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Bosch-Alcaraz A, Tamame-San Antonio M, Luna-Castaño P, Garcia-Soler P, Falcó Pegueroles A, Alcolea-Monge S, Fernández Lorenzo R, Piqueras-Rodríguez P, Molina-Gallego I, Potes-Rojas C, Gesti-Senar S, Orozco-Gamez R, Tercero-Cano MC, Saz-Roy MÁ, Jordan I, Belda-Hofheinz S. Specificity and sensibility of the Spanish version of the COMFORT Behaviour Scale for assessing pain, grade of sedation and withdrawal syndrome in the critically ill paediatric patient. Multicentre COSAIP study (Phase 1). Enferm Intensiva (Engl Ed) 2022; 33:58-66. [PMID: 35534412 DOI: 10.1016/j.enfie.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/15/2021] [Indexed: 06/14/2023]
Abstract
AIM The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.
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Affiliation(s)
- A Bosch-Alcaraz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain.
| | | | - P Luna-Castaño
- Unidad de Apoyo a la Investigación Enfermera, Hospital Universitario La Paz, Madrid, Spain
| | - P Garcia-Soler
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario Carlos Haya, Málaga, Spain
| | - A Falcó Pegueroles
- Departamento de Enfermería Fundamental y Medicoquirúrgica, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Spain. Miembro de un grupo de investigación consolidado en torno a técnicas estadísticas aplicadas a la psicología (SGR 2014-326)
| | - S Alcolea-Monge
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - R Fernández Lorenzo
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - P Piqueras-Rodríguez
- Máster en Cuidados Críticos, Supervisor Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, Spain
| | - I Molina-Gallego
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, Spain
| | - C Potes-Rojas
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - S Gesti-Senar
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - R Orozco-Gamez
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M C Tercero-Cano
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Á Saz-Roy
- Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Spain
| | - I Jordan
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Belda-Hofheinz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
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González-Gil MT, Alcolea-Cosín MT, Pérez-García S, Luna-Castaño P, Torrent-Vela S, Piqueras-Rodríguez P, Gil-Domínguez S, Alonso-Lloret F, Belda-Holfheinz S, Sánchez-Díaz JI, Espinosa-Bayal MÁ. Children's visits to the paediatric intensive care unit from the nurses' experience. Enferm Intensiva (Engl Ed) 2021; 32:133-144. [PMID: 34391734 DOI: 10.1016/j.enfie.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/01/2020] [Indexed: 10/20/2022]
Abstract
BACKGROUND Family process disruption is one of the main consequences of the hospitalization of a critically ill child in a Paediatric Intensive Care Unit (PICU). Children's visits to PICU may help improve family coping. However, this is not standard practice and nurses' experiences in facilitating children's visits to units where it is encouraged is unknown. AIM To explore nurses' experience related to promoting the visits of siblings to PICU. METHODS An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They were all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. RESULTS Nurses' experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. CONCLUSIONS The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making.
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Affiliation(s)
- M T González-Gil
- Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
| | - M T Alcolea-Cosín
- Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - S Pérez-García
- Unidad de Apoyo a la Investigación en Enfermería, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - P Luna-Castaño
- Enfermería de Investigación, Hospital Universitario de la Paz, Madrid, Spain
| | - S Torrent-Vela
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - P Piqueras-Rodríguez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario de la Paz, Madrid, Spain
| | - S Gil-Domínguez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - F Alonso-Lloret
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - S Belda-Holfheinz
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - J I Sánchez-Díaz
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - M Á Espinosa-Bayal
- Departamento de Psicología Evolutiva y Educación, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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Bosch-Alcaraz A, Tamame-San Antonio M, Luna-Castaño P, Garcia-Soler P, Falcó Pegueroles A, Alcolea-Monge S, Fernández Lorenzo R, Piqueras-Rodríguez P, Molina-Gallego I, Potes-Rojas C, Gesti-Senar S, Orozco-Gamez R, Tercero-Cano MC, Saz-Roy MÁ, Jordan I, Belda-Hofheinz S. Specificity and sensibility of the Spanish version of the COMFORT Behaviour Scale for assessing pain, grade of sedation and withdrawal syndrome in the critically ill paediatric patient. Multicentre COSAIP study (Phase 1). Enferm Intensiva (Engl Ed) 2021; 33:S1130-2399(21)00055-9. [PMID: 34226130 DOI: 10.1016/j.enfi.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Abstract
AIM The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.
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Affiliation(s)
- A Bosch-Alcaraz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España.
| | | | - P Luna-Castaño
- Unidad de Apoyo a la Investigación Enfermera, Hospital Universitario La Paz, Madrid, España
| | - P Garcia-Soler
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario Carlos Haya, Málaga, España
| | - A Falcó Pegueroles
- Departamento de Enfermería Fundamental y Medicoquirúrgica, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, España. Miembro de un grupo de investigación consolidado entorno a técnicas estadísticas aplicadas a la psicología (SGR 2014-326)
| | - S Alcolea-Monge
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - R Fernández Lorenzo
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - P Piqueras-Rodríguez
- Máster en Cuidados Críticos, Supervisor Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, España
| | - I Molina-Gallego
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, España
| | - C Potes-Rojas
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - S Gesti-Senar
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - R Orozco-Gamez
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | - M C Tercero-Cano
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Á Saz-Roy
- Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, España
| | - I Jordan
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - S Belda-Hofheinz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
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Bosch-Alcaraz A, Alcolea-Monge S, Fernández Lorenzo R, Luna-Castaño P, Belda-Hofheinz S, Falcó Pegueroles A, Piqueras-Rodríguez P, Molina-Gallego I, Potes-Rojas C, Gesti-Senar S, Orozco-Gámez R, Tercero-Cano MC, Saz-Roy MÁ, Jordan I, García-Soler P, Tamame-San Antonio M. Grade of sedation in the critically ill paediatric patient and its correlation with sociodemographic and clinical variables. Multicentre COSAIP study. Enferm Intensiva (Engl Ed) 2021; 32:S1130-2399(21)00002-X. [PMID: 33824050 DOI: 10.1016/j.enfi.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/19/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
AIMS To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. METHODS Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, 11per shift over 24hours. RESULTS A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n=183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24±14.96 during the morning and 50.75±15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. CONCLUSIONS Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required.
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Affiliation(s)
- A Bosch-Alcaraz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España.
| | - S Alcolea-Monge
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - R Fernández Lorenzo
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - P Luna-Castaño
- Unidad de Apoyo a la Investigación Enfermera, Hospital Universitario La Paz, Madrid, España
| | - S Belda-Hofheinz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | - A Falcó Pegueroles
- Departamento de Enfermería Fundamental y Medicoquirúrgica, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
| | - P Piqueras-Rodríguez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, España
| | - I Molina-Gallego
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, España
| | - C Potes-Rojas
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell (Barcelona), España
| | - S Gesti-Senar
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell (Barcelona), España
| | - R Orozco-Gámez
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | - M C Tercero-Cano
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Á Saz-Roy
- Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, España
| | - I Jordan
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - P García-Soler
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario Carlos Haya, Málaga, España
| | - M Tamame-San Antonio
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell (Barcelona), España
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