PARENTS AND PROCEDURES - A RANDOMIZED CONTROLLED TRIAL

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.