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Promoting parental use of nonpharmacologic techniques with children during lumbar punctures
1University of Minnesota School of Nursing, Minneapolis, USA.
Insights
Teaching nonpharmacologic techniques to children with acute leukocytic leukemia and their parents reduced distress behaviors during lumbar punctures. This intervention also decreased children
Area of Science:
- Pediatric Oncology
- Pain Management
- Child Psychology
Background:
- Lumbar punctures are a common and often distressing procedure for children with acute leukocytic leukemia (ALL).
- Effective pain and distress management is crucial for improving the patient experience and adherence to treatment.
- Nonpharmacologic techniques offer a promising avenue for managing procedural pain and anxiety in pediatric cancer patients.
Purpose of the Study:
- To evaluate the impact of teaching nonpharmacologic techniques to children with ALL and their parents.
- To assess the effectiveness of these techniques in reducing distress behaviors during lumbar punctures.
- To measure children's self-reported pain and parents' and nurses' perceptions of pain.
Main Methods:
- A pretest-posttest control group design was employed.
- Eight children (aged 6-14 years) with ALL and their parents received training in nonpharmacologic techniques.
- Distress behaviors were observed, and pain was assessed using the Visual Analogue Scale (VAS).
Main Results:
- The treatment group showed significantly fewer verbal resistance (P = .04) and muscular rigidity (P = .04) compared to the control group.
- Children in the treatment group reported lower pain levels (P = .09) and exhibited fewer fear expressions (P = .10) post-intervention.
- Parents and children reported benefits from using the nonpharmacologic techniques.
Conclusions:
- Teaching nonpharmacologic techniques is effective in reducing distress and pain during lumbar punctures for children with ALL.
- Parental involvement and training in these techniques can enhance their supportive role during procedures.
- Nonpharmacologic strategies are a valuable addition to the pain management toolkit for pediatric oncology patients.
Abstract:
A pretest and posttest with control group design was used to examine the effect of teaching eight children with acute leukocytic leukemia, aged 6 to 14 years, and their parents about selected nonpharmacologic techniques, then to support their use of these techniques during children's lumbar punctures. Children's distress behaviors were observed and recorded during the procedures. A Visual Analogue Scale was used to obtain children's self-report and parents' and staff nurses' perceptions of children's pain during the procedure. Posttest comparison of four subjects in the treatment group with four subjects in the control group indicated that the treatment group had fewer expressions of verbal resistance (P = .04), less muscular rigidity (P = .04), and more parent interventions (P = .06). Preintervention with postintervention comparison of all eight subjects indicated that following intervention, children had lower levels of self-reported pain (P = .09), fewer requests for emotional support (P = .07), fewer expressions of verbal fear (P = .10), and fewer information-seeking questions (P = .10). Comments from children and parents indicate that children benefitted from nonpharmacologic techniques.