This study explored the relationships among medical fears, coping behaviour patterns and acute pain perceptions in 17 children with cancer who were encountering a painful medical procedure. The children completed the Child Medical Fear Scale (CMFS) before undergoing a lumbar puncture (LP), which was videotaped. The children's coping behaviour during the procedure was rated independently and classified as active or passive behaviour. Immediately following the LP, the children, using a pictorial scale, reported their pain perceptions. Most of the children's scores on the CMFS indicated a moderately low level of fear of medical experiences. A majority of the children perceived a great deal of pain during the LP. During the five phases of the painful medical procedure, more than half of the children exhibited a combination of active and passive behaviour. No significant differences were found between exhibited active or passive coping behaviour and reported medical fear levels; however, children who exhibited passive coping behaviour patterns reported more pain than those who demonstrated active coping behaviour. Implications for practice relate to the need for continual preparation and support of children during a painful procedure.

The effectiveness of a paediatric pain management programme was examined using a multiple case study design. This study examined both the children's pain experience during cancer treatment, as well as their parents’anxiety and behavioural stress. Fourteen people were videotaped while receiving lumbar punctures during an 8–12 month period. Baseline data were obtained at the first of three visits prior to the introduction of relaxation, imagery and distraction exercises. Self‐ratings of child fear and parent anxiety, videotaped observations of child and parent behaviour and child pain ratings were obtained at all three visits. The children's behavioural responses to the procedure varied considerably, but their fear scores were stable and their reports of pain decreased over time. Parents reported high‐trait, low‐state anxiety scores that were stable over time. They were observed to be very supportive during the procedures. Implications for further research in this area and recommendations for practice are presented.

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Background Because of large class sizes and limited resources, students participating in high-fidelity simulation experiences may be assigned to an observer role as opposed to an active nursing role. Purpose Educators need to determine if anxiety levels and student learning outcomes are comparable for students in active and observer roles. Methods A quasi-experimental study was conducted with 132 prelicensure baccalaureate students. Active nursing roles consisted of primary care, documentation, and medication nurse roles. Observer role students were provided with resources to guide them with developing their observational skills and achieving the simulation objectives. Results There were no significant differences between simulation roles for anxiety levels, satisfaction with learning, self-confidence in learning, clinical ability, problem solving, confidence in clinical practice, and collaboration. Conclusions These findings suggest that either role is an appropriate assignment during simulation. Educators should identify ways to be supportive and reduce anxiety in students during simulation experiences.