Do parents really want pain prevention strategies for immunizations?

Abstract

Pain experienced by children during immunizations often is associated with significant parental distress and may have long-term adverse effects for the child (e.g. anxiety, pain sensitivity, poorer immunization adherence). Evidence-based pain prevention strategies for pediatric immunizations are available, but remain poorly implemented in clinical practice. While some barriers have been identified at the healthcare provider level, far less is known about parent knowledge and attitudes toward immunization pain that may impact efforts to optimize pain prevention for childhood immunizations. The present study sought to better understand parent perceptions regarding pain prevention for immunizations. A questionnaire was developed based on existing literature regarding pain knowledge, attitudes, and barriers, as well as expert review/consensus. Questionnaires were completed by 101 parent/guardians (87% female; 36% Black, 33% White, and 14% Hispanic) of children ages 0-5 years attending appointments at a hospital-based general pediatrics clinic in the Midwest. Results suggest that most parents (91%) agree it is important to lessen a child's pain during immunizations; however, more than half (63%) perceived little actual benefit from previously used pain prevention and approximately a quarter (28%) reported that nothing could help their child's immunization-related pain. Lack of knowledge and safety concerns were the most frequently endorsed barriers to using pain prevention, while concerns about cost, side effects, and time were additional barriers endorsed by up to one-third of parents. Moreover, 4 in 10 parents reported being unwilling to pay any money or to spend more than 10 minutes to eliminate immunization pain, suggesting limited perceived value or motivation for pain prevention during immunizations. Data from this study suggest that, beyond healthcare provider barriers, several parent-related barriers exist that need to be taken into account when translating evidence-based pain prevention strategies into the routine provision of childhood immunizations within the clinical setting.