Discomfort of the critically ill paediatric patient and correlated variables.

Discomfort factors Infant welfare Intensive care units Paediatric nursing Patient comfort

Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
11 2020
Historique:
received: 12 07 2019
revised: 07 02 2020
accepted: 17 02 2020
pubmed: 2 7 2020
medline: 25 11 2021
entrez: 2 7 2020
Statut: ppublish

Résumé

The care of critically ill children is usually invasive and aggressive, requiring numerous traumatic procedures that may cause fear, pain, and discomfort. The aim of this study was to analyse the level of discomfort of patients admitted to the paediatric intensive care unit of a specialist children's hospital and to determine the sociodemographic and clinical variables that influence the degree of discomfort experienced by critically ill paediatric patients. We performed a descriptive observational cross-sectional study that included a total of 311 children with a median age of 5.07 y (interquartile range = 0.9-11.7). A team of 10 paediatric critical care nurses assessed the degree of discomfort once for each shift (morning, afternoon, and night) on 2 successive days using the COMFORT Behavior Scale-Spanish version. In total, 49.8% (n = 155) of the patients were free of discomfort (score ≤10 points) vs. 50.2% (n = 156) who experienced discomfort. There was a significant negative correlation between discomfort and the length of stay in days (Rho = 0.16; p = 0.02), that is, the longer the stay, the less discomfort the patient felt. The correlation between age and degree of discomfort was found to be both positive and significant (Rho = 0.230, p < 0.001); the greater the age, the greater the discomfort. In comparison of all children who received analgosedation (n = 205), with discomfort levels of 10.77 ± 2.94, with those who did not receive analgosedation (n = 106), with discomfort levels of 11.96 ± 2.80, we did find a statistically significant difference (χ Half of the patients admitted to the paediatric intensive care unit experienced discomfort. Age and analgosedation were the two most important variables involved with a high degree of discomfort. Clinical care practices must consider these factors and try to plan activities designed to relieve discomfort in all critically ill paediatric patients.

Identifiants

pubmed: 32605846
pii: S1036-7314(20)30052-7
doi: 10.1016/j.aucc.2020.02.009
pii:
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Pagination

504-510

Informations de copyright

Copyright © 2020 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The authors declare that they have no conflicts interest.

Auteurs

Alejandro Bosch-Alcaraz (A)

Pediatric Nurse, Hospital Sant Joan de Déu, Barcelona, Spain; Department of Public Health, Mental Health, and Maternity/Childhood Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. Electronic address: abosch@sjdhospitalbarcelona.org.

Iolanda Jordan (I)

Pediatric Intensive Care Specialist, Hospital Sant Joan de Déu, Barcelona, Spain; Medicine Unit of Training and Research, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

Llúcia Benito-Aracil (L)

Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Spain.

Mª Ángeles Saz-Roy (MÁ)

Department of Public Health, Mental Health, and Maternity/Childhood Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

Anna Falcó-Pegueroles (A)

Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Spain; Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain.

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Classifications MeSH