Consequences of Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3–7 Years)

Karlsson, Katarina; Rydström, Ingela; Nyström, Maria; Enskär, Karin; Englund, Ann-Charlotte Dalheim

doi:10.1016/j.pedn.2015.09.008

Cited by 39 publications

(41 citation statements)

References 43 publications

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“…A protesting child is highly unlikely to have consented to the implementation of the painful medical procedure. In such scenarios, Nurses, contest the UN Convention (UNCRC, 1989), the Swedish Health Care Act (SFS, 1982:763 Papers that form the basis of this study (Darcy et al, 2014b(Darcy et al, , 2015(Darcy et al, , 2014aKarlsson et al, 2016bKarlsson et al, , 2014Karlsson et al, , 2016a, show the importance for a child to trust adults during medical procedures. Children and adults need to be in connection with others in order to experience togetherness and belonging (Todres et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Children's opinions are seldom requested, their inner experiences are not explored or taken account of which may lead to a kind of objectification. This could be exacerbated when fear is the most salient feeling children experiences during different procedures (Darcy, Knutsson, Huus, & Enskär, 2014a;Karlsson, Rydström, Nyström, Enskär, & Dalheim Englund, 2016a 1 3 2 ---2 3 2 3 2 -3 2 4 3 2 1 4 4 4 3 4 2 5 1 1 3 3 3 6 ---1 3 7 ----2 objectification are common and occur for example, when young children were diagnosed with cancer (or long-term illness). At diagnosis and start of treatment parental and healthcare professionals focus was solely on the illness and not on the child, resulting in an obscuring of insiderness and potentially contributing to objectification.…”

Section: Insiderness ↔ Objectificationmentioning

confidence: 99%

“…Passivity can commonly occur when the child and their body are exposed to internal and external forces in care. For example, evidence from Darcy et al (2014a) and Karlsson et al (2016a) paper suggests that adults forced the child to do things against their will: The child is held down by the parent while the nurse inserts the needle. The child is sweating, kicking, and screaming; hitting the nurse in the stomach; crying and trying to get away [Observation, five-year-old boy].…”

Section: Agency ↔ Passivitymentioning

confidence: 99%

“…Isolation occurs when children sense separation from parents, siblings and friends: I always played with my best friend before, now we never play [Interview, four-year-old girl]. Isolation may also occur if the parents are worried and sad about the child's illness or medical procedure (Karlsson et al, 2016a). This can lead to feelings of sadness and loneliness, which this quotation exemplifies: During the interview, the child asked.…”

Section: Togetherness ↔ Isolationmentioning

confidence: 99%

“…Another example of emphasizing meaning-making is when choosing words and phrases, finding the right fit for the specific moment: A child says while the anaesthetic patch is removed: 't's as slow as a snail when it slides. [Observation, five-yearold boy] (Karlsson et al, 2016a). Another example of how metaphors can be used that can help the child achieve meaning is: I think it's like a small aircraft … You can refuel … You can say "the airplane has crashed" [if the intravenous cannula insertion fails] [Observation, six -year-old girl].…”

Section: Meaning-making ↔ Loss Of Meaningmentioning

confidence: 99%

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Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care – a discussion paper

Karlsson

Galvin

Darcy

2019

International Journal of Qualitative Studies on Health and Well

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Purpose: Children’s perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation.Method: The present paper illustrates children’s experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework.Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation.Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children’s own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings.

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Section: Discussionmentioning

confidence: 99%

Section: Insiderness ↔ Objectificationmentioning

confidence: 99%

Section: Agency ↔ Passivitymentioning

confidence: 99%

Section: Togetherness ↔ Isolationmentioning

confidence: 99%

Section: Meaning-making ↔ Loss Of Meaningmentioning

confidence: 99%

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Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care – a discussion paper

Karlsson

Galvin

Darcy

2019

International Journal of Qualitative Studies on Health and Well

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Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Wong

Choi

2023

JAMA Netw Open

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ImportanceVenipuncture is one of the most painful and distressing procedures experienced by pediatric patients. Emerging evidence suggests that providing procedural information and distraction using immersive virtual reality (IVR) may reduce pain and anxiety among children undergoing needle-related procedures.ObjectivesTo examine the effects of IVR on reducing the pain, anxiety, and stress experienced by pediatric patients undergoing venipuncture.Design, Setting, and ParticipantsThis 2-group randomized clinical trial recruited pediatric patients aged 4 to 12 years undergoing venipuncture from a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March to May 2022.InterventionsParticipants were randomly allocated to an intervention (an age-appropriate IVR intervention offering distraction and procedural information) or a control (standard care only) group.Main Outcomes and MeasuresThe primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure (rated on a 40 point scale, with higher scores indicating greater satisfaction). Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure.ResultsA total of 149 pediatric patients were recruited, with 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group (mean [SD] age, 7.21 [2.49] years), the 75 participants in the IVR group (mean [SD] age, 7.21 [2.43] years) reported significantly less pain (β = −0.78; 95% CI, −1.21 to −0.35; P &lt; .001) and anxiety (β = −0.41; 95% CI, −0.76 to −0.05; P = .03) immediately after the intervention. Health care professional satisfaction in the IVR group (mean [SD] score, 34.5 [4.5]) was significantly higher than that in the control group (mean [SD] score, 32.9 [4.0]; P = .03). Moreover, the length of venipuncture procedure in the IVR group (mean [SD] duration, 4.43 [3.47] minutes) was significantly shorter than that in the control group (mean [SD] duration, 6.56 [7.39] minutes; P = .03).Conclusions and RelevanceIn this randomized clinical trial, integrating procedural information and distraction in an IVR intervention for pediatric patients undergoing venipuncture significantly improved pain and anxiety in the IVR group compared with the control group. The results shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures.Trial RegistrationChinese Clinical Trial Registry identifier: ChiCTR1800018817

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Positive effects of a child‐centered intervention on children's fear and pain during needle procedures

Kleye

Sundler

Karlsson

et al. 2023

Paediatric and Neonatal Pain

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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.

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Consequences of Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3–7 Years)

Cited by 39 publications

References 43 publications

Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care – a discussion paper

Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care – a discussion paper

Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Positive effects of a child‐centered intervention on children's fear and pain during needle procedures

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