Psychosocial intervention on procedure-related distress in children being treated for laceration repair.

OBJECTIVE: Research has demonstrated that emergency department visits for injured children are highly stressful experiences, especially when they include a painful procedure. This pilot study explored the impact of an intervention, which included preparation and distraction on procedure-related distress in children treated for laceration repair in the emergency department. METHOD: Distress and parent ratings of satisfaction were compared between children who received individualized preparation and distraction interventions for laceration repair provided by a child life specialist and children who received no intervention. Twenty-four subjects, aged 3 to 13 yr, were recruited from a pediatric emergency department within a university medical center. Patients receiving the intervention were provided with preprocedure age appropriate information relating to the laceration repair and distraction during the procedure. RESULTS: Results showed that children who received psychosocial intervention had lower observed distress behaviors during suturing compared with patients who did not receive the intervention. Results also showed that parents of patients who received the intervention perceived less distress in their children and rated their overall care significantly higher. CONCLUSION: These findings have significant implications for children's health care and supporting family needs when a child enters the emergency department.

The effect of educational interventions with siblings of hospitalized children.

OBJECTIVE: Research has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions. METHODS: A pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching. RESULTS: Results shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions. CONCLUSION: These findings have significant impact on children's health care and supporting family needs when a child is hospitalized.