Potentially Stressful Care Interactions in Hospitalized Children: Incidence and Associated Factors During a 6‐h Observation Period
Danton Matheus de Souza, Larissa Soares Butrico, Caroline Knoner Monteiro, Gabriela Silveira Valério, Lisabelle Mariano RossatoABSTRACT
Aim
To determine the incidence of potentially stressful care interactions and their associated factors in hospitalized children observed over a 6‐h period.
Design
Observational, longitudinal, and prospective study.
Methods
The study was conducted in a paediatric inpatient unit at a teaching hospital in São Paulo, Brazil, with 75 hospitalized children aged between 28 days and under 10 years. The children were observed for 6 h during morning and afternoon periods to record the number of potentially stressful care interactions. Descriptive and inferential analyses were performed.
Results
Eight hundred and fifty‐nine potentially stressful care interactions were recorded, corresponding to a mean of 11 per child. Physical examinations were the most frequent procedure ( n = 363; mean = 4.8), followed by vital signs measurements ( n = 182; mean = 2.4) and nasal lavage ( n = 119; mean = 1.6). The factors associated with a higher number of manipulations were younger children ( p < 0.001), with emphasis on infants (mean = 16.7); those observed during the morning shift (mean = 12.3) ( p = 0.04); and those with an underlying chronic condition (mean = 13.9) ( p = 0.036).
Conclusion
Over a short observation period of hospitalized children, a high number of potentially stressful care interactions were observed, demonstrating the need to reflect on current care routines and identify opportunities for change.
Implications for the Profession and/or Patient Care
This study has practical implications for healthcare professionals—particularly nursing staff—who routinely perform potentially stressful care interactions. These professionals must consider strategies to minimize frequent manipulations and/or reframe them through appropriate preparation of the child and family.
Reporting Method
STrengthening the Reporting of OBservational studies in Epidemiology.