A Measure of Caregivers' Distress-Promoting Behaviors During Toddler Vaccination: Validation of the OUCHIE-RV

Shaylea D Badovinac; David B Flora; Heather Edgell; Dan Flanders; Hartley Garfield; Eitan Weinberg; Deena Savlov; Rebecca R Pillai Riddell

doi:10.1093/jpepsy/jsad050

A Measure of Caregivers' Distress-Promoting Behaviors During Toddler Vaccination: Validation of the OUCHIE-RV

J Pediatr Psychol. 2023 Sep 20;48(9):787-797. doi: 10.1093/jpepsy/jsad050.

Authors

Shaylea D Badovinac¹, David B Flora¹, Heather Edgell², Dan Flanders³, Hartley Garfield^{3

4}, Eitan Weinberg³, Deena Savlov³, Rebecca R Pillai Riddell^{1

3

4}

Affiliations

¹ Department of Psychology, York University, Toronto, ON, Canada.
² School of Kinesiology & Health Science, York University, Toronto, ON, Canada.
³ University of Toronto, Toronto, ON, Canada.
⁴ The Hospital for Sick Children, Toronto, ON, Canada.

PMID: 37568248
PMCID: PMC10516456 (available on 2024-08-11)
DOI: 10.1093/jpepsy/jsad050

Abstract

Objective: The current study discusses the development and preliminary validation of an observational measure of caregivers' distress-promoting behavior (OUCHIE-RV) in the context of toddler routine vaccination.

Methods: Measure validation was based on a sample of caregiver-toddler dyads (N = 223) from a longitudinal cohort-sequential study who were observed during toddlers' 12-, 18-, or 24-month routine vaccinations. Validity was assessed using correlations and cross-lagged path analysis and associations were tested between OUCHIE-RV composite scores and toddlers' pain-related distress as well as caregivers' state anxiety, soothing behaviors, heart rate, and heart rate variability. Interrater reliability was examined using intraclass correlations (ICC) and kappa coefficients.

Results: Results of a cross-lagged path analysis indicated positive concurrent (β = .27 to β = .37) and cross-lagged predictive associations (β = .01 to β = .34) between OUCHIE-RV composite scores (reflecting the frequency and intensity of caregivers' distress-promoting behavior) and toddlers' pain-related distress. OUCHIE-RV composite scores were negatively associated with caregivers' concurrent use of physical comfort (r = -.34 to -.24) and rocking (r = -.36 to -.19) and showed minimal associations with caregivers' use of verbal reassurance (r = .06 to .12), state anxiety (r = -.02 to r = .09), heart rate (r = -.15 to r = .05), and heart rate variability (r = -.04 to r = .13). Interrater reliability was strong (Cohen's k = .86 to .97, ICC = .77 to .85).

Conclusions: Findings provide support for the validity and reliability of the OUCHIE-RV as a research tool for measuring caregiver behaviors that promote toddlers' pain-related distress during routine vaccinations and contribute to a better understanding of the dynamics of caregiver-toddler interaction in acute pain contexts.

Keywords: acute pain; infancy and early childhood; measure validation; parenting.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Caregivers*
Child, Preschool
Emotions*
Humans
Pain
Reproducibility of Results
Vaccination

Grants and funding

GSD-164166/CIHR/Canada