Neto Júlia, Fernandes Rita, Andrade Luísa, Fernandes Ilda, Martins Teresa, do Céu Barbieri-Figueiredo Maria, Carvalho Fernanda, Lima Lígia
Escola Superior de Enfermagem do Porto, RISE-Health, Porto, Portugal.
Departamento de Enfermería, Universidade de Huelva, Huelva, Spain.
Front Pediatr. 2025 May 15;13:1543138. doi: 10.3389/fped.2025.1543138. eCollection 2025.
Invasive procedures in pediatric nursing practice require a child-centered approach to minimize pain levels associated with manifestations of stress, anxiety, and long-term traumatic reactions.
This cross-sectional study aimed at identifying nurses' perception of stress, anxiety, and pain levels in children and adolescents (0-18 years) undergoing invasive procedures, and strategies used to minimize the associated distress. Based on a literature review, an online questionnaire was developed that evaluates the distress associated with frequent invasive procedures and strategies used to reduce discomfort.
Participants were 157 nurses who provided nursing care to children in all types of healthcare settings, such as hospitals and community health centers. Nurses evaluated lumbar puncture and catheter insertion as the procedures that caused more stress, anxiety, and pain in all age groups. ANOVA and analyses indicate that nurses perceived adolescents as experiencing less stress than children in all the invasive procedures. Pediatric specialist nurses perceived a significantly higher total level of distress (an index that indicates stress, anxiety or pain in the whole group of procedures) compared to nurses with other specialties or generalist nurses, in all age groups. Non-pharmacological strategies were the most frequently used strategies used by nurses for minimizing distress in children, including distraction (51.2%), preparation (30.7%), and sensory techniques (14.6%). Pharmacological strategies, such as topical anesthetics and light sedation, were less frequently used.
This study highlights the importance of specialized training and knowledge concerning strategies to reduce distress in pediatric invasive procedures, suggesting the need for more significant investment in education and support for nursing professionals to improve patient experience.
儿科护理实践中的侵入性操作需要以儿童为中心的方法，以尽量减少与压力、焦虑和长期创伤反应表现相关的疼痛程度。
这项横断面研究旨在确定护士对接受侵入性操作的儿童和青少年（0至18岁）的压力、焦虑和疼痛程度的看法，以及用于尽量减少相关痛苦的策略。基于文献综述，开发了一份在线问卷，以评估与频繁侵入性操作相关的痛苦以及用于减轻不适的策略。
参与者为157名护士，他们在各类医疗环境（如医院和社区卫生中心）为儿童提供护理。护士们评估腰椎穿刺和导管插入术是在所有年龄组中引起更多压力、焦虑和疼痛的操作。方差分析和其他分析表明，在所有侵入性操作中，护士认为青少年比儿童经历的压力更小。与其他专科护士或普通护士相比，儿科专科护士在所有年龄组中都认为痛苦的总体水平显著更高（该指标表明整个操作组中的压力、焦虑或疼痛）。非药物策略是护士最常使用的用于尽量减少儿童痛苦的策略，包括分散注意力（51.2%）、准备工作（30.7%）和感官技巧（14.6%）。局部麻醉剂和轻度镇静等药物策略使用频率较低。
本研究强调了关于减少儿科侵入性操作中痛苦的策略的专业培训和知识所具有的重要性，这表明需要对护理专业人员的教育和支持进行更多投入，以改善患者体验。
