How Often Do Hospitalized Children Receive Nonpharmacological Interventions During Painful and Stressful Procedures?

To analyze the use of nonpharmacological interventions during painful and stressful procedures in hospitalized children, monitored for 6 hours, and their associated factors.

An observational, longitudinal, prospective study conducted between April and June 2024 at a teaching hospital in São Paulo, Brazil, with children aged between 28 days and 10 years, hospitalized in a Pediatric Inpatient Unit. Data were collected using simple random sampling, with children observed for 6 hours during the morning and afternoon periods. Data included characterization of the children, the number of painful procedures and their pain scores, the number of stressful procedures, and the nonpharmacological interventions used during types of procedures. Data were analyzed descriptively and inferentially, with binomial logistic regression models, along with generalized mixed-effects models for binomial family and multinomial distribution.

Seventy-five children who underwent 1,210 procedures were observed, with 351 painful and 859 stressful procedures. In total, 250 nonpharmacological interventions were applied, with the highest incidence of non-nutritive sucking, distraction, and skin-to-skin contact. Factors associated with the application of nonpharmacological interventions in painful procedures included the child's age, pain score, sex, and dressings change. In stressful procedures, factors associated included morning follow-up, hygiene procedures, and the child's behavior. Painful procedures had a higher chance of receiving nonpharmacological interventions compared to stressful ones.

Demonstrating the reality of clinical practice can serve as a guide for future efforts aimed at changing practices and ensuring that nonpharmacological interventions are implemented in clinical practice.