Attitudes and Opinions of Adolescent Females Regarding 2 Methods of Bladder Filling for Transabdominal Ultrasound

Abstract

Objectives Adolescent female patients who are not sexually active and who present to a pediatric emergency department with abdominal pain require a full bladder prior to transabdominal ultrasound. Procedures to fill the bladder are largely institution or provider dependent. We examined adolescent females' attitudes and opinions toward 2 common methods of bladder filling, intravenous fluid administration and transurethral Foley catheter placement, by means of a Q-sort study. Methods Two convenience samples of adolescent female patients in the pediatric emergency department at an academic children's hospital participated in the study. In part 1, subjects underwent a semistructured interview to elicit their opinions regarding 2 methods of bladder filling: intravenous fluid or transurethral catheter. The summation of subject statements was then narrowed down to a final Q set of 25 statements. In part 2, a second sample of subjects independently arranged this Q set according to their own agreement or disagreement with each statement. Principal components analysis was conducted to examine factors or collections of statements representing a shared viewpoint and to describe commonalities. Results Part 1 was completed with 9 subjects, and part 2 with 26 subjects. Factors revealed from the Q-sort data included acceptance of tests deemed medically necessary, desire for parental involvement, and a wish to minimize discomfort. Most adolescents aligned with 1 of these 3 factors. Conclusions Adolescent female patients varied in their attitudes and opinions regarding intravenous catheter hydration and Foley catheter placement for transabdominal ultrasound. Knowledge of adolescent viewpoints may help better inform practitioner-patient communication for this procedure.

Leaving Without Being Seen From a Pediatric Emergency Department

“…For subjective topics like a decision to LWBS, wherein there are no right and wrong perspectives, Q-methodology is suitable as an investigative strategy because it illuminates possible ways of thinking about a topic 14,16 . Q-methodology can uncover important perspectives without being dependent upon a large sample size of study participants 16,17 . To elaborate, take for example a topic which has n distinct perspectives that are manifested among a mix of different people for whom that topic is pertinent; if those perspectives coexist as the most prominent ways of thinking about that topic, then adding more people to the sample may not add more information 18…”

“…14,16 Q-methodology can uncover important perspectives without being dependent upon a large sample size of study participants. 16,17 To elaborate, take for example a topic which has n distinct perspectives that are manifested among a mix of different people for whom that topic is pertinent; if those perspectives coexist as the most prominent ways of thinking about that topic, then adding more people to the sample may not add more information. 18…”

The Effect of Rapid Fluid Infusions on Transabdominal Pelvic Ultrasound Timing Among Female Pediatric Patients: A Randomized Controlled Pilot Trial

“…Transabdominal ultrasound is a common noninvasive method to evaluate abdominal pain in females who are not sexually active 1,2 . Unlike transvaginal ultrasounds, the patient’s bladder must be full to receive a high‐quality sonographic view 2 . Oral or intravenous (IV) fluids and bladder filling through a transurethral catheter are both used 2 .…”

“…1,2 Unlike transvaginal ultrasounds, the patient's bladder must be full to receive a high-quality sonographic view. 2 Oral or intravenous (IV) fluids and bladder filling through a transurethral catheter are both used. 2 For pediatric patients, transurethral catheterization raises concerns over modesty, 2 favoring IV fluids.…”

“…2 Oral or intravenous (IV) fluids and bladder filling through a transurethral catheter are both used. 2 For pediatric patients, transurethral catheterization raises concerns over modesty, 2 favoring IV fluids. Unless performed over rapid infusion, IV infusion pumps have a maximum individual rate of 999 mL/hr, and more than one fluid bolus may be required to achieve a highquality sonographic view.…”