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To systematically analyse expert perspectives on paediatric-friendly care in the emergency department and establish specific indicators.
With an increasing number of children seeking emergency care, nurses must understand the specific needs of paediatric patients and their families.
A two-round modified Delphi method was used in this study.
In this study, experts from clinical practice and academia assessed 56 paediatric-friendly care criteria in the emergency department. Data were collected to establish a consensus and ensure content validity.
Thirty experts completed two survey rounds with response rates of 100% and 93.3%, respectively. In the initial survey, no consensus was reached for eight items. After the items were consolidated, 37 paediatric emergency-friendly care needs were identified. For each need, the item-level content validity index exceeded 0.79 for importance and feasibility. The average scale-level content validity index values were 0.95 and 0.92 for importance and feasibility. These needs were categorised into six dimensions: timely comfort (3 items), emotional care (5 items), frontline safety (11 items), emergency response (10 items), human resources support (5 items) and treatment efficiency (3 items).
Paediatric emergency nurses play a vital role in caring for children, improving soft skills through compassion and training and ensuring a well-equipped, safe environment in the emergency department.
This study offers valuable insights for emergency department nurses on the needs of children and their families, emphasising the importance of patient and family education, environmental considerations and the role of certified child life specialists in supporting the emergency healthcare team and ensuring appropriate paediatric care.
No direct patient, service user, caregiver or public involvement existed in this study.
The purpose of this study was to explore the relationship between symptom clusters and self-management among maintenance haemodialysis (MHD) patients.
MHD patients experience disease progression and multiple symptom burdens that severely impact quality of life, and self-management of symptoms may significantly improve patient-reported outcomes.
A cross-sectional study.
This cross-sectional descriptive study included 194 patients undergoing MHD. The patients were assessed using the Dialysis Symptom Index (DSI) and the Haemodialysis Self-Management Instrument (HD-SMI). We used descriptive analysis, exploratory factor analysis, Pearson's correlation analysis and linear regression analysis to examine (1) the level of individual self-management, (2) the presence of symptom clusters by symptom severity and (3) the correlation between symptom clusters and self-management behaviours. This study was conducted in accordance with the STROBE checklist.
The top five most severe symptoms among the patients were itching, feeling tired or lack of energy, difficulty sleeping, dry mouth and dry skin. We identified five groups of symptoms: (1) poor sleep, (2) neuromuscular, (3) gastrointestinal, (4) skin irritation and (5) psychological. In the present study, MHD patients reported low to moderate levels of self-management behaviours (50.84 ± 10.56), and low self-management ability was correlated with greater severity of the five symptom clusters (p < 0.01). Linear regression analysis revealed that all five symptom clusters were included in the regression equation, explaining 30% of the total variance in self-management skills among MHD patients.
Enhanced awareness of symptom clusters and comprehensive symptom management are necessary to improve patients' quality of life.
Nursing practices should incorporate comprehensive symptom assessments to help patients develop effective self-management strategies to improve quality of life.
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