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Attitudes and Opinions of Adolescent Females Regarding 2 Methods of Bladder Filling for Transabdominal Ultrasound

A Q-Sort Study

Waterhouse, Marie R. MD*†; Pham, Phung K. MS, MA*; Chang, Todd P. MD, MAcM*†

doi: 10.1097/PEC.0000000000001645
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Objectives Adolescent female patients who are not sexually active and who present to a pediatric emergency department with abdominal pain require a full bladder prior to transabdominal ultrasound. Procedures to fill the bladder are largely institution or provider dependent. We examined adolescent females' attitudes and opinions toward 2 common methods of bladder filling, intravenous fluid administration and transurethral Foley catheter placement, by means of a Q-sort study.

Methods Two convenience samples of adolescent female patients in the pediatric emergency department at an academic children's hospital participated in the study. In part 1, subjects underwent a semistructured interview to elicit their opinions regarding 2 methods of bladder filling: intravenous fluid or transurethral catheter. The summation of subject statements was then narrowed down to a final Q set of 25 statements. In part 2, a second sample of subjects independently arranged this Q set according to their own agreement or disagreement with each statement. Principal components analysis was conducted to examine factors or collections of statements representing a shared viewpoint and to describe commonalities.

Results Part 1 was completed with 9 subjects, and part 2 with 26 subjects. Factors revealed from the Q-sort data included acceptance of tests deemed medically necessary, desire for parental involvement, and a wish to minimize discomfort. Most adolescents aligned with 1 of these 3 factors.

Conclusions Adolescent female patients varied in their attitudes and opinions regarding intravenous catheter hydration and Foley catheter placement for transabdominal ultrasound. Knowledge of adolescent viewpoints may help better inform practitioner-patient communication for this procedure.

From the *Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles; and

Keck School of Medicine, University of Southern California, Los Angeles, CA.

Disclosure: The authors declare no conflict of interest.

Reprints: Todd P. Chang, MD MAcM, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027 (e-mail: tochang@chla.usc.edu).

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