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行动中的分散注意力工具©:临床环境中的可行性和可用性

The Distraction in Action Tool©: Feasibility and Usability in Clinical Settings.

作者信息

Hanrahan Kirsten, Kleiber Charmaine, Miller Ben J, Davis Heather, McCarthy Ann Marie

机构信息

Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.

Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, United States.

出版信息

J Pediatr Nurs. 2018 Jul-Aug;41:16-21. doi: 10.1016/j.pedn.2017.11.002. Epub 2017 Nov 10.

Abstract

PURPOSE

Distraction is a relatively simple, evidence-based intervention to minimize child distress during medical procedures. Timely on-site interventions that instruct parents on distraction coaching are needed. The purpose of this study was to test the feasibility and usability of the Distraction in Action Tool© (DAT©), which 1) predicts child risk for distress with a needle stick and 2) provides individualized instructions for parents on how to be a distraction coach for their child in clinical settings.

DESIGN AND METHODS

A mixed-methods descriptive design was used to test feasibility and usability of DAT in the Emergency Department and a Phlebotomy Lab at a large Midwest Academic Medical Center. Twenty parents of children ages 4-10years requiring venipuncture and clinicians performing 13 of those procedures participated. Participants completed an evaluation and participated in a brief interview.

RESULTS

The average age of the children was 6.8years, and 80% of parent participants were mothers. Most parents reported the DAT was not difficult to use (84.2%), understandable (100%), and they had a positive experience (89.5%). Clinicians thought DAT was helpful (100%) and did not cause a meaningful delay in workflow (92%).

CONCLUSION

DAT can be used by parents and clinicians to assess their children's risk for procedure related distress and learn distraction techniques to help their children during needle stick procedures.

PRACTICE IMPLICATIONS

DAT for parents is being disseminated via social media and an open-access website. Further research is needed to disseminate and implement DAT in community healthcare settings.

摘要

目的

分散注意力是一种相对简单且基于证据的干预措施,可最大程度减少医疗程序中儿童的痛苦。需要及时进行现场干预,指导家长进行分散注意力训练。本研究的目的是测试“行动中的分散注意力工具©”(DAT©)的可行性和可用性,该工具1)预测儿童在针刺时的痛苦风险,2)为家长提供个性化指导,告知他们如何在临床环境中成为孩子的分散注意力训练指导者。

设计与方法

采用混合方法描述性设计,在中西部一家大型学术医疗中心的急诊科和静脉采血实验室测试DAT的可行性和可用性。20名年龄在4至10岁、需要静脉穿刺的儿童的家长以及执行其中13例该操作的临床医生参与了研究。参与者完成了一项评估并参加了简短访谈。

结果

儿童的平均年龄为6.8岁,80%的家长参与者为母亲。大多数家长表示DAT不难使用(84.2%)、易于理解(100%),且他们有积极的体验(89.5%)。临床医生认为DAT有帮助(100%),且不会导致工作流程出现明显延迟(92%)。

结论

家长和临床医生可以使用DAT来评估孩子在医疗程序相关痛苦方面的风险,并学习分散注意力技巧以在针刺操作过程中帮助孩子。

实践意义

面向家长的DAT正在通过社交媒体和一个开放获取的网站进行传播。需要进一步研究以在社区医疗环境中传播和实施DAT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4536/6349520/dd041adf44ec/nihms-1002846-f0001.jpg

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