No More Ouchie Mommy!

5:27 PM |

Adults, especially parents, usually feel sorry when they see that their children are in pain. For instance when my brother and I are sick, my parents would say that they want to do anything to alleviate whatever pain we’re feeling, but the thing is, sometimes there seems to be no way to do so, incidents when only the doctors and nurses, and God, have the ability and power to lessen the pain. I’m sure the same is true for all the parents, especially those whose children are still young, who cannot bear the pain they are feeling and even more for the infants who cannot even express pain (i.e. telling what part of the body hurts) aside from crying.

As pain is considered as one of the major health problems, both in adults and in children (Hasanpour et. al., 2006; cited in Tüfekci et. al., 2009), there have been a number of researches that aims to discover what could lessen it. For instance, in study of Tüfekci, Çelebioğlu and Küçükoğlu (2009), it has been investigated if a distracter, particularly a kaleidoscope, would lessen the perceived pain of children who are undergoing venipuncture.

To take things one by one, let’s first define the terms and variable involved. Venipuncture is the act of collecting blood from the veins— which is of course, painful. In fact, several studies had evaluated venipuncture as the most painful intervention commonly applied to children (Wong & Baker, 1988; Young et al., 1996; Jacobson, 1999; Smalley, 1999; cited in Tüfekci et. al., 2009) , not to mention that procedures made by needles alone are the most common sources of pain in children (Uman et. al., 2006: Tüfekci et. al., 2009).

Aside from such studies that evaluate the pain levels in patients, there had also been investigations on how to reduce pain, specifically in the hospital setting. Bellieni and his colleagues (2006; cited in Tüfekci et. al., 2009) had described two approaches in alleviating pain, the pharmacological and non-pharmacological methods, the latter reported to be more favorable and effective—particularly to the school-age children-- by Vessey and Carlson (1996; cited in Tüfekci et. al., 2009). Non-pharmacological approaches include distraction techniques. “Distraction is a nursing attempt focusing a patient’s attention to any other stimulants to control and reduce pain better (p. 2181; also in McCaffery 1990, Hasanpour et al. 2006)”. Several stimuli had actually been used as a distracter; some of these are party blowers, distracting toys, blowing out air, music through earphones, cartoon watching, and non-procedural talk (Tüfekci et. al., 2009).

In Tüfekci et. al.’ study (2009), they had used a kaleidoscope to serve as a distracter to children. A kaleidoscope is toy which is played simply by looking through a hole where colorful patterns can be seen when the cylinders are rotated. These patterns consist of various colors and shapes of beads that form unique designs (Tüfekci et. al., 2009). Thus with such visual elements, it draws the attention an interest of the children who plays it. Since it calls the attention of children, Tüfekci et. al. (2009) hypothesized that it will lessen the pain the children would feel during venipuncture, at the same time, they also hypothesize that some characteristics of children affect the perception of pain.

To test the hypotheses, the study had to conduct an experiment consisting of a control and an intervention group. The 206 participants are children, between ages 7 to 11, who were scheduled to have venipuncture on a specific day and reported not having any chronic diseases and/or developmental problem or disabilities which would make communication more complex. The treatment that differ the two groups is that for the intervention group, after the children, accompanied by their parents—who gave an approval for their children to be a part of the study-- were admitted to the waiting room for venipuncture, a kaleidoscope was introduced each of them. Instructions on how to use it were also given.

By using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale (WB-FPRS), the former providing qualitative data while the latter quantitative, the pain perceived by each children, in both treatment groups, were evaluated. An additional form determined the general characteristics of the participants (i.e. gender, age, previous experience of venipuncture, level of fear) (Tüfekci et. al., 2009).

Results, both from VAS and WB-FPRS, show that participants in the intervention group (mean: 3.14; SD: 1.41) perceived lesser pain compared to the control group; thus the first hypothesis was supported. Likewise, the second hypothesis was supported when the study found that other characteristics that were enumerated above affected the children’s perception of pain. For instance, female children felt less pain than did the male children which might have an implication on cultural roles of male who are expected to endure pain; also, children who had four or more experience of venipuncture experienced less pain. On another note, children who feared the procedure and had 1 to 3 experiences of venipuncture perceived higher levels of pain.

These results suggest that nurses should take into account the gender and other characteristics of the children, especially when performing needle procedures such as venipuncture to them. The result may also be beneficial for the parents and caretakers of the children, suggesting simple tips on how to reduce the pain their children are feeling.