Taddio Anna, Parikh Chaitya, Yoon Eugene W, Sgro Michael, Singh Harvinder, Habtom Erita, Ilersich Andrew F, Pillai Riddell Rebecca, Shah Vibhuti
Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, Canada Department of Pediatrics, St Michael's Hospital, Toronto, Canada Department of Psychology, York University, Toronto, Canada Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada.
Pain. 2015 Jan;156(1):185-191. doi: 10.1016/j.pain.0000000000000021.
Educating parents about ways to minimize pain during routine infant vaccine injections at the point of care may positively impact on pain management practices. The objective of this cluster randomized trial was to determine the impact of educating parents about pain in outpatient pediatric clinics on their use of pain treatments during routine infant vaccinations. Four hospital-based pediatric clinics were randomized to intervention or control groups. Parents of 2- to 4-month-old infants attending the intervention clinics reviewed a pamphlet and a video about vaccination pain management on the day of vaccination, whereas those in the control clinics did not. Parent use of specific pain treatments (breastfeeding, sugar water, topical anesthetics, and/or holding of infants) on the education day and at subsequent routine vaccinations 2 months later was the primary outcome. Altogether, 160 parent-infant dyads (80 per group) participated between November 2012 and February 2014; follow-up data were available for 126 (79%). Demographics did not differ between groups (P > 0.05). On the education day and at follow-up vaccinations, use of pain interventions during vaccinations was higher in the intervention group (80% vs 26% and 68% vs 32%, respectively; P < 0.001 for both analyses). Educating parents about pain management in a hospital outpatient setting leads to higher use of pain interventions during routine infant vaccinations.
在医疗现场对家长进行关于如何将常规婴儿疫苗注射时的疼痛降至最低的教育，可能会对疼痛管理措施产生积极影响。这项整群随机试验的目的是确定在门诊儿科诊所对家长进行疼痛教育，对他们在常规婴儿疫苗接种期间使用疼痛治疗方法的影响。四家医院的儿科诊所被随机分为干预组或对照组。在干预诊所就诊的2至4个月大婴儿的家长在接种疫苗当天查看了一份关于疫苗接种疼痛管理的宣传册和一段视频，而对照组诊所的家长则没有。家长在教育日以及2个月后的后续常规疫苗接种时使用特定疼痛治疗方法（母乳喂养、糖水、局部麻醉剂和/或怀抱婴儿）的情况是主要观察指标。2012年11月至2014年2月期间，共有160对母婴（每组80对）参与；126对（79%）有随访数据。两组之间的人口统计学特征无差异（P>0.05）。在教育日和随访疫苗接种时，干预组在疫苗接种期间使用疼痛干预措施的比例更高（分别为80%对26%和68%对32%；两项分析的P均<0.001）。在医院门诊环境中对家长进行疼痛管理教育，会导致在常规婴儿疫苗接种期间更多地使用疼痛干预措施。
