Medical procedures are a common part of life and elicit a great deal of anxiety among people of all ages. Anxiety is defined as a “diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness” (Townsend, 2009, p. 15). Children experience high levels of procedural anxiety because they do not understand what to expect and they fear the pain they may experience. I was therefore interested in researching whether the presence of parents during painful procedures decreases anxiety in pediatric patients. My desire to someday work with the pediatric population has intrigued me to further understand the importance of this issue to best meet the needs of the patient and family. The topics to be discussed include the benefits of having parents present during painful procedures, the disadvantages of having parents present, and doctors and nurses attitudes regarding the presence of parents.
Parental presence is an issue that has been debated upon for a long time. An important statistic to consider is that currently only 40% of US hospitals have a policy that supports family presence (Chorney & Kain, 2010). Not every situation allows a parent to be present, but research has found that parents prefer to be present during their child’s procedure. “Boie et al. (1999) carried out a survey in the US and found that 97.5 percent of 400 parents surveyed wished to be present with their child during venipuncture” (as cited in Gilboy & Hollywood, 2009). Procedures that children may undergo include venipuncture, dental procedures, and minor outpatient procedures. According to Townsend (2009), signs of anxiety in children include crying, shaking, quietness, and acting scared or frightened (p. 17). Doctors, n...
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la Haye, K., Green, H. D., Kennedy, D. P., Zhou, A., Golinelli, D., Wenzel, S. L., & Tucker, J. S.
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More often than not positive patient outcomes come from these procedures, but not without challenges along the road to recovery. Recently I had a patient that underwent a bowel resection with establishment of an end colostomy for the treatment of her diverticulitis. Fortunate, the procedure went without complications from a surgeon’s point of view, but sadly this was not the case for the patient. Caring for this patient postoperatively presented great opportunity for me to practice presence. The pain and suffering my patient was experiencing had nothing to do with the mechanical aspect of her surgery, but rather the emotional craters created by discovering her colostomy bag. For the patient, a colostomy was the absolute worst case scenario. New colostomies require frequent attention from nurses; checking for viable tissue, emptying output, and watching for signs of infection. Each time I assessed the ostomy humiliation and shame consumed her spirit and body. After the second flood of these emotions, I stopped dead in my tracks, pulled up a chair and asked the patient “how are you feeling”. A constant stream of tears ran down her face as she expresses to me the fear she has in telling her significant other that she will forever have “a bad of feces” on the outside of her abdomen. My heart cried for her! I couldn’t imagine how she must feel. As a woman, she previously viewed her body as a sacred part of her that she was able to share with her partner, but she no longer felt beautiful and sexy, but rather a disgrace. Her painful emotions struck my heart like a bolt of lightning, how was I supposed to help her see the beauty of this colostomy? In the end, it was my time and patience coupled with positive affirmations that relieved her fears of the unknown. I had every opportunity to place ignorance at the frontline of my care and ignore the obvious
American Academy of Pediactrics. (2003). Family-Centered Care and the Pediatrician’s Role. Available: http://pediatrics.aappublications.org/content/112/3/691.full. Last accessed 23/01/14.
I believe this can only benefit the hospital and patient care, and have a new way that the patient is cared for. Treating the whole family, instead of just the patient is what the future is all about. Implementation of this type of care requires creating a partnership between the patient, physicians, nurses, and patient’s families. This can only improve performance improvement, and treat the patient the way we would want to be treated. My goal is to decrease the patients and families anxiety throughout their hospital experience, and keep the whole family informed of the patients treatment plan.
The whole perspective of a child being in intensive care is hard, and especially for parents who do not know how to handle the situation of having their newborn baby in intensive care. There are many challenges that parents face; facing emotional problems is the biggest challenge. Not knowing how to handle the whole situation of seeing their new born child in a situation like intensive care is pretty hard. It is pretty intimidating and not being to take care and be able to hold their baby all day like they would want to, is also hard. Parents face high levels of distress, anxiety, depression, and trauma symptoms. Mothers have a harder time dealing with their emotions. They carried their baby inside them for several months, have felt the kicks and the movements, and they often feel like a failure feeling guilt and shame. A mother wants the best for their baby and they often think that their baby will have complications with growth and development, and often blaming themselves for giving birth to an unhealthy baby wondering what they could have done differently. Because of the parents stress and anxiety of not knowing what will happen, there is an inability to preform a normal parenting role. Perhaps the best way for parents to be able to relax and be more helpful to their babies is to move on from the situation and only look forward the health of the child. Parents also loose one of the best memories they wish they could keep fo...
Primary caregivers are given an opportunity to take care of their loved ones; however, this job comes with a lot of stress and its consequences (Tsai, 2003). Primary caregivers take care of those with a chronic illness such as a family member or friend, are given a task that is so immense that it induces a lot of stress. In the previous decades, many research articles have developed studies which focused on stressors that were associated with the task of being the primary caregiver; yet, a theory surrounding this topic has not been developed until the early 2000s. Tsai (2003) developed the Theory of Caregiver Stress based on the Roy Adaptation Model to identify the caregiver’s response, perceptions, and adaptations to the stress and burden that primary caregiver’s experience.
During my community placement of the cataract clinic at St. Joseph’s Hospital, one patient I observed looked extremely anxious and when I took a further look and watched her behaviour more closely, I recognized the concepts of stress and vulnerability were playing a key role in how she perceived the upcoming operation. I seized an opportunity to quietly speak with her and she explained that she had not received an adequate amount of rest the night before and the travel down had been exhausting. She also expressed concerns of being fearful about going into the operating room. I overheard a nurse earlier ask the group as a whole if anyone wanted an ativan to ease anxiety and the group consensus was no. I felt that because it was unanimous, she may have been embarrassed if it was only her that requested it. My concern for this patient was for her to remain comfortable and provide any healing initiatives that would reassure her that she was safe. I took it upon myself to advocate for her and asked if she would like an ativan, explaining it would provide a calming effect. She agreed and I asked one of the nurses if I could a...
McCart, M. R., Smith, D. W., Saunders, B. E., Kilpatrick, D. G., Resnick, H., & Ruggiero, K. J.
Stuart, G. L., Moore, T. M., Elkins, S. R., O’Farrell, T. J., Temple, J. R., Ramsey, S. E.,
This is achieved through the close relationship of the family members the pediatric patient. Safety is increased because the family members are treated as part of the health care team and not simply visitors (Moore, Coker, DuBuisson, Swett, & Edwards, 2003). Furthermore, the patients are able to communicate with personnel about what they see happening to their child as well as making decisions regarding what treatments they want their infant to receive (Moore et al., 2003). The input from the patient 's family is very important in ensuring patient safety because the family members know the patient much better than medical staff (IWK Health Centre, 2016). This allows family members to more acutely notice changes in the pediatric patients status which allows them to quickly notify health care professionals. This could prove very beneficial when providing care for a pediatric patient in intensive
The Theory of Caregiver Stress was a significant breakthrough for the reasoning of why caregivers are so deeply affected by this job. “The Theory of Caregiver Stress was derived from the Roy Adaptation Model to use as basis in understanding the relationships among caregivers and the stress faced when caring for a chronically ill relative” (Tsai, 2003). The Theory of Caregiver stress is a middle-range theory used to predict the outcome for stress and other various side effects (Dobratz, 2011). These adverse effects are predicted by: Demographic Characteristics, Burden in Caregiving, Stressful life events, Social Support and Social Roles. Also, because of the multitude of different scenarios and background for both the patient and the caregiver, these categories are necessary to compare and effectively use the results. The theory makes four main assumptions regarding adaption: “environmental change; the caregivers’ perceptions will determine how they will respond to the environmental stimuli; the caregivers’ adaptation is a function of their environmental stimuli and adaptation level, and lastly the caregivers’ effectors are results of chronic caregiving such examples include marital satisfaction and self-...
A social psychology based study found that children can suffer from dental anxiety because their parents are nervous or anxious. About 50% of mothers were found to be more likely to be anxious when it came to their children receiving dental care (Fazli & Kavandi, 2015). While fathers were more likely to suffer from anxiety less than 25% of the time (Fazli & Kavandi, 2015). Mothers were also more likely to accompany children to their appointments, which means the more anxious parent was almost always the one brining the child to the dentist. The research team concluded that the best course of action would be to involve fathers more and to better educate parent across the board. This study is valuable to dental professionals due to the fact that it can used to improve the dental experience for both patients and professionals. Having fathers
My first concept is the importance of play. I learned from the readings in section 8 that medical play and preparation are both used to inform children about upcoming events. These strategies also are assumed to adjust anxiety to a level that children can learn, adapt, and master their experience. Medical play may also be used after the events and serve a greater purpose. Introducing medical play before a procedure can help children relax as well as the parents. Piaget’s theory talks about the importance of