Bowlby's attachment theory-based postural intervention for infants and toddlers after transcatheter arterial sclerotherapy and embolization: A historically controlled study.

PURPOSE: This study aimed to evaluate the effects of Bowlby's attachment theory-based postural intervention on puncture site complications and postoperative distress in infants and toddlers following Transcatheter Arterial Sclerotherapy and Embolization (TASE).

METHODS

A strictly controlled historical case-control study design was employed, enrolling children aged 30 days to 3 years undergoing TASE via femoral artery puncture for peripheral vascular malformations. The control group (n = 430) received conventional postoperative positioning care: supine position with the operated limb extended and immobilized. The experimental group (n = 356) received the attachment-based postural intervention, selecting horizontal, inclined, or vertical holding positions according to the infant's or toddler's age, supplemented with manual knee restraint when necessary. Outcomes included puncture site complications, FLACC scores, crying scores, position tolerance time, and physiological stress indicators.

RESULTS

The attachment-based postural intervention did not increase the risk of puncture site complications compared to conventional positioning (p>0.05). No severe complications occurred in either group. Experimental group patients demonstrated significantly longer tolerated positioning times than the control group (p<0.001). Within three hours of returning to the ward, the experimental group exhibited significantly lower FLACC scores, crying scores, heart rate increases, and systolic blood pressure increases compared to the control group (p<0.001).

CONCLUSION

The attachment-based postural intervention was associated with significantly enhanced comfort and reduced distress without increasing complication risks, suggesting its potential for integration into family-centered pediatric nursing practice.

PRACTICE IMPLICATIONS: Pediatric nurses can implement this intervention as a safe, effective, and humanizing alternative to traditional physical restraint for postoperative immobilization in young children.