Alleviating needle-related pain and distress in children

Abstract

Throughout development, children tend to undergo a significant amount of routine as well as unplanned needle-related medical interventions (NRMIs) as part of prevention, diagnosis and treatment. Despite their important benefits, NRMIs are a common source of pain and distress amongst children. Evidence from several studies suggests that distraction can be efficacious in alleviating the pain and distress caused by such interventions; however, till present no guidelines have been implemented yet. The PICO question investigated in this dissertation reads: “Is distraction (I) effective in alleviating needle- related procedural pain and distress (O) in children aged 6 to 12 years? (P)”. A thorough systematic search was conducted to retrieve relevant studies that met the inclusion and exclusion criteria employed. The inclusion criteria consisted of studies that compared the use of one or more distraction methods with a control; included children undergoing a NRMI; addressed alleviated pain and distress as an outcome; were peer-reviewed; available in full text and published in English with a publication date between 2006 and 2016. On the other hand, studies that did not meet the inclusion criteria were automatically discarded. Seven studies were found to be relevant including five PRCTs and two RCTs. The selected studies were critically appraised using an appropriate CASP checklist. Results were classified into two categories: the effects of distraction on NRPP and the effects of distraction on NRPA. Nearly all studies found that children within the distraction groups reported lower pain and anxiety levels than those in the control groups. Thus it was concluded that distraction is effective in alleviating the pain and anxiety associated with NRMIs amongst children. In view of this, the use of distraction during such interventions is therefore recommended. Further research ideally within the local setting should be conducted to explore which distraction methods are most suitable for specific age groups.