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The effects of child life specialists' interventions on the distress of pediatric patients during laceration repair




Johnson, Eugene, author
MacPhee, David, advisor
Quijano, Louise, committee member
Gaynard, Laura L., committee member

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Children who are treated for injuries in the emergency department (ED) have been shown to have an increase in anxiety and distress, poor pain control, and reported lower ratings of overall satisfaction. Child life specialists (CLSs) are trained to help minimize stress, promote coping, and use nonpharmacological methods for pain relief with pediatric patients in health care. Previous studies confirm the work of CLSs with patients in other units of the hospital, and are expected to have similar results in the ED setting. In this study, I examined what type of effect CLSs had on pediatric patients self-reported pain, fear, and observed distress while receiving sutures for a laceration. The parent and patient's satisfaction with their experience also was measured. It was hypothesized that the involvement of a child life specialist during this procedure would decrease patients' self-reports of pain, fear, and observed distress, and increase self-reports of satisfaction. As well, exploratory analyses were conducted to determine whether patient self-reports of pain and fear are related to clinical observations of patient distress as well as biological markers of stress (i.e., cortisol). Fifty-two pediatric patients with a laceration were studied in a level one ED trauma center of a free-standing children's hospital. Results indicated that patients who received child life services had better outcomes than those who did not. Specifically, fear and distress were shown to be significantly lower for these patients. Also, the parents of these patients were significantly more satisfied with the care received with CLS involvement. These results lend strong support for CLSs involvement with pediatric patients receiving a laceration repair.


2013 Summer.
Includes bibliographical references.

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child life council
child life specialist
emergency department


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