Use of Lightened and Musical Baby Mobile in a Pediatric Emergency Clinic
Condition: Sleep; Nursing Caries
MeSH terms: Emergencies
Study type: Interventional

Summary: 
      The aim of this study is to present results on the effect of lightened and musical baby
      mobile on sleep quality in children hospitalized in the pediatric emergency clinic. In the
      randomized controlled study, 124 children hospitalized in the pediatric emergency clinic of a
      public hospital and appropriate the inclusion criteria were equally divided into 2 groups.
      The lightened and musical baby mobile was used during the night's sleep in the patient's room
      of the children in the first group (intervention group). The children in the second group
      (control group) did not use a lightened and musical baby mobile. The sleep quality of the
      children in the 2 groups was evaluated with the Child's Sleep Quality Evaluation Form
      (CSQEF).
    

Detailed description: 
      Illness, hospital environment, hospitalization and routines; are common sources of stress
      experienced by children. This experience; delays the child's recovery process and
      growth-development, impairs play activity and sleep quality. The aim of this randomized
      controlled study is to present results on the effect of lightened and musical baby mobile on
      sleep quality in children hospitalized in the pediatric emergency clinic.

      METHODS This study was conducted in a single-center, prospective randomized controlled
      design. The sample size of the study was calculated in the program of G* Power 3.1.9.2
      (Heinrich Heine University Düsseldorf, Germany). The sample size was found to be 60 children
      for each group. The study authors considered possible sample losses during the study process.
      It was decided to conduct the study with a total of 124 children. There were 62 children in
      each group (intervention and control group). This study included 150 children hospitalized in
      a 6-bed pediatric emergency clinic of a public hospital in Istanbul between October and
      December 2019. Of these children, 124 children who met the inclusion criteria were included
      in the study. Children who were transferred to other inpatient units after hospitalization in
      the emergency department (n=18) and whose parents refused to participate in the study (n=8)
      were excluded from the study.

      Procedures:

      Assigning the participants to the groups, positioning and operating the lightened and musical
      baby mobile in the child's room, taking vital signs, collecting the data in the CSQEF and all
      recordings were made by the first researcher. The first researcher has 5 years of experience
      as a pediatric emergency nurse. In the pediatric emergency clinic, nurses work in 2 shifts
      (08:00-17:00 and 16:00-08:00). The first investigator works in the pediatric emergency
      clinic. In this study, the following procedure was applied, respectively. Each child admitted
      to the pediatric emergency clinic was taken to the patient's room with his mother, his
      clinical status was evaluated, and the children to be included in the intervention and
      control groups were determined. Parents of the children included in the intervention group
      were informed about all stages of the research process, and their verbal and written consents
      were obtained. Assignment of children to groups was done by simple randomization method
      (according to their hospitalization on odd and even number days of the calendar). Children
      who were hospitalized on odd-numbered days of the calendar were included in the intervention
      group, and children hospitalized on even-numbered days were included in the control group.
      For example; The child admitted to the pediatric emergency clinic on October 11 was included
      in the intervention group, and the child hospitalized on October 12 was included in the
      control group. This sequence was repeated until the number of samples was completed. In this
      study, all assessments were made in the same way for the children in the intervention and
      control groups. In this study, data on children's sleep quality and vitals signs were
      re-evaluated in different time periods. These time periods are: pre-intervention and
      intervention day. Intervention day; in the morning (at 08:00), before going to sleep (at
      20:00), during sleep (at 02:00), and the next morning (at 08:00). Before the intervention; It
      covers between at 08:00 in the morning the day before the child is admitted to the emergency
      clinic and at 08:00 in the morning on the day the child is admitted to the emergency clinic.
      Intervention day; It covers the first day of the child's admission to the emergency clinic
      between at 08:00 in the morning and at 08:00 in the next day. Factors defining the sleep
      quality of children; It was evaluated twice, before the intervention and on the day of the
      intervention. Children's vital signs, intervention day; It was measured 4 times ( in the
      morning, before going to sleep, during sleep and the next morning), using a pulse oximetry
      device and an infrared thermometer. All data, except the vital signs of the children, were
      asked to the mothers face-to-face and their answers were recorded in the CSQEF.

      Instruments:

      Data were collected with the Child's Sleep Quality Evaluation Form (CSQEF). CSQEF was
      developed by the authors based on the literature. The questions in the form; The child's age,
      gender, vital signs (blood pressure, radial pulse, respiratory rate and body temperature) and
      factors indicating sleep quality ( night sleep duration/hour and night awakenings/number). In
      the study, a lightened and musical baby mobile, which facilitates the falling asleep of
      children and allows them to continue their sleep, was used in the rooms of the children in
      the hospital. In the study, In the study, a lightened and musical baby that can be hung on
      the wall and fixed on a flat surface was used. An illuminated musical mobile with light
      emitting diode (LED) lights and a reflective interior surface, providing night sky projection
      on the ceiling and walls, with 5 different color options, 4 function keys and soft music, was
      used.

      Intervention:

      Children in the intervention and control groups, who were admitted to the pediatric emergency
      clinic, were monitored by being connected to the pulse oximeter device located at the
      bedside. Vital signs were measured and recorded first thing in the morning (at 08:00) on the
      intervention day. The child's age, gender, and factors defining sleep quality before the
      intervention (1st evaluation) were asked face-to-face to the mothers and their answers were
      recorded in the CSQEF. At 19:00, a mobile with light and music was placed in the middle of
      the bedside table in the room of the children in the intervention group. Checked the volume,
      lighting color, pattern and rotation function. Sound; set to medium level, which facilitates
      the transition to sleep. lighting color; set to a yellow color that provides dim light and is
      not distracting. As a pattern; Reminiscent of the night, the moon-star projection and
      rotation function were used.The patient room of the children in the intervention and control
      groups was illuminated and the window blinds were closed to provide a dark environment. Vital
      signs of the children in the intervention and control groups were measured and recorded at
      20:00. The mobile with light and music placed in the room of the children in the intervention
      group was started at 20:00. The children in the control group did not use lightened and
      musical baby mobile, and the routine sleep pattern was maintained. Children in the
      intervention and control groups at 02:00 (during sleep) and 08:00; Vital signs were measured
      and recorded. The next morning on the intervention day (at 08:00); The mothers in the
      intervention and control groups were asked face-to-face about the factors that define the
      sleep quality of the children in the intervention and control groups between at 20:00 and
      08:00 (2nd evaluation) and that their impair (1st evaluation) and their answers were recorded
      in the CSQEF.
    

Intervention name(s): lightened and musical baby mobile
Intervention type(s): Device
Intervention description(s): Before going to sleep in the infant's room in the intervention group, a lightened and musical baby mobile was used.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Pediatric emergency clinic; Sleep; Sleep quality; Lightened and musical baby mobile