":"Nurse-driven innovation in pediatric care: Usability and securement performance of a novel tubing anchor in simulated clinical scenarios","authors":"Yi-Lin Hsieh MSc, RN ,&nbsp;Malcolm Koo PhD ,&nbsp;Zu-Chun Lin PhD, RN","doi":"10.1016/j.pedn.2026.01.007","DOIUrl":"10.1016/j.pedn.2026.01.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Safe tubing securement is critical in pediatric care, as unplanned extubations can lead to significant morbidity. This study developed and evaluated a novel Pediatric Integrated Tubing Anchor (PITA) device designed to improve securement efficiency and usability compared with a conventional tubing anchor (CTA).</div></div><div><h3>Methods</h3><div>Guided by a user-centered design thinking process, the PITA device was developed to integrate endotracheal, nasogastric, and bite block securement. A randomized crossover trial was conducted with 77 nurses using simulated stable and agitated pediatric patient scenarios. Each nurse applied both the CTA and PITA devices during the simulations.</div></div><div><h3>Results</h3><div>The PITA device significantly reduced securement time compared with the CTA in both stable (mean difference: 92.1 s, <em>p</em> &lt; .001) and agitated scenarios (mean difference: 160.9 s, <em>p</em> &lt; .001). The PITA device also demonstrated superior tubing stability under load and achieved significantly higher usability scores on the Tubing Care Usability Scale (62.0 vs. 47.9, <em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The nurse-developed PITA device offers a more efficient, stable, and user-friendly method for tubing securement. Its clinical adoption may help reduce unplanned extubations, prevent related complications, and save valuable nursing time, particularly in high-risk situations. These findings support the value of empowering frontline nurses as active contributors to healthcare innovation.</div></div><div><h3>Clinical implications</h3><div>Findings from this study demonstrate the importance of nurse-driven, user-centered innovation in developing pediatric-specific devices that enhance patient safety and workflow efficiency.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 136-145"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953449","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 Eeffectiveness of distraction cards in reducing pain in children: A meta-analysis of randomized controlled trials","authors":"Çiğdem Gök ,&nbsp;Pelin Karataş","doi":"10.1016/j.pedn.2026.01.011","DOIUrl":"10.1016/j.pedn.2026.01.011","url":null,"abstract":"<div><h3>Background</h3><div>Distraction cards, colorful pictures, and puzzles are age-appropriate visual and cognitive content that can be used to divert a child's attention away from painful stimuli.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to evaluate the effectiveness of distraction cards in managing pain and anxiety during invasive medical procedures in children aged 3 to 18 years.</div></div><div><h3>Methods</h3><div>Fifteen randomized controlled trials published between 2010 and 2025 were included. Articles were identified using specific keywords in the CINAHL, Cochrane Central, Web of Science, PubMed, Scopus, ScienceDirect, Eric, EBSCO, and OVID databases. The study followed PRISMA 2020 guidelines, and risk of bias was assessed using the Cochrane Collaboration tool. Data were synthesized using a random-effects model to calculate Standardized Mean Differences (SMDs) with 95% confidence intervals, assessing heterogeneity via the I² statistic.</div></div><div><h3>Results</h3><div>Pooled results demonstrated that distraction cards significantly reduced pain levels across all reporters, with large effect sizes observed in children's self-reports (SMD) = −0.90), parent reports (SMD = −1.29), and observer reports (SMD = −1.28). Regarding anxiety, while parents (SMD = −0.97) and observers (SMD = −1.15) reported significant reductions, children's self-reported anxiety reduction did not reach statistical significance (<em>p</em> = 0.14). High heterogeneity (I² &gt; 90%) was observed across the analyses.</div></div><div><h3>Conclusion</h3><div>Findings support the integration of distraction cards into pediatric nursing practice to improve children's experiences during painful procedures, reduce negative emotional responses, and involve parents in care. Distraction cards are a low-cost and easily implementable non-pharmacological method. Their use by pediatric nurses to reduce procedure-related pain is recommended.</div></div>","PeriodicalId":48899,"journal":{"name":"Journal of Pediatric Nursing-Nursing Care of Children & Families","volume":"87 ","pages":"Pages 190-200"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978711","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}