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AnteayerInternacionales

How Often Are Hospitalised Children Physically Restrained During Painful and Stressful Procedures?

ABSTRACT

Aim

To analyse the incidence of physical restraint use during painful and stressful procedures in hospitalised children, as well as the factors associated with its use.

Design

Observational, longitudinal and prospective study.

Methods

Children aged between 28 days and 10 years in a public hospital in Brazil were each observed undergoing clinical procedures over a 6-h period. Data were collected on demographics, observed pain using validated measures, stress behaviours, and the use of physical restraint. Descriptive and inferential analyses were performed. National ethical guidelines were strictly followed.

Results

1210 procedures were observed on 75 children, including 351 painful and 859 stressful procedures. Physical restraint was used in 270 (22.3%) procedures; of these, 131 (48.5%) were painful procedures and 139 (51.5%) were stressful procedures. In stressful procedures, at least one stress-related behaviour was observed before the initiation of physical restraint. Factors associated with increased use of physical restraint during painful procedures were younger children, with higher levels of care dependency, higher pain scores during procedures, and those who underwent intravenous medication administration, airway suctioning, tube insertion, and fixation changes. In stressful procedures, the factors associated with higher use of physical restraint were younger children, hospitalisation due to respiratory conditions, those who underwent physical examinations, inhaled medication, and nasal lavage; and the child's expression of stress behaviour before the procedure starts. Predictors of physical restraint included morning period, younger age group, male or female sex, and transfer from the Intensive Care Unit.

Conclusion

A high incidence of physical restraints was observed across multiple painful and stressful procedures performed within a 6-h period, associated with variables related to both the child's characteristics and the procedures.

Implications for the Profession and/or Patient Care

This study aims to encourage reconsideration of the frequent use of physical restraint in paediatric procedures, calling for a reframing of its application as an unquestioned practice toward an approach that prioritises protecting and respecting a child as a subject with needs, rights, and desires.

Reporting Method

Strengthening the Reporting of Observational studies in Epidemiology (STROBE).

Perspectives of Patients Regarding Artificial Intelligence and Its Application in Healthcare: A Qualitative Study

ABSTRACT

Background

Artificial intelligence integration into healthcare has gained significant attention in recent years, with its use ranging from disease diagnosis to surgical assistance. While artificial intelligence's potential to improve patient outcomes and optimise patient care is undeniable, concerns regarding privacy, transparency, and the potential for medical errors persist. To take full advantage of artificial intelligence's transformative abilities, understanding patient perceptions and attitudes towards its integration into medicine is crucial for ethical considerations and health outcomes.

Purpose

This study aimed to describe patients' perceptions of medical artificial intelligence and its integration into the healthcare system, drawing attention to a crucial yet understudied aspect of artificial intelligence adoption in Kazakhstan.

Design

Descriptive qualitative design.

Method

From February to March 2024, the researchers conducted semi-structured interviews amongst 13 patients. The interviews were audio-recorded, transcribed, translated, and then analysed using a thematic analysis approach. The study adhered to the COREQ guidelines.

Result

Five themes emerged from 13 interviews: the benefits of artificial intelligence on patient care, the importance of human factors on patient care over artificial intelligence, revolutionising patient care delivery through artificial intelligence, patient education and artificial intelligence, and balancing technology and human interaction in artificial intelligence-driven intervention.

Conclusion

Patient perceptions of artificial intelligence integration into healthcare were primarily positive. Nevertheless, patients prefer artificial intelligence as a supplementary tool under human supervision due to risks such as possible medical errors and violations of patient privacy.

Patient or Public Contribution

Patients provided the data for this study. The researchers interviewed them about their perceptions of medical artificial intelligence and its integration into the healthcare system. The patients or the public contributed nothing to the other aspects of the study.

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