Abstract
The main objective of the study was to determine the effect of structured psychological intervention on the level of perceived pain in children undergoing venipuncture. A second goal was to investigate how pain behavior during venipuncture is affected by age, sex, previous number of venipunctures, the presence of parents during the procedure and reason for the venipuncture. Children with indications for venipuncture aged 5-10 years, were randomly divided into a control group and an intervention group. The control group was prepared for the venipuncture routinely. Children in the intervention group were prepared according to prior structured psychological consultation. Perceived pain levels were assessed by the CHEOPS scale and the self report Wong and Baker faces pain rating scale. A significant difference in evaluated pain between the intervention group and the control group was found. The psychological intervention carried out by a nurse proved to lower pain levels from venipuncture as measured by the CHEOPS scale and evaluated using the self-report scale. A greater level of pain was found in children in the age group 5-7 years, in children where peripheral venous catheter was introduced and in children where the parents were present. Special consultation with the child one day before venipuncture reduced pain levels, especially in children below the age-category mentioned. Consultation should be part of the standard of care for children with indications for venipuncture.
Highlights
Deutsch[1] describes any rupture of the skin surface or entry into the body as an invasive procedure
The results show that children in the intervention group who had been prepared for the procedure using education, demonstration on a doll, distracting the child during the procedure, and giving them a reward, reported lower pain behavior during the actual venipuncture than children in the control group who received standard treatment
The study showed that special consultation between nurse and child regarding venipuncture had positive effects on reducing perceived pain during the intervention
Summary
Deutsch[1] describes any rupture of the skin surface or entry into the body as an invasive procedure. Among unpleasant medical invasive procedures in childhood is venipuncture which is understood to be puncturing the vein with an injection needle. Hana et al.[3], Wong and Baker[4], and Duff[5] agree that repeated venipuncture is an especially stressful and painful experience for children while Bijttebier and Vertommen[6] point out that venipuncture involving rough treatment, poor preparation or unbearable pain can have extensive effects that include anxiety, decreased pain threshold, reduced effects of analgesia for further procedures and avoidance of medical care. Dahlquist et al.[7] adds that anxiety and fear during venipuncture reduce cooperation from the child resulting in repeated attempts at carrying out the procedure. Among appropriate ways of reducing anxiety in hospitalized children are psycho pedagogical intervention programmes which increase the cooperation of the children as additional benefits[8]
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