Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents

Kathryn A Birnie; Melanie Noel; Jennifer A Parker; Christine T Chambers; Lindsay S Uman; Steve R Kisely; Patrick J McGrath

doi:10.1093/jpepsy/jsu029

Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents

J Pediatr Psychol. 2014 Sep;39(8):783-808. doi: 10.1093/jpepsy/jsu029. Epub 2014 Jun 2.

Authors

Kathryn A Birnie¹, Melanie Noel², Jennifer A Parker², Christine T Chambers³, Lindsay S Uman⁴, Steve R Kisely², Patrick J McGrath³

Affiliations

¹ Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland kbirnie@dal.ca.
² Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
³ Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
⁴ Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.

Abstract

Objective: To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy.

Methods: 26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias.

Results: Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy.

Conclusions: Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved.

Keywords: distraction; distress; empirically supported treatments; hypnosis; needles; pain; randomized controlled trials.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adolescent
Attention*
Child
Humans
Hypnosis*
Needles / adverse effects*
Pain / etiology
Pain / psychology*
Pain Management / methods*
Treatment Outcome

Grants and funding

Canadian Institutes of Health Research/Canada