This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kazak, A. E.
Right arrow Articles by Himelstein, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kazak, A. E.
Right arrow Articles by Himelstein, B.
Related Collections
Right arrow Tumors

PEDIATRICS Vol. 102 No. 1 July 1998, pp. 59-66

Pharmacologic and Psychologic Interventions for Procedural Pain

Received Jun 12, 1997; accepted Nov 17, 1997.

Anne E. Kazak*, Biancamaria PenatiDagger , Patricia BrophyDagger , and Bruce Himelstein*

From the * Department of Pediatrics, University of Pennsylvania School of Medicine and Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and the Dagger  Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Objective.  This study evaluated a combined pharmacologic and psychologic intervention (combined intervention, CI) relative to a pharmacologic-only (PO) intervention in reducing child distress during invasive procedures in childhood leukemia. Predictors of child distress included age, group (CI, PO), and procedural variables (medications and doses, technical difficulty, number of needles required).

Methodology.  This was a randomized, controlled prospective study that compared the PO (n = 45) and CI arms (n = 47), at 1, 6, and >12 months after diagnosis. A cross-sectional control group consisted of parents of 70 patients in first remission before the prospective study. Parent questionnaires, staff and parent ratings, and data on medications administered, technical difficulty of the procedure, and needle insertions were obtained for each procedure. This article reports on the final data point for the project (>12 months).

Results.  Mothers and nurses reported lower levels of child distress in the CI than the PO group. The CI and PO groups showed lower levels of child and parent distress than the cross-sectional control group. Distress decreased throughout the time, and child age was inversely related to distress (younger children had more distress) regardless of group. Child distress was associated with staff perceptions of the technical difficulty of the procedure and with child age, but not with medications administered.

Conclusions.  The data showed that pharmacologic and psychologic interventions for procedural distress were effective in reducing child and parent distress and support integration of the two approaches. Younger children experienced more distress and warranted additional consideration. Staff perceptions of the technical difficulty of procedures were complex and potentially helpful in designing intervention protocols.

Key words: pediatric oncology, pain, procedures, intervention.




This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
R. W. Smith, V. Shah, R. D. Goldman, and A. Taddio
Caregivers' Responses to Pain in Their Children in the Emergency Department
Arch Pediatr Adolesc Med, June 1, 2007; 161(6): 578 - 582.
[Abstract] [Full Text] [PDF]

Home page
 EDUCATION AND PRACTICEHome page
A. J Harvey and N. S Morton
Management of procedural pain in children
Arch. Dis. Child. Ed. Pract., February 1, 2007; 92(1): ep20 - ep26.
[Full Text] [PDF]

Home page
 CA Cancer J ClinHome page
G. Deng and B. R. Cassileth
Integrative Oncology: Complementary Therapies for Pain, Anxiety, and Mood Disturbance
CA Cancer J Clin, March 1, 2005; 55(2): 109 - 116.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
A. E. Kazak
Evidence-Based Interventions for Survivors of Childhood Cancer and Their Families
J. Pediatr. Psychol., January 1, 2005; 30(1): 29 - 39.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. E. Kazak, M. C. Cant, M. M. Jensen, M. McSherry, M. T. Rourke, W.-T. Hwang, M. A. Alderfer, D. Beele, S. Simms, and B. J. Lange
Identifying Psychosocial Risk Indicative of Subsequent Resource Use in Families of Newly Diagnosed Pediatric Oncology Patients
J. Clin. Oncol., September 1, 2003; 21(17): 3220 - 3225.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
C Crock, C Olsson, R Phillips, G Chalkiadis, S Sawyer, D Ashley, S Camilleri, J Carlin, and P Monagle
General anaesthesia or conscious sedation for painful procedures in childhood cancer: the family's perspective
Arch. Dis. Child., March 1, 2003; 88(3): 253 - 257.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
A. E. Kazak, S. Simms, and M. T. Rourke
Family Systems Practice in Pediatric Psychology
J. Pediatr. Psychol., March 1, 2002; 27(2): 133 - 143.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
W. B. Schiff, K. D. Holtz, N. Peterson, and T. Rakusan
Effect of an Intervention to Reduce Procedural Pain and Distress for Children With HIV Infection
J. Pediatr. Psychol., October 1, 2001; 26(7): 417 - 427.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
M. Best, R. Streisand, L. Catania, and A. E. Kazak
Parental Distress During Pediatric Leukemia and Posttraumatic Stress Symptoms (PTSS) After Treatment Ends
J. Pediatr. Psychol., July 1, 2001; 26(5): 299 - 307.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. H. Hertzog, H. J. Dalton, B. D. Anderson, A. T. Shad, J. E. Gootenberg, and G. J. Hauser
Prospective Evaluation of Propofol Anesthesia in the Pediatric Intensive Care Unit for Elective Oncology Procedures in Ambulatory and Hospitalized Children
Pediatrics, October 1, 2000; 106(4): 742 - 747.
[Abstract] [Full Text]

Home page
 J Pediatr PsycholHome page
E. Chen, M. G. Craske, E. R. Katz, E. Schwartz, and L. K. Zeltzer
Pain-Sensitive Temperament: Does It Predict Procedural Distress and Response to Psychological Treatment Among Children With Cancer?
J. Pediatr. Psychol., June 1, 2000; 25(4): 269 - 278.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
O. J. Z. Sahler, G. Frager, M. Levetown, F. G. Cohn, and M. A. Lipson
Medical Education About End-of-Life Care in the Pediatric Setting: Principles, Challenges, and Opportunities
Pediatrics, March 1, 2000; 105(3): 575 - 584.
[Abstract] [Full Text]