Soothing and Distress Behaviors of Infants, Parents, and Clinicians During Childhood Vaccinations

Abstract

ObjectivesThe purpose of this study is to describe the behaviours of infants who were born preterm, their parent, and clinicians during two-, six-, twelve- and eighteen-month vaccinations. MethodsVaccination sessions were video recorded for 3-5 minutes. The proportion of five-second intervals in which distress and soothing behaviour occurred for infants, parents, and clinicians was coded using the Measure of Adult and Infant Soothing and Distress. Coding consisted of three phases: baseline/anticipatory (60 seconds prior to first needle), procedure (first needle to removal of final needle), recovery (up to 180 seconds after removal of final needle). Results64 infants were included. Distress behaviour for infants during baseline ranged from 13% (twelve-month) to 29% (two-month). There was limited anticipatory soothing behaviour from parents (10% (twelve-month) to 50% (two-month)) and clinicians (6% (twelve-month) to 17% (two-month)). Distress behaviour in infants during procedure ranged from 43% (eighteen-month) to 96% (two-month). There was limited soothing behaviour during procedure from parents (10% (twelve-month) to 81% (twelve-month)) and clinicians (13% (twelve-month) to 71% (two-month)). Few infants received additional pain reducing interventions of skin-to-skin contact, 24% oral sucrose, and topical anesthetic. DiscussionDespite infant distress, there was limited anticipatory behaviour from parents and clinicians. Two-month infants displayed the most distress across all timepoints yet received the least amount of treatment and proximal parent and clinician behaviour. Additional implementation efforts are required to increase awareness and practice uptake among parents and clinicians to ensure infants receive equitable and effective pain management.