An Observation Scale for Measuring Children’s Distress During Medical Procedures

Elliott, Charles H.; Jay, Susan; Woody, Patricia

doi:10.1007/978-1-4899-1248-0_17

Cited by 42 publications

(66 citation statements)

References 6 publications

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“…In a sample of 55 predominately Caucasian participants with pediatric leukemia 3-13 years in age with pediatric cancer the OSBD had statistically significant correlations with nine indicators of child distress, with correlations of .69 for nurse ratings of distress and .55 for procedural heart rate 25. Cronbach's alpha ranged between .68 and .72, indicating generally acceptable levels of internal consistency.…”

Section: Methodsmentioning

confidence: 93%

Criterion and Convergent Validity for 4 Measures of Pain in a Pediatric Sickle Cell Disease Population

McClellan

Schatz²,

Mark³

et al. 2009

The Clinical Journal of Pain

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Objective-To evaluate the psychometric properties of four measures of acute pain in youths with sickle cell disease (SCD) during a medical procedure.Methods-Heart rate, child self-report, parent proxy-report, and observable pain behaviors were examined in 48 youths with SCD ages 2-17 years. Criterion validity for acute pain was assessed by responsiveness to a standardized painful stimulus (venipuncture) in a prospective pre-post design. Convergent validity was evaluated through the correlation across measures in reactivity to the stimulus.Results-Child self-reported pain, parent proxy-report, and behavioral distress scores increased in response to venipuncture (concurrent and convergent validity). In contrast, heart rate did not reliably change in response to venipuncture. Extent of change in response to venipuncture showed moderate inter-correlation across child and parent pain ratings, and behavioral distress. Pre-procedure pain ratings correlated with pain experienced during the procedure. An item analysis of observable pain behaviors suggested differences in the presentation of pain in SCD compared with previous pediatric research.Conclusions-Criterion and convergent validity were demonstrated for child-report, parentreport, and observable pain behaviors. These measures appear to tap into distinct, yet overlapping aspects of the pain experience. Assessment of acute procedural pain responses in SCD requires evaluation of pre-procedural pain due to the frequent presence of low-level, baseline pain.

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Section: Methodsmentioning

confidence: 93%

Criterion and Convergent Validity for 4 Measures of Pain in a Pediatric Sickle Cell Disease Population

McClellan

Schatz²,

Mark³

et al. 2009

The Clinical Journal of Pain

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show abstract

“…Procedure related distress was measured by trained observers using the scale of Observational Scale of Behavioral Distress–Revised (OSBD-R), an observation instrument with established reliability and validity that is used to evaluate distress 6. The presence or absence of eight operationally defined behaviours which indicate pain and anxiety (cry, scream, physical restraint, verbal resistance, seeks emotional support, information seeking, verbal pain, flail) is recorded by trained observers at 15 second intervals throughout the procedure and weighted according to the severity of distress.…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of nitrous oxide in alleviating pain and anxiety during painful procedures

et al. 2001

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Aims-To evaluate the eYcacy and safety of nitrous oxide for children undergoing painful procedures. Methods-Ninety children requiring repeated painful procedures (lumbar puncture, bone marrow aspirate, venous cannulation, or dressing changes) were given nitrous oxide at a variable concentration of 50-70%. Procedure related distress was evaluated using the Observational Scale of Behavioral Distress-Revised (OSBD-R). OSBD-R scores were obtained for each of the following phases of the procedure: phase 1a, waiting period; phase lb, during induction with nitrous oxide; phase 2, during positioning and cleaning of the skin; phase 3, during the painful procedure; and phase 4, immediately following the procedure and withdrawal of nitrous oxide. Side eVects were monitored and recorded by a second observer. Results-OSBD scores reached a maximum during the induction phase with lower scores during subsequent phases. Children over the age of 6 showed a lower level of distress during nitrous oxide administration and the painful procedure. Eighty six per cent of patients had no side eVects. The incidence of vomiting, excitement, and dysphoria was 7.8%, 4.4%, and 2% respectively. Eight patients developed oxygen desaturation (SaO 2 < 95%), but none developed hypoxia, airway obstruction, or aspiration. Ninety three per cent of patients fulfilled the criteria for conscious sedation, and 65% had no recollection of the procedure. Mean recovery time was three minutes. Conclusions-Inhalation of nitrous oxide is eVective in alleviating distress during painful procedures, with minimal side eVects and short recovery time. (Arch Dis Child 2001;84:492-495)

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“…Each child's behavioral manifestations of fear and anxiety (e.g., crying, verbal resistance, flailing) were recorded throughout the study period by one of three trained observers who were also blind to group assignment. Ratings were based on the Observational Scale of Behavioral Distress-Revised (OSBD-R) [16], with the exclusion of the items related to the need for restraint since all children were restrained for these procedures. A visual recall/recognition test was used to evaluate the effects of midazolam on memory.…”

Section: Assessmentsmentioning

confidence: 99%

Midazolam premedication for pediatric bone marrow aspiration and lumbar puncture

Friedman

Mulhern

Fairclough

et al. 1991

Med. Pediatr. Oncol.

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The ability of midazolam, a benzodiazepine, to reduce the distress associated with lumbar puncture and bone marrow aspiration was examined in 23 children with acute lymphocytic leukemia. Patients were randomized to receive 0.2 mg/kg midazolam HCl or placebo intravenously 3-5 min before the procedures, under double-blind conditions. Based on prior experiences, children in both groups anticipated severe pain from these procedures. Postprocedure pain ratings by patients were markedly reduced in the midazolam but not the placebo group. Both physicians and parents judged the midazolam group as significantly less distressed than controls during and after the procedures. Trained observers recorded significantly fewer pain- and anxiety-related behaviors in the midazolam group immediately before and after, but not during the procedures. The amnestic effects of midazolam, confirmed in a visual recall/recognition test, appear to account for the decreased pain ratings since the behavioral manifestations were similar in the two groups. There were no adverse drug reactions or significant changes in vital signs. Midazolam warrants further investigation as a premedication for painful diagnostic and treatment procedures in children with cancer.

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An Observation Scale for Measuring Children’s Distress During Medical Procedures

Cited by 42 publications

References 6 publications

Criterion and Convergent Validity for 4 Measures of Pain in a Pediatric Sickle Cell Disease Population

Criterion and Convergent Validity for 4 Measures of Pain in a Pediatric Sickle Cell Disease Population

Efficacy and safety of nitrous oxide in alleviating pain and anxiety during painful procedures

Midazolam premedication for pediatric bone marrow aspiration and lumbar puncture

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