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Health care provider's responses to children's resistance to peripheral vein cannulation: A qualitative observational
Edel J Svendsen1, Ida T Bjørk1
1Department of Nursing, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Insights
Healthcare providers use various responses like acknowledging, distracting, persuading, and rejecting when children resist peripheral vein cannulation. Awareness of these strategies can improve child-friendly care during medical procedures.
Area of Science:
- Pediatric healthcare
- Clinical nursing
- Medical procedure communication
Background:
- Healthcare often involves restraint for children, despite treatment ideally being voluntary.
- Limited understanding exists regarding healthcare providers' responses to preschool children's resistance during medical procedures.
- Peripheral vein cannulation is a common procedure where children may exhibit resistance.
Purpose of the Study:
- To investigate and describe how healthcare providers respond to preschool children's resistance during peripheral vein cannulation.
- To provide insights into current pediatric care practices in hospital settings.
- To inform strategies for more child-centered approaches during clinical procedures.
Main Methods:
- An explorative qualitative research design was employed.
- Data were collected through observations with video recording.
- Fifteen healthcare providers (8 nurses, 7 physicians) and 6 preschool children were observed during 14 peripheral vein cannulation attempts.
Main Results:
- Healthcare providers utilized 380 responses categorized into acknowledging, distracting, persuading, and rejecting the child.
- All providers used acknowledging and distracting responses, regardless of the child's resistance level.
- Rejecting responses were used more frequently during the implementation phase compared to the preparation phase, with distraction, persuasion, and rejection increasing as the procedure progressed.
Conclusions:
- Healthcare providers employ a diverse range of responses to manage children's resistance during peripheral vein cannulation.
- Increased provider awareness of their response patterns can lead to the adoption of more child-friendly communication strategies.
- Findings can enhance clinical practice by promoting more sensitive and effective care for children undergoing medical procedures.
Aims And Objectives:
Health care and treatment should be voluntary, but restraint is often used during treatment of children. Knowledge about how health care providers respond to preschool children's resistance is lacking and can help understand current paediatric care in hospitals. The aim of the present article was to provide knowledge about how healthcare providers respond to preschool children's resistance during the clinical procedure of peripheral vein cannulation.
Design:
An explorative qualitative research design was developed for this study.
Methods:
Observations with video recording were used to collect data. Eight nurses and seven physicians participated in the study (n = 15). Their responses to preschool children's (n = 6) resistance were studied during 14 attempts of peripheral vein cannulation. Consolidated criteria for reporting qualitative research (COREQ) were used.
Results:
The healthcare providers made 380 responses to children's resistive expressions, interpreted within four main types, responses to acknowledge the child, responses to distract the child, responses to persuade the child and responses to reject the child. All main types of responses were used by both nurses and physicians. Regardless of the amount of resistance the children expressed, all children received distracting and acknowledging responses. Rejecting responses were used approximately twice as much in the implementation phase as in the preparation phase. Distraction, persuasion and rejection began in the preparation phase and increased in the implementation phase.
Conclusions:
The main types and sub-types of responses showed how healthcare providers use a wide array of responses to meet children's resistance during peripheral vein cannulation.
Relevance To Clinical Practice:
The results can enable health care providers to become aware of their own practices during peripheral vein cannulation and other clinical procedures and to elaborate on their use of responses that can be considered intrinsically less child-friendly.
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