The hospitalization process is a tumultuous period that can yield both short-term and long-term adverse consequences for children and their families (Hopia et al., 2005; Karbandi et al., 2020; Melnyk, 2000; Sener & Karaca, 2017; Williams et al., 2019). It introduces conditions such as uncertainty, confusion, harm to bodily integrity, separation from the social environment, restrictions on activities and habits, lack of privacy, and dependency in children (Wilson et al., 2010). As a consequence of hospitalization, children's feelings of safety, independence, and self-control become threatened, giving rise to behaviors such as stress, fear, sleep disturbances, regression, attention-seeking, hyperactivity, crying, unhappiness, aggression, insecurity, and anxiety (Akkavak & Karabudak, 2019; Delvecchio et al., 2019; Favara-Scacco et al., 2001; Fidler et al., 2022; Kadan, 2020; Li et al., 2016; Ryan-Wenger & Gardner, 2012; Sampath et al., 2022; Semerci et al., 2021; Schalkers et al., 2015; Silva et al., 2017). These reactions are influenced by various factors, including the child's age, the diagnosis of the illness, whether the illness is acute or chronic, previous hospital experiences, the support provided by healthcare professionals during the hospitalization process, the degree of pain and movement restriction, and the type/frequency of procedures performed for diagnosis/treatment, as well as the duration of hospitalization (Akkavak & Karabudak, 2019; Kadan, 2020; Semerci et al., 2021; Wilson et al., 2010).

In the literature, the lack of control over the hospital environment and medical procedures is recognized as a significant source of stress for hospitalized children (Li et al., 2011). The hospital environment is often associated with feelings of being in a ‘cold and clinical’ setting, fear of medical examinations, pain, exposure to unfamiliar sights and sounds, an increase in unfamiliar individuals, uncertainty, and a sense of losing control and security. This situation directly impacts children's anxiety levels (Caleffi et al., 2016; Delvecchio et al., 2019). Anxiety is reported as the most common negative response among hospitalized children (Zisk-Rony et al., 2015). Anxiety can be observed in children from the moment of hospitalization (Islaeli et al., 2020; Nilsson et al., 2019). High levels of anxiety can have detrimental effects on children's physiological and psychological health, resulting in extended recovery periods and negatively affecting physical growth and emotional development (Caleffi et al., 2016; Delvecchio et al., 2019; Lerwick, 2016; Sarman & Sarman, 2022; Semerci et al., 2021). Anxiety may hinder children's coping abilities with medical treatment and promote negative and uncooperative behaviors. Additionally, it can lead to increased negative feelings towards healthcare professionals among children (Feng et al., 2021; Li et al., 2016). To manage anxiety and distress in children, it is essential to create a supportive environment in the hospital (Caleffi et al., 2016; Delvecchio et al., 2019; Islaeli et al., 2020; Lerwick, 2016).

Pediatric nurses are essential healthcare professionals who are in direct contact with the child from the beginning to the end of hospitalization (Akkavak & Karabudak, 2019). They play a critical role in managing children's reactions to illness and hospitalization (Dowling, 2002). Taking into account the child's physical, physiological, behavioral, and psychological differences, nurses provide uninterrupted holistic care, comfort, and support (Karaca & Durna, 2019; Noreña Peña & Cibanal Juan, 2011; Ryan-Wenger & Gardner, 2012; Semerci et al., 2021). However, pediatric nurses should collaborate with the child while providing this care. In the literature, the importance of encouraging children admitted to the hospital to participate in the clinical decision-making process is emphasized (Clavering & McLaughlin, 2010; Coyne, 2008; Coyne et al., 2014; Moore & Kirk, 2010; Runeson et al., 2001). Children are not just recipients of healthcare services; they are knowledgeable social individuals with their own perspectives. The right of children to participate in their care and receive information is essential (Comparcini et al., 2018; Schalkers et al., 2015). From the moment of hospitalization, children should be included in the care/treatment by nurses, informed about the process, and provided with a supportive environment. Providing information and education to children and parents by nurses, and giving them the opportunity to express themselves, fosters trust and satisfaction in patients (Comparcini et al., 2018; Karaca & Durna, 2019; Semerci et al., 2021). Patient satisfaction is a multidimensional and complex concept that constitutes a critical aspect of hospital care environments. It is considered the gold standard of care as a health indicator and, therefore, directly concerns nurses (Loureiro et al., 2019). Over time, the patient's perspective has played an increasingly significant role in defining, measuring, and evaluating nursing care (Pelander & Leino-Kilpi, 2004). According to the literature, children have a say in healthcare services, but the quality of nursing care in pediatric settings is mostly assessed by parents/caregivers (Pelander & Leino-Kilpi, 2004; Pelander, Leino-Kilpi, & Katajisto, 2007). While parental views are crucial in pediatric care, they may be incomplete or limited in conveying the experiences of children, thus not fully reflecting the children's perspectives. Children are considered the most accurate source of information about their own experiences (Comparcini et al., 2018; Pelander, Lehtonen, & Leino-Kilpi, 2007; Schalkers et al., 2015).

A literature review revealed that the perception of care quality is generally evaluated by parents (Byczkowski et al., 2013; Keiza et al., 2017; Lacey et al., 2021; Williams et al., 2019), with focus groups often including newborns, pediatric intensive care, and hematology/oncology patients (Jaramillo Santiago et al., 2018; Keiza et al., 2017; Ndwiga et al., 2022). Assessing the quality of nursing care from the perspective of children will help determine their care needs, meet their expectations, and plan nursing interventions. Additionally, the anxiety levels of children who are satisfied with nursing care will be positively affected.

The aim of the research was to investigate the predictive effect of nursing care quality perceived by inpatient children aged 9 to 12 on state anxiety levels. The objectives of this study are to review the literature on children's perceptions of nursing care quality and state anxiety levels, collect data on the quality of nursing care and state anxiety level from a sample child population, analyze the data to identify the relationship between children's quality of nursing care and state anxiety level, and draw conclusions and make recommendations based on the study results.