Introduction. Previous work has shown that parents prefer to be presen
t when their children undergo common invasive procedures, although phy
sicians are ambivalent about parental presence. Purpose. To determine
the effect of a parent-focused intervention on the pain and performanc
e of the procedure, anxiety of parents and clinicians, and parental sa
tisfaction with care. Population. Children younger than 3 years old un
dergoing venipuncture, intravenous cannulation, or uretheral catheteri
zation. Setting. Pediatric emergency department of Boston City Hospita
l. Design. Randomized controlled trial with three groups; parents pres
ent and given instructions on how to help their children; parents pres
ent, but no instructions given; and parents not present. Intervention.
The parents were instructed to touch, talk to, and maintain eye conta
ct during the procedure. Results. A total of 431 parents was randomize
d to the intervention (N=153), present (N=147), and not present (N=131
) groups. The groups were equivalent with respect to measured sociodem
ographic variables and parents' previous experience in the pediatric e
mergency department. No differences emerged with respect to pain Q-poi
nt scale measured by parent and clinician, and analysis of cry); perfo
rmance of the procedure (number of attempts, completion of procedure b
y first clinician, time); clinician anxiety; or parental satisfaction
with care. Parents who were present were more likely to rate the pain
of the children as extreme/severe (52%) in comparison to clinicians (1
5%, kappa.07, poor agreement) and were significantly less anxious than
parents who were not present.