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Using distraction to reduce reported pain, fear, and behavioral distress in children and adolescents: a multisite
K L Carlson1, M Broome, J A Vessey
1College of Nursing, University of New Mexico, Albuquerque, USA. kcarlson@salud.unm.edu
Insights
Distraction interventions, like kaleidoscopes, did not significantly reduce pain or distress in children during venipuncture. Age influenced distress levels, but the intervention
Area of Science:
- Pediatric Pain Management
- Child Psychology
- Clinical Interventions
Background:
- Distraction is a known effective method for reducing procedural pain and distress.
- Despite evidence, distraction is not routinely implemented in clinical settings.
- This study investigates distraction's effectiveness and feasibility during venipuncture.
Purpose of the Study:
- To evaluate the effectiveness of distraction in reducing behavioral distress, pain, and fear.
- To assess the feasibility of implementing distraction during venipuncture or intravenous insertion.
- To identify factors influencing the success of distraction interventions in pediatric patients.
Main Methods:
- A randomized controlled trial involving 384 children across 13 children's hospitals.
- Two-group design comparing distraction intervention with standard care.
- Data collected on behavioral distress, fear, and self-reported pain.
Main Results:
- Age was a significant factor influencing observed behavioral distress, fear, and pain.
- The use of a kaleidoscope as a distraction tool did not significantly reduce pain or distress.
- No statistically significant difference in pain or distress was observed between groups.
Conclusions:
- The study's findings contradict anecdotal evidence regarding the efficacy of distraction.
- Methodological limitations may have masked potential benefits of the distraction intervention.
- Further research is needed to understand the nuances of distraction effectiveness in pediatric procedural care.
Issues And Purpose:
Distraction during painful procedures has been shown to be effective in previous studies, yet this simple intervention is not used routinely. This study examined the effectiveness and feasibility of distraction in reducing behavioral distress, pain, and fear during venipuncture or intravenous insertion.
Design And Methods:
A two-group randomized design with 384 children in 13 children's hospitals.
Results:
Age was a significant factor in observed behavioral distress, reports of fear, and self-reported pain. The use of a kaleidoscope, however, did not significantly reduce pain or distress during venipuncture or i.v. insertion.
Practice Implications:
Failure of the distraction intervention to reach statistical significance in this study is puzzling, given anecdotal reports of clinical efficacy. Methodological issues may have obscured actual differences between experimental and control groups.