title: Children's experiences of procedural pain management in conjunction with trauma wound dressings.
abstract: OBJECTIVE
  This paper is a report of the experiences of children (5-10 years) of procedural pain when they underwent a trauma wound care session.
  
  
  BACKGROUND
  Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children's experiences of comforting activities in conjunction with trauma wound dressings.
  
  
  METHODS
  This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5-10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis.
  
  
  RESULTS
  Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management.
  
  
  CONCLUSIONS
  Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes.
authors.affiliation: Department of Paediatric Anaesthesia and Intensive Care Unit, The Queen Silvia Children's Hospital, Göteborg, Sweden. stefan.r.nilsson@vgregion.se
authors.forename: Stefan
authors.initials: S
authors.lastname: Nilsson
authors.forename: Carina
authors.initials: C
authors.lastname: Hallqvist
authors.forename: Birgitta
authors.initials: B
authors.lastname: Sidenvall
authors.forename: Karin
authors.initials: K
authors.lastname: Enskär
mesh_terms: D000223:Adaptation, Psychological; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D015400:Clinical Nursing Research; D005239:Fear; D005260:Female; D018939:Holistic Nursing; D006801:Humans; D008297:Male; D009742:Nursing Theory; D010146:Pain / Q000209:etiology / Q000451:nursing* / Q000523:psychology; D010358:Patient Participation / Q000523:psychology*; D036301:Qualitative Research; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000451:nursing* / Q000523:psychology