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Full-Text Articles in Medicine and Health Sciences
Heparin Vs. Saline For Peripheral I.V. Locks In Children, Charmaine Kleiber, Kirsten Hanrahan, C. Fagan, M. Zittergruen
Heparin Vs. Saline For Peripheral I.V. Locks In Children, Charmaine Kleiber, Kirsten Hanrahan, C. Fagan, M. Zittergruen
Kirsten M. Hanrahan
PURPOSE: To determine the efficacy of saline versus heparin flush solution to maintain peripheral i.v. locks in a pediatric population. METHOD: A prospective, randomized, double-blind design was used. A sample of 124 peripheral i.vs. were flushed with either saline or heparin in saline. Subjects were infants over 28 days of age and children. FINDINGS: The heparin and saline groups were comparable for total hours duration of the i.v. and for incidence of complications. CONCLUSIONS: Saline is efficacious in maintaining patency of peripheral i.v. locks in children over 28 days of age.
Development Of The Distraction Coaching Index, Charmaine Kleiber, Ann Mccarthy, Kirsten Hanrahan, L. Myers, N. Weathers
Development Of The Distraction Coaching Index, Charmaine Kleiber, Ann Mccarthy, Kirsten Hanrahan, L. Myers, N. Weathers
Kirsten M. Hanrahan
Children's distress during medical procedures can be decreased when professionals or parents provide distraction coaching, but the quality of distraction may contribute to the variation in the results. This article describes the development of the Distraction Coaching Index (DCI), a tool for measuring the quality and frequency of distraction coaching. Nominal group technique and consensus agreement were used for concept clarification and development of behavioral indicators and descriptors. Videotapes of untrained parents, trained parents, and expert professional coaches, who provided distraction to children (4-10 years old) undergoing peripheral intravenous catheter insertion, were used to assess interrater reliability and construct validity. …
Strategies For Salivary Cortisol Collection And Analysis In Research With Children, Kirsten Hanrahan, Ann Mccarthy, Charmaine Kleiber, S. Lutgendorf, E. Tsalikian
Strategies For Salivary Cortisol Collection And Analysis In Research With Children, Kirsten Hanrahan, Ann Mccarthy, Charmaine Kleiber, S. Lutgendorf, E. Tsalikian
Kirsten M. Hanrahan
Salivary cortisol has emerged in pediatric research as an easy-to-collect, relatively inexpensive, biologic marker of stress. Cortisol is highly variable and is responsive to a wide range of factors that should be considered when incorporating this measure into research with children. Strategies for sample collection include: (1) standardizing the time for sample collection, including baseline samples; (2) using consistent collection materials and methods; (3) controlling for certain drinks, foods, medications, and diagnoses; and (4) establishing procedures and protocols. Other strategies for laboratory analyses include: (1) selecting the appropriate assay and laboratory; (2) identifying units of measure and norms; and (3) …
Normative Salivary Cortisol Values And Responsivity In Children, Ann Mccarthy, Kirsten Hanrahan, Charmaine Kleiber, M. Zimmerman, S. Lutgendorf, E. Tsalikian
Normative Salivary Cortisol Values And Responsivity In Children, Ann Mccarthy, Kirsten Hanrahan, Charmaine Kleiber, M. Zimmerman, S. Lutgendorf, E. Tsalikian
Kirsten M. Hanrahan
This was a descriptive study on normative salivary cortisol values and responsivity to a hospital clinic visit and an intravenous (IV) procedure in children. The study presented was a subproject of a primary research study that examined parents coaching their children requiring an IV placement in the use of distraction. One measure of child response in the primary study, salivary cortisol, was included to further our understanding of children's physiologic response to stressful and painful stimuli. Salivary cortisol samples were obtained from 384 children aged between 4 and 10 years upon arrival to the clinic and 20 minutes after their …
Integrating Molecular Genetics Analyses Into Clinical Research, D. Schutte, Ann Mccarthy, M. Floria-Santos, Kirsten Hanrahan, J. Murray, Charmaine Kleiber
Integrating Molecular Genetics Analyses Into Clinical Research, D. Schutte, Ann Mccarthy, M. Floria-Santos, Kirsten Hanrahan, J. Murray, Charmaine Kleiber
Kirsten M. Hanrahan
The integration of molecular genetics approaches into the study of complex health phenomena is an increasingly important and available strategy for researchers across the health science disciplines. Pain sensation and response to painful stimuli are examples of complex health phenomena that are particularly amenable to molecular genetics approaches. Both human and animal model research suggests that differences in these responses may be related, in part, to variation in the genes that modulate sensation and behavior. The authors are currently managing a large cross-disciplinary research effort to identify child characteristics, including genotypes, that predict the degree of distress displayed by children …
Factors Explaining Children's Responses To Intravenous Needle Insertions, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen
Factors Explaining Children's Responses To Intravenous Needle Insertions, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen
Kirsten M. Hanrahan
BACKGROUND: Previous research shows that numerous child, parent, and procedural variables affect children's distress responses to procedures. Cognitive-behavioral interventions such as distraction are effective in reducing pain and distress for many children undergoing these procedures. OBJECTIVES: The purpose of this report was to examine child, parent, and procedural variables that explain child distress during a scheduled intravenous insertion when parents are distraction coaches for their children. METHODS: A total of 542 children, between 4 and 10 years of age, and their parents participated. Child age, gender, diagnosis, and ethnicity were measured by questions developed for this study. Standardized instruments were …
Predictors Of Topical Anesthetic Effectiveness In Children, Charmaine Kleiber, D. Schutte, Ann Mccarthy, M. Floria-Santos, J. Murray, Kirsten Hanrahan
Predictors Of Topical Anesthetic Effectiveness In Children, Charmaine Kleiber, D. Schutte, Ann Mccarthy, M. Floria-Santos, J. Murray, Kirsten Hanrahan
Kirsten M. Hanrahan
Some children report significant pain with peripheral intravenous catheter (IV) insertion, despite the appropriate use of topical lidocaine anesthetics. This analysis of data from an existing study identified factors related to variation in topical anesthetic effectiveness used for IV insertion. The children (n = 218) in this investigation were 4 to 10 years old and undergoing a scheduled IV insertion. Inclusion criteria were (1) topical anesthetic was used according to manufacturer's recommendations, (2) DNA material was available, and (3) child completed a self-report measure of pain intensity (Oucher scale). Low pain phenotype was defined as a pain intensity score of …
Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen
Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen
Kirsten M. Hanrahan
This study evaluates the impact of parent-provided distraction on children's responses (behavioral, physiological, parent, and self-report) during an IV insertion. Participants were 542 children, 4 to 10 years old, randomized to an experimental group that received a parent distraction coaching intervention or to routine care. Experimental group children had significantly less cortisol responsivity (p = .026). Children that received the highest level of distraction coaching had the lowest distress on behavioral, parent report, and cortisol measures. When parents provide a higher frequency and quality of distraction, children have lower distress responses on most measures.
Cognitive Behavioral Interventions For Children During Painful Procedures: Research Challenges And Program Development, Ann Mccarthy, V. Cool, Kirsten Hanrahan
Cognitive Behavioral Interventions For Children During Painful Procedures: Research Challenges And Program Development, Ann Mccarthy, V. Cool, Kirsten Hanrahan
Kirsten M. Hanrahan
The purpose of this report is to describe a pilot program designed to introduce the use of cognitive behavioral interventions for painful pediatric procedures at a university hospital, and to discuss the challenges that occurred during this process. Participants in the program included ten parents and their children who were newly diagnosed with leukemia, and staff who provided treatment for these children. Measures included direct videotaped observations of the children, perceptions of pain and anxiety completed by children, parents, and staff, and parent and staff ratings of satisfaction with the program. Results indicated strong acceptance of the interventions. This report …