York University.
Hospital for Sick Children.
J Pediatr Psychol. 2018 Apr 1;43(3):224-233. doi: 10.1093/jpepsy/jsx122.
To test the efficacy of a brief behavioral pain management strategy (The ABCDs of Needle Pain Management), delivered via video, on infants' and toddlers' pain scores and on parental soothing behavior.
This was a double-blind, parallel trial design. Parent-child dyads (N = 128) were recruited before their child's 6-month (infant) or 18-month (toddler) vaccination in a pediatric clinic and randomly assigned to watch a 5-min treatment video or a placebo video. The primary outcome was the Modified Behavior Pain Scale (Taddio et al., Journal of Pain and Symptom Management, 10, pp. 456-463, 1995), coded during four epochs (Pain Reactivity, Pain Regulation 1 min, Pain Regulation 2 min, and Pain Regulation 3 min) after the last vaccination needle. Secondary analyses examined parental use of distraction, rocking, and physical comforting over this same time period.
Results demonstrated a treatment effect for toddlers (18-month-olds) for the Pain Regulation 1 (d = 0.84) and Pain Regulation 2 (d = 0.76) postvaccination scores. Secondary analyses found differences in parental rocking and physical comforting between treatment conditions and between age-groups (d's = 0.37-0.54).
The ABCD pain management strategy delivered via video was an effective way to reduce toddler pain after vaccination and increase parental use of rocking and physical comforting. The treatment effect was not demonstrated with infants.
通过视频传递一个简短的行为疼痛管理策略（ABCD 方案），测试其在婴儿和幼儿疼痛评分以及父母安抚行为上的疗效。
这是一项双盲、平行试验设计。在儿科诊所招募了即将接受 6 个月（婴儿）或 18 个月（幼儿）疫苗接种的母婴二人组（N=128），并随机分配观看 5 分钟的治疗视频或安慰剂视频。主要结局是改良行为疼痛量表（Taddio 等人，《疼痛与症状管理杂志》，10 期，第 456-463 页，1995 年），在最后一针疫苗接种后四个时段（疼痛反应、疼痛调节 1 分钟、疼痛调节 2 分钟和疼痛调节 3 分钟）进行编码。次要分析检查了在此期间父母使用分心、摇晃和身体安慰的情况。
结果表明，18 个月大的幼儿在接种疫苗后的疼痛调节 1 分钟（d=0.84）和疼痛调节 2 分钟（d=0.76）的评分上存在治疗效果。次要分析发现，在治疗条件和年龄组之间，父母的摇晃和身体安慰存在差异（d 值为 0.37-0.54）。
通过视频传递的 ABCD 疼痛管理策略是一种有效减少幼儿接种疫苗后疼痛和增加父母使用摇晃和身体安慰的方法。但该治疗效果在婴儿中未得到证实。
