Clinical Research Directory

Reducing Fear and Anxiety in Children Through Free Play

The aim of this study was to determine the effect of free-play activities on preoperative fear and state anxiety in children aged 5-10 years and on parental anxiety. The research was conducted as a randomized controlled trial. The study population consisted of children aged 5-10 years and their parents who underwent planned surgical procedures in the pediatric surgery ward of a training and research hospital. Eligible child-parent dyads were recruited using a convenience sampling method and were then randomly assigned to the intervention and control groups. The data collection process in the study was conducted in two stages, with intervention and control groups: pretest and posttest. Tests for both groups were administered before the planned surgical procedure. A pretest for the children and their parents in the intervention group was administered approximately 2 hours before the surgical procedure, just before the start of the free-play intervention. At this stage, baseline data were obtained by measuring the children's fear and state anxiety levels and the parents' anxiety levels. Following this, the children participated in approximately 40 minutes of child-directed free play. A posttest was administered immediately after the free-play intervention, approximately 20 minutes before surgery. This measurement was used to evaluate the effect of free play on the dependent variables. In the control group, no study-related intervention was applied, and routine preoperative care continued. This group was also assessed with a pretest approximately 2 hours before surgery and a posttest after the corresponding 40-minute period, approximately 20 minutes before surgery, to evaluate the children's fear and state anxiety levels and parental anxiety. This allowed the differences between the two groups to be compared. This timing was selected to assess children's anxiety and fear during the period when preoperative distress was expected to be high and to evaluate the immediate effect of free play. Study Population: The study population consisted of children aged 5-10 years who underwent elective surgical procedures and their parents. Study Sample: The study included children aged 5-10 years who underwent surgical procedures and one accompanying parent for each child. The child-parent dyads were randomly assigned to the intervention and control groups. An a priori power analysis was performed using G\*Power version 3.1.9.7. Based on Cohen's d = 0.65, an α level of .05, statistical power of 80%, and a 1:1 allocation ratio, at least 39 child-parent dyads were required in each group. To account for potential attrition or missing data, 80 child-parent dyads were recruited, with 40 assigned to the intervention group and 40 assigned to the control group. The hypotheses of the study were: H1a: The posttest Children's Fear Scale scores of children in the free-play group are lower than their pretest scores. H1b: Children in the free-play group have lower posttest Children's Fear Scale scores than children in the control group. H2a: The posttest Children's Anxiety Meter-State scores of children in the free-play group are lower than their pretest scores. H2b: Children in the free-play group have lower posttest Children's Anxiety Meter-State scores than children in the control group. H3a: Parents in the free-play group have lower posttest anxiety scores than their pretest scores. H3b: Parents in the free-play group have lower posttest anxiety scores than parents in the control group. H4: There are positive associations among parental anxiety, children's state anxiety, and children's fear levels both before and after the intervention.

AI-Supported Empathy Mapping to Enhance Communication and Grit in Pediatric Nursing Students

The nurse-patient communication environment in pediatric care is characterized by high uncertainty and complexity. Due to children's limited language development and emotional regulation abilities, coupled with parents' high level of involvement, nursing students often experience anxiety, lack of confidence, and avoidance behaviors, which negatively affect their clinical learning outcomes and the establishment of therapeutic relationships. Therefore, providing effective communication support strategies is essential in pediatric nursing education. This study aims to implement an instructional scaffolding model using artificial intelligence (AI)-generated empathy maps to enhance the communication skills, empathy performance, and grit of nursing students during pediatric clinical practicums when encountering communication challenges. A mixed-methods research design was adopted, and the participants were third-year nursing students enrolled in a pediatric nursing practicum course. The teaching intervention included AI-assisted generation of age-appropriate communication strategies, the construction of a grit-oriented empathy map, small group scenario-based exercises, and the application of learned strategies in clinical settings. Quantitative data were collected using pre- and post-intervention assessments, including an empathy scale, a communication skills scale, and a grit scale, to evaluate changes in learning outcomes. Qualitative data, including reflective journals, clinical observations, and focus group interviews, were analyzed to explore students' learning processes and strategy adaptations. Triangulation was applied to strengthen the validity of the findings. It is anticipated that this teaching model will enhance students' understanding of pediatric patients' emotional needs, strengthen their communication strategy application and clinical interaction quality, and promote persistence and adaptability in challenging situations. Through evidence-based teaching practice, this study is expected to provide a feasible and scalable innovative instructional model that supports the effective integration of AI into clinical nursing education, thereby improving pediatric nursing competence and the quality of care for children.

"Effect of LEGO® Serious Play® Trauma-Informed Care Training on Nursing Students

Hospitalization can have traumatic effects on children and their families, highlighting the importance of trauma-informed care in pediatric nursing. Post-hospitalization trauma, anxiety, and depression are frequently observed in both children and parents, negatively affecting health outcomes and treatment adherence. Since trauma-informed care requires a child- and family-centered, safe, and sensitive approach, educating nursing students on this topic is essential. However, this training is often insufficient in nursing curricula, and its abstract and emotionally challenging nature may hinder students' learning. In this context, the LEGO® Serious Play® method, which helps concretize abstract experiences and supports interactive learning, may serve as an effective educational tool. This study aims to evaluate the effects of trauma-informed pediatric care education delivered through the LSP method on nursing students' knowledge, self-confidence, and satisfaction.

CesiKids Trial: Enhancing Psychological Resilience in Adolescents With Cancer

This study will develop and evaluate a mobile-based co-design intervention (CesiKids) to enhance psychosocial resilience in hospitalized adolescents aged 12-18 diagnosed with cancer. The program will be created using Bronfenbrenner's Ecological Systems Theory and designed in collaboration with nurses, recovered adolescents, and parents. A randomized controlled design will be used. The intervention group will participate in a four-week structured program, while the control group will receive standard care. Psychosocial resilience and coping outcomes will be assessed at baseline, post-intervention, and follow-up. This research aims to offer an evidence-based, scalable model to support resilience among adolescents with cancer in clinical settings.

The Effect of Digital and Classical Education Based on Planned Behavior Theory Given to Mothers in the Risk Group on Their Self-Efficacy in Identifying Safety Measures and First Aid for Home Accidents

Childhood home accidents are a significant health problem in our country and the world. Home accidents are more common in children aged 1-5, and cause temporary and permanent disabilities in deaths. In the project proposal, it is planned to conduct a randomized controlled trial to determine the effects of digital and classical home accident and first aid training given to mothers in the risk group with children aged 1-3 in line with the Planned Behavior Theory (PDT) on home accident safety precautions and first aid self-efficacy. In the study, the features of the education model that will provide original value and original contribution are that it is digitally based (animated video) education, which will allow individuals to receive training at their own pace and in accordance with their needs due to its individualizable feature. This will encourage mothers to participate more at the appropriate time and actively participate in the training. It is a more cost-effective and time-saving application compared to other teaching materials. In addition, it is original in that the group to be trained is mothers in the risk group. It is different from other studies on 'home accidents' in that it is planned in line with the PDT, randomized controlled, and the outputs will be measured with repeated measurements. The implementation of this project will consist of four main stages. In the first stage, the creation of the educational content, preparation of digital and classical educational materials in line with expert opinions and their evaluation by expert opinions. In the second stage, the final version will be arranged in line with the preliminary application. In the third stage, the implementation of the initiative and the collection of data. In the fourth stage, the statistical analysis of the data. The total duration of the project will be divided into approximately 3 months in the first stage, 1 month in the second, 7 months in the third and the last stage in the 1-month stage. In order for the project to be carried out healthily and effectively, the project manager and the doctoral student specialist nurse will take part. Since the project is original, if it is successful, there is a high probability that a doctoral thesis will be formed. It is highly likely that a researcher with a doctorate title will be formed upon completion of the project. The importance of the digital education method is very clear and its active use in nursing education will positively contribute to the development of child and family health. It is highly probable that the training model to be created will be recommended for use in secondary and tertiary healthcare institutions, including primary healthcare.

The Effect of Gardening Activities on Anxiety and Psychosocial Symptoms of Hospitalized Children

The experience of hospitalization in childhood can often lead to traumatic consequences. Various practices (play, art therapy, music therapy, etc.) are used to help children cope with this process. In recent years, attention has been drawn to nature-based approaches in addition to existing practices. Within the scope of this approach, this study was planned in a parallel group (experimental-control) randomized controlled experimental design to determine the effect of garden activities on anxiety levels and psychosocial symptoms of hospitalized children aged 6-12 years. Hypotheses of the study H1: The gardening activities program applied to hospitalized children; H1a: There is an effect on children's anxiety. H1b: There is an effect on psychosocial symptoms of children. In this direction, the population of the study will consist of children between the ages of 6-12 in the children's ward of University Research and Application Hospital. The sample size determined as a result of G\*power analysis was found as control (18) and intervention (18). The research will be conducted between September 2024 and June 2025. 'Child Descriptive Information Form', "Child Follow-up Form", "Child Anxiety Scale-Conditioning" and "Psychosocial Symptoms Diagnostic Scale for Hospitalized Children" will be used for data collection. The data collection process consists of three stages: pre-intervention period, intervention period and post-intervention period. Children in the intervention group will have three sessions of gardening activities within the scope of the 'Gardening Activities Program' during their hospitalization. Children in the control group will receive services within the scope of the routine treatment and nursing care protocol of the clinic during hospitalization.

Simulation Based Child and Family Communication Practice

The use of simulation-based methods in training pediatric nurses plays an important role in improving their communication skills. In this context, the aim of the research is to develop a simulation-based child and family communication training program. The study aims to evaluate the effect of this communication practice on the communication and problem-solving skills of pediatric nurses. The research is designed as a quasi-experimental study. The study sample will consist of 48 nurses working in pediatric clinics. The nurses, who will receive information about the simulation laboratory, will be divided into groups of 3, and the application will be conducted using a semi-structured scenario in the simulation laboratory. The application will be recorded on video, and feedback will be provided through debriefing sessions based on these recordings. A descriptive data form, a simulation self-assessment scale, a communication skills inventory, and an adult problem-solving scale will be used for data collection. Data will be collected before the application, and at the 1st week and 1st month after the application. As a result of the research, it is aimed to adapt the simulation-based communication skills given to pediatric nurses to the clinical environment. Questions of the study; Pediatric nurses before and 1 week and 1 month after simulation-based child and family practice: Is there a difference between the mean scores of the Communication Skills Inventory? Is there a difference between the mean scores of the Problem Solving Inventory? Pediatric nurses 1 week and 1 month after simulation-based child and family practice: Is there a difference between the mean scores of the Simulation Self-Assessment Scale?