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Children's Anxiety, Pain, and Distress Related to the Perception of Care While Undergoing an Acute Radiographic Examination
Jönköping University, School of Health and Welfare, HHJ. CHILD.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
2014 (English)In: Journal of Radiology Nursing, ISSN 1546-0843, Vol. 33, no 2, 69-78 p.Article in journal (Refereed) Published
Abstract [en]

Visiting the hospital is likely a frightening experience for a child, and going through a radiographic examination has been reported as both distressing and painful. More knowledge from the children's perspective is needed on this subject, however, and thus, the aim of this study was to investigate children's anxiety, pain, and distress in conjunction with an acute radiographic procedure and whether these factors can be related to the perception of care. A mixed method design was used to analyze data from 110 participants between 5 and 15 years of age, who were examined in a Swedish radiology department. The quantitative findings showed anxiety, pain, and distress to be a concern during a radiographic examination. Significant correlations were obtained between anxiety and pain as well as between anxiety and distress. In addition, also the qualitative findings showed pain and the waiting time to be concerns. Regardless of the quantitative findings, however, children of all ages were satisfied with the care performed in the periradiographic process, perceiving the examination as supportive and geared to their needs. Robust assessment of anxiety, pain, and distress is imperative when interacting with children in acute examination situations to avoid both negative short-term and long-term consequences.

Place, publisher, year, edition, pages
2014. Vol. 33, no 2, 69-78 p.
Keyword [en]
Radiographic examination, Children, Anxiety, Pain, Distress, Care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-23730DOI: 10.1016/j.jradnu.2013.12.003Scopus ID: 2-s2.0-84901832249OAI: oai:DiVA.org:hj-23730DiVA: diva2:714515
Available from: 2014-04-28 Created: 2014-04-28 Last updated: 2016-10-18Bibliographically approved
In thesis
1. Children in the Radiology Department: a study of anxiety, pain, distress and verbal interaction
Open this publication in new window or tab >>Children in the Radiology Department: a study of anxiety, pain, distress and verbal interaction
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This dissertation focuses on children’s experiences of going through an acute radiographic examination due to a suspected fracture. The findings from interviews with children aged 3-15 years showed anxiety, pain and distress to be a concern in conjunction with an examination (Paper I). These initial findings entailed empirical studies being undertaken in order to further study children’s pain and distress in conjunction with an examination (Paper II) as well as children’s anxiety, pain and distress related to the perception of care in the periradiographic process (Paper III). Finally, the verbal interaction between the child and radiographer during the examination was studied (Paper IV).

The research was conducted through qualitative, quantitative and mixed method studies. The data collection methods comprised interviews (Paper I), children’s self-reports (Papers II and III), drawings (Paper III), questionnaire (Paper III) and video recordings (Papers I, II and IV). Altogether, 142 children (3-15 years) and 20 female radiographers participated in the studies.

Children aged 5-15 years were observed and they completed selfreports on pain and distress. The children were also provided with an opportunity to express their perceptions of the peri-radiographic process and to make a drawing that was analysed with regard to their level of anxiety. Finally, the verbal interaction between the child and radiographer during the examination was analysed.

Qualitative content analysis was used to analyse the interviews and the written comments in the questionnaire (Papers I and III). The Child Drawing: Hospital Manual (CD:H) was used when analysing the children’s drawings (Paper III), and the Roter Interaction Analysis System (RIAS) was used when analysing the verbal interaction derived from the video recordings (Paper IV). Non-parametric statistics were applied when analysing the quantitative data (Papers II, III and IV). The findings showed that children aged 5-15 years reported pain on the Coloured Analogue Scale (CAS) and distress on the Facial Affective Scale (FAS) above levels at which treatment or further intervention is recommended. These findings corresponded to the observed pain behaviour measured on the Face, Legs, Activity, Cry and Consolability Scale (FLACC) and anxiety expressed through drawings (CD:H). The children’s perception of the care being provided in the peri-radiographic process, was not related to the experience of anxiety, pain and distress however. The children were confident in the radiographers, who they perceived to be skilled in the task and sensitive to their needs. These findings are supported by the analysis of the verbal interaction (RIAS), which showed that the radiographer adjusted the communication when balancing the task-focused and socio-emotional interaction according to the child’s age.

The findings point to the conclusion that children going through an acute radiographic examination should be assessed regarding the anxiety, pain and distress they experience. This is a prerequisite for the radiographer to provide care according to the child’s ability and preferences when interacting with children in the peri-radiographic process.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2014. 94 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 51
Keyword
Children, radiography, experiences, anxiety, pain, distress, verbal interaction, examination
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-23732 (URN)978-91-85835-50-8 (ISBN)
Public defence
2014-06-05, Forum Humanum, HHJ, 10:00
Opponent
Supervisors
Available from: 2014-04-29 Created: 2014-04-29 Last updated: 2014-04-29Bibliographically approved

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