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Parent participation during painful wound care procedures
1Child Development Unit, Children's Hospital, Denver, CO 80218.
Insights
Parental presence during pediatric burn care, particularly for children under 3, did not show statistically significant differences in pain or anxiety. However, clinical observations led to a unanimous decision to allow parent participation in wound care.
Area of Science:
- Pediatric Burn Care
- Child Psychology
- Pain Management
Background:
- Parental involvement in pediatric burn wound care is controversial.
- Separation from caregivers can increase distress and anxiety in young children during painful procedures.
- Burn center staff disagreed on policies restricting parental presence during hydrotherapy and dressing changes.
Purpose of the Study:
- To assess young children's behavioral responses to painful burn care procedures with and without parental presence.
- To determine if parental support reduces observable pain responses and anxiety in pediatric burn patients.
- To inform policy decisions regarding parental participation in burn care.
Main Methods:
- A study was conducted to compare behavioral responses of young children undergoing painful burn care procedures.
- Children were observed with and without a parent present during hydrotherapy and dressing changes.
- Behavioral pain and anxiety indicators were analyzed.
Main Results:
- No statistically significant difference was found in behavioral responses between children with and without parental presence.
- Clinical observations, however, provided strong evidence supporting the benefits of parental presence.
- The study highlighted the subjective impact of parental support on coping mechanisms.
Conclusions:
- While not statistically significant, clinical observations supported the value of parental presence during painful pediatric burn care.
- A unanimous decision was made to establish parent participation as a patient care option.
- This approach aims to enhance a child's ability to cope with burn wound care procedures.
Abstract:
The role of the parent during painful wound care is an area of controversy among burn care professionals. Children younger than the age of 3 years may be particularly distressed by separation from the primary caretaker, thus increasing anxiety levels and reducing the capacity to cope with wound care procedures. Burn center staff at this facility were in strong disagreement regarding a change in policy that barred parent participation during hydrotherapy and dressing change. This study was conducted to assess young children's behavioral responses to painful burn care procedures with and without a parent present to determine whether parent support enhanced the child's ability to cope by reducing observable pain responses and expression of anxiety. It was anticipated that results of the study would assist staff in reaching an objective, rational decision regarding changes in policy and procedures. Results of the study failed to show a statistically significant difference between the two comparison groups. However, the strength of clinical observations facilitated a unanimous decision to establish parent participation as a patient care option.