Children undergo numerous painful medical procedures, which can result in a host of short- and long-term negative repercussions. In addition, the patients' parents and the medical staff experience undue collateral distress. It is heartening that a number of interventions have been shown to reduce the procedural distress experienced by the child, parent, and staff. However, these interventions have not been well disseminated into pediatric practice, which is likely due to their high costs and low feasibility. The purpose of the proposal is to evaluate a pediatric pain management package, which has a high potential for widespread use in health care facilities. Participants will include 150 4- to 6-year-olds receiving preschool vaccinations and their parents. Families will be randomly assigned to one of three conditions: Training and Distraction, Distraction Alone, or Typical Care. Via an interactive computer training program, families assigned to the Training and Distraction condition will learn parent coaching and child coping skills to use during the noxious event. These children will also be shown a distracting movie during the immunization. Children in the Distraction Alone condition will not receive the pre-procedure training but will be shown the movie. Typical Care participants will neither receive training nor the movie. Parent and nurse coaching behavior will be quantified with a behavior observation scale. Child anxiety and pain will be assessed with self-report, parent-report, nurse report, a behavior observation scare, and heart rate. Parent-report, nurse-report, and heart rate will estimate parent anxiety; and nurses will rate their own distress. Parents and nurses will provide satisfaction ratings for the three conditions. A knowledge test, used at the time of the procedure and 3-months later, will evaluate parents' understanding and retention of coaching behaviors shown in research to be helpful and not helpful to children during painful events. Results might support an innovative intervention that can be used to train parents and children in proven pain management skills to use during an invasive medical procedure. ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HD047263-01A1
Application #
6965626
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Quatrano, Louis A
Project Start
2005-07-15
Project End
2007-07-14
Budget Start
2005-07-15
Budget End
2006-07-14
Support Year
1
Fiscal Year
2005
Total Cost
$187,695
Indirect Cost
Name
Georgia State University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
837322494
City
Atlanta
State
GA
Country
United States
Zip Code
30302
Mougianis, Ifigenia D; Cohen, Lindsey L; Shih, Sharon W (2017) Parent-Child Behavioral Interactions during Pediatric Immunizations in a Latino Sample. Clin Pract Pediatr Psychol 5:209-220
Cohen, Lindsey L; Rodrigues, Nikita P; Lim, Crystal S et al. (2015) Automated parent-training for preschooler immunization pain relief: a randomized controlled trial. J Pediatr Psychol 40:526-34
Bearden, Donald J; Feinstein, Amanda; Cohen, Lindsey L (2012) The influence of parent preprocedural anxiety on child procedural pain: mediation by child procedural anxiety. J Pediatr Psychol 37:680-6