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Comparative study of distraction versus topical anesthesia for pediatric pain management during immunizations
L L Cohen1, R L Blount, R J Cohen
1Department of Psychology, Washington State University, Pullman 99164-4820, USA. CohenL@WSU.Edu
Insights
Distraction techniques significantly reduced distress during pediatric immunizations compared to anesthetic cream (EMLA) or typical care. Children showed better coping and less distress with distraction, making it a preferred and economical option.
Area of Science:
- Pediatric Health
- Pain Management
- Psychology
Background:
- Pediatric immunizations can cause anxiety and pain in children.
- Current pain management strategies include anesthetics and typical care.
- Need for effective, child-centered interventions during vaccinations.
Purpose of the Study:
- To compare the effectiveness of distraction, anesthetic cream (EMLA), and typical care for managing distress during pediatric immunizations.
- To evaluate child distress, coping mechanisms, and nurse coaching across different intervention conditions.
Main Methods:
- 39 fourth-grade students participated in a 6-month study involving a 3-injection vaccination series.
- Observational measures assessed child distress, nurse coaching, and child coping.
- Participant ratings and heart rate were recorded; satisfaction was surveyed.
Main Results:
- Distraction led to increased nurse coaching, child coping, and decreased child distress compared to EMLA and typical care.
- EMLA did not improve child coping or reduce distress; typical care showed better coping trends than EMLA.
- No significant differences in participant ratings or heart rate were observed among conditions, though all improved over time.
Conclusions:
- Distraction is a superior intervention for reducing distress and enhancing coping during pediatric immunizations.
- Children preferred distraction and typical care over EMLA; nurses found value in all methods.
- Distraction is a more economical and effective strategy than EMLA for pediatric vaccination pain management.
Abstract:
This study compared distraction, an anesthetic (eutectic mixture of local anesthetics [EMLA]), and typical care during pediatric immunizations. Participants were 39 4th graders receiving a 3-injection vaccination series over a 6-month period. Children displayed low distress despite reporting moderate anxiety and pain. Distraction resulted in more nurse coaching and child coping and less child distress than did EMLA or typical care on an observational measure. EMLA did not result in increased child coping or decreased distress. In fact, the nurse coached more, and trends suggested that children coped more with typical care than with EMLA. Whereas participant ratings and heart rate did not differ among conditions, all 3 conditions demonstrated improvements over time with these measures. Satisfaction ratings suggested that children preferred the treatments to typical care, whereas the nurse appreciated aspects of each of the conditions. Finally, distraction was more economical than EMLA.