Purpose: The study was designed as an experimental study to describe the effect of the first bathing time on the body temperature and skin moisture of a newborn after birth.Design and Methods: The study population consisted of term newborns between JanuaryThe sample group was randomly divided into two groups according to different bathing times. The first group (39 infants) was given a bath 24 hr after birth, and the second group (34 infants) was given a bath 48 hr after birth. The infants in both the groups were dried with the first towel and then wrapped in a second dry towel, and a cap put to prevent hypothermia and to minimize any minor fluid loss. The body temperature and skin moisture level were measured before the bath, after the bath, and 10 min after the bath.Results: It was determined that the 10th-minute body temperatures of the infants with the first bathing time 48 hr after birth were significantly higher compared with the infants with the first bath time 24 hr after birth (Z = −2.654; p = .008).Practical Implications: Postponing of the first bathing time of newborns to 48 hr after birth was effective in preserving the body temperature of the infant. Postponing the bath to the 48th hr improved moisture, which may improve skin integrity and aid with skin development. K E Y W O R D S baths, body temperature, infant, newborn, skin 1 | WHAT IS CURRENTLY KNOWN? Bathing newborns is a part of routine care in hospital nurseries. While some studies recommend that newborns should be bathed during the first 2-4 hrs after birth, the World Health Organization (2013) suggests that newborns should be bathed when vital signs are stable within 24 hr after birth. | WHAT DOES THIS ARTICLE ADD?As a result of this research, postponing the first bath 48 hours after birth shows a positive effect on keeping the body temperature and moisture of the infant. | INTRODUCTIONChanges occur in the skin of newborns during the process of their adaptation to the external environment as a result of the transition from the postnatal intrauterine medium to the extrauterine medium.These changes begin quickly after birth. The maturation of the skin structure and functions of newborns starts from the first months and continues for a lifetime (Dyer, 2013;Kuller, 2014). Providing hydration of the stratum corneum is effective in maintaining skin integrity, skin barrier function property, and body temperature. The stratum corneum layer of the newborn's skin is relatively drier when compared with bigger infants (1, 2, 6-month-old) and adults, and the water retention capacity of the skin is more limited due to the lower sweat gland activity (Visscher, 2009).

Background: The organizational climate in paediatric intensive care units is specific to the conditions of the patient, and there may be a relationship between the ethical climate perception and moral distress levels of the nurses working in this unit.Aim: The research aim was to examine the relationship between the moral distress levels and their perceptions of hospital ethical climate of paediatric intensive care unit nurses.Methods: This research was aimed a descriptive, cross-sectional and correlational type with 239 paediatric intensive care unit nurses of public, university and training and research hospitals in Turkey. Research data were evaluated with mean, Pearson correlation and multiple linear regression analysis. Results:The total score of moral distress scale was 106.36 AE 53.63, and of the hospital ethical climate scale was 100.60 AE 14.41. A moderate negative relationship was found between nurses' moral distress levels and ethical climate perceptions, ethical climate perception explained moral distress levels with a 12% variance and this significance came from the physicians sub-dimension. Conclusions:The moral distress levels of paediatric intensive care nurses were below the average, and their ethical climate perceptions were above the average. It was seen that the physicians sub-dimension was an important explanatory on the total moral distress.Implication for Nursing Management: In order to eliminate the moral distress arising from the hospital ethical climate, practices should be developed to increase the cooperation between nursing and physicians.

Background/Aim: Circumcision is an invasive operation that male children undergo in our country and some others. During this process, the child can experience fear, anxiety, and pain simultaneously. As a randomized controlled VR study, this research was conducted to determine the effect of virtual reality (VR) glasses on reducing fear/anxiety and pain during circumcision in children. Methods: The study was conducted on 125 children (6-11 years old). The same healthcare team performed the circumcision of the children in both groups. The children were randomly split into VR and control groups. The children in the VR group, just before the circumcision, watched their preferred cartoon film via VR glasses. No additional procedure was applied to the children in the control group except for ordinary procedures in the hospital. The fear and pain status measured by Wong-Baker Faces Pain Rating Scale and Children Fair Scale of all the children were evaluated before and after the operation by the child, parents, and the observer. Descriptive statistics, chi-square, and t-tests analyzed the data. Results: There was no significant difference between the groups regarding demographic characteristics such as age, BMI, previous hospitalization, and anesthetic drug used before the procedure of the children included in the study. Preoperative (VR = 1.03 (0.18), control = 1.05 (0.22)) and pre-procedural (VR = 2.61 (1.02), control = 2.33 (1.22)) fear levels were also similar (P > 0.05). After the procedure, it was determined that the mean duration of the procedure (365.36 (64.73) sec), crying time (21.31 (41.74) sec), and fear scores (0.36 (0.68)) of the children in the VR group were lower (P < 0.001). However, pain mean scores were similar (P > 0.05). Conclusion: It is thought that watching a cartoon with VR glasses during the circumcision operation may be effective in reducing the child's fear level, crying, and operation time.

Objective: This study was conducted as a randomized controlled and experimental to compare the effect of breastfeeding and distraction methods on vital signs, pain level, and the duration of crying due to vaccine injection in healthy infants. Methods: The population of the study consisted of 120 infants between 1 and 12 months of age who had met the inclusion criteria. The sample group was randomized and divided into two groups. The control group was breastfeed according to clinical procedure, including 58 infants, and the distraction group was include 62 infants. For both groups, the oxygen saturation (SpO2), heart rate (HR), crying duration, and pain scores were compared both before and following vaccination sessions. Results: The vaccination pain scores of the infants from the distraction group (4.39±2.18) were significantly lower than those of the breastfeeding group (7.05±1.55; p=0.001). The post-vaccination SpO2 was higher in infants in distraction group; whereas, HR was lower in this group compared to the breastfeeding group. The post-vaccination crying durations of those in the distraction group were also shorter than those in the breastfeeding group. Conclusion: The distraction method is adopted by the use of a toy has been found to be effective in decreasing the acute pain during vaccine administrations.

Aim: This research was carried out to determine the factors affecting the toy selection of physically disabled children.Material and Method: 19 children, 19 mothers and 10 teachers participated in this study, which used a qualitative research design. The data were collected through a structured interview with the 'Data Collection Form' consisting of similar questions about the toy. The researcher interviewed the child, mother and teacher separately and alone. While analyzing the sociodemographic characteristics of the data, frequency, mean, standard deviation were used. Content analysis was carried out in the qualitative dimension of the research and the main themes were determined and interpreted by the researchers.Results: When the answers given to the "toy definition" in the research were examined, the children emphasized that the toy should be "fun", while mothers and teachers emphasized that it was "useful", "educative and instructive". When the answers given to the 'toy selection' are examined, it is seen that the children's should be 'color' and 'of their own will' , and that should be 'chosen by the children' , 'quality and healthy' , 'appropriate for their age' , 'inexpensive' and 'according to the disability' by mothers and teachers. When the responses to the 'toy perception' were analyzed, it was emphasized that children should be 'gender-specific' , while mothers and teachers should not be 'gender-specific' . When the answers given to the "added information about the toy" were examined, it was determined that the children should be toys "according to my mobility and disability" and that the mothers should be "more development toys for the physically disabled". Conclusion:In this study, it was determined that being physically disabled affects the toy selection of children and especially mothers.