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Analysis of child and parent behavior during painful medical procedures
P B Jacobsen1, S L Manne, K Gorfinkle
1Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Insights
Child distress during cancer treatment venipuncture is higher in younger children with fewer prior procedures. Parent explanations can reduce distress, but timing and the child
Area of Science:
- Pediatric Oncology
- Child Psychology
- Medical Procedures
Background:
- Pediatric cancer patients experience significant distress during invasive procedures.
- Understanding factors influencing child distress is crucial for effective pain and anxiety management.
- Parental behavior plays a role in modulating child distress during medical interventions.
Purpose of the Study:
- To investigate demographic, medical, and psychological predictors of child distress during venipuncture for cancer treatment.
- To examine the association between parental behaviors and child distress across different procedural phases.
- To identify specific parent actions that may mitigate or exacerbate child distress.
Main Methods:
- Seventy pediatric cancer patients (ages 3-10) undergoing outpatient venipuncture.
- Assessment of child distress and relevant demographic, medical, and psychological factors.
- Observation and parent-reported data on parental behaviors during the procedure.
Main Results:
- Younger children, those with fewer prior venipunctures, poorer venous access, and perceived lower cooperativeness, exhibited greater distress.
- Parental provision of explanations about the procedure was significantly associated with child distress.
- The effect of parental explanations was moderated by the timing of the explanation and the child's distress level at that moment.
Conclusions:
- Child distress during venipuncture is multifactorial, influenced by child characteristics and medical history.
- Parental explanations can impact child distress, with effectiveness contingent on delivery timing and child's current emotional state.
- Optimizing parental communication strategies may improve the procedural experience for pediatric cancer patients.
Abstract:
Examined (a) the impact of demographic, medical, and psychological factors on overall child distress during an invasive medical procedure required for pediatric cancer treatment and (b) the relationship of individual parent behaviors to child distress across phases of the procedure. Seventy 3- to 10-year-old pediatric cancer patients receiving outpatient venipuncture and their parents participated. Overall distress was greater in younger children who had fewer previous venipunctures and poorer venous access and whose parents rated them prior to the procedure as less likely to be cooperative. Providing explanations regarding the procedure was the parent behavior most clearly associated with child distress. The impact of parent explanation depended on when the explanation was given and on the child's level of distress at the time.