title: The role of parental presence in the context of children's medical procedures: a systematic review.
abstract: BACKGROUND
  There are conflicting views and practices regarding whether or not parents should be present at the time of their child's medical procedure. A systematic review was conducted to assess the effects of parental presence in the paediatric treatment room on child, parent and health professional outcomes and to synthesize this body of literature.
  
  
  METHODS
  Based on a comprehensive literature search, studies investigating parental presence in the paediatric treatment room were included in the review if they had a concurrent control group (i.e. a parent-absent group).
  
  
  RESULTS
  A total of 28 studies met inclusion criteria, which included 1256 children with a parent present and 1025 children without a parent present. There were mixed findings regarding the effect of parental presence on measures of child distress and affect, however, studies of lower levels of evidence were more likely to report significant results. Parents who were present during their child's medical intervention were either better off or no different from parents who were absent with regard to their levels of distress and satisfaction. There was no evidence of increased technical complications nor elevated staff anxiety for health professionals attending to children with a parent present as compared to attending to children without their parents.
  
  
  CONCLUSIONS
  Although parental presence may not have a clear, direct influence on child distress and behavioural outcomes, there are potential advantages for parents. It seems appropriate that clinicians provide parents with the opportunity to be present during their child's painful procedure.
authors.affiliation: Pain Research Unit, Sydney Children's Hospital, Randwick, Australia. piirat@sesahs.nsw.gov.au
authors.forename: T
authors.initials: T
authors.lastname: Piira
authors.forename: T
authors.initials: T
authors.lastname: Sugiura
authors.forename: G D
authors.initials: GD
authors.lastname: Champion
authors.forename: N
authors.initials: N
authors.lastname: Donnelly
authors.forename: A S J
authors.initials: AS
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D004644:Emotions; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D010287:Parent-Child Relations; D010290:Parents; D017060:Patient Satisfaction; D010372:Pediatrics; D002666:Psychology, Child; D012107:Research Design; D013315:Stress, Psychological