Predicting Children's Responses to Distraction from Pain

预测儿童对分散疼痛的反应

• 批准号: 6625744
• 负责人: Ann Marie McCarthy
• 金额: $ 46.81万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-06-01 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6625744
• 关键词: anxiety; behavior prediction; behavioral /social science research tag; cognitive behavior therapy; coping; human subject; human therapy evaluation; middle childhood (6-11); nursing intervention; pain threshold; parent offspring interaction; patient oriented research; personality; preschool child (1-5); training

DESCRIPTION: (provided by applicant) There is growing evidence that children who experience inadequate pain control during medical procedures may suffer long lasting effects research has demonstrated that cognitive behavioral interventions are effective in reducing pain and distress behavior for some, but not all, children during medical procedures. Cost effectiveness and parental interest have resulted in research on parental coaching of children in the use of cognitive behavioral interventions during painful medical procedures. Research is needed to determine which children benefit from cognitive behavioral interventions and under what circumstances. This research will identify factors that predict which children benefit from and which parents can effectively provide distraction to alleviate the child's behavioral distress during a medical procedure. This will guide the development of a clinically relevant predictive distress profile. The specific study aims are to: 1) determine the effectiveness of training parents to be distraction coaches during a medical procedure (intravenous insertion) by comparing responses of parents and children who receive the training (experimental group) with those who do not (control group); 2) identify parent and child characteristics predictive of children who respond with low versus high indicators of distress following parent delivered distraction during a painful medical procedure; and 3) determine the relationships and interactions among study variables that are associated with low versus high distress in children following a parent delivered distraction during a painful medical procedure. Approximately 540 children scheduled for an IV insertion for a medical test and their parents from 3 children's hospitals will be randomly assigned to an experimental or control group. The distraction intervention will be taught to families in the experimental group. The operational definition of distraction includes: reading to the child, pointing out specific items in books, talking to the child about non-procedure related topics, telling stories, blowing bubbles, finger play or using toys to capture the child's attention. Child and parent characteristics will be assessed to describe and define how each impacts the child response to the intervention and the medical procedure. Parent success response will be measured with self-assessment of success and observation of performance of distraction. Logistic regression will be used to develop the predictive models.

说明：（由申请人提供）越来越多的证据表明，儿童 在医疗过程中疼痛控制不足的人可能会遭受 长期影响研究表明，认知行为 干预措施在减少一些人的疼痛和痛苦行为方面是有效的， 但不是所有的儿童在医疗过程中。成本效益和 父母的兴趣导致了对父母指导孩子的研究， 在痛苦的医疗过程中使用认知行为干预， 程序.需要进行研究以确定哪些儿童受益于 认知行为干预以及在什么情况下。本研究 将确定哪些因素可以预测哪些儿童受益于 父母可以有效地分散孩子的注意力， 医疗过程中的痛苦。这将指导 临床相关的预测性痛苦特征。具体的研究目的是 要：1）确定培训家长分心的有效性 在医疗程序（静脉注射）期间， 家长和接受培训的儿童的反应（实验组） 与那些没有（对照组）; 2）识别父母和孩子 低与高应答儿童的预测特征 在痛苦的过程中，父母分散注意力后的痛苦指标 医疗程序;和3）确定之间的关系和相互作用 研究变量与儿童的低痛苦和高痛苦相关 在一次痛苦的医疗过程中，父母分散了他的注意力。 约有540名儿童计划接受静脉注射进行医学检查， 他们的父母来自3家儿童医院，将被随机分配到一个 实验组或对照组。分心干预将被教导 实验组的家庭。分心的操作定义 包括：阅读给孩子听，指出书中的具体项目， 向孩子讲述与手术无关的话题，讲故事，吹口哨， 泡泡，手指游戏或使用玩具来吸引孩子的注意力。儿童和 将评估母公司的特征，以描述和定义每种特征如何影响 儿童对干预和医疗程序的反应。母 将通过对成功的自我评估来衡量成功反应， 注意力分散的表现。逻辑回归将用于 建立预测模型。