Children's Hospital Boston, Department of Anesthesia, Perioperative and Pain Medicine, 300 Longwood Ave, Boston, MA 02115, USA.
Pediatrics. 2010 Dec;126(6):e1514-21. doi: 10.1542/peds.2010-1597. Epub 2010 Nov 15.
The goal was to examine the impact of a teaching module on immunization pain reduction practices in pediatric offices 1 and 6 months after the intervention.
Fourteen practices were selected randomly to receive a 1-hour teaching session on immunization pain reduction techniques, and 13 completed the study. Before the intervention, telephone interviews were conducted with parents concerning their children's recent immunization experiences. At 1 and 6 months after the intervention, parents of children who had recent immunizations were interviewed by using the same questionnaires. Clinicians also were surveyed at baseline and at 6 months.
A total of 839 telephone interviews and 92 clinician surveys were included. Significant changes from baseline were identified at 1 and 6 months after the intervention. At 1 month, parents were more likely to report receiving information (P = .04), using strategies to reduce pain (P < .01), learning something new (P < .01), using a ShotBlocker (P < .01), using sucrose (P < .01), and having higher levels of satisfaction (P = .015). At 6 months, all rates remained significantly higher than baseline findings (all P < .01) except for satisfaction. Clinician surveys revealed significant increases in the use of longer needles, sucrose, pinwheels, focused breathing, and ShotBlockers at 6 months.
A 1-hour teaching session had measurable effects on the use of pain-reducing strategies at 1 and 6 months after the intervention. This research supports the hypothesis that small-group teaching sessions at the site of care can be associated with changes in practice behaviors.
本研究旨在探讨 1 小时教学模块对儿科诊室中疫苗接种疼痛缓解实践的影响,在干预后 1 个月和 6 个月分别对其进行评估。
随机选择 14 家诊所接受 1 小时的疫苗接种疼痛缓解技术教学课程,其中 13 家完成了研究。在干预前,通过电话采访了解父母最近的儿童疫苗接种经历。在干预后 1 个月和 6 个月,采用相同的问卷对最近接受过疫苗接种的儿童的父母进行采访。在基线和 6 个月时还对临床医生进行了调查。
共纳入 839 次电话采访和 92 次临床医生调查。在干预后 1 个月和 6 个月时,与基线相比,均出现了显著变化。在 1 个月时,父母更有可能报告接受了信息(P =.04)、使用了减轻疼痛的策略(P <.01)、学到了新东西(P <.01)、使用了 ShotBlocker(P <.01)、使用了蔗糖(P <.01),满意度更高(P =.015)。在 6 个月时,除了满意度之外,所有比率仍显著高于基线(均 P <.01)。临床医生调查显示,在 6 个月时,更长的针、蔗糖、风车、专注呼吸和 ShotBlocker 的使用显著增加。
1 小时的教学课程在干预后 1 个月和 6 个月时对使用疼痛缓解策略产生了可衡量的影响。这项研究支持了这样一种假设,即在护理现场进行小组教学可以与实践行为的改变相关联。