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The Children's Action-Reaction Assessment Tool (CARAT) as an observational technique for assessing symptom
Katarina Karlsson1, Ensa Johnson2, Stefan Nilsson3
1Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Insights
The Children's Action-Reaction Assessment Tool (CARAT) shows sufficient inter-rater reliability for assessing coping strategies in young children during needle procedures. This tool can help improve care by evaluating action-reaction strategies.
Area of Science:
- Pediatric Nursing
- Pain Management
- Child Psychology
Background:
- Needle procedures often cause significant fear and pain in children.
- Effective symptom management requires assessing pain and fear, then implementing coping strategies.
- The Children's Action-Reaction Assessment Tool (CARAT) is designed to evaluate action-reaction strategies.
Purpose of the Study:
- To determine the inter-rater reliability of the CARAT.
- To assess the CARAT's utility in evaluating action-reaction strategies during needle procedures.
- To evaluate the CARAT for children aged 3-7 years.
Main Methods:
- Quantitative approach utilizing direct observation.
- Two independent observers evaluated 21 children during needle procedures.
- Inter-rater reliability was assessed using descriptive statistics and the intraclass correlation coefficient (ICC) on SPSS.
Main Results:
- The CARAT indicated the use of action-reaction strategies, though not frequently.
- Parents were infrequently involved in the observed procedures.
- Sufficient inter-rater reliability was found between the observers for the CARAT.
Conclusions:
- The CARAT demonstrates promising inter-rater reliability for use with children aged 3-7 years.
- The CARAT can be a valuable tool for assessing action-reaction strategies during pediatric needle procedures.
- This tool has the potential to facilitate improved care for children experiencing procedural pain and fear.
Purpose:
For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child's pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children's Action-Reaction Assessment Tool (CARAT) is built on action-reaction strategies. This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3- to 7-year-old children. DESIGN AND METHODS: We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25.
Results:
The completed CARAT indicated the use of action-reaction strategies. Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers. PRACTICE IMPLICATIONS: This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action-reaction strategies in conjunction with needle procedures in children aged 3-7 years.
