ABSTRACT
The purpose of our pilot study was to evaluate the effects of a companion animal (dog) on physiologic arousal and behavioral distress among children undergoing a dental procedure. A repeated measures experimental design was used to study 40 children between the ages of 7 and 11 years who were undergoing procedures in a pediatric dental clinic. Half the children had the dog present during the procedure and half did not. Data were obtained before, during, and after the procedure. Behavioral distress was measured using the Observational Scale of Behavioral Distress; procedures were videotaped. Physiologic arousal was measured using a YSI telethermometer taped to the child's index finger. Student's t-test and repeated measures analysis of variance were used to answer the research question. No significant differences in behavioral distress or physiologic arousal were found between experimental and control groups. Further analysis revealed that for children who initially verbalized distress on arrival at the clinic, the presence of the dog decreased physiologic arousal during the time the child was on the dental table waiting for the dentist to arrive. Further research should be conducted to verify the effect of a companion animal on initial stress experienced by children for whom the visit to the dentist is most stressful.
Subject(s)
Animals, Domestic , Dental Care/psychology , Animals , Child , Dogs , Female , Humans , Male , Pilot Projects , Skin Temperature , Stress, Psychological/physiopathology , Stress, Psychological/prevention & controlABSTRACT
The purpose of this study was to investigate the effects of audiotaped lullabies on physiological and behavioral distress and perceived pain among children during routine immunization. An experimental design was used to study 99 healthy children ages 3 to 6 years. Half the children received the musical intervention during the immunizations, while the other half did not. Groups were assessed during five phases: baseline, preimmunizations, during the immunization, after Band-Aid application, and 2 min after phase 4. Physiological variables (heart rate, blood pressure) were obtained in phases 1, 4, and 5. Behavioral distress was measured using the Observational Scale of Behavioral Distress during phases 1, 2, 3, and 4. Pain perception was measured using the Oucher in phases 1 and 4. No significant differences were found between experimental and control groups for heart rate, blood pressure, or Oucher scores. However, total distress scores were significantly less for the experimental group. These results indicate that immunization is a stressful experience for children. Recommendations include further study incorporating pharmacological and nonpharmacological interventions.
Subject(s)
Immunization/adverse effects , Music Therapy/methods , Pain/prevention & control , Stress, Psychological/prevention & control , Child , Child Behavior/psychology , Child, Preschool , Female , Humans , Immunization/nursing , Immunization/psychology , Male , Pain/diagnosis , Pain/etiology , Pain Measurement , Psychology, Child , Stress, Psychological/diagnosis , Stress, Psychological/etiologyABSTRACT
The specific aims of this research project were to (a) describe selected verbal, nonverbal, and physiological arousal indicators of the child's pain; (b) describe which pain indicators were most influential to nurses in decision-making about interventions for managing the child's pain; (c) describe pain interventions used by nurses; (d) compare postoperative analgesic orders to recommended dosages for the children; and (e) explore relationships between the child's self-report of pain and medication dosages administered. Subjects included 19 children aged 5-17 years who experienced 20 orthopedic surgical procedures (one child had two surgeries one week apart). Data were collected by staff nurses for the first five days after surgery. Pain levels were reported using the Oucher Scale. Postoperative pain was reported at moderate levels and showed only a gradual decrease throughout the hospital stay. Nonverbal pain indicators included crying and tense face. The child's complaint of pain and reported Oucher scores were most influential in influencing nurses to intervene in the child's pain. Nonpharmacological comfort measures included positioning and reassurance. All children received medications for pain; 49% of the orders were within the recommended therapeutic dosage range. A small but significant correlation was found between the child's reported pain level and the morphine equivalents of pain medication received. Recommendations included development of nursing flow charts that provide space to record pain levels and nursing interventions, in-service education for nurses on nonpharmacological interventions, and further research with a larger sample and a single pain rating scale.
Subject(s)
Attitude to Health , Child, Hospitalized/psychology , Nursing Assessment/methods , Orthopedic Procedures/adverse effects , Pain Measurement/nursing , Pain, Postoperative/nursing , Pain, Postoperative/psychology , Adolescent , Arousal , Child , Child, Preschool , Female , Humans , Male , Nursing Evaluation Research , Orthopedic Nursing/methods , Pain, Postoperative/drug therapy , Pain, Postoperative/etiology , Pediatric Nursing/methodsABSTRACT
The purpose of this study was to examine the effects of the presence of a companion animal on physiological arousal and behavioral distress exhibited by preschool children during a routine physical examination. A within-subject, time-series design was used to study 23 healthy children ages 3 years to 6 years during two physical examinations, with and without a dog. Statistically significant differences were found with greater reductions in subjects' systolic and mean arterial pressure, heart rate, and behavioral distress when the dog was present. Findings support the use of a companion animal in reducing stress experienced by children during a physical examination.
Subject(s)
Animals, Domestic , Physical Examination/psychology , Stress, Psychological/prevention & control , Analysis of Variance , Animals , Blood Pressure , Child , Child, Preschool , Dogs , Female , Heart Rate , Humans , Male , Nebraska , Skin Temperature , Stress, Psychological/physiopathology , Stress, Psychological/psychologyABSTRACT
This study employed a Posttest-Only Control Group Design to assess the effects of a victimization prevention program, Project TRUST, on elementary school students' knowledge of general prevention concepts, knowledge of difficult-to-acquire prevention concepts, anxiety, and reporting of abuse. A selected subgroup of experimental subjects was also assessed for retention of acquired concepts over time. Students exposed to Project TRUST demonstrated significantly greater knowledge of maltreatment prevention information, as well as difficult-to-acquire concepts, than control group students. A 3-month delayed reassessment of the experimental subgroup showed no loss in acquired prevention information. No differences in anxiety scores existed between experimental and control groups. First-time student abuse disclosures were greater in the experimental than in the control group. These findings support the effectiveness of Project TRUST as a strategy to increase prevention knowledge and generate abuse disclosures without creating student anxiety.
Subject(s)
Child Abuse/prevention & control , Crime Victims/education , Health Education/methods , Health Knowledge, Attitudes, Practice , Analysis of Variance , Anxiety/etiology , Child , Crime Victims/psychology , Drama , Female , Follow-Up Studies , Humans , Male , Sampling Studies , Self DisclosureABSTRACT
A Delphi survey was conducted to investigate the frequency and importance of conflicts identified by quality assurance/improvement professionals as well as the actions taken and resources used to deal with the conflicts. Responses to three rounds of the Delphi survey from 86 participants indicated that the predominant conflicts involved intrapersonal concerns, such as worry about the future, interpersonal and political barriers to change in quality work, and, rarely, ethical conflicts. A variety of collaborative and educational strategies were used to deal with conflicts. Results may be useful to examine from the perspective of health care professionals currently involved in quality work.
Subject(s)
Conflict, Psychological , Delphi Technique , Interprofessional Relations , Nursing Staff, Hospital , Total Quality Management , Adaptation, Psychological , Humans , Nursing Administration Research , Organizational Innovation , United StatesABSTRACT
Central to nursing practice today is the theme of caring. Yet nursing faculty are themselves experiencing a lack of caring. Faculty frequently voice the complaint that no one in the school of nursing work environment cares about them as they struggle to balance the demands of work with the demands of a personal life. A descriptive phenomenological approach was used to facilitate understanding of the caring experiences of nurses who teach. The question guiding this study was, "How do nurse educators experience caring in their work situations?" Nomination and purposive sampling techniques were used to select seven nurse faculty as participants. Unstructured interviews, lasting approximately one hour, were audiotaped and transcribed. Colaizzi's (1978) methodology was used to analyze the resulting data. Resulting themes included: 1) Caring is Connection and 2) Caring is a Pattern of Establishing and Maintaining Relationships. The use of narrative, journaling, and dialogue are suggested as techniques that will help nurse educators experience caring in schools of nursing.
