How Often Are Hospitalised Children Physically Restrained During Painful and Stressful Procedures?

Area of Science:

• Pediatric healthcare research
• Clinical procedure safety
• Child psychology in medical settings

Background:

• Physical restraint is often employed during pediatric medical procedures.
• Understanding the incidence and associated factors of restraint use is crucial for improving patient care.

Purpose of the Study:

• To analyze the incidence of physical restraint use in hospitalized children during painful and stressful procedures.
• To identify factors associated with the use of physical restraint in pediatric clinical settings.

Main Methods:

• An observational, longitudinal, and prospective study was conducted.
• 1210 procedures were observed in 75 children (28 days to 10 years) in a Brazilian public hospital.
• Data included demographics, pain, stress behaviors, and physical restraint use, analyzed descriptively and inferentially.

Main Results:

• Physical restraint was used in 22.3% of observed procedures.
• Factors associated with restraint included younger age, higher pain scores, care dependency, and specific procedures (e.g., IV administration, airway suctioning).
• Stress behaviors preceded restraint use in stressful procedures; predictors included younger age, morning period, and ICU transfer.

Conclusions:

• A high incidence of physical restraint was observed during painful and stressful pediatric procedures.
• Child characteristics and procedural factors significantly influence the use of physical restraint.
• The findings call for a reevaluation of restraint practices to prioritize child well-being and rights.