Document Type : Original Article

Authors

1 Instructor, Department of Nursing, Faculty of Medical Sciences, Islamic Azad University, Saveh Branch, Saveh, Iran

2 Assistant Professor, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Peripheral intravenous catheterization is one of the most painful procedures in children settings. Based on evidence, most of children do not benefit from pharmacological and non- pharmacological methods of pain management for this procedure and family members consider this experience as one of the most distressing ones in the hospital. This study aimed to explore the experience of mothers who had experienced difficult vascular catheterization of their children.
Methods: This qualitative study using content analysis was carried out in different wards of a pediatrics referral center in Tehran, Iran (Markaz-e-Tebbi-Koodakan) in 2017. Purposeful sampling method was used to select 18 mothers who had suffered from their children's vascular catheterization. Deep semi structured interviews were used as the method of data gathering and qualitative content analysis was used for data analysis.
Results: The main category was "unperceived frustration" which includes three subcategories, "role of nurse", "inability to support" and "coping ability".
Conclusions: The present study increases our understanding of mothers' experiences of peripheral venous catheterization of their children. Despite being a routine experience for nurses, this experience appears to be very hard for mothers.

Keywords

1.       Moadad N, Kozman K, Shahine R, Ohanian S, Badr LK. Distraction using the BUZZY for children during an IV insertion. J J Pediatr Nurs 2016;31(1):64-72.
2.       Blaivas M, Lyon M. The effect of ultrasound guidance on the perceived difficulty of emergency nurse-obtained peripheral IV access. J Emerg Med 2006;31(4):407-10.
3.       Pagnutti L, Bin A, Donato R, Di Lena G, Fabbro C, Fornasiero L, et al. Difficult intravenous access tool in patients receiving peripheral chemotherapy: A pilot-validation study. Eur J Oncol Nurs 2016;20:58-63.
4.       Malyon L, Ullman AJ, Phillips N, Young J, Kleidon T, Murfield J, et al. Peripheral intravenous catheter duration and failure in paediatric acute care: a prospective cohort study. Emerg Med Australas. 2014;26(6):602-8.
5.       Leidel BA, Kirchhoff C, Bogner V, Stegmaier J, Mutschler W, Kanz K-G, et al. Is the intraosseous access route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department? A prospective observational pilot study. Patient Saf Surg 2009;3(1):1.
6.       Duff A. Incorporating psychological approaches into routine paediatric venepuncture. Arch Dis Child 2003;88(10):931-7.
7.       Crowley M, Brim C, Proehl J, Barnason S, Leviner S, Lindauer C, et al. Clinical Practice Guideline: Difficult Intravenous Access. Emergency Nurses Association 2011;pp1-17.
8.       Haile D, Suominen P. Technologies in pediatric vascular access: have we improved success rate in peripheral vein cannulation? Acta Anaesthesiol Scand. 2017;61 (7): 710-13.
9.       Haas NA. Clinical review: vascular access for fluid infusion in children. Crit care. 2004;8(6):478-84.
10.     Piira T, Sugiura T, Champion G, Donnelly N, Cole A. The role of parental presence in the context of children's medical procedures: a systematic review. Child Care Health Dev. 2005;31(2):233-43.
11.     McMurtry CM, McGrath PJ, Chambers CT. Reassurance can hurt: Parental behavior and painful medical procedures. J pediatr. 2006;148(4):560-1.
12.     Liossi C, White P, Franck L, Hatira P. Parental pain expectancy as a mediator between child expected and experienced procedure-related pain intensity during painful medical procedures. Clin J Pain. 2007;23(5):392-9.
13.     Pruitt LM, Johnson A, Elliott JC, Polley K. Parental presence during pediatric invasive procedures. J Pediatr Health Care. 2008;22(2):120-7.
14.     Kennedy RM, Luhmann J, Zempsky WT. Clinical implications of unmanaged needle-insertion pain and distress in children. Pediatrics. 2008;122(Supplement 3):S130-S3.
15.     McMurtry CM, McGrath PJ, Asp E, Chambers CT. Parental reassurance and pediatric procedural pain: A linguistic description. J Pain. 2007;8(2):95-101.
16.     Amouzeshi Z, Unesi Z, Saadatjoo SA. Mothers' Knowledge of pediatric pain management in the pediatric ward of Valli-e-asr hospital in 2011. J Birjand Univ Med Sci. 2013;19(4):448-54 [In Persian].
17.     Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15.
18.     Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24(2):105-12.
19.     Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative: Lippincott Williams & Wilkins; 2011.
20.     Wolfram RW, Turner ED. Effects of parental presence during children's venipuncture. Acad Emerg Med 1996;3(1):58-64.
21.     Cummings JA. Pediatric procedural pain: how far have we come? An ethnographic account. Pain Manag Nurs 2015;16(3):233-41.
22.     Nikfarid L, GHAMAR YR, Namazian M, Namdar F, AZAM NM. Comparison of EMLA cream versus local refrigeration for reducing venipuncture-related pain in pediatric patients of Children’s Medical Center, 2008. Iranian Journal of Nursing Research 2010; ; 5(16): 32 -7 [In Persian].
23.     Razaghi N, Givari A, Tatarpoor P, Hoseini A. Comparing the effect of two methods of distraction and touch on intensity of pain related to venipuncture in 5-10 years old children. Iran Journal of Nursing. 2012;25(77):50-9 [In Persian]..
24.     Olsen K, Weinberg E. Pain-Less Practice: Techniques to Reduce Procedural Pain and Anxiety in Pediatric Acute Care. Clin Pediatr Emerg Med. 2017;18(1):32-41.
25.     Borhani F, Bagherian S, Abaszadeh A, Ranjbar H, Tehrani H, Soleimanizadeh L. Correlation between anxiety and pain due to intravenous catheters in children with thalassemia. Sci J Iran Blood Transfus Organ 2012;9(2): 170-4.
26.     McMurtry CM. Pediatric needle procedures: Parent–child interactions, child fear, and evidence-based treatment. Canadian Psychology/Psychologie canadienne. 2013;54(1):75-9.
27.     Rauch D, Dowd D, Eldridge D, Mace S, Schears G, Yen K. Peripheral difficult venous access in children. Clin Pediatr (Phila) 2009;48(9):895-901.
28.     Curtis SJ, Craig WR, Logue E, Vandermeer B, Hanson A, Klassen T. Ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children: a pragmatic randomized controlled trial. CMAJ 2015;187(8):563-70.
29.     Cohen LL, Bernard RS, Greco LA, McClellan CB. A child-focused intervention for coping with procedural pain: Are parent and nurse coaches necessary? J Pediatr Psychol 2002;27(8):749-57.
30.     Spagrud LJ, von Baeyer CL, Ali K, Mpofu C, Fennell LP, Friesen K, et al. Pain, distress, and adult-child interaction during venipuncture in pediatric oncology: an examination of three types of venous access. J pain symp manag 2008;36(2):173-84.
31.Mohebbi P, Azimzadeh R. Barrier of implementing non-pharmacological pain management in children and presented intereventions by nurses. J Holist Nurs Midwifery 2014;24(2):40-8 [In Persian].
32.     Karimi R, Daneshvar Z, Sadat Hoseini A, Mehran A, Shiri M. Perceptions of parents and nurses on needs of hospitalized children's parents. Journal of hayat. 2008;14(1):31-9 [In Persian].
33.     Aein F, Alhani F, Mohammadi E, Kazemnejad A. Marginating the interpersonal relationship: Nurses and parent's experiences of communication in pediatric wards. Iranian Journal of Nursing Research. 2008;3(9):71-83 [In Persian].
34.     Gonzalez JC, Routh DK, Armstrong FD. Effects of maternal distraction versus reassurance on children's reactions to injections. J Pediatr Psychol 1993;18(5):593-604.
35.     Kristjánsdóttir Ó, Unruh AM, McAlpine L, McGrath PJ. A systematic review of cross-cultural comparison studies of child, parent, and health professional outcomes associated with pediatric medical procedures. J Pain. 2012;13(3):207-19.
36.     Bagheriyan S, Borhani F, Abbaszadeh A, Miri S, Mohsenpour M, Zafarnia N. Analgesic Effect of Regular Breathing Exercises with the Aim of Distraction during Venipuncture in School-aged Thalassemic Children. Iran J Ped Hematol Oncol 2012; 2(3):116-22.
37.     Loghmani L, Borhani F, Abbaszadeh A. Factors affecting the nurse-patients’ family communication in intensive care unit of kerman: a qualitative study. J Caring Sci 2014;3(1):67-82.