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Preparing children for venepuncture. The effect of an integrated intervention on distress before and during
A M Kolk1, R van Hoof, M J Fiedeldij Dop
1Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Insights
Preparing children for blood draws significantly reduces their distress before and during the procedure. This preparation involves local anesthesia, information, and parental involvement, benefiting all children regardless of background.
Area of Science:
- Pediatric healthcare
- Child psychology
- Pain management
Background:
- Venepuncture (routine blood sampling) causes significant distress in children, both during and in anticipation of the procedure.
- Existing interventions often focus on only one phase of the venepuncture process.
- A comprehensive approach addressing both anticipatory and procedural distress is needed.
Purpose of the Study:
- To evaluate the effectiveness of an integrated preparation strategy on reducing children's distress during venepuncture.
- To assess distress levels before and during the procedure in prepared versus unprepared children.
Main Methods:
- A randomized controlled trial with 31 children assigned to either a preparation group or a no-preparation control group.
- The preparation group received local anesthesia, sensory and procedural information, and parental involvement.
- Independent raters, blinded to group assignment, used the Groninger Distress Scale to score videotaped child behavior.
Main Results:
- Children in the preparation group exhibited significantly lower distress levels before and during venepuncture compared to the control group.
- The positive effect of preparation was consistent across different genders, ethnic origins, ages, and injection histories.
- Parental tension did not influence the effectiveness of the preparation strategy.
Conclusions:
- An integrated preparation strategy combining local anesthesia, information, and parental involvement is effective in reducing children's distress during venepuncture.
- This multimodal approach successfully mitigates distress in both anticipatory and procedural phases.
- The findings support the routine implementation of this preparation protocol for pediatric blood sampling.
Abstract:
Venepuncture for routine blood sampling is a very distressing experience for a considerable number of children. Not only do they express high levels of distress during venepuncture but also in anticipation of the procedure. Therefore, prevention or reduction of distress should focus on both phases of the procedure. To this end, three preparation elements were combined: local anaesthesia of the skin, provision of sensory and procedural information, and involvement of the parent. In order to test the effect of this integrated procedure on the distress reactions of young children before as well as during venepuncture, 31 children were randomly assigned to one of two conditions: preparation or no preparation. Independent raters, who were blind to group assignments, scored segments of the videotaped behaviour of the children, according to the Groninger Distress Scale. Prepared children displayed significantly less distress before and during venepuncture than not-prepared children, regardless of their gender, ethnical origin, age, injection history, and the tension of their parent.