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Effects of parental holding on pain response in young children during cystometry: A randomized controlled trial
Jieun Park1,2, Hyejung Lee3, Sang Won Han4,5
1Graduate School of Nursing, Yonsei University, Seoul, Republic of Korea.
Insights
Parental holding significantly reduces pain responses in children during cystometry. This non-pharmacological method improves behavioral pain scores and physiological indicators like heart rate and oxygen saturation, offering a more comfortable experience.
Area of Science:
- Pediatric Urology
- Pain Management in Children
- Non-pharmacological Interventions
Background:
- Cystometry is crucial for assessing bladder function in children.
- Urethral catheterization during cystometry can cause pain and anxiety in pediatric patients.
- Existing evidence supporting non-pharmacological pain management methods like parental holding during cystometry is limited.
Purpose of the Study:
- To investigate the effectiveness of parental holding in mitigating pain during cystometry in infants and young children.
- To provide empirical evidence for the International Children's Continence Society's recommendation on parental holding.
Main Methods:
- A randomized controlled trial with a pre-post test design involving 64 children aged 6-18 months.
- Experimental group: Children were held by parents during cystometry.
- Control group: Children were laid on an examination table; parents could touch but not hold.
- Pain assessment included behavioral (FLACC scale) and physiological (oxygen saturation, heart rate) measures at multiple time points post-catheterization.
Main Results:
- The experimental group showed significantly decreased behavioral pain responses at 3 and 10 minutes after urethral catheter insertion compared to immediately after.
- In the experimental group, oxygen saturation increased more, and heart rate decreased more at 10 minutes compared to 3 minutes post-insertion.
- These findings suggest a positive impact of parental holding on pain reduction and physiological stability during the procedure.
Conclusions:
- Parental holding is an effective non-pharmacological strategy for reducing pain and distress in children undergoing cystometry.
- The study supports the use of parental holding as a valuable intervention in pediatric urological procedures.
- Further research is recommended to solidify the applicability and benefits of this method.
Introduction:
Cystometry is essential for evaluating bladder function. However, children may react negatively to the physical pain of urethral catheterization or anxiety and fear of an unfamiliar environment. These pain responses during the cystometry procedure may interfere with the cystometry procedure and make it difficult to interpret the cystometry result. In this regard, the International Children's Continence Society has advised performing cystometry while holding infants as an effective nonpharmacological pain management method, but there is insufficient evidence to support this.
Purpose:
This study aimed to analyze the effect of parental holding on reducing pain in children during cystometry.
Methods:
This was an experimental study in a randomized controlled pre-post test design. A total of 64 participants aged 6-18 months were recruited. During cystometry, the participants in the experimental group were placed on the parent's laps and held in the parents' arms. The participants in the control group were laid down on the examination table. During the procedure, both groups of parents were allowed to touch their children in all ways except holding them and to use the pacifier if they wished. The behavioral (face, leg, activity, cry, consolability scale) and physiological (oxygen saturation and heart rate) pain responses were measured at three-time points (immediately, 3, and 10 min after urethral catheter insertion).
Results:
Comparing the two groups, in the experimental group, the behavioral pain response at 3 min after urethral catheter insertion (t = -2.165, p = 0.034) and 10 min after (t = -3.155, p = 0.002) was decreased compared with that immediately after urethral catheter insertion. In addition, oxygen saturation increased more (t = 2.021, p = 0.048), and the heart rate decreased more (t = -2.033, p = 0.047) at 10 min than at 3 min after urethral catheter insertion in the experimental group.
Conclusions:
This study revealed that parental holding could reduce pain responses during cystometry in children. Further research is required to confirm the applicability and usefulness of parental holding during cystometry.
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