IJCRR - 6(19), October, 2014
EFFICACY OF DISTRACTION TECHNIQUE IN REDUCING PAIN AMONG CHILDREN RECEIVING VACCINATION
Author: Richa Talwar, Anita Yadav, Rupinder Deol, Jasbir Kaur
Background: Vaccination is the process whereby a person is made immune or resistant to an infection. Routine vaccination is a universal phenomenon which is administered repeatedly throughout infancy, childhood and adolescence. It is the common source of iatrogenic pain in childhood. Pain from injection is a source of distress for children, their parents and vaccinators, and if not addressed, can lead to pre-procedural anxiety in future, medical fears and healthcare avoidance behaviours. So, there is a great need to study the methods of alleviation of vaccination related pain in children. Objectives: The study was undertaken with the objective to assess the efficacy of distraction technique in reducing level of pain among healthy children during vaccination. Methods: A quasi experimental study design was used to evaluate the efficacy of distraction technique in reducing level of pain among healthy children receiving vaccination at well baby clinic in selected hospital, Ludhiana. Sample size of 200 healthy children using convenience sampling (100 in each group) was used. The standardised FLACC (face, leg, activity, cry, consolability) - Behavioral Pain Assessment scale was used to observe level of pain among the healthy children during vaccination. A sound and light producing movable toy was used as distraction technique in experimental group during vaccination. Video recording of the children receiving vaccination was done and the pain score was calculated. Results: Findings revealed that 7% of the children in experimental group as compared to only 1% in control group experienced no pain during vaccination. The mean pain score among experimental and control group were 4.02±1.694 and 4.89±1.503 respectively (p<0.001). Conclusion: The distraction technique significantly reduces the level of pain in healthy children receiving vaccination (p<0.05). Therefore, it is recommended that distraction technique should be used during every painful procedure among children.
Keywords: Distraction technique, Pain, Vaccination, Children, FLACC (face, Leg, Activity, Cry, consolability) Behavioral Pain Assessment scale
Richa Talwar, Anita Yadav, Rupinder Deol, Jasbir Kaur. EFFICACY OF DISTRACTION TECHNIQUE IN REDUCING PAIN AMONG CHILDREN RECEIVING VACCINATION International Journal of Current Research and Review. 6(19), October, 42-46
1. OP, Gupta P and Paul VK.Ghai. Essential Pediatrics. 6th ed. New Delhi: CBS Publishers, 2008.p.181.
2. FDA/NIH/WHO Workshop. Immune response in children to influenza vaccination;[cited 2011 July 28].Available from: http://www.fda.gov/downloads/BiologicsBloodVaccines/NewsEvents/WorkshopsMeetingsConferences/ ucm090464 pdf.
3. Abbot K and Fowler-Kery S. The use of a topical refrigerant anaesthetic to reduce injection pain in children. Journal of Pain and Symptom Management 1995; 10: 584-90.
4. Agras S, Sylvester D andOliveau D. The epidemiology of common fear and phobias. Comprehensive Psychiatry; 1969:1511-56.
5. American Academy of Pediatrics Committee on Infectious Diseases. Recommended childhood and adolescent immunization schedule-United States, 2003.Pediatrics 2003;111: 212-16.
6. Schechter NL, Zempsky WT, Cohen LL, McGrath PJ, McMurtry CM, Bright NS. Pain reduction during paediatric immunisations: evidence-based review and recommendations. Paediatrics 2007 May; 119(5):1184-98.
7. Schecter NL, Altman A and Wiseman SJ. An introduction: American Academy of Paediatrics report of the subcommittee on management of pain associated with procedures in children with cancer. Paediatrics 1990; 86:813.
8. Help. Eliminate pain in kids. Clinical practice guidelines for pain management during childhood vaccination, Technical report, http://www.cdha.nshealth.ca/default retrieved on 25-03-2011.
9. Anand KJS, Thrivikraman KV, Engelmann M, Su Y andPlotsky PM. Adult rat behaviour and stress responses following pain in the neonatal period. Pediatr Res 1995; 37:57A.
10. Fassler D. The fear of needles in children. Am J Orthopsychiatry 1985; 55:371–77.
11. Hamilton JG. Needle phobia: a neglected diagnosis. J FamPract 1995; 41:169-75.
12. Ball JW andBindler RC. Clinical handbook for pediatric nursing. 2nd ed. St. Louis: Mosby Publication; 1998.
13. Fernandez E. A classification system of cognitive coping strategies for pain; 1986; 26,141,151.
14. McCarthy MA andKliebre C. A conceptual model of factors influencing children’s response to a painful procedure when parents are coaches. Journal of Paediatric Nursing 2006; 21.
15. MacLaren JE and Cohen LL. A comparison of distraction strategies for venipuncture distress in children. JPediatrPsychol 2005; 30:387–96.
16. French MG, Painter CE and Larry LD. Blowing away shot pain: a technique for pain management during immunisation. Paediatrics 1994 Jun; 6:210-7.
17. Bellieni CV, Cordelli DM, Raffaelli M, Ricci B, Morgese G andBuonocore G. Analgesic effect of watching TV during venipuncture. Arch Dis child. 2006 December; 91(12):1015- 1017.
18. Allen KD, White DD andWalburn JN. Sucrose as an analgesic for infants during immunisation injections. Arch PediatrAdolesc Med 1996 Mar; 150