Mary Erickson Megel

Companion Animals Alleviating Distress in Children

ABSTRACTPhysiological arousal and behavioral distress in children aged from two to six years undergoing a physical examination were examined with and without the presence of a companion dog. An experimental/control group, repeated measures design was utilized to study children at a pediatric clinic. Thirty-four (14 males, 20 females) children were assigned randomly either to a treatment group (n=15) in which a therapy dog was present during their examinations or to a control group (n=19) which had the usual pediatric exam without a dog present. Physiological variables (systolic, diastolic, and mean arterial pressures, heart rate, and fingertip temperatures) were measured at baseline and at two-minute intervals during each examination. Subjects were videotaped during the examination for analysis of behavioral distress using the Observation Scale of Behavioral Distress (OSBD). Physiological measurements were not statistically significantly different between the dog and no-dog groups but were found not to be...

The effects of a companion animal on distress in children undergoing dental procedures.

The purpose of our pilot study was to evaluate the effects of a companion animal (dog) on physiologic arousal and behavioral distress among children undergoing a dental procedure. A repeated measures experimental design was used to study 40 children between the ages of 7 and 11 years who were undergoing procedures in a pediatric dental clinic. Half the children had the dog present during the procedure and half did not. Data were obtained before, during, and after the procedure. Behavioral distress was measured using the Observational Scale of Behavioral Distress; procedures were videotaped. Physiologic arousal was measured using a YSI telethermometer taped to the childs index finger. Students t-test and repeated measures analysis of variance were used to answer the research question. No significant differences in behavioral distress or physiologic arousal were found between experimental and control groups. Further analysis revealed that for children who initially verbalized distress on arrival at the clinic, the presence of the dog decreased physiologic arousal during the time the child was on the dental table waiting for the dentist to arrive. Further research should be conducted to verify the effect of a companion animal on initial stress experienced by children for whom the visit to the dentist is most stressful.

The Voices of Children: Stories About Hospitalization

INTRODUCTION The study explored childrens views of hospitalization through their own voices. METHOD In this secondary analysis, 93 children aged 5 to 9 years told stories about hospitalization using a set of drawings of children in the hospital. Children were recruited in the hospital and in the community. Themes were identified through qualitative analysis. RESULTS Childrens stories focused on being alone and feeling scared, mad, and sad. These children wanted protection. Children in the stories were not always facing scary events. They were simply not at home and feeling bored, lonely, and sad. They wanted companions. Children displayed awareness of both good and bad outcomes. The hospital was a unique environment that could be fun as well as threatening. DISCUSSION Childrens views of hospitalization were not invariably negative. The themes of hospitalized and never-hospitalized children were different only in degree of detail.

Children's responses to immunizations: lullabies as a distraction.

The purpose of this study was to investigate the effects of audiotaped lullabies on physiological and behavioral distress and perceived pain among children during routine immunization. An experimental design was used to study 99 healthy children ages 3 to 6 years. Half the children received the musical intervention during the immunizations, while the other half did not. Groups were assessed during five phases: baseline, preimmunizations, during the immunization, after Band-Aid application, and 2 min after phase 4. Physiological variables (heart rate, blood pressure) were obtained in phases 1, 4, and 5. Behavioral distress was measured using the Observational Scale of Behavioral Distress during phases 1, 2, 3, and 4. Pain perception was measured using the Oucher in phases 1 and 4. No significant differences were found between experimental and control groups for heart rate, blood pressure, or Oucher scores. However, total distress scores were significantly less for the experimental group. These results indicate that immunization is a stressful experience for children. Recommendations include further study incorporating pharmacological and nonpharmacological interventions.

Faculty retirement: stemming the tide.

The shortage of nursing faculty is becoming a crisis in schools of nursing and is contributing to the shortage of qualified graduates to add to the nursing workforce. Aging and retirement of existing faculty contribute to the crisis. Creating retention initiatives may encourage faculty to postpone retirement. This article explored the conditions and situations which would entice faculty to continue working beyond their intended retirement date. Faculty identified workload and responsibilities, available resources, personal and professional characteristics, and work environment as areas that could be developed into incentives to remain in the faculty workforce.

Nurses' assessments and management of pain in children having orthopedic surgery

The specific aims of this research project were to (a) describe selected verbal, nonverbal, and physiological arousal indicators of the childs pain; (b) describe which pain indicators were most influential to nurses in decision-making about interventions for managing the childs pain; (c) describe pain interventions used by nurses; (d) compare postoperative analgesic orders to recommended dosages for the children; and (e) explore relationships between the childs self-report of pain and medication dosages administered. Subjects included 19 children aged 5-17 years who experienced 20 orthopedic surgical procedures (one child had two surgeries one week apart). Data were collected by staff nurses for the first five days after surgery. Pain levels were reported using the Oucher Scale. Postoperative pain was reported at moderate levels and showed only a gradual decrease throughout the hospital stay. Nonverbal pain indicators included crying and tense face. The childs complaint of pain and reported Oucher scores were most influential in influencing nurses to intervene in the childs pain. Nonpharmacological comfort measures included positioning and reassurance. All children received medications for pain; 49% of the orders were within the recommended therapeutic dosage range. A small but significant correlation was found between the childs reported pain level and the morphine equivalents of pain medication received. Recommendations included development of nursing flow charts that provide space to record pain levels and nursing interventions, in-service education for nurses on nonpharmacological interventions, and further research with a larger sample and a single pain rating scale.

Physiologic and behavioral responses to stress, temperament, and incidence of infection and atopic disorders in the first year of life: a pilot study

The purpose of this pilot study was to explore relationships among physiologic and behavioral responses to a standardized stressor (routine immunization), parent-reported temperament, and numbers of infections and atopic disorders in the first year of life. Infants were studied during 2- (n = 30) and 4-month (n = 24) routine clinic visits. Behavioral data were coded from videotapes filmed for 90 seconds after immunizations. Salivary cortisol measured physiologic arousal; specimens were obtained before and after immunizations. Two-month-old infants with higher levels of cortisol required more time to calm after immunization. Relationships were found between the temperament characteristics of persistence and adaptability and infections at 12 months.