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Aarvik RS, Svendsen EJ, Agdal ML. Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway. Eur Arch Paediatr Dent 2022; 23:609-618. [PMID: 35763246 PMCID: PMC9338127 DOI: 10.1007/s40368-022-00724-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/03/2022] [Indexed: 12/19/2022]
Abstract
Aim This study aimed to estimate the prevalence of a self-reported history of restraint in children and adolescents when receiving dental care by non-specialist dentists and to assess differences in dental fear and anxiety (DFA), intra-oral injection fear, and trust in dentists between patients with and without a self-reported history of restraint. Methods An electronic cross-sectional survey was distributed to all 9 years old (n = 6686) and 17 years old (n = 6327) in the Public Dental Service in Hordaland County, Norway, in 2019. For statistical evaluation, we generated descriptive statistics and Mann–Whitney U tests. Results The response rate ranged between 43.5 and 59.9% for the different questions. The prevalence of a self-reported history of being held still against one’s will during dental treatment and pressured to undergo dental treatment against one’s will was 3.6% and 5.1%, respectively. In general, these patients reported higher DFA, and higher intra-oral injection fear compared with those without such histories of restraint. Patients who had reported being held still against their will during dental treatment had significantly higher distrust in dentists than those who did not report restraint (p < 0.001). Conclusion To feel pressured to receive dental treatment and to be held still against one’s will overlap with the concepts of psychological and physical restraint. Patients with a self-reported history of restraint recorded significant differences in DFA, intra-oral injection fear, and trust in dentists compared to those who did not report restraint. Future studies should explore the role that restraint may play in relation to a patient’s DFA, intra-oral injection fear, and trust in dentists.
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Affiliation(s)
- R S Aarvik
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
| | - E J Svendsen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2b, 0373, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - M L Agdal
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Aarvik RS, Agdal ML, Svendsen EJ. Restraint in paediatric dentistry: a qualitative study to explore perspectives among public, non-specialist dentists in Norway. Acta Odontol Scand 2021; 79:443-450. [PMID: 33587861 DOI: 10.1080/00016357.2021.1881159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to explore the perspectives of non-specialist dentists on the use of restraint in paediatric dentistry in the Public Dental Service in Norway. MATERIALS AND METHOD Two focus group interviews involving four and five dentists, respectively, were conducted in one of the most populated counties in Norway in September 2019. The thematic analysis by Braun and Clarke informed the qualitative analysis. RESULTS According to the dentists, physical restraint in paediatric dentistry is usually used when dental treatment is absolutely necessary. The qualitative analysis revealed the following three main themes: (1) some dentists justify the use of restraint in paediatric dentistry; (2) physical restraint is often legitimised by the fact that the child is sedated; (3) the use of restraint evokes difficult ethical evaluations. Additionally, the dentists had an overarching perspective of acting in the child's best interest, but they sometimes struggled to find a justifiable path in situations involving restraint. CONCLUSIONS Dentists seem to consider the use of restraint combined with sedation as legitimate for absolute necessary dental treatment. Furthermore, the use of restraint involves difficult ethical evaluations.
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Affiliation(s)
- Regina Skavhellen Aarvik
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Tomás-Jiménez M, Díaz EF, Sánchez MJF, Pliego AN, Mir-Abellán R. Clinical Holding in Pediatric Venipuncture: Caring by Empowering the Caregiver. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147403. [PMID: 34299852 PMCID: PMC8306602 DOI: 10.3390/ijerph18147403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
The use of restraint in the child-adolescent population is highly controversial due to the consequences it can have for patients and their families, although it is sometimes necessary to employ restraint to perform techniques safely and effectively. Clinical Holding is committed to the involvement of parents during venipuncture in the context of family-centred care. This study assesses levels of distress and pain in children undergoing this procedure, as well as satisfaction in parents and nurses. Parents assist in the restraint of children and provide accompaniment during venipuncture. Levels of distress and pain were not particularly elevated. Satisfaction levels among parents and nurses were high. A positive correlation was found between anticipatory and real distress (r = 0.737, p = 0.000), and between real distress and real pain (r = 0.368, p = 0.035). A negative correlation was observed between real pain and parent satisfaction (r = -0.497, p = 0.003). Parental participation during venipuncture contributed to better management of distress and pain. In the future, it would be advisable to incorporate the other pharmacological and non-pharmacological measures recommended by Clinical Holding to ensure care of the highest quality and safety.
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Affiliation(s)
- Manuel Tomás-Jiménez
- Patient Safety Research Group, Hospital Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (A.N.P.); (R.M.-A.)
- Correspondence:
| | - Elena Fernández Díaz
- Pediatric Service, Hospital Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (E.F.D.); (M.J.F.S.)
| | - María Jesús Flores Sánchez
- Pediatric Service, Hospital Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (E.F.D.); (M.J.F.S.)
| | - Andrea Navarro Pliego
- Patient Safety Research Group, Hospital Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (A.N.P.); (R.M.-A.)
| | - Ramon Mir-Abellán
- Patient Safety Research Group, Hospital Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (A.N.P.); (R.M.-A.)
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Jackson AP, Almerol LA, Campbell J, Hamilton L. Needlestick injuries: the role of safety-engineered devices in prevention. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:S22-S30. [PMID: 32697642 DOI: 10.12968/bjon.2020.29.14.s22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The first documented mention of a needlestick injury (NSI) in the medical literature appeared in 1906. Despite growth in academic and clinical interest for NSI prevention, a global report identified that approximately 3 million healthcare workers have suffered percutaneous exposure to blood-borne pathogens. Legislation is an important component of NSI prevention. Unfortunately, the impact of legislation may not always reduce the incidence of NSI as much as expected. Safety-engineered device (SED) implementation has demonstrated a substantial reduction in NSI rates compared with non-SEDs. More importantly, passive SEDs are 10 times less likely to be connected with an NSI incident.
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Affiliation(s)
- Andrew Paul Jackson
- IV Nurse Consultant, The Rotherham NHS Foundation Trust, and Director, IVTEAM.com
| | - Leo Andrew Almerol
- Vascular Access Clinical Nurse Specialist, Bedfordshire Hospitals NHS Foundation Trust
| | | | - Louise Hamilton
- IV Clinical Nurse Specialist, Ashford and St Peter's NHS Foundation Trust
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Sørensen K, Skirbekk H, Kvarstein G, Wøien H. Children's fear of needle injections: a qualitative study of training sessions for children with rheumatic diseases before home administration. Pediatr Rheumatol Online J 2020; 18:13. [PMID: 32033566 PMCID: PMC7007654 DOI: 10.1186/s12969-020-0406-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/09/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Treatment of rheumatic diseases in children often includes long-term needle injections, which represent a risk for refusing medication based on potential needle-fear. How nurses manage children's fear and pain during the initial educational training session of subcutaneous injections, may affect the management of the subsequent injections in the home settings. The aim of this study was to explore how children expressed fear and pain during these training sessions, and how adults' communication affected children's expressed emotions. METHODS This qualitative explorative study used video observations and short interviews during training sessions in a rheumatic hospital ward. Participants were children between five and fifteen years (n = 8), their parents (n = 11) and nurses (n = 7) in nine training sessions in total. The analysis followed descriptions of thematic analysis and interaction analysis. RESULTS The children expressed fears indirectly as cues and nonverbal signs more often than direct statements. Three children stated explicit being afraid or wanting to stop. The children worried about needle-pain, but experienced the stinging pain after the injection more bothersome. The technical instructions were detailed and comprehensive and each nurse shaped the structure of the sessions. Both nurses and parents frequently offered coping strategies unclearly without sufficient time for children to understand. We identified three main adult communication approaches (acknowledging, ambiguous and disregarding) that influenced children's expressed emotions during the training session. CONCLUSIONS Children's expression of fear was likely to be indirectly, and pain was mostly related to the injection rather than the needle stick. When adults used an acknowledging communication and offered sufficient coping strategies, children seemed to become involved in the procedure and acted with confidence. The initial educational training session may have a great impact on long-term repeated injections in a home setting by providing children with confidence at the onset.
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Affiliation(s)
- Kari Sørensen
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Department of Undergraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Helge Skirbekk
- Department of Undergraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Gunnvald Kvarstein
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, the Arctic University of Norway, Tromsø, Norway
| | - Hilde Wøien
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Christie S, Ng CKC, Sá Dos Reis C. Australasian radiographers' choices of immobilisation strategies for paediatric radiological examinations. Radiography (Lond) 2019; 26:27-34. [PMID: 31902451 DOI: 10.1016/j.radi.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/07/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Immobilisation may be necessary to ensure patient safety and examination success in paediatric medical imaging. Little guidance exists regarding the selection of different immobilisation methods. The purpose of this study was to explore radiographers' selection of immobilisation methods in paediatric medical imaging and the influences on their choices. METHODS Ethical approval was obtained. A mixed methods approach consisting of online questionnaire distribution followed by individual interviews was used to explore Australasian radiographers' self-reported patterns of immobilisation use and the underlying reasons and beliefs. Quantitative data were described using frequency data, with a Fisher's Exact test used to determine any association between demographic variables and immobilisation methods. Qualitative data were evaluated using content analysis. RESULTS Sixty-five radiographers returned completed questionnaires, with seven participating in interviews. Psychological immobilisation methods were preferred to minimise patient pain and distress, but physical methods were considered more effective, with parental holding the most likely method to be used (63/65, 96.9%). Participants assumed certain methods to be more appropriate based on patient age and examination type, but adapted their choices based on many other factors, seeking to provide personalised care. Further training was strongly desired (48/64, 75.0%). Participants disagreed on whether introducing written guidance would be beneficial (33/62, 53.2%). CONCLUSION Choosing an immobilisation method appears to be a case-by-case activity requiring critical assessment of multiple factors in order to balance patient care with examination success. IMPLICATIONS FOR PRACTICE Improvements in quality and quantity of education are recommended to enhance radiographers' ability to make choices based on all relevant factors.
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Affiliation(s)
- S Christie
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - C K C Ng
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - C Sá Dos Reis
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Av. de Beaumont 21, 1011, Lausanne, Switzerland; CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Portugal.
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Sri Rahyanti NM, Nurhaeni N, Wanda D. Could a Certain Sitting Position Reduce the Pain Experienced by a Child? The Benefits of Parental Holding and an Upright Position. Compr Child Adolesc Nurs 2018; 40:8-13. [PMID: 29166185 DOI: 10.1080/24694193.2017.1386965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Intravenous injection is the most feared medical procedure and gives rise to an experience of mild to severe pain in children. Unrestrained pain has a negative effect on the child. Pain management in the form of a convenient sitting position is needed by children who undergo intravenous injection procedures. This study aims to determine the effect of parental holding and an upright position on children's pain during intravenous injection procedures. The study used the Randomized Clinical Trial method involving 34 respondents, aged 1-4 years, who were included in the intervention and control group. The result of a Mann-Whitney U test analysis showed a significant difference in the pain score between the intervention and control groups (p value = .000; α = .05). The parental holding and upright position can be applied as a nonpharmacological pain management strategy for children who undergo intravenous injection procedures.
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Affiliation(s)
- Ni Made Sri Rahyanti
- a Faculty of Nursing , Universitas Indonesia, Jalan Bahder Djohan Campus , Depok , Indonesia
| | - Nani Nurhaeni
- a Faculty of Nursing , Universitas Indonesia, Jalan Bahder Djohan Campus , Depok , Indonesia
| | - Dessie Wanda
- a Faculty of Nursing , Universitas Indonesia, Jalan Bahder Djohan Campus , Depok , Indonesia
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Svendsen EJ, Pedersen R, Moen A, Bjørk IT. Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians. Int J Qual Stud Health Well-being 2018; 12:1363623. [PMID: 28889788 PMCID: PMC5653956 DOI: 10.1080/17482631.2017.1363623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to explore nurses’ and physicians’ perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care. We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway. The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities. The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.
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Affiliation(s)
- Edel Jannecke Svendsen
- a Department of Nursing, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Reidar Pedersen
- b Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Anne Moen
- a Department of Nursing, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Ida Torunn Bjørk
- a Department of Nursing, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
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Oulton K, Oldrieve N, Bayliss J, Jones V, Manning I, Shipway L, Gibson F. Using participatory and creative research methods to develop and pilot an informative game for preparing children for blood tests. Arts Health 2017. [DOI: 10.1080/17533015.2017.1392329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kate Oulton
- Great Ormond Street Hospital for Children NHS Foundation Trust, Centre for Outcomes and Experience Research in Children’s Health, Illness and Disability (ORCHID), London, UK
| | - Naomi Oldrieve
- St George’s University Hospitals NHS Foundation Trust, Children’s Services, London, UK
| | - Julie Bayliss
- Great Ormond Street Hospital NHS Foundation Trust, The Louis Dundas Centre Oncology Outreach and Palliative Care, Charles West Division, London, UK
| | | | - Isobel Manning
- Great Ormond Street Hospital NHS Foundation Trust, GOSH Arts, London, UK
| | - Lisa Shipway
- Great Ormond Street Hospital NHS Foundation Trust, Charles West Division, London, UK
| | - Faith Gibson
- Great Ormond Street Hospital for Children NHS Foundation Trust, Centre for Outcomes and Experience Research in Children’s Health, Illness and Disability (ORCHID), London, UK
- School of Health Sciences, University of Surrey, Guildford, UK
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