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Reducing immunization discomfort in 4- to 6-year-old children: a randomized clinical trial
F Ralph Berberich1, Zachary Landman
1Pediatric Medical Group, Berkeley, California 94705, USA. dr.berberich@pediatricsuggestions.net
Insights
A new distraction technique significantly reduced pain during childhood immunizations. This method combined verbal suggestions, visual focus, and cooling spray for children aged 4 to 6 years.
Area of Science:
- Pediatric Pain Management
- Clinical Psychology
- Childhood Immunization Interventions
Background:
- Injection-associated pain is a common concern during childhood immunizations.
- Effective pain management strategies are crucial for young children's cooperation and future healthcare experiences.
Purpose of the Study:
- To evaluate a multifaceted distraction intervention for reducing pain and discomfort in school-aged children undergoing immunizations.
- To assess the efficacy of combining sensory and cognitive distraction techniques.
Main Methods:
- A randomized clinical trial involving 41 children aged 4 to 6 years receiving standard immunizations.
- The intervention group received topical ethyl chloride spray, verbal suggestions, and a visual focusing activity involving an arm gripper and vibrating instrument.
- The control group received standard office routine care.
Main Results:
- The intervention group demonstrated statistically significant reductions in pain and discomfort compared to the control group.
- Patient self-report (P < .0013), parent report (P < .0002), and observational scores (P < .0001) all indicated significant pain reduction.
Conclusions:
- The multifaceted distraction intervention effectively and significantly reduced pain and discomfort associated with childhood immunizations in 4- to 6-year-old children.
- This approach offers a promising non-pharmacological method for managing procedural pain in pediatric populations.
Objective:
The goal was to test a multifaceted distraction method designed to reduce injection-associated pain in school-aged children.
Methods:
A clinical trial evaluated 41 children, 4 to 6 years of age, who were given 3 standard prekindergarten immunizations; 21 were assigned randomly to an office routine control group, whereas 20 received a multifaceted, discomfort-reducing intervention. The intervention added verbal suggestions of diminished sensation and a visual focusing activity to the use of ethyl chloride, an established pain-reducing measure. The distraction materials used for the intervention consisted of topical ethyl chloride spray, an improvised, plastic, multipronged arm gripper, and a vibrating instrument descending on the contralateral arm, which provided the focusing task and visual distraction.
Results:
According to patient and parent Faces Pain Scale-Revised scores and nonblinded, video-taped observations scored according to the face-legs-activity-crying-consolability method, the intervention group showed highly significant reductions in pain and discomfort, compared with the control group (patient self-report, P < .0013; parent report, P < .0002; observation score, P < .0001).
Conclusion:
This multifaceted distraction intervention reduced significantly the pain and discomfort of childhood immunizations in children 4 to 6 years of age.
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