Young children's distress during radiological examinations

This thesis presents a series of studies aiming to understand young children's (12 to 41 months of age) distress behaviour during radiological examinations. A multifactorial model is proposed to account for variations in the amount of distress behaviour children exhibit during radiological examinations. By way of testing the model, the research examines the relative contribution of a number of variables to such distress behaviour. The Feasibility Study (n=34) was designed mainly to obtain an overall understanding of the different examinations that young children receive at the Department of Paediatric Radiology in a children's hospital. It involved twelve different examinations. The purposes of the Pilot Study (n=48) were to ensure that it was possible to assess in a systematic way the patterns of behaviour presented by young children undergoing ultrasound scans, and to identify and refine the structure of the instruments to be used in a substantial study which would be submitted to the hospital's Research Ethics Committee. The ultrasound scan was the sole examination observed in this study. The Intervention Study's (n=213) main purpose was to assess whether an approach which involved prior rehearsal of the examination and an active, structured role for the parent and child, was effective in reducing children's distress. For this study, two different examinations, i.e., micturating cystogram and ultrasound scan were included. The aims of the Study of Staff Behaviour (n=41) were to show whether the behaviour of the staff contributed to the child's reduced level of distress during the examination. It comprised observations of the ultrasound scan examinations. The results demonstrated that the ultrasound examination, which was not painful or uncomfortable, was almost as distressing for these young children as an examination (the micturating cystogram) which involved substantial discomfort. Parent-child preparation was not effective in preventing or reducing the children's distress. However, staff behaviour during the initial phase of the examination was an important determinant of the child's subsequent distress behaviour