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Communication and child behaviour associated with unwillingness to take premedication
Marie Proczkowska-Björklund1, Ingrid Runeson, Per A Gustafsson
1Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. marie.proczkowska.bjorklund@lj.se
Aim:
To see how dominance in adult communication and child behaviour during premedication affects the child's unwillingness to take premedication.
Method:
Ninety-five children scheduled for ENT surgery were video-filmed during premedication. All communication was translated verbatim and the communication was grouped according to; if the parent or nurse directed their communication towards the child or not, or; if they talked about nonprocedural matters or procedural matters.
Results:
Unwillingness to take premedication was associated with more parent communication and less anaesthetic nurse communication compared to willingness to take premedication. There was a heighten risk that the child took their premedication unwillingly if their parent talked more directly to the child (OR = 4.9, p < or = 0.01), the child gave hesitant eye contact with the anaesthetic nurse (OR = 4.5, p < or = 0.05), the child had experienced an earlier traumatic medical procedure (OR = 4.1. p < or = 0.001) or if the child placed her/himself nearby their parent (OR = 4.0, p < or = 0.001).
Conclusion:
Together with behaviour that could be signs of shyness and earlier medical traumatic experience, parents that are actively communicating with their child before premedication may heighten the risk that the child will take the premedication unwillingly.
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