Parental behavior and child distress and pain during pediatric medical procedures: Systematic review and meta-analysis
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Małgorzata Sobol-Kwapińska1, Marek Sobol2, Ewa Woźnica-Niesobska3
1Department of Psychology, University of Wroclaw.
Insights
Parental behaviors significantly impact pediatric patients' distress and pain during medical procedures. Positive interactions like empathy reduce pain in older children, while insensitive actions increase distress in infants.
Area of Science:
- Psychology
- Pediatrics
- Medical Sociology
Background:
- Parental behavior is crucial in modulating pediatric patient experiences during medical procedures.
- Understanding the link between parental actions and child distress is vital for improving healthcare.
- Existing research has explored this relationship, but a comprehensive synthesis is needed.
Purpose of the Study:
- To systematically review and analyze the relationship between observed parental behaviors and pediatric patient distress and pain.
- To identify specific parental behaviors associated with reduced or increased distress in children undergoing medical procedures.
- To differentiate findings based on age groups (infants vs. older children).
Main Methods:
- Systematic literature search across multiple databases (PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, DARE).
- Assessment of risk of bias and level of evidence for selected studies.
- Meta-analyses performed on relevant variables from 29 selected publications.
Main Results:
- For children aged 2-18 years, apology, providing control, empathy, and criticism were strongly linked to distress and pain.
- For infants under 2 years, insensitive parental behaviors correlated positively with distress levels.
- Lack of physical closeness increased distress in infants; focusing on threats increased distress in older children.
Conclusions:
- Parental behaviors play a critical role in pediatric pain and distress during medical procedures.
- Age-specific parental strategies are effective: empathy and control for older children, and gentle, sensitive care for infants.
- Healthcare providers should consider parental involvement and specific behavioral strategies to mitigate pediatric procedural pain and distress.
Abstract:
In this study review, the relationship between observed parental behavior and the observed symptoms of distress in pediatric patients, as well as the subjective experiences of pain in pediatric patients undergoing painful medical procedures, was analyzed. A systematic search of articles using PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, and DARE was performed. The risk of bias and the level of evidence were assessed. Meta-analyses were performed for the selected variables. Twenty-nine relevant publications were selected. The results of the analyses showed that apology, giving control to the child, empathy, and criticism were most strongly associated with children's distress and pain during painful medical procedures in the group of patients aged 2 to 18 years. In the case of patients below the age of 2, insensitive behaviors were positively related to the level of distress. The lack of tender, physical closeness with the parent increases distress in children under 2 years of age during painful medical procedures, and adults drawing their attention to the threatening aspects of a medical situation produces this effect in older children. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
