Line Caes1, Jennifer Keane2, Anna Newell2, Caroline Heary2, Brian McGuire2, Vincent McDarby2
1)Scotland 2) Ireland
Although commonly used to reduce pediatric needle-related pain and distress, there is a paucity of research exploring specific mechanisms of distraction effectiveness. Laboratory-based research findings have identified differences between the relative effectiveness of different types of distraction, including interactive and passive distraction. However, the applicability of findings in real-life medical contexts are unknown. It also remains unclear whether additional benefit may be derived from parent coaching. This study aimed to explores how distraction type, parent coaching and individual characteristics may contribute to distraction effectiveness for children’s pain and distress when receiving a venepuncture.
Dyads comprising 213 children aged 6-12 undergoing a venepuncture and one of their parents were randomly allocated to one of four experimental conditions; interactive distraction only, passive distraction only, interactive distraction plus parent coaching and passive distraction plus parent coaching. A series of ANOVAs were used to assess the impact of distraction type and parent coaching on 1) children’s self-reported pain and distress; 2) parental knowledge of effective pain management techniques; and 3) observed parental engagement with distraction.
No significant differences were found between the groups for child-reported pain and distress. Parental coaching increased parent’s knowledge of effective pain management (F = 5.51, p < .05), but did not increase their engagement with distraction. High child pre-procedural distress was the only factor influencing parent’s increased engagement with distraction (F = 7.32, p < .008).
Results reveal that both passive and active distraction may be equally beneficial in reducing child pain during venepunctures. The role of parental coaching is less clear, as despite improvements in parental knowledge of effective pain management techniques; this did not translate into differences in parent’s observed behaviour. Parental behaviour was primarily determined by their child’s distress, further stressing the importance of child/parent interactions in medical settings.
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