Abstract
A systematic review and meta-analysis conducted to evaluate the combined effect of distraction intervention for needle-related pain in order to provide the basis for developing an effective nursing intervention for children. We searched three electronic databases, PubMed, Embase, and CINAHL, for original articles published in the period from 1 January 2011 to 31 July 2019. In addition, a manual search was performed on the basis of references in the literature and the references of the articles in pursuit of comprehensive data until 10 December 2019. Meta-analysis was performed by the synthesis of the effect size, homogeneity, heterogeneity, and trim-and-fill method using MIX 2.0 Pro. Well-planned RCTs, single-center studies, high-quality studies, participants older than 10 years of age, and visual and clown distraction interventions were effective for needle-related pain and distress management among children. The results showed evidence supporting the effect of distraction interventions for children’s needle-related pain and distress. Through this review, strategies were identified to design better interventions to improve the outcomes.
Highlights
Several international pain-related expert groups, including the World Health Organization (WHO), contend that optimally effective pain management is a fundamental human right and good and ethical practice [1,2]
The population was limited to children, intervention to distraction intervention for relieving needle-related pain and distress, comparison to patients given usual care, outcome to needle-related pain and distress, and study design to randomized controlled trials (RCTs) and studies with a quasi-experimental design
For the total 37 RCTs, including the two crossover RCTs, the overall effects were at a medium level of −0.61 and the needle-related pain decreased significantly after distraction intervention (Z = −3.85, p < 0.001)
Summary
Several international pain-related expert groups, including the World Health Organization (WHO), contend that optimally effective pain management is a fundamental human right and good and ethical practice [1,2]. Healthcare providers, including pediatric nurses, have an ethical obligation and responsibility to use the up-to-date scientific ground to relieve any pain and fear that children may experience during treatment [3]. Both healthy and medically ill children may have difficulty with needle-related procedures [4]. Vaccination, blood collection, and intravascular injection are treatment procedures causing pain and fear that children may most frequently experience [4,5,6] They may have such painful experiences in diverse places, including public health clinics and hospitals [1]. Children remember the past painful experiences, and the negative memory of pain or fear caused by poor management during treatment can affect the subsequent treatment, having an adverse long-term
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