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Potentially Stressful Care Interactions in Hospitalized Children: Incidence and Associated Factors During a 6-h
Danton Matheus de Souza1, Larissa Soares Butrico1, Caroline Knoner Monteiro1
1Department of Maternal, Child, and Psychiatric Nursing, School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
Insights
Hospitalized children experience numerous stressful care interactions, averaging 11 per child over six hours. Younger children, infants, and those with chronic conditions faced more frequent, potentially stressful procedures.
Area of Science:
- Pediatric Healthcare
- Nursing Research
- Patient Experience
Background:
- Hospitalized children frequently encounter care interactions that can cause stress.
- Understanding the frequency and triggers of these stressful events is crucial for improving pediatric patient care.
Purpose of the Study:
- To quantify the incidence of potentially stressful care interactions in hospitalized children.
- To identify factors associated with a higher number of these interactions.
Main Methods:
- An observational, longitudinal, and prospective study was conducted.
- 75 hospitalized children (28 days to <10 years) in a Brazilian teaching hospital were observed for 6-hour periods.
- Data on care interactions were collected and analyzed using descriptive and inferential statistics.
Main Results:
- A total of 859 potentially stressful care interactions were recorded (mean of 11 per child).
- Physical examinations, vital signs measurement, and nasal lavage were the most common procedures.
- Younger children (especially infants), morning observation periods, and the presence of chronic conditions were associated with more interactions.
Conclusions:
- Hospitalized children undergo a high volume of potentially stressful care interactions, even in short observation periods.
- Current care routines require re-evaluation to minimize stress and improve patient outcomes.
- Healthcare professionals, particularly nurses, should develop strategies to reduce or reframe these manipulations through better child and family preparation.
Aim:
To determine the incidence of potentially stressful care interactions and their associated factors in hospitalized children observed over a 6-h period.
Design:
Observational, longitudinal, and prospective study.
Methods:
The study was conducted in a paediatric inpatient unit at a teaching hospital in São Paulo, Brazil, with 75 hospitalized children aged between 28 days and under 10 years. The children were observed for 6 h during morning and afternoon periods to record the number of potentially stressful care interactions. Descriptive and inferential analyses were performed.
Results:
Eight hundred and fifty-nine potentially stressful care interactions were recorded, corresponding to a mean of 11 per child. Physical examinations were the most frequent procedure (n = 363; mean = 4.8), followed by vital signs measurements (n = 182; mean = 2.4) and nasal lavage (n = 119; mean = 1.6). The factors associated with a higher number of manipulations were younger children (p < 0.001), with emphasis on infants (mean = 16.7); those observed during the morning shift (mean = 12.3) (p = 0.04); and those with an underlying chronic condition (mean = 13.9) (p = 0.036).
Conclusion:
Over a short observation period of hospitalized children, a high number of potentially stressful care interactions were observed, demonstrating the need to reflect on current care routines and identify opportunities for change.
Implications For The Profession And/Or Patient Care:
This study has practical implications for healthcare professionals-particularly nursing staff-who routinely perform potentially stressful care interactions. These professionals must consider strategies to minimize frequent manipulations and/or reframe them through appropriate preparation of the child and family.
Reporting Method:
STrengthening the Reporting of OBservational studies in Epidemiology.
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