Background: Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children’s daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients’ quality of life, especially in a safe, enjoyable, and playful environment. Purpose: This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP. Methods: We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2. Results: Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function. Conclusion: With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.

Background: The high number of cases of COVID-19 has caused an increase in workload and a shortage of medical personnel in various countries, so volunteers are needed, such as health students. However, becoming a volunteer during a pandemic is influenced by motivational factors and barriers. Purpose: This study aims to identify the motivations and barriers of health students as COVID-19 volunteers. Methods: This study uses a systematic scoping review. A literature review was conducted using CINAHL, PubMed, and ScienceDirect databases. The study was eligible for inclusion if it included articles published from 2020 to 2022, full-text, and primary studies. Studies were excluded if they were not in English. The keywords used in English were “health students OR nursing students OR medical students” AND “motivation OR willingness” AND “Barriers” AND “volunteer OR volunteering OR volunteerism OR voluntary” AND “COVID-19 OR covid-19 OR SARS-CoV-2 OR COVID-19 pandemic”. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool. Results: We found 12 articles showing motivational factors and barriers among health students volunteering to control COVID-19. Motivational factors include domain values, understanding, enhancement, career, incentive, government, social, and demographics. In contrast, barriers include fear, lack of training and knowledge, PPE shortage, unpreparedness and role uncertainty, and lack of interest, support, and protection. Conclusion: Our findings highlight that eight motivational factors and seven barriers influence health students’ involvement in COVID-19 volunteering. However, to optimize the potential of health students, further preparation is essential to ensure that students can volunteer effectively, such as integrating volunteer training programs into the curriculum in preparation for future pandemic mitigation.

Background: The incidence of chronic diseases in children is increasing worldwide, which can disrupt the quality of life. Family empowerment (FE) is one approach to strengthen family care among children with chronic diseases. In addition, internet has the potential in healthcare service interventions for families. Purpose: This study aimed to determine the efficacy of internet-based family empowerment interventions among children with chronic diseases. Methods: The study used a mixed-methods systematic review. A literature review was conducted following PRISMA guidelines using the PubMed, Scopus, ScienceDirect, and CINAHL databases. We used the PCC framework: chronic diseases (Population), family empowerment (Concept), and internet-based intervention (Context). Studies were eligible if published between 2013 and 2023, full-text, original study design, and focused on family empowerment in children with chronic diseases. Studies would be excluded if they were not in English or if the population was adults. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT) version 2018. The study analysis used Sequential Explanatory Synthesis, which is a quantitative study (QUAN) synthesis followed by a qualitative study (QUAL) synthesis, then integrated using the QUAL data transformation technique. Results: We highlight the quantitative study findings that an internet-based family empowerment intervention positively impacted family members’ ability to care for children with chronic diseases with a mean Family Empowerment Scale (FES) total score of 4.13. We analyzed six study and identified four themes regarding efficacy of internet-based interventions in empowering families with children with chronic diseases: knowledge; availability of resources and time-saving; connectedness and communication; and family management and self-confidence. Conclusion: Our study highlights that online-based interventions in family empowerment positively impact enhancing all domains of empowerment. This findings suggest that internet-based family interventions need to be adopted to fulfill the care needs of children with chronic diseases sustainably.

COVID-19 has caused widespread psychological suffering. Anxiety is one of the several psychological disorders that are escalating globally, yet social distance constraints restrict in-person mental health therapy. Anxiety and other psychological disorders whose treatments are limited due to social distancing continue to grow, so there is an increasing need to use mental healthcare that can be offered remotely, especially in the pandemic era. This study aimed to conduct a systematic review and meta-analysis of the efficacy of online-based interventions for anxiety during COVID-19. This study followed the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA). We collected data from three databases, namely PubMed, CINAHL, and Oxford Library Press, published in 2020–2022. Additionally, we collected data using the snowball technique. This meta-analysis analyzed the pooled mean difference (MD) and its p-value using random-effects models. Critical appraisal and risk of bias were assessed using Cochrane Risk of Bias (Rob) 2. We retrieved 34 RCTs for systematic review and 14 RCTs for meta-analysis, yielding 9159 participants for general anxiety disorder (GAD-7) measurement and 1303 participants for depression anxiety stress scale (DASS-21) measurement. This study shows that online-based interventions significantly reduce GAD-7 score (a pooled MD of 1.30; 95% CI: 2.83–4.65; p = 0.00001) and insignificantly reduce DASS-21 (0.05; 95% CI: −2.63–2.72; p = 0.97) according to pre- and post-test in intervention group. Additionally, there is a significant difference between the intervention and control groups, where the intervention group performed statistically progressively better than the controls (−7.26; 95% CI: −11.58–−2.95; p = 0.001) (−2.08; 95% CI: −6.71–2.55; p = 0.001). Online-based interventions have proved effective for reducing general anxiety during the COVID-19 pandemic. Consequently, this meta-analysis can be adapted as a model for mental health services in the new normal.

Background: Invasive procedures in children can lead to painful and uncooperative procedures. It is essential to determine the appropriate method to create a comfortable environment for children during invasive procedures. However, audiovisuals are one of the distraction techniques used in pain management. Purpose: This study aims to identify and categorize related audiovisual distraction techniques in reducing pain due to invasive procedures among children. Methods: This study uses a systematic scoping review. A literature review was conducted using PubMed, EBSCO, Science Direct, Scopus and grey literature through Google Scholar. The study was eligible for inclusion if it included articles published from 2012 to 2022, full-text and open accessed articles, and in Indonesian and English language. Studies were excluded if they were review studies and the adult population. The keywords in English were ”Children” OR ‘Child’ OR ”Kids” OR ‘Youth’ OR ‘Adolescents’ OR ‘Teenager’ OR ‘Teens’ OR ‘Young People’ OR ‘Pediatric’ OR ‘Paediatric’ OR ‘Childhood’ AND ”Audiovisual” OR ‘Movie’ OR ‘Video’ OR ‘Animation’ AND ”Pain” AND ”Invasive procedures” and keyword in Indonesia were ”Anak” OR ‘Remaja’ OR ‘Bayi’ OR ‘Balita’ AND ”Audiovisual” OR ‘Film’ OR ”Video” OR ‘Animasi’ OR “Nyeri” AND ‘Prosedur invasif’. Results: We found 15 articles showing audiovisual distraction techniques in managing pain among children undergoing invasive procedures. Three types of audiovisual interventions were used, including virtual reality (VR), video music, and animated cartoons. In addition, types of invasive procedures that benefited from the analyzed interventions were infusion, surgery, injection, blood draw, dressing change, circumcision, endoscopy, and phlebotomy. Conclusion: Our findings highlight that virtual reality, video music, and animated cartoons have clinical implications in helping to distract from pain in children undergoing invasive procedures. Our study indicates that the potential of audiovisual intervention can be used as an intervention strategy in the pediatric nursing area.

Background: Infants are in a critical period during which often occur many problems, such as growth, development, and motor delays. One of the interventions that can potentially reduce these problems is by giving a massage therapy. Purpose: This study aims to conduct a systematic scoping review of massage therapy’s potential for growth and development among infants under nine months. Methods: This study followed a Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA-ScR). We collected data from three databases, including PubMed, Scopus, and CINAHL with full text, published in 2013– 2022, subjects aged less than nine months, full-text articles, and randomized controlled trials. Studies were excluded if they were not in English. Results: Of the 11 studies found, it shows that therapy massage can effectively increase infants’ growth and development, including body weight, length, visual-motor coordination and integration, hand-eye, hearing, speech, social, vagal activity, language, locomotion, stationary, and reflexes. The interventions include medium chain triglyceride oil massage, Dabur Lal Tail massage, oil massage, massage by mothers, and massage therapy without additives for 5– 45 minutes. In addition, massage therapy has a positive effect on infants with various conditions, including preterm infants, infants with HIV-infected mothers, and infants with Down’s syndrome. Conclusion: Our findings highlight that infants receiving massage therapy were significantly more likely to increase growth and development than the population who were not given massage therapy. However, further investigation into preventing the severity of growth and developmental problems is urgently needed.