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Jeong and Ahn: Peripheral Intravenous Injection Pain in Hospitalized Children
Original Article

Perspectives in Nursing Science 2014;11(2):144-152.

Published online: 21 October 2014

DOI: https://doi.org/10.16952/pns.2014.11.2.144

Peripheral Intravenous Injection Pain in Hospitalized Children

Jun Hee Jeong1, Hye Young Ahn2

1Team director, Eulji General Hospital, Seoul, Korea

2Professor, College of Nursing, Eulji University, Daejeon, Korea

Corresponding author: Ahn, Hye Young College of Nursing, Eulji University, 771-77 Beon-gil, Gyeryong-ro, Joong-gu, Daejeon 301-746, Korea. Tel: +8-42-259-1715, Fax: +82-42-259-1709, E-mail: ahanaya@eulji.ac.kr

Received 21 August 20142 October 2014       Accepted 3 October 2014

Copyright © 2014 The Research Institute of Nursing Science, Seoul National University

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children.

Methods

A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0.

Results

Younger patients showed higher pain response than older patients (F=33.87, p<.001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation.

Conclusion

A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.

Keywords: Hospitalization, Children, Peripheral intravenous cannulation, Pain

REFERENCES

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Table 1.
Pain Response (FPRS) by Children's Characteristics (N=200)
Variables Categories n(%) M±SD Min Max t or F p Scheffé
Pain (FPRS) All 200(100.0) 4.64±0.53 3.0 5.0
Gender Male 108 (54.0) 4.67±0.51 0.77 .443
Female 92 (46.0) 4.60±0.55
Developmental stage Infancy 74 (37.0) 4.83±0.40 33.87 ＜.001 a, b＞c
Toddler 62 (31.0) 4.80±0.43
Preschooler 64 (32.0) 4.25±0.53
Activity Low 9 (4.5) 4.44±0.72 1.52 .220
Medium 105 (52.5) 4.69±0.52
High 86 (43.0) 4.59±0.51
Diagnosis Respiratory 67 (33.5) 4.77±0.45 4.17 .017 a＞b
GI 50 (25.0) 4.55±0.54
Etc 83 (41.5) 4.61±0.53
Experience of IV Yes 63 (31.5) 4.63±0.54 -0.09 .927
No 137 (68.5) 4.64±0.52
Caregiver Mother 118 (59.0) 4.70±0.51 3.53 .016 b, a＞c
Father 16 (8.0) 4.81±0.40
Etc 66 (33.0) 4.42±0.53
Body weight (kg) ≤9 61 (30.5) 4.80±0.44 16.80 ＜.001 b, a, c＞d
10~12 50 (25.0) 4.86±0.40
13~16 41 (20.5) 4.58±0.54
≥17 48 (24.0) 4.25±0.52

FPRS=Faces pain rating scale; IV=Intravenous.

Table 2.
Infant and Toddler's Pain (PBCL) Response by Children's Characteristics (N=136)
Variables Categories n M±SD Min Max t or F p Scheffé
Pain (PBCL) All 136 4.73±1.02 2.0 6.0
Gender Male 74 4.84±1.06 1.24 .268
Female 62 4.62±0.96
Age Infant 74 4.71±0.99 1.57 .657
Toddler 62 4.79±1.04
Activity Low 7 4.00±0.81 3.07 .050
Medium 90 4.68±1.01
High 39 4.97±1.02
Diagnosis Respiratory 54 5.24±0.69 25.31 ＜.001 a＞c＞b
Gastro-intestinal 31 3.83±0.96
Others 51 4.74±0.97
Experience of IV Yes 40 4.97±1.07 3.18 .770
No 96 4.63±0.98
Caregiver Mother 90 4.71±1.04 0.99 .402
Father 11 5.00±0.89
Others 35 4.55±1.05
Body weight (kg) ≤9 60 4.73±0.97 0.20 .895
10~12 49 4.77±1.00
13~16 55 4.42±1.20
≥17 5 4.40±1.14

PBCL=Procedure behavior check list; IV=Intravenous.

Table 3.
Preschooler's Pain Response (PBCL) by Children's Characteristics (N=64)
Variables Categories n M±SD Min Max t or F p
Pain (PBCL) All 64 4.59±1.61 2.0 8.0
Gender Male 34 4.94±1.73 2.04 .045
Female 30 4.16±1.34
Activity Low 2 3.50±0.70 0.78 .452
Medium 15 4.33±0.89
High 47 4.70±1.77
Diagnosis Respiratory 14 4.92±1.84 0.55 .578
Gastro-Intestinal 19 4.31±1.52
Others 31 4.62±1.58
Experience of IV Yes 23 5.13±1.81 2.05 .045
No 41 4.29±1.41
Caregiver Mother 28 4.82±1.56 1.17 .330
Father 5 5.20±1.64
Others 31 3.95±0.89
Body weight (kg) ≤9 1 4.00 2.64 .058
10~12 1 8.00
13~16 19 5.05±1.80
≥17 43 4.32±1.61

PBCL=Procedure behavior check list; IV=Intravenous.

Table 4.
Pain Response according to Peripheral Intravenous Recannulation (N=200)
Variables Categories Cannulation (n=129) Recannulation (n=71) t p
M±SD M±SD
Pain (FPRS) 4.54±0.57 4.81±0.38 -3.60 ＜.001
Pain (PBCL) Infant & toddler 4.41±0.98 5.22±0.88 -4.88 ＜.001
Preschooler 4.17±1.22 5.76±1.98 -3.86 ＜.001

FPRS=Faces pain rating scale; PBCL=Procedure behavior check list.

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