ArticleParental Holding and Positioning to Decrease IV Distress in Young Children: A Randomized Controlled Trial
Section snippets
Review of the Literature
Receiving a needle (IV or injection) is rated by children as one of their most feared medical events (Broome & Hellier, 1987, Hart & Bossert, 1994, Siaw et al., 1986). Research has found long-term traumatic memories for some children receiving painful medical procedures (Chen et al., 2000, Stuber et al., 1996). Furthermore, “… an intervention that successfully reduces children's negative memories may alleviate their distress during future stressful events” (Chen et al., 2000, p. 944). Watching
Methodology
This study was conducted in a Level I trauma emergency department of a pediatric hospital in a large midwestern city. Research assistants trained in data collection explained the study and obtained consent from parents/guardians of eligible study children. Inclusion criteria for study children were as follows: ages of 6 months to 4 years; categorized through triage as requiring urgent or emergent care; needing an IV catheter placed; and had a parent or guardian who was able to give consent.
Results
One hundred thirty-five subjects were recruited for the study, but 17 of these were not used for the analysis; therefore, the total sample size comprised 118 subjects. Reasons for not being able to use the data included the following: video recording errors (seven); wrong age of subject (four); incomplete forms (two); no legal guardian (one); did not need IV (one); child became critically ill (one); mother refused flat position (one). In the last case, the mother of the child had been willing
Discussion
Parental holding and upright positioning appear to be successful in reducing the distress of having an IV started in young children. The two prior studies with upright positioning and IV/venipuncture procedures (Cavender et al., 2004, Kaher, 2003) both found lower distress scores with upright positioning, although in neither study was the difference statistically significant. However, both studies had small sample sizes. In this study, children in the experimental group had significantly lower
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