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Resistive expressions in preschool children during peripheral vein cannulation in hospitals: a qualitative
Edel Jannecke Svendsen1, Anne Moen2, Reidar Pedersen3
1Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. e.j.svendsen@medisin.uio.no.
Insights
Children’s medical procedure resistance was studied, identifying three expressions: protest, escape, and endurance. Understanding these expressions can help healthcare providers support children during procedures.
Area of Science:
- Pediatric healthcare
- Child psychology
- Medical procedure adaptation
Background:
- Children often resist medical procedures, necessitating restraint.
- Limited empirical research exists on children's expressions during these events.
Purpose of the Study:
- To explore preschool children's resistive expressions during peripheral vein cannulation.
- To develop a typology of children's resistance during medical procedures.
Main Methods:
- Video recording of naturally occurring peripheral vein cannulation procedures.
- In-depth analysis of six newly hospitalized preschool children's behavior.
- Development of a typology for resistive expressions.
Main Results:
- Fourteen peripheral vein cannulation attempts were analyzed.
- Three types of resistive expressions were identified: protest, escape, and endurance.
- Protest involved an insistent attitude, escape involved panic and avoidance, and endurance involved being stiff and motionless.
Conclusions:
- Identified three resistive expressions (protest, escape, endurance) to understand children better.
- Findings can inform clinical judgment in challenging procedural situations.
- Knowledge can sensitize healthcare providers to facilitate children's participation.
Background:
Children may resist common medical procedures, and this may lead to the use of restraint. This can be challenging to all of the involved parties, but empirical research is scarce on children's expressions during these procedures.
Methods:
To explore preschool children's resistive expressions during peripheral vein cannulation we video recorded and performed an in-depth analysis of naturally occurring situations with six newly hospitalized preschool children.
Results:
Fourteen attempts of peripheral vein cannulation were recorded. A typology of resistive expressions was developed consisting of: protest, escape, and endurance. During the expression of protest, the children showed an insistent attitude where they were maintaining their view. The expression of escape was when children were panicked, avoiding hands of adults when being approached. When expressing endurance the children were stiff, motionless and introverted. Less physical restraint is required during endurance, but children still appear to refuse participation.
Conclusions:
We identified three types of resistive expressions that can be used to better understand the individual child and inform clinical judgment in challenging procedural situations. This knowledge can help to sensitize health care providers in their attempt to arrange for children's participation.
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