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A multifactorial strategy of pain management is associated with less pain in scheduled vaccination of children . A study realized by family practitioners in 239 children aged 4-12 years old . BACKGROUND AND AIMS The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia . We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination , as compared to usual care , in 4- to 12-year-old children . METHODS In all , 239 children were enrolled by 25 family practitioners in an open-label study . After a pseudo-randomization , usual pain management ( n = 132 ) was compared to a multifactorial strategy ( n = 107 ) associating preliminary application of an anesthesic patch , preferential use of specified vaccines , child education by the parents and the doctor , parental accompaniment and child distraction with soap bubbles during the procedure . The primary outcome ( i.e . child pain ) was assessed with a self-report scale named visual analog scale ( VAS ) of pain . RESULTS A significant decrease in pain was obtained using the multifactorial strategy , as assessed by self-reported VAS ( P < 0.0001 ) . This was confirmed by another self-report scale ( the facial pain scale revised : P = 0.005 ) , as well as with hetero-evaluations by GPs and parents [ Children 's Hospital of Eastern Ontario Pain Scale : P = 0.0007 ; GPs VAS ( P < 0.0001 ) , parents VAS ( P < 0.0001 ) ] , which were secondary outcome criteria . CONCLUSIONS This multifactorial method significantly decreases vaccination pain in 4- to 12-year-old children . This strategy could make vaccines more acceptable to children and may improve child-doctor relationships and contribute to a decrease in child fear about health care .
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Intervention_Physical
usual pain management ( n = 132 ) was compared to a multifactorial strategy ( n = 107 ) associating preliminary application of an anesthesic patch , preferential use of specified vaccines
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Intervention_Educational
child education by the parents and the doctor , parental accompaniment and child distraction with soap bubbles during the procedure
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Outcome_Pain
child pain )
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Outcome_Pain
self-report scale named visual analog scale ( VAS ) of pain
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Outcome_Other
.
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Outcome_Pain
pain
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Outcome_Pain
facial pain scale
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Outcome_Other
[
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Outcome_Pain
Children 's Hospital of Eastern Ontario Pain Scale
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Outcome_Other
:
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Outcome_Pain
parents VAS
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Outcome_Pain
pain