Lena Hedén1, Louise von Essen1, Gustaf Ljungman1
1) Sweden
The primary aim was to determine the levels of, and potential relationships between, procedure-related fear and pain in children. Secondary aims were to investigate potential associations between fear and pain and the child’s age, sex, time since last needle insertion, and cortisol changes.
The children’s levels of pain and fear were reported on 0-100 mm visual analog scales (VAS). Ninety children aged between 7 and 18 years were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anesthesia. The effects of the child’s age, sex, time since last needle insertion, and cortisol changes on fear and pain levels was investigated with multiple regression analysis.
The needle-related fear level was reported to be as high as the needle-related pain level (mean VAS: 14 mm and 12 mm respectively, n=90). With fear as the dependent variable, age and pain were significantly associated and explained 18% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post-hoc analysis indicated that younger children reported their fear levels to be higher than their pain levels.
Children experience fear levels as high as their pain levels during needle insertion involving topical anesthesia. Age is an important factor with regard to the fear level experienced, and an extended focus on fear-reducing interventions is warranted, especially in younger children.
