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Active versus passive distraction for reducing procedural pain and anxiety in children: a meta-analysis and
Ting Shen1, Xixi Wang1, Qiaoyun Xue1
1Department of Emergency, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China.
Insights
Active distraction significantly reduced children's procedural pain and anxiety compared to passive distraction, according to parent and staff reports. Further research with larger sample sizes is recommended.
Area of Science:
- Pediatric Pain Management
- Child Psychology
- Clinical Trials
Background:
- Procedural pain and anxiety are significant concerns in pediatric clinical care.
- Evaluating the efficacy of distraction techniques is crucial for improving children's healthcare experiences.
- This study focuses on comparing active versus passive distraction methods.
Approach:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
- Searched major databases (Web of Science, PubMed, EMBASE, etc.) for relevant RCTs up to May 2023.
- Data analysis was performed using Review Manager 5.3, with independent screening and extraction by two researchers.
Key Points:
- 13 RCTs involving 1104 children were analyzed.
- No significant difference was found in self-reported pain between active and passive distraction.
- Active distraction showed significantly lower parent-reported pain, staff-reported pain, and all measures of anxiety (child, parent, staff reported).
Conclusions:
- Active distraction appears more effective than passive distraction in reducing procedural pain and anxiety in children, based on proxy reports.
- Larger sample size studies are needed to further validate these findings.
- Evidence suggests active distraction is a promising intervention for pediatric procedural distress.
Background:
Procedural pain is very important in clinical children care. We aimed to evaluate the effects of active versus passive distraction for reducing procedural pain and anxiety in children.
Methods:
Two researchers searched the Web of Science, PubMed, EMBASE, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure, Weipu databases for the randomized controlled trials(RCTs) on the active versus passive distraction affecting procedural pain and anxiety in children until May 18, 2023. The literature screening and data extraction were carried out by two researchers independently. Review Manager 5.3 software was used for data analysis.
Results:
13 RCTs were finally included. 553 children received active distraction intervention and 551 children received passive distraction intervention. There were no significant differences in the children self-reported procedural pain betweent active and passive distraction. The parent-reported procedural pain, medical staff-reported procedural pain, children-reported procedural anxiety, parent-reported procedural anxiety, medical staff-reported procedural anxiety in the active distraction were significant less than that of active distraction. Egger regression analysis showed that there was no publication bias in the results.
Conclusions:
Existing evidence suggests that active distraction may be more effective in reducing operational pain and anxiety in children than passive distraction. More studies on the effects of active distraction versus passive distraction in children with larger sample size are needed in the future.
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