A literature review of comfort in the paediatric critical care patient

Bosch-Alcaraz, A.; Falcó‐Pegueroles, Anna; Jordan, Iolanda

doi:10.1111/jocn.14345

Cited by 16 publications

(10 citation statements)

References 61 publications

(123 reference statements)

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“…It is highlighted that the findings related to fear coincide with those of a review study, which investigated the change in the comfort of children and adolescents in critical conditions (15). The authors stated that intensive treatment in the hospital environment, the absence of close family members, and invasive procedures trigger the feeling of fear in these patients (15).…”

Section: Discussionmentioning

confidence: 75%

“…Likewise, other evidence reports that the pain experienced by children and adolescents with cancer causes an unpleasant sensation, of a multi-factor origin, which is difficult to manage, and may lead to physical and emotional changes (11,12,39). Thus, the management of pain represents a challenge for professionals who work in the area, especially in its identification and management prior to the cancer treatment to which this population is submitted (13)(14)(15)39).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the evaluation of comfort provides healthcare professionals with more effective assistance by prioritizing health activities in patient care and improving the provision of individualized and comprehensivve care within the clinical process (15). Therefore, in the face of the effects that the oncologic treatment can have on the comfort of children and adolescents with cancer, the search for knowl-edge of this fact becomes relevant in the hope of developing strategies to promote the comfort of this population during therapy (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Cancer Treatment on the Comfort of Children and Adolescents with Cancer: A Scoping Review

et al. 2022

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Objectives: To map and examine the scientific evidence concerning the effects of cancer treatment on the comfort of children and adolescents with cancer. Materials and Methods: This scoping review was carried out in the following electronic information resources: BVS, PubMed, Cinahl, SciVerse Scopus, Lilacs, Web of Science, and Google Scholar. Two independent reviewers analyzed the studies’ relevance. Results: The search yielded 4,295 publications, of which 20 comprised the final sample. Following evidence mapping, the effects (20; 100 %) on comfort were found, and the most prevalent were pain (12; 60 %), fear (9; 45 %), nausea (5; 25 %), difficulty eating (4; 20 %), and distress (4; 20 %). Regarding the oncologic treatment modality, antineoplastic therapy prevailed in 11 (55 %) of the selected articles. Conclusions: Cancer treatment affects the comfort of children and adolescents with cancer, causing suffering and changing their well-being. It indicates the need to evaluate its impact and take nursing care measures to reduce complications and improve these patients’ adaptation to treatment.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Cancer Treatment on the Comfort of Children and Adolescents with Cancer: A Scoping Review

et al. 2022

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“…The degree of this discomfort, as measured using clinical scales, is higher when using a JN system compared to a NHF system [20]. The Comfort Behavior Scale (CBS) was designed for use in pediatric populations with a similar age to the present study [24], and it is a valid and reliable tool for assessing comfort in critical care pediatric patients [25]. Like other authors, we believe that pain scores are central to our ability to evaluate and titrate pain relief [26].…”

Section: Discussionmentioning

confidence: 96%

Observational study of newborn infant parasympathetic evaluation as a comfort system in awake patients admitted to a pediatric intensive care unit

Arnáez

Calvo²,

Gómez

et al. 2019

J Clin Monit Comput

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To compare the newborn infant parasympathetic evaluation system (NIPE) scores with a validated clinical scale using two different nebulizers in children with bronchiolitis admitted to a PICU. Comfort was evaluated using the COMFORT-behavior scale (CBS) before (T1), during (T2) and after (T3) each nebulization. In order to compare NIPE and CBS values during the whole T1 to T3 period, the variable Dif-CBS was defined as the difference between maximal and minimal CBS scores, and Dif-NIPE as the difference between 75th and 25th percentile NIPE values. Analyses were carried out, firstly for the total of nebulizations and secondly comparing two different nebulization systems: a jet nebulizer (JN) and a nebulizer integrated in high flow nasal cannulas (NHF). 84 nebulizations were recorded on 14 patients with a median [25th-75th percentile] age of 6 months (3.1-9.5). A Dif-CBS of 4 points (2-7), as well as changes in CBS scores between T1 and T2, defined the nebulization as a discomfort stimulus. The NIPE system, represented as the Dif-NIPE, showed a median variation of 9 points (7-10), and was poorly correlated to Dif-CBS [r s 0.162 (P = 0.142)]. Discomfort during nebulization, assessed by CBS was greater with the JN system compared to vs 13 (9-15) (P = 0.001). NIPE monitoring detected no significant differences between both nebulization systems (P = 0.706). NIPE monitoring showed a variation in comfort during nebulization in the patient with bronchiolitis, though correlation with CBS was poor. Further research is required before NIPE can be suggested as a comfort monitoring system for the awake infant.

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“…19 The complexity of managing the comfort of patients admitted to a specialised facility of this kind represents one of the greatest challenges for the personnel providing care. 7,20 Nonetheless, there have been no studies carried out to analyse the sociodemographic and clinical variables that might need to be considered in determining the degree of discomfort experienced by critically ill paediatric patients. Knowing what these factors are would allow for the design of additional analgesic strategies and sedative treatment that would improve the overall comfort of critically ill paediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Discomfort of the critically ill paediatric patient and correlated variables

Bosch-Alcaraz

Jordán

Benito-Aracil³

et al. 2020

Australian Critical Care

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Introduction: The care of critically ill children is usually invasive and aggressive, requiring numerous traumatic procedures that may cause fear, pain, and discomfort. Objectives: The aim of this study was to analyse the level of discomfort of patients admitted to the paediatric intensive care unit of a specialist children's hospital and to determine the sociodemographic and clinical variables that influence the degree of discomfort experienced by critically ill paediatric patients. Methods: We performed a descriptive observational cross-sectional study that included a total of 311 children with a median age of 5.07 y (interquartile range ¼ 0.9e11.7). A team of 10 paediatric critical care nurses assessed the degree of discomfort once for each shift (morning, afternoon, and night) on 2 successive days using the COMFORT Behavior ScaledSpanish version. Results: In total, 49.8% (n ¼ 155) of the patients were free of discomfort (score 10 points) vs. 50.2% (n ¼ 156) who experienced discomfort. There was a significant negative correlation between discomfort and the length of stay in days (Rho ¼ 0.16; p ¼ 0.02), that is, the longer the stay, the less discomfort the patient felt. The correlation between age and degree of discomfort was found to be both positive and significant (Rho ¼ 0.230, p < 0.001); the greater the age, the greater the discomfort. In comparison of all children who received analgosedation (n ¼ 205), with discomfort levels of 10.77 ± 2.94, with those who did not receive analgosedation (n ¼ 106), with discomfort levels of 11.96 ± 2.80, we did find a statistically significant difference (c 2 ¼ À4.05; p < 0.001). Conclusions: Half of the patients admitted to the paediatric intensive care unit experienced discomfort. Age and analgosedation were the two most important variables involved with a high degree of discomfort. Clinical care practices must consider these factors and try to plan activities designed to relieve discomfort in all critically ill paediatric patients.

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A literature review of comfort in the paediatric critical care patient

Abstract: Comfort is subjective and difficult to assess. It has four facets: physical, emotional, social and environmental. High levels of noise and light are the inputs that cause the most discomfort. Comfort is a holistic, universal concept and an important component of quality nursing care.

Cited by 16 publications

References 61 publications

Effects of Cancer Treatment on the Comfort of Children and Adolescents with Cancer: A Scoping Review

Effects of Cancer Treatment on the Comfort of Children and Adolescents with Cancer: A Scoping Review

Observational study of newborn infant parasympathetic evaluation as a comfort system in awake patients admitted to a pediatric intensive care unit

Discomfort of the critically ill paediatric patient and correlated variables

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