ABSTRACT
INTRODUCTION: Holistic comfort is an essential component of pediatric procedural care. However, a main gap in the literature is the ability to measure this. In this study, researchers report the feasibility of implementing a newly developed psychosocial measurement instrument in clinical practice. METHOD: This mixed methods study was guided by Kolcaba's holistic comfort theory. Descriptive and inferential statistics and a qualitative descriptive approach to cognitive interviewing were used. Children aged 4 to 8 years (nâ¯=â¯16) experiencing a nonurgent needle procedure and registered nurses (nâ¯=â¯14) who administered the instrument were recruited. RESULTS: Eight qualitative themes of feasibility and comprehensibility were identified. Perspectives of children and nurses were not significantly associated with any demographic variable. The Pediatric Procedural Holistic Comfort Assessment is a feasible instrument to implement but will benefit from minor revisions. DISCUSSION: This study has implications for nursing practice, research methodology, and future research. The Pediatric Procedural Holistic Comfort Assessment can be successfully implemented by nurses in health care settings.
Subject(s)
Holistic Nursing , Patient Comfort , Child , Child, Preschool , Feasibility Studies , Female , Humans , Injections/adverse effects , Injections/methods , Male , Pain, Procedural/nursing , Pain, Procedural/prevention & control , Patient Comfort/methodsABSTRACT
PURPOSE: Children often experience the uncomfortable effects of invasive procedures as a part of primary care and during times of illness. Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child's perspective. In this study, holistic comfort related to an invasive venipuncture procedure was explored in children age 5 to 7 years and their caregivers of all ages. DESIGN: A qualitative descriptive design described by Sandelowski was used. METHOD: The philosophical underpinnings of naturalistic inquiry of Guba and Lincoln were used. Semistructured interviews were conducted with 13 child and 15 caregiver participants. Children also drew pictures to help describe their perceptions. FINDINGS: Traditional thematic content analysis described by Hsieh and Shannon yielded four overarching themes of holistic comfort related to venipuncture procedures in children: Body Comfort, Cognitive and Emotional Comfort, Comfort in the Procedure Surroundings, and Comfort Play. CONCLUSIONS: Numerous recommendations for future research are included. Implications for nursing and related health sciences, organizational and administrative policy, invasive procedures, theory, and methods were found and are discussed. Findings from this study will assist nurses in providing procedure management for children from a holistic care perspective.
Subject(s)
Patient Comfort/standards , Pediatrics/methods , Phlebotomy/adverse effects , Caregivers/psychology , Child , Child, Preschool , Female , Holistic Health/standards , Humans , Interviews as Topic/methods , Male , Patient Comfort/methods , Pediatrics/standards , Phlebotomy/methods , Phlebotomy/standards , Qualitative Research , Surveys and QuestionnairesABSTRACT
Comfort interventions for children during invasive nursing procedures have been well documented in the literature. It is important, however, to distinguish between the provision of holistic comfort management and pain alleviation. Holistic comfort focuses on treating the child's whole procedural experience and includes more than simply reducing pain. In this literature review, 33 intervention studies were examined. These studies focused on evaluating comfort effects from nursing interventions on pain, anxiety, fear, and distress. Four themes of procedural comfort intervention emerged: music therapy, amusement and entertainment, caregiver facilitation, and a multifaceted approach. Important findings of this review, gaps in the literature, and implications for future research are discussed.