Background & Aims

One of the most stressful tasks for health professionals is working in emergency services. The coping style for stress used by health personnel can significantly impact their ability to adapt to the challenges of the environment and the quality of care provided to patients; and can either promote collaborative and self-regulated behaviors or increase the child’s stress and pain levels. Current literature primarily focuses on studying individual, team, and contextual risk and protective factors, as well as individual coping styles and strategies. However, there is a lack of research on strategies used by health personnel to assist in regulating children’s stress, which is essential to incorporate into studies on staff stress and their existing coping mechanisms. Therefore, the objective is to assess how the coping styles and behaviors of staff (both individual and relational) influence the child’s coping experience during treatment in the emergency department.

Methods

Medical procedures were recorded on video with facial blurring and written documentation. The young children used self-report pain scales (FPS-R) and fear scales (CFS), while healthcare personnel assessed the same perceived levels in the child using a visual numerical scale. Verbal and non-verbal behaviors of both the child and healthcare personnel were identified using the Child-Adult Medical Procedure Interaction Scale-Revised adapted for the emergency department (CAMPIS-ED). Additionally, healthcare personnel completed an individual stress coping scale (PSS-14) and reported on typical strategies for managing children’s responses to painful experiences and procedures (PH-CSH). Descriptive and regression analyses were conducted to determine the primary individual coping styles and child regulation strategies, as well as to explore the predictive relationship between individual and relational coping during healthcare procedures in emergency departments.

Results

A group of 65 healthcare professionals participated in caring for a group of 100 preschoolers, with 51% girls and 49% boys; 82% of preschoolers experienced pain. Health personnel exhibited an average of 26.8 (SD 5.1) for positive coping with stress and 18.7 (SD 4.6) for negative coping. Regarding the main child regulation strategies, 63% engaged in dialogue behaviors with the child about their feelings, 57% used distraction, 56% employed reinforcement and empathy phrases, 49% utilized behavioral commands for coping, and 46% used humor. Correlational findings indicate a significant association between higher levels of staff stress and increased perception of pain and fear in children during pediatric care (r=0.23-0.38). Observational data suggest that the most effective staff strategies for children’s regulation include the use of behavioral coping commands, distraction, and providing advance warning and explanations of procedures.

Conclusions

The results indicate that child regulation behaviors primarily aim to enhance coping and emotional validation. Staff stress levels and their coping mechanisms can impact how preschool children perceive pain and fear during emergency medical treatment. To enhance effectiveness, healthcare professionals should prepare children before procedures, offer guidance on coping strategies during procedures, and provide reinforcement afterward.

References

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Presenting Author

Scarlett Caroca

Poster Authors

Scarlett Caroca

BNSc

Universidad de Chile. Bachelor in Medicine, Universidad de Chile

Lead Author

Mariela Bustamante

PhD

Universidad de Chile. Master in Health Psychology and Doctoral Candidate in Psychology Pontificia Universidad Católica de Chile

Lead Author

Sofía Hidalgo Vilche

BS

Universidad de Chile. Psychology Student, Universidad de Chile

Lead Author

Gabriela Ruiz

BNSc

Universidad de Chile. Medical Student, Universidad de Chile

Lead Author

Oscar Baquero

MD

Hospital Félix Bulnes, Chile

Lead Author

Topics

  • Mechanisms: Psychosocial and Biopsychosocial