Observational Behavioral Coding in the Pediatric Emergency Department: Development of the Emergency Department Child Behavior Coding System

被引:0
作者
Martin, Sarah R. [1 ,2 ,3 ]
Heyming, Theodore W. [3 ,4 ]
Valdez, Brooke J. [3 ]
Salas, Luis H. [3 ]
Cohen, Lindsey L. [5 ]
Fortier, Michelle A. [1 ,2 ,6 ,7 ]
Lee, Kent [3 ]
Kaplan, Sherrie [8 ]
Kain, Zeev N. [1 ,2 ,7 ,9 ]
机构
[1] Univ Calif Irvine, Irvine Sch Med, Dept Anesthesiol & Perioperat Care, Irvine, CA USA
[2] Univ Calif Irvine, Ctr Stress & Hlth, Irvine, CA USA
[3] Childrens Hosp Orange Cty, Emergency Med, Orange, CA USA
[4] Univ Calif Irvine, Dept Emergency Med, Orange, CA USA
[5] Georgia State Univ, Dept Psychol, Atlanta, GA USA
[6] Univ Calif Irvine, Sue & Bill Gross Sch Nursing, Irvine, CA USA
[7] Childrens Hosp Orange Cty, Orange, CA USA
[8] Univ Calif Irvine, Irvine Sch Med, Dept Med, Irvine, CA USA
[9] Yale Univ, Ctr Child Study, New Haven, CT USA
基金
美国国家卫生研究院;
关键词
behavior; emergency department; measure-; ment; pain; pediatric; POSTANESTHESIA CARE-UNIT; PREOPERATIVE ANXIETY; OBSERVER AGREEMENT; PAIN; PREDICTORS; STRESS; SCALE;
D O I
10.1016/j.jemermed.2024.01.019
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Despite improvements over the past decade, children continue to experience significant pain and distress surrounding invasive procedures in the emergency department (ED). To assess the impact of newly developed interventions, we must create more reliable and valid behavioral assessment tools that have been validated for the unique settings of pediatric EDs. Objective: This study aimed to create and test the Emergency Department Child Behavior Coding System (ED-CBCS) for the assessment of child distress and nondistress behaviors surrounding pediatric ED procedures. Methods: Via an iterative process, a multidisciplinary expert panel developed the ED-CBCS, an advanced time-based behavioral coding measure. Interrater reliability and concurrent validity were examined using 38 videos of children aged from 2 to 12 years undergoing laceration procedures. Face, Legs, Activity, Cry, Consolability (FLACC) scale scores were used to examine concurrent validity. Results: The final ED-CBCS included 27 child distress and nondistress behaviors. Time-unit kappa values from 0.64 to 0.98 and event alignment kappa values from 0.62 to 1.00 indicated good to excellent inter-rater reliability for all but one of the individual codes. ED-CBCS distress ( B = 1.26; p < 0.001) and nondistress behaviors ( B = -0.69, p = 0.025) were independently significantly associated with FLACC scores, indicating concurrent validity. Conclusions: We developed a psychometrically sound tool tailored for pediatric ED procedures. Future work could use this measure to better identify behavioral targets and test the effects of interventions to relieve pediatric ED pain and distress. (c) 2024 Elsevier Inc. All rights reserved.
引用
收藏
页码:e50 / e59
页数:10
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