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The use of distraction and imagery with children during painful procedures
M E Broome1, P P Lillis, T W McGahee
1Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL.
Insights
A pediatric pain management program effectively reduced pain in children undergoing cancer treatment. Parents reported stable anxiety levels and provided consistent support during procedures.
Area of Science:
- Pediatric Oncology
- Pain Management
- Psychological Stress
Background:
- Cancer treatment procedures like lumbar punctures can cause significant pain and distress in children.
- Parental anxiety and behavioral stress can impact a child's experience during medical procedures.
- Effective pain management strategies are crucial for improving pediatric cancer care.
Purpose of the Study:
- To evaluate the effectiveness of a pediatric pain management program.
- To assess children's pain experience and behavioral responses during cancer treatment.
- To examine parental anxiety and behavioral stress during pediatric cancer procedures.
Main Methods:
- A multiple case study design was employed.
- Fourteen children undergoing lumbar punctures were videotaped over an 8-12 month period.
- Data included child self-ratings of fear and pain, parent anxiety ratings, and behavioral observations before and after implementing relaxation, imagery, and distraction exercises.
Main Results:
- Children's reported pain decreased over time, despite stable fear scores.
- Behavioral responses to procedures varied among children.
- Parents exhibited high-trait, low-state anxiety, remained stable, and were observed to be highly supportive.
Conclusions:
- The pediatric pain management program demonstrated effectiveness in reducing children's pain during cancer treatment.
- Interventions focusing on relaxation, imagery, and distraction can positively impact pediatric pain.
- Supportive parental presence is a key factor in managing children's procedural distress.
Abstract:
The effectiveness of a pediatric pain management program was examined using a multiple case study design. This study examined both the children's pain experience during cancer treatment, as well as their parents' anxiety and behavioral stress. Fourteen children were videotaped while receiving lumbar punctures during an 8-12 month period. Baseline data were obtained at the first of three visits prior to the introduction of relaxation, imagery, and distraction exercises. Self-ratings of child fear and parent anxiety, videotaped observations of child and parent behavior, and child pain ratings were obtained at all three visits. The children's behavioral responses to the procedure varied considerably, but their fear scores were stable and their reports of pain decreased over time. Parents reported high-trait, low-state anxiety scores that were stable over time. They were observed to be very supportive during the procedures. Implications for further research in this area and recommendations for practice are presented.