A Comparison of the Effects of Cutaneous Stimulation and Distraction on Children's Perceptions of Injection Pain
Review TypeNone: Degree-based Submission
Repository Posting Date2019-03-22T17:48:25Z
Author(s)Sparks, Laurie G.
Author DetailsLaurie Allyn Sparks, RN, PhD
Lead Author Sigma AffliationGamma Chi
Level of EvidenceQuasi-Experimental Study, Other
Research ApproachQuantitative Research
CINAHL HeadingsDistraction -- In Infancy and Childhood; Injections -- Adverse Effects -- In Infancy and Childhood; Sensory Stimulation -- In Infancy and Childhood; Touch -- In Infancy and Childhood; Treatment Related Pain -- Nursing -- In Infancy and Childhood; Distraction; Injections -- Adverse Effects; Sensory Stimulation; Touch; Treatment Related Pain -- Nursing; Injections; Treatment Related Pain
Research has shown that children fear injections and perceive them as painful. Virtually all children experience injections through immunizations, and, therefore, methods to decrease injection pain could have widespread results. This study examined the effects of two nursing interventions on injection pain in preschool children: distraction and cutaneous stimulation. A quasi-experimental design was employed to test the interventions. The study was guided by Roy's adaptation theory of nursing and the gate-control theory of pain. The sample included 105 preschool children who were attending several immunization clinics in a metropolitan area. The children were randomly assigned to 1 of 3 groups prior to their Diphtheria-Tetanus-Pertussis injection. Children in group I received the intervention of distraction through bubble-blowing, children in group 2 received the intervention of cutaneous stimulation by touch, and children in group 3 received standard care. Demographic data and a measure of each child's fear, using the Child Medical Fear Scale, were obtained prior to injection. All children self-reported their pain using the Oucher Scale. Analyses found the lowest mean pain scores in the touch group, followed closely by the distraction group, and highest in the standard care group. Analysis of variance found no significant difference between the interventions (F = .08, p = .79), but a significant difference between the intervention groups and the standard care group (F = 6.48, p = .0 13). Factorial ANOVA demonstrated 4 significant treatment main effect, but no significant interaction effect of age or gender. Therefore, both distraction and touch reduced significantly the injection pain in this sample of preschool children. The study results have nursing research and practice implications. Further research is needed to determine if these interventions are effective with multiple injections and with other age groups, to compare distraction with topical anesthetics, and to examine the use of distraction and touch for other forms of pediatric pain. The study results demonstrate the effectiveness of distraction and touch in reducing injection pain, and all nurses are encouraged to use these methods when administering injections to help children cope with this common, painful experience.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9926980; ProQuest document ID: 304453697. The author still retains copyright.
Degree GrantorSaint Louis University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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