Exploring Holistic Comfort in Children who Experience a Clinical Venipuncture Procedure
Repository Posting Date2015-09-03T19:14:56Z
Author(s)Bice, April Athena
Author DetailsApril Athena Bice CPNP, PhD, 865-292-1430, firstname.lastname@example.org
Lead Author Sigma AffliationGamma Chi
Level of EvidenceQualitative Study, Other
Research ApproachQualitative Research
CINAHL HeadingsVenipuncture--In Infancy and Childhood; Comfort
MeSH HeadingsHolistic Nursing
Introduction: Children often experience the uncomfortable effects of invasive procedures as a part of primary health supervision and during times of illness. Inadequate procedural comfort management can lead to numerous lasting harmful effects including distrust of healthcare providers, future intensified pain responses, negative cognitive and emotional experiences, and psychosocial health problems (Czarnecki et al. 2011). 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.
Objective: The purpose of this study was to explore perspectives of children age 4 to 7 years and their caregivers regarding procedural holistic comfort. A qualitative descriptive design described by Sandelowski (2000; 2010) was used with the philosophical underpinnings of naturalistic inquiry (Guba & Lincoln, 1982).
Methods: Purposive and convenience sampling was completed with a flyer handout to recruit participants from an outpatient hospital laboratory. The sample included 13 child participants and 15 caregiver participants who were interviewed using a semi-structured format. Children were additionally asked to complete and discuss a drawing task. This facilitated age and developmentally appropriate data collection and increased richness of data. Traditional thematic content analysis described by Hsieh and Shannon (2005) was implemented to interpret themes.
Results: Four overarching themes of holistic comfort related to venipuncture procedures in children emerged: Body Comfort, Cognitive and Emotional Comfort, Comfort in the Procedure Surroundings, and Comfort Play. Children perceived venipuncture procedures as an experience that produced anger, anxiety, distress, fear, opposition, pain, and sadness. Caregivers described seeing anticipation, anxiety, distress, embarrassment, fear, opposition, pain, and building resilience.
Conclusion: Literature on procedural holistic comfort in children was missing. With the findings from this study and future outcomes research, there is potential for enhancement of overall procedural holistic comfort in children. Future research should focus on: the development of a valid and reliable procedural holistic comfort measurement tool, further exploratory and empirical studies, and investigating different populations such as children of various age groups, children with special health needs, disparate groups, and children of different ethnic or cultural backgrounds. Implications include relevance and recommendations in the areas of nursing and related health sciences, organizational and administrative policy, invasive procedures, theory, and study methods.