Pain experienced by infants and toddlers at urine collection bag removal: A randomized, controlled, clinical trial.


Journal

International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 18 09 2018
revised: 18 03 2019
accepted: 18 03 2019
pubmed: 15 4 2019
medline: 1 1 2020
entrez: 15 4 2019
Statut: ppublish

Résumé

In pre-continent children, collection bags are frequently used as a first-line option to obtain a urine specimen. This practice, acknowledged by several guidelines for the step of UTI screening, is driven by a perception of the technique as being more convenient and less painful. However, our own experience led us to consider bag removal as a painful experience. Our aim was to determine whether the use of an oleo-calcareous liniment to aid bag removal reduced the acute pain expressed by young children. This prospective, randomized, controlled, single blind study was carried out in two emergency pediatrics departments. Pre-continent children aged 0-36 months admitted with an indication for urine testing were eligible for the study. Urine for dipstick test screening was obtained using a collection bag. At micturition, the patients were randomized into bag removal with (intervention group) or without (control group) liniment. Bag removal was recorded on video in such a manner as to permit independent assessments of pain by two evaluators blinded to group allocation. Pain was assessed using the FLACC scale. 135 patients were analyzed: 70 in the intervention group and 65 in the control group. The median FLACC scores [interquartile range] for the intervention and control groups, respectively 4.0 [2.0-7.0] and 4.0 [3.0-7.0], did not differ significantly (p = 0.5). A FLACC score ≥4 was obtained for 56% of the patients and a score ≥7 for 28%. Removal of urine collection bags caused moderate to severe pain in half of the children included. The use of an oleo-calcareous liniment did not reduce this induced pain.

Sections du résumé

BACKGROUND BACKGROUND
In pre-continent children, collection bags are frequently used as a first-line option to obtain a urine specimen. This practice, acknowledged by several guidelines for the step of UTI screening, is driven by a perception of the technique as being more convenient and less painful. However, our own experience led us to consider bag removal as a painful experience.
OBJECTIVE OBJECTIVE
Our aim was to determine whether the use of an oleo-calcareous liniment to aid bag removal reduced the acute pain expressed by young children.
METHODS METHODS
This prospective, randomized, controlled, single blind study was carried out in two emergency pediatrics departments. Pre-continent children aged 0-36 months admitted with an indication for urine testing were eligible for the study. Urine for dipstick test screening was obtained using a collection bag. At micturition, the patients were randomized into bag removal with (intervention group) or without (control group) liniment. Bag removal was recorded on video in such a manner as to permit independent assessments of pain by two evaluators blinded to group allocation. Pain was assessed using the FLACC scale.
FINDINGS RESULTS
135 patients were analyzed: 70 in the intervention group and 65 in the control group. The median FLACC scores [interquartile range] for the intervention and control groups, respectively 4.0 [2.0-7.0] and 4.0 [3.0-7.0], did not differ significantly (p = 0.5). A FLACC score ≥4 was obtained for 56% of the patients and a score ≥7 for 28%.
CONCLUSION CONCLUSIONS
Removal of urine collection bags caused moderate to severe pain in half of the children included. The use of an oleo-calcareous liniment did not reduce this induced pain.

Identifiants

pubmed: 30981953
pii: S0020-7489(19)30082-3
doi: 10.1016/j.ijnurstu.2019.03.014
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-6

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Charles Lamy (C)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: charlesophie.lamy@hotmail.fr.

Valérie Loizeau (V)

CHI de Poissy, Département de pédiatrie, 11 rue du champs de Gaillards 78300 Poissy-St Germain-en-Laye, France. Electronic address: valerie.loizeau@chi-poissy.fr.

Catherine Couquet (C)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: catherine.couquet@chu-limges.fr.

Caroline Sturtzer (C)

CHI de Poissy, Département de pédiatrie, 11 rue du champs de Gaillards 78300 Poissy-St Germain-en-Laye, France. Electronic address: caroline.sturtzer@chi-poissy.fr.

Coralie Fluteau (C)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: Coralie.fluteau@chu-limoges.fr.

Manon Dugas (M)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: manon_mear@hotmail.fr.

Anaïs Labrunie (A)

CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: anais.labrunie@chu-limoges.fr.

Benoît Marin (B)

CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: benoit.marin@unilim.fr.

Jean-Luc Desfougères (JL)

CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: jean-luc.desfougeres@chu-limoges.fr.

Claire Bahans (C)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: Claire.bahans@chu-limoges.fr.

Vincent Guigonis (V)

CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: vincent.guigonis@unilim.fr.

Pascale Beloni (P)

CHU de Limoges, Hôpital Dupuytren, Coordination Générale des Soins, 2 avenue Martin Luther-King, 87042 LIMOGES Cedex, France. Electronic address: pascale.beloni@chu-limoges.fr.

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