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Positive effects of a child‐centered intervention on children's fear and pain during needle procedures
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)ORCID iD: 0000-0001-6614-0493
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)ORCID iD: 0000-0002-9194-3244
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)
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2023 (English)In: Paediatric and Neonatal Pain, ISSN 2637-3807, Vol. 5, no 1, p. 23-30Article in journal (Refereed) Published
Abstract [en]

To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure. 

Place, publisher, year, edition, pages
2023. Vol. 5, no 1, p. 23-30
Keywords [en]
child-centered care, fear, needle procedure, pain
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-30382DOI: 10.1002/pne2.12095OAI: oai:DiVA.org:hb-30382DiVA, id: diva2:1791010
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2023-10-19Bibliographically approved
In thesis
1. Barncentrerad vård vid nålprocedurer: Betydelsen av att möta barns rädsla och smärta
Open this publication in new window or tab >>Barncentrerad vård vid nålprocedurer: Betydelsen av att möta barns rädsla och smärta
2023 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Children report needle procedures as the worst source of fear and pain during hospital care and treatment. How children communicate their fear and pain varies, which can be challenging for nurses to understand and meet. Nurses need to be able to recognize and acknowledge children’s emotions for needle procedures to be child centered. 

Aim: To explore the effects of a child centered intervention on fear and pain during needle procedures. 

Methods: Four studies combining qualitative and quantitative approaches, with boys and girls aged 4 – 12 years old undergoing a needle procedure, were conducted. Study I explored child-identified strategies used to manage fear and pain in hospital, with data collected through semi-structured interviews. Data through observations from video recordings were used in Study II to explore children’s expressions of emotional cues and concerns, and nurses’ response to these expressions. To examine whether children experience less fear and pain when receiving standard care with the addition of the intervention iCC compared with the experience of standard care only, self-reported fear and pain before and immediately after a needle procedure were conducted in study III. To further evaluate the effect of the intervention, time required for the procedure, heart rate, success rate for the procedure, behavioral observations, and patient preference to undergo the needle procedure in the same way again, were collected. Study IV evaluated child-nurse emotional communication when using a child centered intervention versus a control group. Data collection consisted of video-observations. 

Main results: The opportunity to choose strategy themselves was particularly supportive to children. Unpleasant emotions were commonly expressed through non-verbal communication, but seldom acknowledged by nurses. Less fear and pain were observed in the intervention group and less time required performing the needle procedure. Most children using iCC intervention were positive to the possibility of undergoing a needle procedure in the same way again in the future. Nurses using the intervention acknowledged the child’s expressed unpleasant emotions to a greater extent. 

Conclusion: Approaching children as active and competent actors during needle procedures contributes positively to nurses’ involvement, to the time a needle procedure takes, and to children’s experiences and emotional state.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2023
Series
Skrifter från Högskolan i Borås, ISSN 0280-381X ; 141
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29843 (URN)978-91-89833-09-8 (ISBN)978-91-89833-10-4 (ISBN)
Public defence
2023-11-17, Sparbankssalen, Järnvägsgatan 5, Borås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2023-10-20 Created: 2023-05-29 Last updated: 2023-10-19Bibliographically approved

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Kleye, IdaSundler, Annelie JohanssonKarlsson, KatarinaDarcy, LauraHedén, Lena

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