Ethnic Differences in Parent Preference to Be Present for Painful Medical Procedures

Abstract

ABSTRACT. Objective. To examine ethnic differences between white, black, and Hispanic (Englishspeaking and Spanish-speaking) parents in their desire to remain present during their children's painful medical procedures.Methods. A convenience sample of parents from each of 4 ethnic groups (black, white, and Hispanic [divided into English-speaking Hispanic and Spanish-speaking Hispanic]) was surveyed regarding their preferences for remaining present for 5 hypothetical painful procedures: venipuncture, laceration repair, lumbar puncture, fracture reduction, and critical resuscitation. For each procedure, a short description of the procedure was read to the parent, and a picture of the procedure was shown. The effect of ethnicity on parental desire to stay was examined by using the 2 test and multivariate logistic regression.Results. Complete data on 300 parents, 72 to 79 from each ethnic group, were obtained. There were no significant demographic differences between groups except that English-speaking Hispanic parents were younger, and black parents were relatively well educated, whereas Spanish-speaking Hispanic parents were relatively less well educated. Overall, the percentages of those who would wish to remain with their child during the procedures were 94% (venipuncture), 88% (laceration repair), 81% (lumbar puncture), 81% (fracture reduction), and 81% (critical resuscitation). The only significant ethnic difference was that English-speaking Hispanic parents were less likely to want to remain present during a critical resuscitation (P ‫؍‬ .01). Black parents were less likely, and English-speaking Hispanic parents were more likely, to want physicians to decide for them whether they should remain present. Parents generally preferred to actively participate during the procedure by coaching and soothing their child rather than to just observe.Conclusions. We found few ethnic differences in parents' desire to be present during their child's painful medical procedures. Overall, the vast majority of parents would prefer to remain present even for highly invasive procedures. Pediatrics 2005;116:e191-e197. URL: www. pediatrics.org/cgi

Part 14: Pediatric Advanced Life Support

“…[462][463][464][465][466][467][468][469][470][471] Studies show that family members who are present at a resuscitation would recommend it to others. 462,463,465,471,472 Parents of chronically ill children are comfortable with medical equipment and emergency procedures, but even family members with no medical background who were at the side of a loved one to say goodbye during the final moments of life believe that their presence was beneficial to the patient, [462][463][464]466,[471][472][473][474][475][476] comforting for them, 462-465,468 -471,476 and helpful in their adjustment [463][464][465]472,473,476,477 and grieving process. 477 Standardized psychological examinations suggest that, compared with those not present, family members present during attempted resuscitations have less anxiety and depression and more constructive grieving behavior.…”

Part 3: Ethics

“…61 Most parents surveyed indicated that they wanted to be offered the option of being present during the resuscitative effort for their child. 60,[71][72][73][74][75][76][77][78][79] In the absence of data documenting harm and in light of data suggesting that it may be helpful, offering select family members the opportunity to be present during a resuscitation is reasonable and desirable (assuming that the patient, if an adult, has not raised a prior objection) (Class IIa, LOE C for adults and Class I, LOE B for pediatric patients). Parents and other family members seldom ask if they can be present unless they are encouraged to do so by healthcare providers.…”

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

“…It is clear that cultural differences can contribute to how an individual or family manifests behavioral distress and anxiety [16][17][18][19] ; however, no predictable patterns have emerged with regard to a consistent pain experience within ethnic groups. 20 Studies have noted that Hispanic and black individuals with long-bone fractures were less likely to receive analgesics than were non-Hispanic white individuals. [21][22][23] A review of the National Hospital Ambulatory Medical Care Survey from 1992 to 1997 demonstrated that among patients with fractures, black children covered by Medicaid were least likely to receive parenteral sedation and analgesia.…”