Matching Doses of Distraction With Child Risk for Distress During a Medical Procedure

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Abstract

Parents often want to provide support to their children during medical procedures, but not all parents are effective in providing distraction after brief training.

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Review of Systematic Reviews on Acute Procedural Pain in Children in the Hospital Setting

Janet Yamada, Alison Dickson, Jasmine Lamba … (2008)

BACKGROUND: Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated. OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children. METHODS: Published systematic reviews and meta-analyses on pharmacological and nonpharmacological management of acute procedure-related pain in hospitalized children aged one to 18 years were evaluated. Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Two reviewers independently selected articles for review and assessed their quality using a validated seven-point quality assessment measure. Any disagreements were resolved by a third reviewer. RESULTS: Of 1469 published articles on interventions for acute pain in hospitalized children, eight systematic reviews met the inclusion criteria and were included in the analysis. However, only five of these reviews were of high quality. Critical appraisal of pharmacological pain interventions indicated that amethocaine was superior to EMLA (AstraZeneca Canada Inc) for reducing needle pain. Distraction and hypnosis were nonpharmacological interventions effective for management of acute procedure-related pain in hospitalized children. CONCLUSIONS: There is growing evidence of rigorous evaluations of both pharmacological and nonpharmacological strategies for acute procedure-related pain in children; however, the evidence underlying some commonly used strategies is limited. The present review will enable the creation of a future research plan to facilitate clinical decision making and to develop clinical policy for managing acute procedure-related pain in children.

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Training children to cope and parents to coach themduring routine immunizations: Effects on child, parent, and staff behaviors

William Chaplin, Sandra D. Blount, Mary Henderson … (1993)

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Factors associated with young children's long-term recall of an invasive medical procedure: a preliminary investigation.

Karen Salmon, John Pereira, Alexander M. Price (2002)

This exploratory study investigated children's recall of the voiding cysto-urethrogram (VCUG, x-ray of the kidneys) after a 6-month delay and the associations between children's memory reports and specific behaviors coded during the procedure (distraction, crying, procedure-related talk). Thirty-two children, aged 2 to 7 years, were interviewed 6 months after undergoing the VCUG. Twenty-nine of the 32 children reported information about the VCUG after 6 months. Free recall was skeletal but highly accurate; more information was reported in prompted recall, but accuracy was reduced. Older children provided more complete and accurate reports than did younger children. Independently of age, specific child behaviors were associated with children's memory reports: crying during the VCUG was negatively associated with the correct information reported and accuracy in prompted recall; procedure-related talk was positively associated with the correct information reported in free recall; and distraction was negatively associated with the accuracy of free recall. The implications for intervention in pediatric contexts are discussed.