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Child-Centered Procedural Experience Measures in Pediatric Emergency Care: A Scoping Review
Chloe Yian Yee Wong1, Stan Earnshaw2,3, Victoria Murray1
1Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Context:
Procedural care in pediatric emergency departments (PEDs) frequently involves painful and anxiety-provoking interventions such as fracture reductions and laceration repairs. These experiences can result in significant psychological impacts, including long-term anxiety and posttraumatic stress.
Objective:
To systematically map existing pediatric procedural experience measures in PEDs, focusing on pain, anxiety, and satisfaction associated with both pharmacological and nonpharmacological interventions.
Data Sources:
A comprehensive search was conducted across the MEDLINE, Embase, and Web of Science databases from inception to August 28, 2024. Additional references were identified through citation searching.
Study Selection:
All forms of primary research assessing pediatric procedural experiences, including both pharmacological and nonpharmacological interventions in emergency or urgent care settings, were eligible. Conference abstracts were included if sufficient data were available.
Data Extraction:
Data were extracted using a custom extraction form. A narrative synthesis was performed, comparing demographic characteristics, interventions, and outcome measures.
Results:
A total of 143 studies were included, with 82.5% focusing on pharmacological interventions and 14.7% on nonpharmacological strategies. Under half (45.1%) of reported outcomes included child self-reports. Satisfaction measures were predominantly caregiver-focused, and qualitative methods were employed in just 3.5% of studies.
Conclusions:
This review highlights the need for standardized frameworks integrating pain, anxiety, and satisfaction measures while prioritizing child perspectives. Current approaches often overlook emotional and psychological dimensions, relying on clinician- or caregiver-focused assessments and quantitative measures. Future research should prioritize the development of multidimensional, child-reported experience frameworks that integrate pain, anxiety, and satisfaction to guide more emotionally supportive and trauma-informed pediatric procedural care.
