The objective of this review is to identify the outcomes of family presence in pediatric intensive care units (PICUs) that have been studied and reported in the literature.

PICU admission can be traumatic for children and their families. While family presence at the patient bedside is recommended to support family participation and engagement in care and is supported in recent family-centered care guidelines, it is not consistently optimized. To guide family presence research, a scoping review is needed to identify outcomes associated with family presence.

This review included quantitative, qualitative, and mixed methods studies published from 1960 to 2022 in any language that reported outcomes of family presence at the bedside in the PICU for patients, their family members, and PICU health care professionals (HCPs).

Following JBI methodology for scoping reviews, we searched MEDLINE (Ovid), PsycINFO (EBSCOhost), CINAHL (EBSCOhost), Embase, as well as 16 sources of gray literature for studies that addressed outcomes of family presence at the bedside in the PICU as they relate to the key players. Two independent reviewers screened titles and abstracts, followed by full texts of selected records according to the inclusion criteria. A priori, we identified categories of outcomes (biologic, psychologic, social, caring behavior) and key groups (HCPs, patients, families) to which the outcomes may apply. Data were extracted by 2 independent reviewers using a data extraction tool developed by the study team. Data were presented in tabular format to address findings related to the review objectives.

We identified 12,411 records through database searches, backward reference chaining, and gray literature searching. We removed 3012 duplicates, excluded 9244 records at the title and abstract review, and excluded 92 reports after full-text review. We extracted data from 62 reports of which 12 were mixed methods, 25 were quantitative, and 25 were qualitative spanning from 1982 to 2022.Of 46 unique outcomes, 39 reports addressed 28 outcomes for family members (psychologic n=13, social n=8, biologic n=5, caring behavior n=2; most common was stress, n=11 reports). Twenty reports addressed 16 outcomes for patients (psychologic n=7, social n=0, biologic n=6, caring behavior n=2, and other outcomes n=1; most common was out-of-bed mobilization, n=4 reports). Eleven reports addressed 9 outcomes for HCPs (psychologic n=3, social n=2, biologic n=0, caring behavior n=3, and other outcomes n=1; most common was procedural performance, n=3). The most frequently studied biologic outcome was sleep (n=7 reports; family members n=6, patients n=1), psychologic outcome was stress (n=13 reports; family members n=11, HCPs n= 2), social outcomes were role changes (n=4 reports; family members n=3, HCPs n=1) and financial challenges (n=4 reports for family members), and caring behavior outcome was out-of-bed mobility (n=4 reports for patients).

A relatively large, heterogenous body of literature addresses biologic, psychologic, social, and caring behavior outcomes for family members, patients, and HCPs. The review highlights the heterogeneity of available data and identifies a need for a concerted analysis. Important gaps remain, including social and longer-term mental health outcomes for patients, outcomes for siblings, and infection transmission for all key groups.

This article examines the pivotal role of critical care nurses in managing pediatric pain, emphasizing the multifaceted nature of care. It covers the challenges and opportunities nurses face, stressing the importance of education and training. The background section underscores the global issue of inadequately managed pediatric pain and the importance of addressing social determinants of health while recognizing perceptions, beliefs, stereotypes, and biases on pain management. A multimodal approach in treatment is detailed in pharmacologic and non-pharmacologic approaches. Barriers nurses encounter are discussed, with recommendations for a holistic and individualized approach to pediatric pain management in critical care settings.

Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units.

Using the Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews, CINAHL, MEDLINE, PsycINFO, Cochrane DSR, Cochrane Central, and JBI EBP were searched for qualitative, quantitative, mixed methods, and review studies with no time limits published in English. Included studies presented findings on the experiences of developing trust between pediatric nurses and children under 18 years of age and their caregivers within inpatient care units.

A total of 12,269 titles and abstracts were reviewed independently by two reviewers. 366 full-text articles were retrieved, a final of 81 studies were included in the review.

Trust was bi-directional between nurses and children/caregivers, developed over time during multiple interactions, and foundational to the development of relationships. Distinct facilitators and barriers to the development of trust between nurses and children/caregivers were identified. The development of trust was rewarding and enriching for both nurses and children/caregivers and was the fundamental to the provision of safe and high-quality nursing care.

Findings provide nurses with direction and strategies on how to develop and maintain trust with children/caregivers on inpatient care units. The development of training programs and interventions geared at equipping nurses with the skills to develop trust with children/caregivers is needed.

We aimed to synthesize the qualitative evidence on the impacts of COVID-19-related restricted family presence policies from the perspective of patients, families, and healthcare professionals from neonatal (NICU), pediatric (PICU), or adult ICUs.

We searched MEDLINE, EMBASE, Cochrane Databases of Reviews and Clinical Trials, CINAHL, Scopus, PsycINFO, and Web of Science. Two researchers independently reviewed titles/abstracts and full-text articles for inclusion. Thematic analysis was completed following appraising article quality and assessing confidence in the individual review findings using standardized tools.

We synthesized 54 findings from 184 studies, revealing the impacts of these policies in children and adults on: (1) Family integrated care and patient and family-centered care (e.g., disruption to breastfeeding/kangaroo care, dehumanizing of patients); (2) Patients, families, and healthcare professionals (e.g., negative mental health consequences, moral distress); (3) Support systems (e.g., loss of support from friends/families); and (4) Relationships (e.g., loss of essential bonding with infant, struggle to develop trust). Strategies to mitigate these impacts are reported.

This review highlights the multifaceted impacts of restricted visitation policies across distinct care settings and strategies to mitigate the harmful effects of these policies and guide the creation of compassionate family presence policies in future health crises.

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290263 .

To understand nursing team professionals' strategies to include the family in painful procedures performed on hospitalized children.

An exploratory-descriptive, qualitative study, carried out with nursing professionals. Data were collected through semi-structured interviews, guided by a script of topics, transcribed and submitted to thematic content analysis, in the light of Symbolic Interactionism, discussed considering the Family-Centered Care philosophy assumptions.

Two central categories emerged, "Theoretical perspective: the family as a care agent in painful procedures" and "Practical perspective: experiences, challenges and strategies in painful procedures for family inclusion", with their respective subcategories.

Nursing professionals have theoretical knowledge about family inclusion in painful procedures based on the assumptions: Family-Centered Care: dignity and respect; information sharing; joint participation; and family collaboration. However, knowledge is not applied in clinical practice; consequence of the interaction between beliefs and attitudes unfavorable to family presence.

The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients' risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.

To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.

We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.

Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.

As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.

Husbandry and veterinary procedures have the potential to generate fear and stress in animals. In horses, the associated responses can pose a significant safety risk to the human personnel involved in the procedure, as well as to the animal itself. Traditionally, physical restraint, punishment, and/or threat of an aversive, have been the most common strategies used to achieve compliance from the horse. However, from a welfare perspective, this is less than ideal. This approach also has the potential for creating a more dangerous response from the horse in future similar situations. When caring for companion animals, and captive animals within zoological facilities, there has been a steady transition away from this approach, and toward strategies aimed at reducing fear and stress during veterinary visits and when undertaking routine husbandry procedures. This review discusses the current approaches to horse care and training, the strategies being used in other animal sectors, and potential strategies for improving human safety, as well as the horse's experience, during husbandry and veterinary procedures.

This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6-8 years.

This experimental study randomly assigned 56 children aged 6-8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests.

The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008).

This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6-8 years compared to bubble-blowing as an active distraction method.

The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6-8 years.