Nonpharmacological pain management in vaccination. Perception of paediatricians, patients and guardians

Abstract

IntroductionThe use of nonpharmacological measures to reduce pain during vaccination has been studied extensively in infants, but there are fewer studies on its effectiveness in older children and on the parental perception of pain in children. MethodsWe conducted a multicentre, quasi-experimental interventional study with a control group. Patients: infants aged 2–11 months and children aged 4 years that attended routine vaccination appointments. Setting: Primary care. Intervention during vaccination: infants were breastfed and 4-year-old children blew a party horn. Control: vaccination performed following routine practice. Measurement: NIPS (Neonatal Infant Pain Scale) and duration of crying in infants, Wong-Baker FACES pain rating scale in older children and parents. ResultsThe study included 125 children (intervention: 60; control: 65). There was a significant decrease in perceived pain in the intervention groups: NIPS score in infants, 3.8 ± 1.1 compared to 5.2 ± 0.7 (P < .001); Wong-Baker FACES score at 4 years of 3.3 ± 1.7 compared to 4.2 ± 1.6 (P = .042). These same differences in support of the intervention were reflected in the parental assessments (3.4 ± 1.3 vs 4.5 ± 1.5; P < .001). The correlation between child and parent scores was strongly positive: 0.7 (95% CI, 0.59−0.78). However, the duration of crying was longer in the intervention group. ConclusionThe use of distraction techniques reduces pain in children and the pain perceived by parents in their children, thus increasing their satisfaction with the procedure.