Discomfort of the critically ill paediatric patient and correlated variables. Issue 6 (November 2020)

• Record Type: Journal Article
• Authors: Bosch-Alcaraz, Alejandro; Jordan, Iolanda; Benito-Aracil, Llúcia; Saz-Roy, Mª Ángeles; Falcó-Pegueroles, Anna
• Is Part Of: Australian critical care. Volume 33:Issue 6(2020)
• Page Start: 504
• Page End: 510
• Publication Date: 2020-11
• Subjects: Patient comfort -- Paediatric nursing -- Intensive care units -- Infant welfare -- Discomfort factors; Intensive care nursing -- Periodicals; Intensive care nursing -- Australia -- Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.aucc.2020.02.009
• Languages: English
• ISSNs: 1036-7314

Abstract

Abstract: Introduction: The care of critically ill children is usually invasive and aggressive, requiring numerous traumatic procedures that may cause fear, pain, and discomfort. Objectives: The aim of this study was to analyse the level of discomfort of patients admitted to the paediatric intensive care unit of a specialist children's hospital and to determine the sociodemographic and clinical variables that influence the degree of discomfort experienced by critically ill paediatric patients. Methods: We performed a descriptive observational cross-sectional study that included a total of 311 children with a median age of 5.07 y (interquartile range = 0.9–11.7). A team of 10 paediatric critical care nurses assessed the degree of discomfort once for each shift (morning, afternoon, and night) on 2 successive days using the COMFORT Behavior Scale—Spanish version. Results: In total, 49.8% (n = 155) of the patients were free of discomfort (score ≤10 points) vs. 50.2% (n = 156) who experienced discomfort. There was a significant negative correlation between discomfort and the length of stay in days (Rho = 0.16; p = 0.02), that is, the longer the stay, the less discomfort the patient felt. The correlation between age and degree of discomfort was found to be both positive and significant (Rho = 0.230, p < 0.001); the greater the age, the greater the discomfort. In comparison of all children who received analgosedation (n = 205), with discomfort levels of 10.77 ± 2.94, with those who did not receive analgosedation (n = 106), with discomfort levels of 11.96 ± 2.80, we did find a statistically significant difference (χ 2 = −4.05; p < 0.001). Conclusions: Half of the patients admitted to the paediatric intensive care unit experienced discomfort. Age and analgosedation were the two most important variables involved with a high degree of discomfort. Clinical care practices must consider these factors and try to plan activities designed to relieve discomfort in all critically ill paediatric patients.