Actitud de los profesionales sanitarios ante la familia y los procedimientos invasivos en pediatría

Abstract

Although scientific evidence has revealed the importance of the presence of parents during invasive procedures to reduce levels of anxiety and pain in children, the variation in practice and confronted opinion among healthcare professionals continue today. Objective: To determine the attitude of health professionals who work at the Children's Hospital of the University Hospital Virgen de la Arrixaca in Murcia (Spain) regarding the presence of parents in invasive procedures. Methodology: We carry out a descriptive and comparative study through surveys and analysis of comments. Our study population is made up of 444 health professionals. The sample is stratified by professional categories (pediatricians, nurses and assistants) and a cluster distribution is made so that all hospital units are represented. After the sample calculation, it is obtained that for a precision of 5%, a power of 80% and a confidence level of 95%, a sample of 308 professionals is required. A sample of 494 professionals responding to the survey is obtained, 227 surveys in 2015 and 267 surveys in 2020, and changes in attitude are analyzed. The results of the surveys were processed with Microsoft Excel to obtain descriptive analysis. Statistical analysis was performed using the statistical software STATA. The study of contingency tables through Pearson's Chi-square test was used in order to analyze the association between qualitative variables. In addition, residual analysis was performed in the 2x2 cell contingency tables. The comparison between quantitative variables was analyzed using the Student's “t” test and the analysis of variance (ANOVA). Finally, multivariate analysis was performed using logistic regression. The qualitative analysis of the comments was carried out by transcription and coding of the text, a text analytical program KH Coder was also used. Results: • Health professionals 407 (82%) always or occasionally work with parents present. Only 87 (18%) health workers responded that they did not perform invasive procedures in the presence of parents. • Parents are present in less invasive techniques 412 (83%) compared to 82 (17%) that allow the presence of parents in the more invasive techniques. • A high percentage of health workers 396 (80%) has expressed having problems when parents have been present in invasive techniques, these problems have been mainly: 197 (40%) "family indisposition ..." and 199 (40%) " worst behavior of the child ”. • The attitude of health professionals has improved due to: - Favorable change in the attitude of pediatricians. This has led to changes in the healthcare team, increasing the presence of parents in the most invasive techniques by 12%. - Depending on the healthcare unit where you work, healthcare professionals will be more or less favorable to the presence of parents. - In 2015, only 54 (24%) healthcare professionals believed that the presence of parents was necessary for invasive techniques, whereas in 2020, 110 (41%) believed their presence was necessary. - As health workers perform invasive techniques on children in the presence of their parents, they improve their attitude towards parents until they decide to always work with them. - Not having had problems or only occasionally, the attitude of health professionals towards family presence has improved. - Younger health workers have a more favorable attitude towards the presence of parents during invasive techniques. • A high percentage of health workers 440 (89%) state that there are no protocols for the presence of parents in invasive techniques. • The majority of health workers 384 (82%) state that they need training in this area