This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children’s responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models. Models were validated using multiple cross-validation tests and by comparing variables identified as explanatory in the traditional versus support vector machine regression. Rule-based approaches were applied to the model outputs to identify overall risk for distress. A decision tree was then applied to evidence-based instructions for tailoring distraction to characteristics and preferences of the parent and child. The resulting decision support computer application, titled Children, Parents and Distraction, is being used in research. Future use will support practitioners in deciding the level and type of distraction intervention needed by a child undergoing a healthcare procedure.
Author Affiliations: College of Nursing, University of Iowa, Nursing Research and Evidence-Based Practice, University of Iowa Hospitals and Clinics, Iowa City (Dr Hanrahan); College of Nursing, University of Iowa (Drs McCarthy and Kleiber); Argyros School of Business and Economics, Chapman University, Orange, California (Dr Ataman); and Tippie College of Business (Dr Street), Biostatistics Consulting Center, Department of Biostatistics (Dr Zimmerman), and College of Nursing (Dr Ersig), University of Iowa.
This study was funded by R01 grant NR05269-01A2 from the National Institute for Nursing Research.
The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.
Corresponding author: Kirsten Hanrahan, ARNP, DNP, College of Nursing, University of Iowa, Nursing Research and Evidence-Based Practice, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, T 140 CNO, Iowa City, IA 52242 (firstname.lastname@example.org).
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