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Evaluation of child life intervention in emergency department suturing
Insights
Child life staff interventions significantly reduced anxiety and improved satisfaction during emergency department suturing. This support was most effective for older children with severe facial injuries.
Area of Science:
- Pediatric Emergency Medicine
- Child Psychology
- Healthcare Intervention Studies
Background:
- Emergency department (ED) visits for suturing can cause significant stress and anxiety in children.
- Standard care in EDs may not adequately address the emotional and psychological needs of pediatric patients during procedures.
- Child life services offer potential benefits in mitigating procedural distress.
Purpose of the Study:
- To evaluate the effectiveness of a stress-reducing intervention delivered by child life staff during ED suturing procedures.
- To compare outcomes between children receiving intervention and two control groups (pediatric hospital and general hospital).
- To identify demographic and injury-related factors influencing intervention effectiveness.
Main Methods:
- A comparative study involving children undergoing suturing in an ED.
- Intervention group received emotional support, procedural information, and coping strategies from child life staff.
- Control groups received standard care without specific intervention.
- Data collected included observable anxiety, self-reported anxiety and pain, post-visit behavior, return visit anxiety, and parent satisfaction and anxiety.
Main Results:
- The intervention was most effective for 11- to 14-year-olds with facial injuries requiring six or more sutures.
- Children in the intervention group reported fewer fears compared to the general hospital control group.
- Parents of children receiving the intervention reported significantly higher satisfaction with overall ED care.
Conclusions:
- Child life intervention is an effective strategy for reducing anxiety and enhancing patient and parent satisfaction during ED suturing.
- Targeted application of these interventions, particularly for older children with more severe injuries, can maximize benefits.
- Integrating child life services into ED procedural care is recommended for improving pediatric patient experience.
Abstract:
The effects of stress-reducing intervention in emergency department suturing were evaluated by comparing children receiving intervention from child life staff, with two control groups who did not receive intervention, control A at a pediatric hospital and control B at a general hospital. The following measures were obtained: observable anxiety during the procedure; the child's self-report of anxiety, self-report of pain, postemergency visit behavior, and anxiety about a return visit; the parent's overall rating of satisfaction with care given and the parent's feelings of anxiety. Children and parents in the intervention group received emotional support and information concerning the medical procedure, and were taught appropriate coping strategies. Measures were obtained across three age groups (four to six years, seven to 10 years, 11 to 14 years) divided by sex; site of cut (face or body), and extent of injury (five or fewer sutures, six or more sutures). Intervention had its greatest influence on 11- to 14-year-olds with a facial injury requiring six or more sutures. Children in the intervention group expressed fewer fears than children in the general hospital control group. Parents of children who received intervention reported a significantly higher degree of satisfaction with the overall care given in the emergency department.