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Altering children's distress behavior during orthopedic cast removal
Insights
Providing sensory information about physical sensations during threatening experiences significantly reduces children's distress. This finding highlights the importance of managing expectations for better coping mechanisms in pediatric patients.
Area of Science:
- Psychology
- Pediatric Medicine
- Health Psychology
Background:
- Discrepancy between expected and experienced physical sensations during threatening events can cause distress.
- Understanding how to mitigate distress in children during medical procedures is crucial.
Purpose of the Study:
- To test the hypothesis that sensory information reduces distress during a threatening experience.
- To investigate the impact of different types of preparatory information on children's distress.
Main Methods:
- 84 children (6-11 years) undergoing orthopedic cast removal were assigned to sensory information, procedure information, or control groups.
- Distress was measured using observed behaviors and pulse rate.
- A two-factor analysis of variance was used to analyze the data.
Main Results:
- Children receiving sensory information showed significantly less distress compared to the control group.
- Children with pre-existing fear exhibited higher distress levels.
- Pulse rate changes mirrored distress scores but were not statistically significant.
Conclusions:
- Providing detailed sensory information is effective in reducing distress in children during medical procedures.
- Managing children's expectations about physical sensations is key to minimizing anxiety.
- Further research could explore other interventions to reduce pediatric procedural distress.
Abstract:
The hypothesis treated was that discrepancy between expected and experienced physical sensations (what is felt, seen, heard, tasted, and smelled) during a threatening experience will result in distress. The subjects were 84 children, 6 to 11 years of age, male and female. The threatening experience was orthopedic cast removal. Tape recorded preparatory information was used to vary systematically expectations about physical sensations. The children were randomly assigned to one of three information groups: 1) sensory information which described the sensory experience during cast removal, 2) procedure information which described the steps of the experience, 3) control group which heard no tape recorded information. Nonverbal and verbal signs of distress reactions and the pulse rate were observed during cast removal. Signs of distress were scaled from zero to two, with zero meaning no distress behaviors and two, high distress behavior. A two-factor analysis of variance (two levels of pre-fear and three levels of information) was used for analysis. As hypothesized, the mean distress score for the sensation group (.50) differed significantly from the control group mean (1.00 p less than .025). The procedure group distress score mean (.71) fell between the sensation and control group means but did not differ significantly from the control group mean. The no pre-fear group distress score mean (.52) was significantly lower than the some pre-fear group mean (1.00 p less than .02). Mean pulse rate changes for information groups for before to during cast removal were in the same order as the distress scores, but the differences were not statistically significant. The findings were similar to those from other tests of the hypothesis.