Clinical Holding in Pediatric Venipuncture: Caring by Empowering the Caregiver.

Manuel Tomás-Jiménez,Ramon Mir-Abellán,Elena Fernández Díaz,María Jesús Flores Sánchez,Andrea Navarro Pliego

doi:10.3390/ijerph18147403

Manuel Tomás-Jiménez, Ramon Mir-Abellán + Show 3 more

Open Access

https://doi.org/10.3390/ijerph18147403

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Abstract

The use of restraint in the child-adolescent population is highly controversial due to the consequences it can have for patients and their families, although it is sometimes necessary to employ restraint to perform techniques safely and effectively. Clinical Holding is committed to the involvement of parents during venipuncture in the context of family-centred care. This study assesses levels of distress and pain in children undergoing this procedure, as well as satisfaction in parents and nurses. Parents assist in the restraint of children and provide accompaniment during venipuncture. Levels of distress and pain were not particularly elevated. Satisfaction levels among parents and nurses were high. A positive correlation was found between anticipatory and real distress (r = 0.737, p = 0.000), and between real distress and real pain (r = 0.368, p = 0.035). A negative correlation was observed between real pain and parent satisfaction (r = −0.497, p = 0.003). Parental participation during venipuncture contributed to better management of distress and pain. In the future, it would be advisable to incorporate the other pharmacological and non-pharmacological measures recommended by Clinical Holding to ensure care of the highest quality and safety.

Highlights

The use of restraint in children can lead to a series of physical consequences such as pain, a variety of injuries, or even speech disorders [1] and psychological repercussions that can range from emotional distress to ineffective coping skills and phobias that can complicate relationships with healthcare professionals [2]
The aims of this study were, first, to assess distress and pain in children and adolescents undergoing venipuncture and, second, to determine the degree of satisfaction of parents and nurses involved in the process
Real distress was higher in males (M: 1.94 SD: 0.938) than in females (M: 1.87 SD: 0.990)

Summary

Introduction

The use of restraint in children can lead to a series of physical consequences such as pain, a variety of injuries, or even speech disorders [1] and psychological repercussions that can range from emotional distress to ineffective coping skills and phobias that can complicate relationships with healthcare professionals [2]. Restraint of children should be considered a measure of last resort in the healthcare setting when other verbal and non-verbal techniques have failed, and with the aim of avoiding harm to the child, other patients or professionals. This represents a particular challenge in the area of physical health as many techniques require a certain level of restraint for them to be applied swiftly, effectively and without harming the patient. If such action is necessary, the period of application and the degree of force applied should be kept to a minimum [6,7]

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