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Therapeutic communication improves patient comfort during venipuncture in children: a single-blinded intervention
Lonneke A M Aarts1, Geert-Jan van Geffen2, Eva A L Smedema3
1Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands. lonneke.aarts@radboudumc.nl.
Insights
Therapeutic communication (TC) did not reduce self-reported pain in children during venipuncture. However, TC significantly lowered anxiety and procedural time, improving overall comfort in the outpatient setting.
Area of Science:
- Pediatric healthcare
- Clinical communication strategies
- Pain management
Background:
- Medical procedures, particularly those involving needles, induce anxiety and fear in pediatric patients.
- Hypnosis-based communication techniques have demonstrated efficacy in mitigating pain and anxiety during medical procedures in adults.
Purpose of the Study:
- To evaluate the impact of therapeutic communication (TC) on children's comfort during venipuncture compared to standard communication.
- To assess if TC can reduce pain, anxiety, and procedural time, and enhance satisfaction in pediatric patients undergoing venipuncture.
Main Methods:
- A single-blinded interventional study involving 105 children aged 5-18 years in an outpatient tertiary hospital setting.
- Participants received either standard communication (SC group, n=51) or therapeutic communication (TC group, n=54), alongside topical anesthesia (EMLA).
- Outcomes included self-reported pain (Faces Pain Scale Revised), observed pain and anxiety (Numeric Rating Scale), and procedural time.
Main Results:
- No significant difference was observed in self-reported pain between the TC and SC groups.
- The TC group exhibited significantly lower self-reported and observed anxiety levels in both children and parents (p < 0.05).
- Procedural time was significantly reduced in the TC group (p=0.011), and medical personnel satisfaction was higher (p=0.014).
Conclusions:
- Therapeutic communication (TC) does not reduce self-reported pain during pediatric venipuncture.
- TC significantly improves secondary outcomes, including reduced anxiety and shorter procedure times, enhancing patient and staff experience.
- TC is a valuable communication strategy for improving pediatric comfort in outpatient venipuncture settings.
Abstract:
The aim of this study was to examine whether therapeutic communication improves children's comfort during venipuncture compared to standard communication. This study was registered in the Dutch trial register (NL8221), December 10, 2019. This single-blinded interventional study was carried out in an outpatient clinic of a tertiary hospital. Inclusion criteria were age between 5 and 18 years, use of topical anesthesia (EMLA) and sufficient understanding of the Dutch language. 105 children were included, 51 assigned to the standard communication group (SC group) and 54 patients to the therapeutic communication group (TC group). The primary outcome measure was self-reported pain based on the Faces Pain Scale Revised (FPS-R). Secondary outcome measures were observed pain (numeric rating scale (NRS)), self-reported/observed anxiety in child and parent (NRS), self-reported satisfaction in child, parent and medical personnel (NRS), and procedural time. No difference was found for self-reported pain. Self-reported and observed anxiety (by parents and medical personnel) was lower in the TC group (p-values ranged from p = 0.005 to p = 0.048). Procedural time was lower in the TC group (p = 0.011). Satisfaction level of medical personnel was higher in the TC group (p = 0.014). Conclusion: TC during venipuncture did not result in lower self-reported pain. However, secondary outcomes (observed pain, anxiety and procedural time) were significantly improved in the TC group. What is Known: • Medical procedures, especially needle related procedures, cause anxiety and fear in children and adults. • In adults communication techniques based on hypnosis are effective in reducing pain and anxiety during medical procedures. What is New: • Our study found that with a small change in communication technique (called therapeutic communication or TC), the comfort of children during venipuncture improves. • This improved comfort was mainly reflected by reduced anxiety scores and shorter procedural time. This makes TC suitable for the outpatient setting.
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