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Cognitive-behavioral interventions for IV insertion pain.

Ann F Jacobson1

  • 1Kent State University College of Nursing, Kent, Ohio, USA.

AORN Journal
|January 16, 2007
PubMed
Summary
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Cognitive-behavioral interventions (CBIs) like music or guided imagery did not significantly reduce pain during IV catheter insertion. Insertion difficulty, particularly in women, was linked to increased pain intensity and distress.

Area of Science:

  • Pain Management
  • Medical Procedures
  • Psychological Interventions

Background:

  • Intravenous (IV) catheter insertion is a common yet painful medical procedure.
  • Cognitive-behavioral interventions (CBIs) show potential for pain reduction by redirecting patient attention.
  • Exploring the efficacy of specific CBIs for procedural pain is crucial.

Purpose of the Study:

  • To evaluate the effectiveness of three CBIs (music, kaleidoscope, guided imagery) in mitigating IV insertion pain.
  • To compare pain levels between patients receiving CBIs and a control group.
  • To investigate patient preference versus assignment of CBIs.

Main Methods:

  • A randomized controlled trial involving 324 patients undergoing IV catheter insertion.
  • Patients were assigned to receive music, kaleidoscope, guided imagery, or standard care (control).

Related Experiment Videos

  • Pain intensity, distress, and insertion difficulty were assessed; patient choice of CBI was also analyzed.

    • Main Results:

    • No statistically significant differences in IV insertion pain were observed among the CBI groups and the control group.
    • No significant difference in pain was found between patients who chose their CBI and those who were assigned one.
    • Female patients experienced more difficult insertion attempts, which correlated with higher pain intensity and distress.

    Conclusions:

    • The tested CBIs (music, kaleidoscope, guided imagery) did not effectively reduce pain during IV insertion in this study population.
    • Insertion difficulty, particularly in women, is a significant factor influencing pain intensity and distress.
    • Pain intensity is associated with the insertion site and the gauge of the catheter used.