Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Acil Servise Başvuran Çocuklarda Hemşire, Ebeveyn ve Çocuğun Ağrı Değerlendirmesinin Karşılaştırılması: Tanımlayıcı ve Karşılaştırmalı Bir Çalışma
Comparison of Nurse, Parent, and Child's Pain Assessment in Children Presenting to the Emergency Department: A Descriptive and Comparative Study
Ayla İrem AYDINa , Nevin ALb,c
aBursa Uludağ Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Bursa, Türkiye
bBursa Dörtçelik Çocuk Hastalıkları Hastanesi, Bursa, Türkiye
cİstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, Çocuk Sağlığı ve Hastalıkları Hemşireliği Doktora Programı, İstanbul, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(2):319-24
doi: 10.5336/nurses.2023-99810
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, acil servise başvuran çocuk hastalarda hemşire, ebeveyn ve çocuğun ağrı değerlendirmesini karşılaştırmaktır. Gereç ve Yöntemler: Bu tanımlayıcı ve karşılaştırmalı tipteki çalışma, Nisan-Mayıs 2023 tarihleri arasında bir devlet hastanesinin çocuk acil servisinde 7-18 yaş grubu 201 çocukla yürütüldü. Çocukların ağrı değerlendirmesinde çocuğun öz bildirimiyle, anne ve hemşirenin değerlendirdiği ağrı şiddeti skorları karşılaştırıldı. Çocukların ağrı değerlendirmesinde görsel analog skala [visual analogue scale (VAS)] kullanıldı. Veriler SPSS 23.0 programında sayı, yüzde, ortalama, standart sapma, medyan istatistikleri kullanılarak analiz edildi. Çocuk, hemşire ve ebeveyn arasındaki ağrı skorlarına ilişkin uyumun değerlendirilmesinde, sınıf içi korelasyon katsayısı [intraclass correlation coefficient (ICC)] kullanıldı. Bulgular: Çalışmaya katılan çocukların %67,7'sinin acil servise başlıca başvuru nedeni ağrı şikâyetiydi ve çocukların ağrı skoru ortalaması 5,87±1,98 olarak belirlendi. Ağrı değerlendirmesi yapan hemşirelerin %75,6'sının çalışma deneyimi 10 yıldan fazlaydı. Annenin değerlendirdiği ağrı skoruyla çocuğun değerlendirdiği ağrı skoru arasında orta derecede bir uyum olduğu belirlenirken (ICC=0,640), hemşirenin değerlendirdiği ağrı skoruyla çocuğun ağrı skoru arasında zayıf düzeyde bir uyum olduğu saptandı (ICC=0,436). Anne ve çocuk tarafından değerlendirilen ağrı skoru medyanı 6 (2-10), hemşirenin değerlendirdiği ağrı skoru medyanı 4 (0-8) olarak bulundu. Sonuç: Acil servise başvuran çocuklar orta derecede ağrı bildirmiştir. Ebeveynler, çocuğun ağrı değerlendirmesine en yakın uyumu sağlamıştır. Ağrının bireysel olarak bildirimi, ağrı değerlendirmesinin altın standardıdır. Bununla birlikte ağrı değerlendirmesinin çocuktan bireysel bildirim olarak alınamadığı durumlarda, ağrının değerlendirmesi ebeveynler tarafından yapılabilir.

Anahtar Kelimeler: Ağrı; çocuk; hemşire; ebeveyn
ABSTRACT
 Objective: The aim of this study was to compare the pain assessment of nurse, parent, and child in pediatric patients admitted to the emergency department. Material and Methods: This descriptive and comparative study was conducted with 201 children aged 7-18 years in the pediatric emergency department of a state hospital between April and May 2023. In the pain assessment of the children, the child's self-report and the pain intensity scores assessed by the mother and the nurse were compared. Visual analogue scale (VAS) was used for pain assessment of children. Data were analyzed using number, percentage, mean, standard deviation and median statistics in the SPSS 23.0 program. The intraclass correlation coefficient (ICC) was used to evaluate the concordance of pain scores between the child, nurse, and parent. Results: The main reason for applying to the emergency department in 67.7% of the children participating in the study was pain, and the average pain score of the children was determined as 5.87±1.98. 75.6% of the nurses performing pain assessment had more than 10 years of working experience. There was a moderate agreement between the mother's pain score and the child's pain score (ICC=0.640), while there was a weak agreement between the nurse's pain score and the child's pain score (ICC=0.436). The median pain score the mother and child evaluated was 6 (2-10), and the median pain score evaluated by the nurse was 4 (0-8). Conclusion: Children presenting to the emergency department reported moderate pain. Parents provided the closest adherence to the child's pain assessment. Self-report of pain is the gold standard of pain assessment. However, in cases where pain assessment cannot be self-reported by the child, pain assessment can be performed by the parents.

Keywords: Pain; child; nursing; parent
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