68546
document
Matching doses of distraction with child risk for distress during a medical procedure : a randomized clinical trial . BACKGROUND Parents often want to provide support to their children during medical procedures , but not all parents are effective in providing distraction after brief training . OBJECTIVE The aim of this study was to investigate the effects of three doses of distraction intervention for children at high and medium risk for procedure-related distress . METHODS Children undergoing scheduled intravenous insertions for diagnostic or treatment purposes and their parents participated . A computerized application , Children , Parents and Distraction , was used to predict distress risk . Doses of intervention were basic ( parents trained on providing distraction ) , enhanced ( basic training plus tailored instructions , environmental modifications , and support and guidance from the research assistant ) , and professional ( a trained research assistant provided distraction ) . Outcome measures were Observational Scale of Behavioral Distress-Revised for behavioral distress , Oucher for self-reported pain , parent report of child distress , and salivary cortisol for physiological distress . RESULTS A total of 574 children , ages 4-10 , and their parents participated . The Children , Parents and Distraction predicted that the risk for distress was high for 156 children , medium for 372 , and low for 46 . Children predicted to have higher risk for distress displayed more behavioral distress ( p < .01 ) . Children in the medium-risk group who had the professional intervention displayed significantly less behavioral distress ( p < .001 ) . Children in the high-risk group tended to have less behavioral distress when receiving the professional intervention ( p = .07 ) . There were no significant group differences for self-report of pain , parent report of distress , or cortisol levels . DISCUSSION Some parents may need additional training in providing distraction to their children during procedures , and some children at medium and high risk for distress may need professional support . Parents should be asked about their preferences in acting as the distraction coach and , if willing , be provided as much training and support as possible in the clinical situation .
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Intervention_Educational
doses of distraction intervention
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Intervention_Educational
( parents trained on providing distraction )
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Intervention_Educational
( a trained research assistant provided distraction )
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Outcome_Mental
Observational Scale of Behavioral Distress-Revised for behavioral distress , Oucher for self-reported pain , parent report of child distress , and salivary cortisol for physiological distress .
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Outcome_Mental
risk for distress
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Outcome_Mental
behavioral distress
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Outcome_Mental
behavioral distress
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Outcome_Pain
self-report of pain ,
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Outcome_Mental
parent report of distress
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Outcome_Mental
cortisol levels
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Participant_Age
child
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Participant_Condition
risk for distress
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Participant_Age
children
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Participant_Condition
high and medium risk for procedure-related distress
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Participant_Condition
scheduled intravenous insertions for diagnostic or treatment purposes
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Participant_Sample-size
574
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Participant_Age
children
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Participant_Age
ages 4-10
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Participant_Condition
children at medium and high risk for distress