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Distraction for children of different ages who undergo repeated needle sticks
Lynnda M Dahlquist1, Suzanne M Busby, Keith J Slifer
1University of Maryland Baltimore County, Baltimore, MD 21250, USA.
Insights
This study shows that distraction techniques effectively reduced pain and distress in children with chronic illnesses during needle sticks. Parents learned to coach their children, leading to sustained improvements in managing medical procedure anxiety.
Area of Science:
- Pediatric Psychology
- Pain Management
- Child Health
Background:
- Children with chronic illnesses often experience significant pain and distress during medical procedures like needle sticks.
- Managing procedural pain and distress is crucial for improving treatment adherence and quality of life in pediatric patients.
Purpose of the Study:
- To evaluate the effectiveness of a distraction intervention for managing pain and behavioral distress in children undergoing repeated needle sticks.
- To assess the role of parents in coaching children through distraction techniques during medical procedures.
Main Methods:
- A distraction intervention using age-appropriate cognitive distractors was implemented for six children (ages 2-8) with chronic illnesses.
- Parents were trained by a therapist to coach their children in distraction techniques during procedures like intramuscular injections, port accesses, and IV placements.
- Outcomes measured included child's behavioral distress, heart rate, parent-reported fear and upset, and nurse-reported cooperation.
Main Results:
- Five out of six children showed reductions in behavioral distress during the distraction intervention.
- Improvements were observed in parental reports of child distress, nurse ratings of cooperation, and parents' self-reported upset.
- One child maintained improvements for 16 weeks without therapist involvement, demonstrating lasting effects.
Conclusions:
- Distraction interventions, with parental coaching, are effective in reducing procedural pain and distress in children with chronic illnesses.
- This approach can improve cooperation and reduce parental anxiety during medical procedures.
- The positive effects of distraction techniques can be sustained long-term, reducing the need for ongoing therapist support.
Abstract:
A distraction intervention for pain management and behavioral distress was implemented for six children with chronic illnesses and their parents as the children underwent repeated needle sticks. The children ranged in age from two to eight years. Several different cognitive distractors were used for the children based on their respective developmental levels. The needle stick procedures during which treatment was implemented included intramuscular injections, implanted port accesses, and intravenous placements. Nine sessions of distraction were provided in which a therapist taught parents to coach their children to use distraction techniques. Dependent measures included the child's behavioral distress and heart rate, parent ratings of the child's fear before the procedure, parent self-ratings of feeling upset during the procedure, and nurse ratings of the child's cooperation. Reductions in child behavioral distress during the distraction treatment program were observed in five out of the six cases. Concomitant improvements in parental reports of child distress, nurse estimates of child cooperation, and parents' self-report of feeling upset during the medical procedures also were found. Follow-up data were available for one of the successfully treated children. His improvements were maintained for both intramuscular injections and portacatheter accesses over 16 weeks without therapist involvement.