Parental presence in the context of medical procedures in children
What do Uruguayan parents and children think?
Keywords:
MEDICAL PROCEDURES, CHILD ADVOCACY, PATIENT RIGHTSAbstract
Introduction: in Uruguay, parental presence during medical procedures in their children is a controversial practice. There is no national research in the field. Neither are there publications asking children, the protagonists.
Objective: to learn about the opinion of:
- parents about their wish to be present during medical procedures in their children,
- Children about their wish to be accompanied by their parents.
Method: descriptive, observational and transversal study. Anonymous, semi-structured survey to parents and children in a pediatrics hospital and primary health care centers.
Results: 126 parents were included in the study. They would like to be present during the following procedures: 91% blood sampling; 89% placement of a venous circuit, 81% vesical catheterism, 77% rachicentesis and 70% endotraqueal intubation. 58 % of parents believe the decision is to be made by de family, the child, or both. 130 were included in the study. . They would like their parents to be present during the following procedures: 93% rachicentesis, 92% blood sampling and 87% vesical catheterism.
Conclusions: most children want tobe accompanied by their parents during medical procedures. Most parents want to be with their children and want to be the ones to decide whether to be present or not. Health professionals and institutions need to respect children's rights and adapt their protocols, policies and regulations to every child and family's preference and cultural values.
References
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(9) American Academy of Pediatrics. Committee on Hospital Care. Family centered care and the pediatrician's role. Pediatrics 2003; 112 (3 Pt 1): 691-7.
(10) American Academy of Pediatrics. Committee on Pediatric Emergency Medicine, American College of Emergency Physicians. Pediatric Emergency Medicine Committee. Patient and family centered care and the role of the emergency physician providing care to a child in the emergency department. Pediatrics 2006; 118(5): 2242-4.
(11) Braude N, Ridley SA, Sumner E. Parents and paediatric anaesthesia: a prospective survey of parental attitudes to their presence at induction. Ann R Coll Surg Engl 1990; 72(1): 41-4.
(12) Boie ET, Moore GP, Brummett C, Nelson DR. Do parents want to be present during invasive procedures performed on their children in the emergency department? A survey of 400 parents. Ann Emerg Med 1999; 34(1): 70-4.
(13) Boudreaux ED, Francis JL, Loyacano T. Family presence during invasive procedures and resuscitations in the emergency department: a critical review and suggestions for future research. Ann Emerg Med 2002; 40(2): 193-205.
(14) Duran CR, Oman KS, Abel JJ, Koziel VM, Szymanski D. Attitudes toward and beliefs about family presence: a survey of healthcare providers, patients' families, and patients. Am J Crit Care 2007; 16(3): 270-9.
(15) Tinsley C, Hill JB, Shah J, Zimmerman G, Wilson M, Freier K, et al. Experience of families during cardiopulmonary resuscitation in a pediatric intensive care unit. Pediatrics 2008; 122(4): e799-804.
(16) Moreno R, Ayala Torales S, Garcia Roig C, Araguas J, Caprotta G. Opinión de los padres y cuidadores de niños internados acerca de su presencia durante la realización de procedimientos invasivos. Arch Argent Pediatr 2008; 106(2): 110-8.
(17) Pérez Alonso V, Gómez Sáez F, González-Granado LI, Rojo Conejo P. Procedimientos invasivos en urgencias: ¿los familiares prefieren estar presentes? An Pediatr (Barc) 2009; 70(3): 230-4.
(18) McClenathan BM, Torrington KG, Uyehara CF. Family member presence during cardiopulmonary resuscitation. Chest 2002; 122(6): 2204-11.
(19) MacLean SL, Guzzetta CE, White C, Fontaine D, Eichhorn DJ, Meyers TA, et al. Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses. Am J Crit Care 2003; 12(3): 246-57.
(20) Fein JA, Ganesh J, Alpern ER. Medical staff attitudes toward family presence during pediatric procedures. Pediatr Emerg Care 2004; 20(4): 224-7.
(21) Caprotta G, Moreno R, Araguas J, Otero P, Pena R. Presencia de los padres y/o cuidadores de pacientes durante la realización de procedimientos: ¿qué opinan los médicos que asisten niños?. Arch Arg Pediatr 2004; 102(4): 246-50.
(22) Parra Cotanda C, Luaces Cubells C, Pou Fernández J. ¿Deberían estar presentes los padres durante los procedimientos invasivos en urgencias? An Pediatr (Barc) 2009; 70(3): 293-6.
(23) American Heart Association. International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102(8 suppl): I1-I374.
(24) Gamell Fullà A, Corniero Alonso P, Parra Cotanda C, Trenchs Sainz de la Maza V, Luaces Cubells C. ¿Están presentes los padres durante los procedimientos invasivos? Estudio de 32 hospitales de España. An Pediatr (Barc) 2010; 72(4): 243-9.
(25) Schofield NM, White JB. Interrelations among children, parents, premedication, and anaesthetists in paediatric day stay surgery. BMJ 1989; 299(6712): 1371-5.
(26) Nigrovic LE, McQueen AA, Neuman MI. Lumbar puncture success rate is not influenced by family-member presence M. Pediatrics 2007; 120(4): e777-82.
(27) Tena Tamayo C, Sánchez González JM. Medicina asertiva: una propuesta contra la medicina defensiva. Ginecol Obstet Mex 2005; 73(10): 553-9.
(28) Rodríguez H. De la medicina defensiva a la medicina asertiva. Rev Méd Urug 2006; 22(3): 167-8.
(29) Briozzo L. La crisis como oportunidad: reformulando la relación sanitaria. Rev Méd Urug 2007; 23(3): 139-41.
(30) Uruguay. Ley Nro.16.137. Convención sobre los derechos del niño. Montevideo 9 nov. 1990. Disponible en: http://www.parlamento.gub.uy/leyes/AccesoTextoLey.asp?Ley=16137& Anchor=. Consulta: 10 julio 2011.
(31) Uruguay. Ley Nro. 17.823. Código de la niñez y la adolescencia. Montevideo 14 set. 2004. Disponible en: http://www.parlamento.gub.uy/leyes/AccesoTextoLey.asp?Ley=17823& Anchor. Consulta: 10 julio 2011.
(32) Henderson DP, Knapp JF. Report of the Nation Consensus Conference on Family Presence During Pediatric Cardiopulmonary Resuscitation and Procedures. Pediatr Emerg Care 2005; 21(11): 787-91.
(33) Dingeman RS, Mitchell EA, Meyer EC, Curley MA. Parent presence during complex invasive procedures and cardiopulmonary resuscitation: a systematic review of the literature. Pediatrics 2007; 120(4): 842-54.
(2) Bonaba J, Saldún M. El rol de la madre en la hospitalización del lactante. Arch Pediatr Urug 1942; 13: 9-18.
(3) Bonaba J, Saldún M. Hospitalización conjunta del hijo con la madre. Arch Pediatr Urug 1943; 14: 566-74.
(4) Osorio A, Ferrari AM, Alonso R, Cardozo N. Hospitalización conjunta del hijo con su madre: programa de madre participante. Bol Of Sanit Panam 1978; 84(3): 240-5 Disponible en: http://hist.library.paho.org/Spanish/BOL/v84n3p240.pdf. Consulta: 7 diciembre 2011.
(5) Gentile I. El niño, el médico y la enfermedad. In: Gentile Ramos I. Puericultura y pediatría social. 2 ed. Montevideo: Librería Médica, 1988: 451-73.
(6) Fernández G. Paciente pediátrico hospitalizado. Disponible en: http://www.dem.fmed.edu.uy/materno/Disciplinas%20 Asociadas/PACIENTE%20PEDIATRICO%20HOSPITALIZADO%20-%20Ps.%20Gabriela%20Fernandez.pdf. Consulta: 7 diciembre 2011.
(7) Barrera F, Moraga F, Escobar S, Antilef R. Participación de la madre y la familia en la atención del niño hospitalizado: análisis histórico y visión del futuro. Rev Chil Pediatr 2007; 78(1): 85-94. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062007000100012 &lng=es&nrm=iso&tlng=es. Consulta: 7 diciembre 2011.
(8) Parlamento Europeo. Carta europea de los niños hospitalizados. Bol Pediatr 1993; 34: 69-71. Disponible en: http://www.pediatriasocial.com/cartaeuropea.pdf. Consulta: 7 diciembre 2011.
(9) American Academy of Pediatrics. Committee on Hospital Care. Family centered care and the pediatrician's role. Pediatrics 2003; 112 (3 Pt 1): 691-7.
(10) American Academy of Pediatrics. Committee on Pediatric Emergency Medicine, American College of Emergency Physicians. Pediatric Emergency Medicine Committee. Patient and family centered care and the role of the emergency physician providing care to a child in the emergency department. Pediatrics 2006; 118(5): 2242-4.
(11) Braude N, Ridley SA, Sumner E. Parents and paediatric anaesthesia: a prospective survey of parental attitudes to their presence at induction. Ann R Coll Surg Engl 1990; 72(1): 41-4.
(12) Boie ET, Moore GP, Brummett C, Nelson DR. Do parents want to be present during invasive procedures performed on their children in the emergency department? A survey of 400 parents. Ann Emerg Med 1999; 34(1): 70-4.
(13) Boudreaux ED, Francis JL, Loyacano T. Family presence during invasive procedures and resuscitations in the emergency department: a critical review and suggestions for future research. Ann Emerg Med 2002; 40(2): 193-205.
(14) Duran CR, Oman KS, Abel JJ, Koziel VM, Szymanski D. Attitudes toward and beliefs about family presence: a survey of healthcare providers, patients' families, and patients. Am J Crit Care 2007; 16(3): 270-9.
(15) Tinsley C, Hill JB, Shah J, Zimmerman G, Wilson M, Freier K, et al. Experience of families during cardiopulmonary resuscitation in a pediatric intensive care unit. Pediatrics 2008; 122(4): e799-804.
(16) Moreno R, Ayala Torales S, Garcia Roig C, Araguas J, Caprotta G. Opinión de los padres y cuidadores de niños internados acerca de su presencia durante la realización de procedimientos invasivos. Arch Argent Pediatr 2008; 106(2): 110-8.
(17) Pérez Alonso V, Gómez Sáez F, González-Granado LI, Rojo Conejo P. Procedimientos invasivos en urgencias: ¿los familiares prefieren estar presentes? An Pediatr (Barc) 2009; 70(3): 230-4.
(18) McClenathan BM, Torrington KG, Uyehara CF. Family member presence during cardiopulmonary resuscitation. Chest 2002; 122(6): 2204-11.
(19) MacLean SL, Guzzetta CE, White C, Fontaine D, Eichhorn DJ, Meyers TA, et al. Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses. Am J Crit Care 2003; 12(3): 246-57.
(20) Fein JA, Ganesh J, Alpern ER. Medical staff attitudes toward family presence during pediatric procedures. Pediatr Emerg Care 2004; 20(4): 224-7.
(21) Caprotta G, Moreno R, Araguas J, Otero P, Pena R. Presencia de los padres y/o cuidadores de pacientes durante la realización de procedimientos: ¿qué opinan los médicos que asisten niños?. Arch Arg Pediatr 2004; 102(4): 246-50.
(22) Parra Cotanda C, Luaces Cubells C, Pou Fernández J. ¿Deberían estar presentes los padres durante los procedimientos invasivos en urgencias? An Pediatr (Barc) 2009; 70(3): 293-6.
(23) American Heart Association. International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102(8 suppl): I1-I374.
(24) Gamell Fullà A, Corniero Alonso P, Parra Cotanda C, Trenchs Sainz de la Maza V, Luaces Cubells C. ¿Están presentes los padres durante los procedimientos invasivos? Estudio de 32 hospitales de España. An Pediatr (Barc) 2010; 72(4): 243-9.
(25) Schofield NM, White JB. Interrelations among children, parents, premedication, and anaesthetists in paediatric day stay surgery. BMJ 1989; 299(6712): 1371-5.
(26) Nigrovic LE, McQueen AA, Neuman MI. Lumbar puncture success rate is not influenced by family-member presence M. Pediatrics 2007; 120(4): e777-82.
(27) Tena Tamayo C, Sánchez González JM. Medicina asertiva: una propuesta contra la medicina defensiva. Ginecol Obstet Mex 2005; 73(10): 553-9.
(28) Rodríguez H. De la medicina defensiva a la medicina asertiva. Rev Méd Urug 2006; 22(3): 167-8.
(29) Briozzo L. La crisis como oportunidad: reformulando la relación sanitaria. Rev Méd Urug 2007; 23(3): 139-41.
(30) Uruguay. Ley Nro.16.137. Convención sobre los derechos del niño. Montevideo 9 nov. 1990. Disponible en: http://www.parlamento.gub.uy/leyes/AccesoTextoLey.asp?Ley=16137& Anchor=. Consulta: 10 julio 2011.
(31) Uruguay. Ley Nro. 17.823. Código de la niñez y la adolescencia. Montevideo 14 set. 2004. Disponible en: http://www.parlamento.gub.uy/leyes/AccesoTextoLey.asp?Ley=17823& Anchor. Consulta: 10 julio 2011.
(32) Henderson DP, Knapp JF. Report of the Nation Consensus Conference on Family Presence During Pediatric Cardiopulmonary Resuscitation and Procedures. Pediatr Emerg Care 2005; 21(11): 787-91.
(33) Dingeman RS, Mitchell EA, Meyer EC, Curley MA. Parent presence during complex invasive procedures and cardiopulmonary resuscitation: a systematic review of the literature. Pediatrics 2007; 120(4): 842-54.
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Published
2012-03-31
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1.
Bernadá M, Más M, Pietrafesa D, Ramos P, Rocchiccioli F. Parental presence in the context of medical procedures in children: What do Uruguayan parents and children think?. Rev. Méd. Urug. [Internet]. 2012 Mar. 31 [cited 2024 Nov. 24];28(1):21-34. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/358
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