Procedural pain in children: a qualitative study of caregiver experiences and information needs

Abstract

BackgroundChildren experience multiple painful procedures when being cared for in emergency departments (EDs). Unfortunately, evidence-based interventions to manage such pain and distress are under-utilized across EDs. Caregivers are uniquely positioned and invested to advocate for the adaptation of such evidence into practice. Our objective was to gather information from caregivers of children experiencing procedural pain in the ED to inform the development of a novel, caregiver-focused knowledge translation (KT) tool.MethodsThe study design was qualitative description. Caregivers of children who underwent intravenous (IV) insertion or venipuncture in the pediatric ED at an urban tertiary care centre were interviewed. Thematic analysis was applied to the data. The TRanslating Emergency Knowledge for Kids (TREKK) Parent Advisory Group continuously informed this study, and provided input on interview guide development and piloting, data collection, analysis of the data, interpretation of the results, and development of next steps.ResultsInterviews revealed four major themes: 1) source of healthcare information; 2) delivering healthcare information; 3) communication with caregivers; and 4) procedure-related anxiety and long-term effects. Caregivers most valued receiving information directly from their healthcare provider. They also expressed that healthcare providers should direct information about the procedure to their child and identified strategies to involve children in their care. Caregivers wanted to be empowered to ask informed questions of their healthcare providers. Finally, caregivers reported negative experiences with procedures for their children, occurring mainly at non-pediatric centres.ConclusionsWe have identified core information needs for caregivers whose children are experiencing IV insertion or venipuncture. These results will form the foundation for the development of a KT tool that may empower caregivers to actively participate in their child’s healthcare.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1300-y) contains supplementary material, which is available to authorized users.

Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization

“…Other barriers relate to a lack of cooperation by parents 36 , although this is not a universally supported finding 37 . A frequent finding in pediatric pain research is the need for improved communication and emotional support for the parents 38,39 . These findings show how nurses’ ability to build a good working relationship with CYP and parents is vital, and how within that relationship the nurse must be a listener, nurturer, teacher, and information source.…”

Procedural Pain: Systematic Review of Parent Experiences and Information Needs

“…A previous study by members of the research team investigated experiences of intravenous insertions and venipuncture among parents who visited the ED at 1 pediatric tertiary care center. 22 That small study highlighted parents’ desire for more information about managing procedural pain; however, the findings could not be generalized. To guide the development of knowledge translation tools for parents, we undertook a systematic review to synthesize current knowledge of parents’ experiences and information needs relevant to simple, common medical procedures performed in or relevant to the ED setting.…”

Dynamics on the field: A focused ethnographic study of pediatric pain management at four Ghanaian hospitals

“…Consistent with earlier studies [45,46], procedural pain was described by the participating children as the most distressing part of the hospitalization process and memories of such events influenced their habitus by discouraging them from co-operating in subsequent procedures. This situation also resulted in a distressing and discomforting habitus among some family caregivers as reported in a previous study [47].…”