25806
document
Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department . BACKGROUND Nonpharmacologic interventions , such as distraction , have been shown to be powerful adjuncts in reducing pain and anxiety in children with both acute and chronic painful conditions . There are no controlled studies evaluating these interventions as adjuncts to facilitate completion of painful procedures in the pediatric emergency department ( ED ) . OBJECTIVE We assessed the effectiveness of distraction techniques in reducing the sensory and affective components of pain among pediatric patients undergoing laceration repair in the ED . METHODS Eligible children between 6 and 18 years of age ( N = 240 ) presenting to the ED for laceration repair were randomly assigned to an intervention or control arm . Those assigned to the intervention arm were given a choice of age-appropriate distracters during laceration repair . Quantitative measures of pain intensity , situational anxiety , and pain distress ( as perceived by the parent ) were assessed by using the 7-point Facial Pain Scale , State Trait Anxiety Inventory for Children , and a visual analog scale , respectively , before and after laceration repair . The State Trait Anxiety Inventory for Children was performed in children > or = 10 years of age . RESULTS There was no difference in mean change in Facial Pain Scale scores between the control and the intervention groups in children < 10 years of age . Multivariate analysis in this same age group showed that the intervention was independently associated with a reduction in pain distress as perceived by parents based on the mean change in visual analog scale scores . In older children , the intervention was independently associated with reduction in situational anxiety but not in pain intensity or in parental perception of pain distress . CONCLUSIONS The use of distraction techniques is effective in reducing situational anxiety in older children and lowering parental perception of pain distress in younger children . This technique may have a role in improving the quality of management of procedural pain in a pediatric ED setting .
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Intervention_Psychological
nonpharmacologic methods
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Intervention_Physical
pain and anxiety management
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Intervention_Educational
Nonpharmacologic interventions , such as distraction
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Intervention_Psychological
distraction techniques
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Intervention_Educational
age-appropriate distracters
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Intervention_Educational
distraction techniques
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Outcome_Pain
pain intensity , situational anxiety , and pain distress ( as perceived by the parent )
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Outcome_Mental
7-point Facial Pain Scale , State Trait Anxiety Inventory
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Outcome_Mental
visual analog scale
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Outcome_Mental
State Trait Anxiety Inventory
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Outcome_Pain
mean change in Facial Pain Scale
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Outcome_Pain
reduction in pain distress
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Outcome_Mental
situational anxiety
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Outcome_Pain
pain intensity or in parental perception
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Participant_Age
children
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Participant_Condition
acute and chronic painful conditions
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Participant_Condition
pediatric patients undergoing laceration repair in the ED
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Participant_Age
children between 6 and 18 years of age
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Participant_Sample-size
( N = 240
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Participant_Condition
presenting to the ED for laceration repair
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Participant_Age
older children