Pain, Distress, and Adult-Child Interaction During Venipuncture in Pediatric Oncology: An Examination of Three Types of Venous Access

Abstract

This study examined pain and distress from needles in children undergoing blood sampling as a function of adult-child interaction and type of venous access (i.e., central external venous lines, internalized ports, or peripheral access via venipuncture). Participants were 55 pediatric oncology patients, aged 3-18 years, who were undergoing routine blood work. Pain ratings were obtained using the Faces Pain Scale-Revised (FPS-R) and conversation during the procedure was audio taped for coding using the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R). Children's ratings of pain using the FPS-R were similar in the port (M=2.57/10, standard deviation [SD]=3.46) and peripheral (M=2.56/10, SD=3.24) groups, despite the fact that most children with internal ports were given a topical anesthetic. Similarly, there were no differences between port and peripheral groups in rates of child coping or distress, or parent and nurse observations of child pain. As would be expected, external line access was not associated with pain or distress, even among very young children, suggesting that they appropriately understood the pain rating scale. Results of the transcribed CAMPIS-R data indicate that the influences in adult-child interaction are bidirectional. Support was found for the well-established positive relationship between child distress and adult reassurance and empathy. Implications for intervention and selection of central venous access devices are discussed.

Parental Distress and Catastrophic Thoughts About Child Pain

“…Of further interest, and in line with previous findings, 13,[22][23][24][25]28 our results pointed out that heightened engagement in pain-attending behavior before the LP/BMA procedure was associated with more distress, pain, and nonverbal pain behavior in young children. However, the impact on the child's level of pain and distress was only significant in case of parental nonverbal behavior, thereby stressing the importance of nonverbal communications in interpersonal interactions, 9,32,67 especially in younger children.…”

Efficacy of Auricular Therapy for Pain Management: A Systematic Review and Meta‐Analysis

“…Auricular therapy is based on long-standing tradition and was modified and updated by Dr. Paul Nogier, the “father of auriculotherapy,” in the 1950s. The World Health Organization considers auricular therapy a form of microacupuncture that can affect the whole body [18]. Auricular therapy involves the relationships among the ear, energy lines (channels and meridians), and muscle regions comprising the whole body, according to a theory known as somatic reflexology.…”

The Effect of Directed Medical Play on Young Children's Pain and Distress During Burn Wound Care

“…For example, parents/guardians of pediatric burn patients have been shown to exhibit significantly higher levels of anxiety and depression than the general population (Phillips & Rumsey, 2008), with as many as 69% showing levels of anxiety outside of normal boundaries. There is a body of research providing evidence to support the idea that a caregiver can impact the distress and pain responses of a child (George & Hancock, 1993; Blount et al, 1989; Bush, Melamed, Sheras, & Greenbaum, 1986; Koller, 2008; Spagrud et al, 2008; Wolfer & Visintainer, 1975). Therefore, understanding the role of medical play as potentially mitigating parental distress is an important consideration.…”