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Tuncay S, Sarman A. Ventriloquist intervention prepared with drama technique in reducing pain, anxiety and fear in children during invasive procedures. Int Emerg Nurs 2024; 75:101462. [PMID: 38850644 DOI: 10.1016/j.ienj.2024.101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/26/2024] [Accepted: 05/12/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION This study aimed to investigate the effects of a ventriloquist nursing intervention, incorporating drama techniques, on pain, anxiety, and fear experienced by children aged 5 to 10 years undergoing painful medical procedures. METHODS This study was designed as a time-series randomized controlled trial. Data were collected from the outpatient units of a Pediatric Hospital in a province in eastern Turkey between 24 May 2023 and 28 October 2023. This study involving a total of 72 children. Pain, anxiety, and fear levels were assessed before, during, and after intravenous cannula insertion. RESULTS Randomization ensured that both groups had similar demographics, with an average age of 7.50 ± 1.73 years and an equal distribution of gender. During the painful procedure, it was observed that both groups experienced an increase in pain, anxiety, and fear, though this increase was statistically less significant in the ventriloquist group. Ultimately, in the post-procedure period, children in the ventriloquist group exhibited lower levels of pain, anxiety, and fear compared to the control group (p < 0.05). CONCLUSION The findings of this study suggest that ventriloquist nursing interventions, utilizing drama techniques, can effectively reduce pain, anxiety, and fear in children undergoing painful medical procedures.
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Affiliation(s)
- Suat Tuncay
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey.
| | - Abdullah Sarman
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey.
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Henkel ED, Haller CN, Diaz LZ, Ricles V, Wong Grossman AV, Nemergut ME, Krakowski AC. Optimizing pediatric periprocedural pain management part II-Adjunct therapies to support the use of infiltrative anesthetics. Pediatr Dermatol 2024; 41:588-598. [PMID: 38965874 DOI: 10.1111/pde.15677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/01/2024] [Indexed: 07/06/2024]
Abstract
Pediatric procedure-related pain management is often incompletely understood, inadequately addressed, and critical in influencing a child's lifelong relationship with the larger healthcare community. We present a comprehensive review of infiltrative anesthetics, including a comparison of their mechanisms of action and relative safety and efficacy data to help guide clinical selection. We also describe the multimodal utilization of adjunct therapies-in series and in parallel-to support the optimization of pediatric periprocedural pain management, enhance the patient experience, and provide alternatives to sedation medication and general anesthesia.
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Affiliation(s)
- Emily D Henkel
- Division of Dermatology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Courtney N Haller
- Division of Dermatology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Lucia Z Diaz
- Division of Dermatology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
- Dell Children's Medical Center, Austin, Texas, USA
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | | | | | | | - Andrew C Krakowski
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA
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Amali RJ, Chavan SS. Effectiveness of Virtual Reality Distraction on Pain Perception and Fear among Children with Cancer Undergoing IV Cannulation. Indian J Community Med 2023; 48:909-914. [PMID: 38249694 PMCID: PMC10795885 DOI: 10.4103/ijcm.ijcm_988_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 10/05/2023] [Indexed: 01/23/2024] Open
Abstract
Background Cancer children are subjected to multiple cannulations during hospitalization. Pain and fear are most common during invasive procedures that are performed, especially IV cannulation, which can lead to worry. Exactly 25% of children are reported to have a fear of needle-related procedures. To examine the impact of virtual reality (VR) distraction on pain perception and fear in children with cancer undergoing IV cannulation. Materials and Methods Using a quasi-experimental design, 80 cancer children with IV cannulation between ages 7-18 were recruited to the intervention and control group (N = 40 + 40) using the purposive sampling technique. The virtual reality distraction device was used 10 min before the peripheral IV cannulation procedure and remained in place until the procedure was completed in the intervention group, and no device was used in the control group. Wong-Baker Faces Pain Rating Scale and Children's Fear Scale were used to assess the pain and fear of children and their mothers. Result Pain perception was found to be significantly lower in the VR distraction group among both children and mothers (1.82 ± 0.18, 8.01 ± 3.21) 95% confidence interval (CI) [0.82, 2.16] compared to the control group, respectively (P = 0.001**). Fear was found to be significantly lower in the VR distraction group among both children and mothers (0.81 ± 0.71, 3.01 ± 1.42) 95% CI [0.46, 0.91]. A strong positive correlation was found between children's and mothers' pain perception (r = 0.91, P = 0.001**) and fear (r = 0.84, P = 0.001**). Conclusion VR distraction can be used as an effective device in pain and fear management among children undergoing IV cannulation.
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Affiliation(s)
- R Jensi Amali
- Department of Pediatric Nursing, Father Muller College of Nursing, Mangalore, Karnataka, India Department of Pediatric Nursing, Father Muller College of Nursing, Mangalore, Rajiv Gandhi University of Health Science, Karnataka, India
| | - Seema S. Chavan
- Associate Professor, College of Nursing, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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Tuncay S, Sarman A, Budak Y. SuperKid makes it easier: Effect of an intervention prepared with cognitive behavioral technique on reducing fear and pain of children during intravenous insertion. J Pediatr Nurs 2023; 73:e164-e171. [PMID: 37591703 DOI: 10.1016/j.pedn.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE The aim of this randomized controlled trial was to evaluate the effectiveness of a cognitive-behavioral SuperKid intervention, in reducing fear and pain among children undergoing intravenous insertion in outpatient services. DESIGN AND METHODS This study was designed as a randomized controlled trial, with 96 children aged 5-7 years. SuperKid intervention employed cognitive-behavioral techniques, implemented through a set of prepared cards. Fear was assessed using the Child Fear Scale, while pain status was measured using the Wong Baker Face Pain Scale. Scoring was performed by the mother, child, and researcher. Time series tests were conducted using the Wilks Lambda test. RESULTS Most children in both the experimental and control groups reported fear regarding hospital procedures, particularly those involving pain and separation from their mothers. However, children in the experimental group who underwent the SuperKid intervention during and after IV insertion procedure experienced significantly less fear and pain than those in the control group. CONCLUSIONS SuperKid intervention was found to be effective in reducing the procedural fear and pain of children undergoing intravenous insertion in outpatient services. The utilization of cognitive-behavioral techniques through a set of prepared cards provides an accessible and engaging means of alleviating negative emotional experiences among children undergoing medical/nursing procedures. PRACTICE IMPLICATIONS SuperKid intervention can potentially improve children's attitudes toward medical care and make future procedures easier for them. Healthcare providers could consider incorporating cognitive-behavioral interventions, such as the SuperKid intervention, into their clinical practice to reduce the fear and pain experienced by children during medical/nursing procedures.
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Affiliation(s)
- Suat Tuncay
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey
| | - Abdullah Sarman
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey.
| | - Yusuf Budak
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey
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Le May S, Genest C, Francoeur M, Hung N, Guingo E, Khadra C, Noel M, Paquette J, Roy A. Virtual reality mobility for burn patients (VR-MOBILE): A within-subject-controlled trial protocol. PAEDIATRIC & NEONATAL PAIN 2022; 4:192-198. [PMID: 36618513 PMCID: PMC9798042 DOI: 10.1002/pne2.12086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
In the acute phase, burn patients undergo several painful procedures. Pediatric burn care procedures conducted in hydrotherapy have been known to generate severe pain intensity and moderate to high levels of anxiety. Hydrotherapy treatments are done with the use of opioids and benzodiazepines for pain and anxiety. Unfortunately, nonpharmacological methods are rarely combined with pharmacological treatments despite evidence showing that distraction can serve as an effective method for pain management and can potentially decrease analgesic requirements in other painful medical procedures. Virtual reality (VR) is a method that uses distraction to interact within a virtual environment. The use of VR is promising for pain reduction in varying settings. Considering the lack of optimal pain and anxiety management during burn wound care and the positive effect of an immersive distraction for painful procedures, using VR for burn wound care procedures may show promising results. This is a within-subject randomized controlled trial design in which each participant will serve as his/her own control. A minimum of 20 participants, aged 7 to 17 years old undergoing a burn care session, will receive both standard and experimental treatments during the same session in a randomized order. The experimental treatment will consist of combining VR distraction using the video game Dreamland® to the current standard pharmacological care as per unit protocol. The control group will only receive the unit's standard pharmacological care. The mean difference in both pain intensity scores and in anxiety between the two different sequences will be the primary outcomes of this study. This study evaluates the effect of VR on burn wound care. If results from this study show a positive effect of VR compared to standard care, this protocol may provide guidance on how to implement this type of immersive care as part of the tools available for distraction of painful procedures for acute burn victims.
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Affiliation(s)
- Sylvie Le May
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
- Faculty of NursingUniversité de MontréalMontréalQuébecCanada
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CRIUSMM)MontréalQuébecCanada
| | - Christine Genest
- Faculty of NursingUniversité de MontréalMontréalQuébecCanada
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CRIUSMM)MontréalQuébecCanada
| | - Maxime Francoeur
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
| | - Nicole Hung
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
- Faculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | - Estelle Guingo
- Department of Creation and NEW MediaUniversité du Québec en Abitibi‐Témiscamingue (UQAT)Rouyn‐NorandaQuébecCanada
| | | | - Melanie Noel
- Department of PsychologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Julie Paquette
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
| | - Andrée‐Anne Roy
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
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The Effect of Robot-Led Distraction during Needle Procedures on Pain-Related Memory Bias in Children with Chronic Diseases: A Pilot and Feasibility Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111762. [PMID: 36421211 PMCID: PMC9688830 DOI: 10.3390/children9111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
The current study evaluated the feasibility and preliminary clinical impact of robot-led distraction during needle procedures in children with chronic diseases on pain-related memories. Participants were 22 children (8−12 years old) diagnosed with a chronic disease (e.g., chronic immune deficiency) and undergoing a needle procedure as part of their routine treatment. Children were randomized to the experimental group (i.e., robot-led distraction) or control group (i.e., usual care). For feasibility, we evaluated study- and needle-procedure-related characteristics, intervention fidelity and acceptability, and nurse perceptions of the intervention. Primary clinical outcomes included children’s memory bias for pain intensity and pain-related fear (1 week later). Results indicated that intervention components were >90% successful. Overall, the robot-led distraction intervention was perceived highly acceptable by the children, while nurse perceptions were mixed, indicating several challenges regarding the intervention. Preliminary between-group analyses indicated a medium effect size on memory bias for pain intensity (Hedges’ g = 0.70), but only a very small effect size on memory bias for pain-related fear (Hedges’ g = 0.09), in favor of the robot-led distraction intervention. To summarize, while feasible, certain challenges remain to clinically implement robot-led distraction during needle procedures. Further development of the intervention while accounting for individual child preferences is recommended.
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Hsu MF, Whu YW, Lin IC, Liu CY, Lai FC, Liu PC, Chen CW. Effectiveness of Virtual Reality Interactive Play for Children during Intravenous Placement: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:87-93. [DOI: 10.1016/j.anr.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
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Redmond P, Blackshear C, Davis J. The Effect of Lidocaine Delivered by Jet Injection on First Attempt Venous Access Success Rates in the Pediatric Emergency Department. Pediatr Emerg Care 2022; 38:e34-e36. [PMID: 34653088 DOI: 10.1097/pec.0000000000002552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Jet injection of 1% lidocaine (J-Tip) has been used in the pediatric emergency department (PED) to reduce pain associated with venipuncture, but there are limited data on the effect of J-Tip on first-attempt venous access success rates. We sought to determine if using a J-Tip altered the first-attempt venous access success rate in the PED. Then, we examined the effect of J-Tip use on pain scores and resource utilization during peripheral venous access. METHODS We prospectively evaluated children over 6 months of age who required peripheral venous access in the PED. The exposure group received 0.25 mL of 1% buffered lidocaine via jet injection 90 seconds before peripheral venous access. The control group received no local anesthesia. Parent and nurse surveys were completed during the visit. RESULTS There was no difference in first attempt success rate between the exposure (n = 136) and control (n = 90) groups (87% vs 88%, P = 0.82). J-Tip use was associated with improved pain scores based on child report (median 1 vs 3; P < 0.001), parent report (median 1 vs 3; P < 0.001), and nurse assessment (median 0 vs 3; P < 0.001). CONCLUSIONS Use of J-Tip in the PED to reduce pain associated with peripheral venous access did not lead to a reduction in first-attempt success rates for peripheral venous access. J-Tip was well received among nurses and parents and was associated with improved pain scores.
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Affiliation(s)
| | - Chad Blackshear
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS
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Lozano S, Sund G, Guimera A, Deukmedjian G, Miller PS. A Comparison of Local Anesthetics for Intravenous Catheter Insertion in Hospitalized Pediatric Patients: A Randomized Clinical Pilot Trial. JOURNAL OF INFUSION NURSING 2021; 44:346-356. [PMID: 34753154 DOI: 10.1097/nan.0000000000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Peripheral intravenous catheter (PIVC) insertion is one of the most painful procedures pediatric patients undergo during hospitalization. To date, local anesthetics delivered via cream, patch, and needle-free injection have not been rigorously evaluated together. This study aimed to investigate feasibility and potential efficacy of local anesthetics on pain intensity during PIVC insertion in an unblinded, single-center, randomized clinical pilot trial. Between March 2017 and February 2020, 88 hospitalized children aged 12 months to 18 years in an acute pediatric unit at an academic medical center were randomized to 1 of 3 local anesthetics: 1) lidocaine/prilocaine cream, 2) lidocaine/tetracaine patch, and 3) unbuffered lidocaine needle-free injection. Feasibility outcomes were recruitment and protocol adherence. Pain intensity was measured using the Face, Legs, Activity, Cry, Consolability (age <8 years) and Verbal Numeric Rating (VNRS) scales (age ≥8 years) before, during, and after procedure. Secondary outcomes included catheterization attempts, procedure time, and parent satisfaction. Recruitment rate was acceptable (2.7 patients per month). Protocol adherence was high (92%). Preliminary clinical findings showed no significant difference in pain intensity across treatments. Procedure time to successful insertion differed in the VNRS group, favoring unbuffered lidocaine needle-free injection. Conduct of a definitive, full-scale randomized clinical trial in the hospitalized pediatric population is feasible.
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Affiliation(s)
- Sally Lozano
- University of California Los Angeles Medical Center, Santa Monica, California (Ms Lozano); University of California Los Angeles Mattel Children's Hospital, Los Angeles, California (Ms Sund); University of California Los Angeles Health, Los Angeles, California (Drs Guimera, Deukmedjian, and Miller)
- Sally Lozano, BSN, RN, CPN , has worked as a pediatric nurse for 15 years at University of California Los Angeles (UCLA) Medical Center. She was recently promoted to clinical nurse manager in the general pediatric unit. Ms Lozano has extensive experience placing and teaching techniques for successful peripheral intravenous catheter insertions
- Grace Sund, MSN, RN, CPNP, CPHON, is a clinical nurse specialist in pediatrics at UCLA Mattel Children's Hospital and has worked as a pediatric nurse for 19 years. She helped create the nurse-driven protocol for topical anesthetics prior to intravenous insertion for the pediatric population across the health system
- Allison Guimera, MD, FAAP, worked as a pediatric hospitalist at UCLA Health and currently practices outpatient pediatrics with UCLA Health. She is a board-certified pediatrician and a fellow of the American Academy of Pediatrics
- Grace Deukmedjian, MD, is a pediatric hospitalist at UCLA Health. Her expertise is in global health, social justice and equity, medical education, and humanities in medicine
- Pamela S. Miller, PhD, RN, ACNP, CNS, PHN, EBP(CH), is a senior nurse scientist in the Center for Nursing Excellence at UCLA Health, where she directs the research, evidence-based practice, and innovation programs. Her research focuses on symptom science
| | - Grace Sund
- University of California Los Angeles Medical Center, Santa Monica, California (Ms Lozano); University of California Los Angeles Mattel Children's Hospital, Los Angeles, California (Ms Sund); University of California Los Angeles Health, Los Angeles, California (Drs Guimera, Deukmedjian, and Miller)
- Sally Lozano, BSN, RN, CPN , has worked as a pediatric nurse for 15 years at University of California Los Angeles (UCLA) Medical Center. She was recently promoted to clinical nurse manager in the general pediatric unit. Ms Lozano has extensive experience placing and teaching techniques for successful peripheral intravenous catheter insertions
- Grace Sund, MSN, RN, CPNP, CPHON, is a clinical nurse specialist in pediatrics at UCLA Mattel Children's Hospital and has worked as a pediatric nurse for 19 years. She helped create the nurse-driven protocol for topical anesthetics prior to intravenous insertion for the pediatric population across the health system
- Allison Guimera, MD, FAAP, worked as a pediatric hospitalist at UCLA Health and currently practices outpatient pediatrics with UCLA Health. She is a board-certified pediatrician and a fellow of the American Academy of Pediatrics
- Grace Deukmedjian, MD, is a pediatric hospitalist at UCLA Health. Her expertise is in global health, social justice and equity, medical education, and humanities in medicine
- Pamela S. Miller, PhD, RN, ACNP, CNS, PHN, EBP(CH), is a senior nurse scientist in the Center for Nursing Excellence at UCLA Health, where she directs the research, evidence-based practice, and innovation programs. Her research focuses on symptom science
| | - Allison Guimera
- University of California Los Angeles Medical Center, Santa Monica, California (Ms Lozano); University of California Los Angeles Mattel Children's Hospital, Los Angeles, California (Ms Sund); University of California Los Angeles Health, Los Angeles, California (Drs Guimera, Deukmedjian, and Miller)
- Sally Lozano, BSN, RN, CPN , has worked as a pediatric nurse for 15 years at University of California Los Angeles (UCLA) Medical Center. She was recently promoted to clinical nurse manager in the general pediatric unit. Ms Lozano has extensive experience placing and teaching techniques for successful peripheral intravenous catheter insertions
- Grace Sund, MSN, RN, CPNP, CPHON, is a clinical nurse specialist in pediatrics at UCLA Mattel Children's Hospital and has worked as a pediatric nurse for 19 years. She helped create the nurse-driven protocol for topical anesthetics prior to intravenous insertion for the pediatric population across the health system
- Allison Guimera, MD, FAAP, worked as a pediatric hospitalist at UCLA Health and currently practices outpatient pediatrics with UCLA Health. She is a board-certified pediatrician and a fellow of the American Academy of Pediatrics
- Grace Deukmedjian, MD, is a pediatric hospitalist at UCLA Health. Her expertise is in global health, social justice and equity, medical education, and humanities in medicine
- Pamela S. Miller, PhD, RN, ACNP, CNS, PHN, EBP(CH), is a senior nurse scientist in the Center for Nursing Excellence at UCLA Health, where she directs the research, evidence-based practice, and innovation programs. Her research focuses on symptom science
| | - Grace Deukmedjian
- University of California Los Angeles Medical Center, Santa Monica, California (Ms Lozano); University of California Los Angeles Mattel Children's Hospital, Los Angeles, California (Ms Sund); University of California Los Angeles Health, Los Angeles, California (Drs Guimera, Deukmedjian, and Miller)
- Sally Lozano, BSN, RN, CPN , has worked as a pediatric nurse for 15 years at University of California Los Angeles (UCLA) Medical Center. She was recently promoted to clinical nurse manager in the general pediatric unit. Ms Lozano has extensive experience placing and teaching techniques for successful peripheral intravenous catheter insertions
- Grace Sund, MSN, RN, CPNP, CPHON, is a clinical nurse specialist in pediatrics at UCLA Mattel Children's Hospital and has worked as a pediatric nurse for 19 years. She helped create the nurse-driven protocol for topical anesthetics prior to intravenous insertion for the pediatric population across the health system
- Allison Guimera, MD, FAAP, worked as a pediatric hospitalist at UCLA Health and currently practices outpatient pediatrics with UCLA Health. She is a board-certified pediatrician and a fellow of the American Academy of Pediatrics
- Grace Deukmedjian, MD, is a pediatric hospitalist at UCLA Health. Her expertise is in global health, social justice and equity, medical education, and humanities in medicine
- Pamela S. Miller, PhD, RN, ACNP, CNS, PHN, EBP(CH), is a senior nurse scientist in the Center for Nursing Excellence at UCLA Health, where she directs the research, evidence-based practice, and innovation programs. Her research focuses on symptom science
| | - Pamela S Miller
- University of California Los Angeles Medical Center, Santa Monica, California (Ms Lozano); University of California Los Angeles Mattel Children's Hospital, Los Angeles, California (Ms Sund); University of California Los Angeles Health, Los Angeles, California (Drs Guimera, Deukmedjian, and Miller)
- Sally Lozano, BSN, RN, CPN , has worked as a pediatric nurse for 15 years at University of California Los Angeles (UCLA) Medical Center. She was recently promoted to clinical nurse manager in the general pediatric unit. Ms Lozano has extensive experience placing and teaching techniques for successful peripheral intravenous catheter insertions
- Grace Sund, MSN, RN, CPNP, CPHON, is a clinical nurse specialist in pediatrics at UCLA Mattel Children's Hospital and has worked as a pediatric nurse for 19 years. She helped create the nurse-driven protocol for topical anesthetics prior to intravenous insertion for the pediatric population across the health system
- Allison Guimera, MD, FAAP, worked as a pediatric hospitalist at UCLA Health and currently practices outpatient pediatrics with UCLA Health. She is a board-certified pediatrician and a fellow of the American Academy of Pediatrics
- Grace Deukmedjian, MD, is a pediatric hospitalist at UCLA Health. Her expertise is in global health, social justice and equity, medical education, and humanities in medicine
- Pamela S. Miller, PhD, RN, ACNP, CNS, PHN, EBP(CH), is a senior nurse scientist in the Center for Nursing Excellence at UCLA Health, where she directs the research, evidence-based practice, and innovation programs. Her research focuses on symptom science
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Le May S, Genest C, Hung N, Francoeur M, Guingo E, Paquette J, Fortin O, Guay S. The Effect of Virtual Reality Game Preparation for Children scheduled for MRI (IMAGINE): a Randomized Controlled Trial Protocol (Preprint). JMIR Res Protoc 2021; 11:e30616. [PMID: 35700000 PMCID: PMC9237773 DOI: 10.2196/30616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/06/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background It is known that magnetic resonance imaging (MRI) procedures generate fear and anxiety. Children may become restless during scanning, which results in movement artifacts requiring the MRI procedure to be repeated with sedation. Few studies seem to have looked at the effect of immersive virtual reality (IVR) on anxiety in children scheduled for MRI scans and how to identify which children are more responsive. Objective The aims of this study are 3-fold: develop an algorithm of predictability based on biofeedback, address feasibility and acceptability of preprocedural IVR game preparation for anxiety management during MRI procedures, and examine the efficacy of IVR game preparation compared with usual care for the management of procedural anxiety during MRI scans. Methods This study will have 2 phases. We will first conduct a field test with 10 participants aged 7 to 17 years to develop a predictive algorithm for biofeedback solution and to address the feasibility and acceptability of the research. After the field test, a randomized controlled trial will be completed using a parallel design with 2 groups: an experimental group (preprocedural IVR game preparation) and a usual care group (standard care as per the radiology department’s protocol) in an equal ratio of 49 participants per group for 98 participants. Recruitment will be carried out at a hospital in Quebec, Canada. The experimental group will receive a preprocedural IVR game preparation (IMAGINE) that offers an immersive simulation of the MRI scan. Participants will complete a questionnaire to assess the acceptability, feasibility, and incidence of side effects related to the intervention and the biofeedback device. Data collected will include sociodemographic and clinical characteristics as well as measures of procedure-related anxiety with the French-Canadian version of the State-Trait Anxiety Inventory for Children (score 1-3) and the Children’s Fear Scale (score 0-4). Physiological signs will be noted and include heart rate, skin conductance, hand temperature, and muscle tension. Measures of the level of satisfaction of health care professionals, parents, and participants will also be collected. Analyses will be carried out according to the intention-to-treat principle, with a Cronbach α significance level of .05. Results As of May 10, 2022, no participant was enrolled in the clinical trial. The data collection time frame is projected to be between April 1, 2022, and March 31, 2023. Findings will be disseminated through peer-reviewed publications. Conclusions Our study provides an alternative method for anxiety management to better prepare patients for an awake MRI procedure. The biofeedback will help predict which children are more responsive to this type of intervention. This study will guide future medical practice by providing evidence-based knowledge on a nonpharmacological therapeutic modality for anxiety management in children scheduled for an MRI scan. Trial Registration ClinicalTrials.gov NCT04988516; https://clinicaltrials.gov/ct2/show/NCT04988516 International Registered Report Identifier (IRRID) PRR1-10.2196/30616
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Affiliation(s)
- Sylvie Le May
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Nicole Hung
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Maxime Francoeur
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Estelle Guingo
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Julie Paquette
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Olivier Fortin
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Stéphane Guay
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
- School of Criminology, Université de Montréal, Montreal, QC, Canada
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A Sorrow Shared Is a Sorrow Halved? Patient and Parental Anxiety Associated with Venipuncture in Children before and after Liver Transplantation. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8080691. [PMID: 34438582 PMCID: PMC8394744 DOI: 10.3390/children8080691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/29/2022]
Abstract
Taking blood via venipuncture is part of the necessary surveillance before and after liver transplantation. The spectrum of response from children and their parents is variable, ranging from a short and limited aversion to paralyzing phobia. The aim of this retrospective, cross-sectional study was to determine the level of anxiety amongst children during venipuncture, to compare the anxiety reported by children and parents, and to identify the factors affecting the children’s and parents’ anxiety in order to develop therapeutic strategies. In total, 147 children (aged 0–17 years, 78 female) and their parents completed questionnaires. Statistical analysis was performed using qualitative and quantitative methods. Results showed that the majority of children reported anxiety and pain during venipuncture. Younger children had more anxiety (self-reported or assessed by parents). Children and parental reports of anxiety were highly correlated. However, the child’s anxiety was often reported as higher by parents than by the children themselves. The child’s general anxiety as well as the parents’ perceived stress from surgical interventions (but not the number of surgical interventions) prompted parental report of child anxiety. For children, the main stressors that correlated with anxiety and pain were factors during the blood collection itself (e.g., feeling the puncture, seeing the syringe). Parental anxiety was mainly related to circumstances before the blood collection (e.g., approaching the clinic, sitting in the waiting room). The main stressors mentioned by parents were the child’s discomfort and their inability to calm the child. Results indicate that the children’s fear of factors during the blood collection, along with the parents’ perceived stress and helplessness as well as their anticipatory anxiety are important starting points for facilitating the drawing of blood from children before and after liver transplantation, thereby supporting a better disease course in the future.
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12
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Kruizinga MD, Stuurman FE, Driessen GJA, Cohen AF, Bergmann KR, van Esdonk MJ. Theoretical Performance of Nonlinear Mixed-Effect Models Incorporating Saliva as an Alternative Sampling Matrix for Therapeutic Drug Monitoring in Pediatrics: A Simulation Study. Ther Drug Monit 2021; 43:546-554. [PMID: 34250966 DOI: 10.1097/ftd.0000000000000904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Historically, pharmacokinetic (PK) studies and therapeutic drug monitoring (TDM) have relied on plasma as a sampling matrix. Noninvasive sampling matrices, such as saliva, can reduce the burden on pediatric patients. The variable plasma-saliva relationship can be quantified using population PK models (nonlinear mixed-effect models). However, criteria regarding acceptable levels of variability in such models remain unclear. In this simulation study, the authors aimed to propose a saliva TDM evaluation framework and evaluate model requirements in the context of TDM, with gentamicin and lamotrigine as model compounds. METHODS Two population pharmacokinetic models for gentamicin in neonates and lamotrigine in pediatrics were extended with a saliva compartment including a delay constant (kSALIVA), a saliva:plasma ratio, and between-subject variability (BSV) on both parameters. Subjects were simulated using a realistic covariate distribution. Bayesian maximum a posteriori TDM was applied to assess the performance of an increasing number of TDM saliva samples and varying levels of BSV and residual variability. Saliva TDM performance was compared with plasma TDM performance. The framework was applied to a known voriconazole saliva model as a case study. RESULTS TDM performed using saliva resulted in higher target attainment than no TDM, and a residual proportional error <25% on saliva observations led to saliva TDM performance comparable with plasma TDM. BSV on kSALIVA did not affect performance, whereas increasing BSV on saliva:plasma ratios by >25% for gentamicin and >50% for lamotrigine reduced performance. The simulated target attainment for voriconazole saliva TDM was >90%. CONCLUSIONS Saliva as an alternative matrix for noninvasive TDM is possible using nonlinear mixed-effect models combined with Bayesian optimization. This article provides a workflow to explore TDM performance for compounds measured in saliva and can be used for evaluation during model building.
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Affiliation(s)
- Matthijs D Kruizinga
- Centre for Human Drug Research, Leiden
- Juliana Children's Hospital, HAGA Teaching Hospital, the Hague
- Leiden University Medical Centre, Leiden ; and
| | - Frederik E Stuurman
- Centre for Human Drug Research, Leiden
- Leiden University Medical Centre, Leiden ; and
| | - Gertjan J A Driessen
- Juliana Children's Hospital, HAGA Teaching Hospital, the Hague
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Adam F Cohen
- Centre for Human Drug Research, Leiden
- Leiden University Medical Centre, Leiden ; and
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13
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Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging. Top Magn Reson Imaging 2021; 29:187-195. [PMID: 32541256 DOI: 10.1097/rmr.0000000000000245] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pediatric imaging presents unique challenges related to patient anxiety, cooperation, and safety. Techniques to reduce anxiety and patient motion in adults must often be augmented in pediatrics, because it is always mentioned in the field of pediatrics, children are not miniature adults. This article will review methods that can be considered to improve patient experience and cooperation in imaging studies. Such techniques can range from modifications to the scanner suite, different ways of preparing and interacting with children, collaborating with parents for improved patient care, and technical advances such as accelerated acquisition and motion correction to reduce artifact. Special considerations for specific populations including transgender patients, neonates, and pregnant women undergoing fetal imaging will be described. The unique risks of sedation in children will also be briefly reviewed.
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14
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Plohal A. A Qualitative Study of Adult Hospitalized Patients With Difficult Venous Access Experiencing Short Peripheral Catheter Insertion in a Hospital Setting. JOURNAL OF INFUSION NURSING 2021; 44:26-33. [PMID: 33394871 DOI: 10.1097/nan.0000000000000408] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hospitalized patients require venous access for procedures, treatments, or therapies. The short peripheral catheter (SPC) is one option for patients who need intravenous (IV) access for treatment. Patients with difficult vasculature sometimes require multiple attempts to obtain SPC access. The aim of this study was to gain an understanding of adult patients' experiences with SPC insertion, specifically those with difficult venous access. Ten participants were purposely sampled over a 2-month period for semistructured interviews from the medical, surgical, and telemetry units at an inner city, 750-bed trauma hospital in the southwestern United States. Four key themes developed from the interview data: skills and techniques of the clinicians, distress and the SPC insertion experience, physical and emotional pain, and patient/clinician communication. These themes provided ways that clinicians might improve the patient experience, including: ensuring experienced and confident inserters are available to insert SPCs, utilizing distraction and pain methods to decrease pain perception, communicating with patients regarding site selection and expectations during SPC insertion, and identifying patients with difficult vascular access to limit attempts per patient to preserve vascular sites.
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Affiliation(s)
- Ann Plohal
- St. Joseph Hospital and Medical Center, Dignity Health, Phoenix, Arizona
- Ann Plohal, PhD, RN, APRN, ACNS-BC, CRNI®, VA-BC , has 38 years of experience as a registered nurse, with 20 years of experience in infusion therapy. She is currently employed at St. Joseph Hospital and Medical Center for the past 4 years with the registered nurses' vascular access team (VAT). Her role includes the development of the VAT with hands-on application, as well as facility and system involvement with central line-associated bloodstream infection prevention and infusion practices. She is a past president of Infusion Nurses Society (2014-2015) and has published multiple articles on infusion therapy in peer-reviewed journals
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15
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Le May S, Tsimicalis A, Noel M, Rainville P, Khadra C, Ballard A, Guingo E, Cotes-Turpin C, Addab S, Chougui K, Francoeur M, Hung N, Bernstein M, Bouchard S, Parent S, Hupin Debeurme M. Immersive virtual reality vs. non-immersive distraction for pain management of children during bone pins and sutures removal: A randomized clinical trial protocol. J Adv Nurs 2020; 77:439-447. [PMID: 33098330 DOI: 10.1111/jan.14607] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022]
Abstract
AIMS To examine the efficacy of an immersive virtual reality distraction compared with an active non-immersive distraction, such as video games on a tablet, for pain and anxiety management and memory of pain and anxiety in children requiring percutaneous bone pins and/or suture removal procedures. DESIGN Three-centre randomized clinical trial using a parallel design with two groups: experimental and control. METHODS Study to take place in the orthopaedic department of three children hospital of the Montreal region starting in 2019. Children, from 7-17 years old, requiring bone pins and/or suture removal procedures will be recruited. The intervention group (N = 94) will receive a virtual reality game (Dreamland), whereas the control group (N = 94) will receive a tablet with video games. The primary outcomes will be both the mean self-reported pain score measured by the Numerical Rating Scale and mean anxiety score, measured by the Child Fear Scale. Recalls of pain and anxiety will be measured 1 week after the procedure using the same scales. We aim to recruit 188 children to achieve a power of 80% with a significance level (alpha) of 5%. DISCUSSION While multiple pharmacological methods have previously been tested for children, no studies have evaluated the impact of immersive virtual reality distraction for pain and anxiety management in the orthopaedic setting. IMPACT Improved pain management can be achieved using virtual reality during medical procedures for children. This method is innovative, non-pharmacological, adapted to the hospital setting, and user-friendly. TRIAL REGISTRATION NCT03680625, registered on clinicaltrials.gov.
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Affiliation(s)
- Sylvie Le May
- Research Center, CHU Sainte-Justine, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Shriners' Hospital for children in Montreal, Montreal, QC, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Pierre Rainville
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | | | - Ariane Ballard
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Estelle Guingo
- UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Casey Cotes-Turpin
- UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Sofia Addab
- Shriners' Hospital for children in Montreal, Montreal, QC, Canada
| | - Khadidja Chougui
- Shriners' Hospital for children in Montreal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | | | - Nicole Hung
- Research Center, CHU Sainte-Justine, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Mitchell Bernstein
- Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, QC, Canada
| | | | - Stefan Parent
- Department of Surgery, CHU Sainte-Justine, Montreal, QC, Canada
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Neshat H, Aslani K, Jamshidi M, Aslanabadi S, Ghorbani F. Comparison of the Effect of Massage and EMLA Cream on Children's Physiological Indices During Venipuncture: A Factorial Clinical Trial. J Perianesth Nurs 2020; 35:619-624. [PMID: 32782077 DOI: 10.1016/j.jopan.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to identify the effect of massage, EMLA cream, and the combination of these two methods on changes in physiological indices because of pain caused by intravenous line insertion in preschool children. DESIGN A four-group randomized nonblinded clinical trial with factorial design. METHODS In total, 140 eligible 3- to 6-year-old children entered the study in Tabriz Children's Hospital in 2017 and were randomly allocated to four groups (EMLA cream, massage, combination of the two, and control). Physiological responses were measured before and immediately after interventions in all groups. Data were collected and analyzed using SPSS version 19. FINDINGS Comparison of the physiological indices changes caused by pain between groups showed that changes in children's heart rate (HR) and respiratory rate (RR) in the EMLA group and in the combined-method group were statistically significant (P < .05). No significant differences were found in systolic blood pressure and oxygen saturation (SPo2) between the four groups. CONCLUSIONS Results indicated that EMLA cream was more effective than massage and a combination of EMLA and massage in reducing an increase in the HR and RR caused by pain in children. Massage alone was not effective in significantly lowering the children's increased physiological indices such as the HR and RR, and it seems the effectiveness of massage is more noticeable in conjunction with EMLA cream.
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Affiliation(s)
- Hanieh Neshat
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kafiyeh Aslani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Massoud Jamshidi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Aslanabadi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Surgery Unit, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ghorbani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran; Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Kleye I, Hedén L, Karlsson K, Sundler AJ, Darcy L. Children's individual voices are required for adequate management of fear and pain during hospital care and treatment. Scand J Caring Sci 2020; 35:530-537. [PMID: 32363693 DOI: 10.1111/scs.12865] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children's fear and pain. More knowledge, from children's own perspectives, is needed about how they deal with their experiences. AIM To explore child-identified strategies that children use to manage fear and pain during needle-related medical procedures in hospital. METHODS Interviews with children, age 4-12 years, with experience of hospital care were analysed qualitatively using content analysis. RESULTS Children have self-identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed. CONCLUSIONS Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child's needs and ability to use their strategies due to lack of knowledge of the child's chosen strategies.
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Affiliation(s)
- Ida Kleye
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Lena Hedén
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Katarina Karlsson
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Annelie J Sundler
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Laura Darcy
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
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Effect of Adding a Pediatric Vascular Access Team Component to a Pediatric Peripheral Vascular Access Algorithm. J Pediatr Health Care 2020; 34:4-9. [PMID: 31375309 DOI: 10.1016/j.pedhc.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/09/2019] [Accepted: 06/02/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Intravenous (IV) placement outcomes in pediatric patients need to be improved. The purpose of the study was to examine if a pediatric peripheral vascular access algorithm with a pediatric vascular access team (PPVAA-VAT) improved IV placement outcomes compared with Pediatric Peripheral Vascular Access Algorithm (PPVAA)-alone use. METHODS This study was a prospective, comparative, two-group design of hospitalized children. Multivariable logistic regression models were used to evaluate differences between cohort outcomes. RESULTS The PPVAA-alone IV attempts (n = 302) were followed by PPVAA-VAT attempts (n = 294). First attempt and overall IV success were higher in the PPVAA-VAT group after adjusting for confounding patient characteristics (p < .001 and p = .002, respectively). The IV attempts and staff required per encounter decreased in the PPVAA-VAT vs. PPVAA-alone group. DISCUSSION The PPVAA-VAT group had greater first attempt and overall IV success, and was more likely to have fewer attempts and staff involved in IV access encounters.
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19
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Genik LM, McMurtry CM, Marshall S, Rapoport A, Stinson J. Massage therapy for symptom reduction and improved quality of life in children with cancer in palliative care: A pilot study. Complement Ther Med 2019; 48:102263. [PMID: 31987232 DOI: 10.1016/j.ctim.2019.102263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND For children with cancer in palliative care, pain and worry are common and frequently under-managed, which negatively impacts quality of life (QOL). Massage therapy (MT) can lead to reduced pain in children with chronic illnesses. Children with cancer have experienced lower anxiety after MT. No studies have examined the effects of MT in pediatric oncology patients receiving palliative care. OBJECTIVE Conduct a MT intervention to determine intervention acceptability and initial effects on ratings of pain, worry reduction, and quality of life. DESIGN Pre-post single group pilot study. SETTING/SUBJECTS Eight children with cancer (age 10-17) and one of their parents were recruited from a palliative care service. PROCEDURE/MEASUREMENTS Baseline (one week prior to intervention): demographics, MT expectations, QOL, and pain measures. Intervention (one month): MT was provided once per week, with children's pain and worry ratings occurring immediately before and after each MT session. Follow Up (4-6 weeks after baseline): QOL, pain, and MT/study acceptability questionnaires. RESULTS Participants reported significant decreases in pain following two MT sessions, and worry following one session. No significant changes in pain symptoms and QOL were found between baseline and follow up. Participants positively endorsed the study and the MT intervention, and there were no adverse effects reported. CONCLUSIONS MT may lead to immediate decreases in pain and worry in children with cancer who are receiving palliative care, however the effects may not be sustained long term. Difficulties regarding protocol feasibility including recruitment and study compliance remain important considerations for future work.
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Affiliation(s)
- Lara M Genik
- Department of Psychology, University of Guelph, Canada.
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Clinical and Health Psychologist, Pediatric Chronic Pain Program, McMaster Children's Hospital, Associate Scientist, Children's Health Research Institute, Adjunct Researcher, Department of Pediatrics, Western University, Canada.
| | | | - Adam Rapoport
- The Hospital for Sick Children, Emily's House Children's Hospice, Canada.
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20
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Toledo del Castillo B, Pérez Torres JA, Morente Sánchez L, Escobar Castellanos M, Escobar Fernández L, González Sánchez MI, Rodríguez Fernández R. Disminuyendo el dolor en los procedimientos invasivos durante la hospitalización pediátrica: ¿ficción, realidad o realidad virtual? An Pediatr (Barc) 2019; 91:80-87. [DOI: 10.1016/j.anpedi.2018.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/08/2018] [Accepted: 10/31/2018] [Indexed: 02/07/2023] Open
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21
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Toledo del Castillo B, Pérez Torres JA, Morente Sánchez L, Escobar Castellanos M, Escobar Fernández L, González Sánchez MI, Rodríguez Fernández R. Reducing the pain in invasive procedures during paediatric hospital admissions: Fiction, reality or virtual reality? ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2018.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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22
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Diener ML, Lofgren AO, Isabella RA, Magana S, Choi C, Gourley C. Children’s distress during intravenous placement: The role of child life specialists. CHILDRENS HEALTH CARE 2018. [DOI: 10.1080/02739615.2018.1492410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marissa L. Diener
- Department of Family & Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Abigail Owens Lofgren
- Patient and Family Support Services, Primary Children’s Medical Center, Salt Lake City, UT, USA
| | - Russell A. Isabella
- Department of Family & Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | | | - Chansong Choi
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Chelsea Gourley
- Patient and Family Support Services, Primary Children’s Medical Center, Salt Lake City, UT, USA
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23
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Christian BJ. Translational Research - The Intersection Between Sociocultural and Environmental Factors and the Health of Children and Families. J Pediatr Nurs 2017; 37:127-131. [PMID: 28988617 DOI: 10.1016/j.pedn.2017.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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