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Effects of distraction on children's pain and distress during medical procedures: a meta-analysis
1College of Nursing, University of Iowa, University of Iowa Hospitals and Clinics, Iowa City, USA. charmaine-kleiber@uiowa.edu
Insights
Distraction effectively reduces children's distress during medical procedures. While it also lessens pain, this effect varies, especially in younger children, suggesting other factors are involved.
Area of Science:
- Pediatric Psychology
- Medical Procedure Outcomes
- Behavioral Intervention Research
Background:
- Assessing distraction's efficacy in mitigating pediatric distress and pain during medical procedures is challenging due to small sample sizes and inconsistent findings in existing research.
- Previous studies often lack the statistical power to draw definitive conclusions about the benefits of distraction interventions for children undergoing medical care.
Purpose of the Study:
- To determine the average effect sizes of distraction interventions on children's distress behaviors during medical procedures.
- To evaluate the mean effect sizes of distraction on young children's self-reported pain experienced during medical procedures.
- To identify potential moderator variables influencing the effectiveness of distraction on pain perception in pediatric populations.
Main Methods:
- A meta-analysis was conducted using Hunter and Schmidt's (1990) procedures.
- Data from 16 studies (n=491) were analyzed for effects on children's distress behavior.
- Data from 10 studies (n=535) were analyzed for effects on children's self-reported pain.
Main Results:
- Distraction demonstrated a mean effect size of 0.33 for reducing distress behavior, with 74% of variance attributable to error.
- A mean effect size of 0.62 was found for distraction's impact on pain, with 35% of variance explained.
- Limiting the pain analysis to children aged 7 years or younger (n=286) increased explained variance to 60%.
Conclusions:
- Distraction positively impacts children's distress behavior during medical procedures across diverse populations.
- The effectiveness of distraction in reducing self-reported pain is moderated by variables such as age and procedure type.
- While age and procedure type explain significant variance in pain reduction, unidentified moderators likely also play a role.
Background:
It is difficult to determine the usefulness of distraction to decrease children's distress behavior and pain during medical procedures because many studies use very small samples and report inconsistent findings.
Objectives:
To investigate the mean effect sizes across studies for the effects of distraction on young children's distress behavior and self-reported pain during medical procedures.
Method:
Hunter and Schmidt's (1990) procedures were used to analyze 16 studies (total n = 491) on children's distress behavior and 10 studies (total n = 535) on children's pain.
Results:
For distress behavior, the mean effect size was 0.33 (+/-0.17), with 74% of the variance accounted for by sampling and measurement error. For pain, the mean effect size was 0.62 (+/-0.42) with 35% of the variance accounted for. Analysis of studies on pain that limited the sample to children 7 years of age or younger (total n = 286) increased the amount of explained variance to 60%.
Conclusions:
Distraction had a positive effect on children's distress behavior across the populations represented in this study. The effect of distraction on children's self-reported pain is influenced by moderator variables. Controlling for age and type of painful procedure significantly increased the amount of explained variance, but there are other unidentified moderators at work.
