Mithal Priyanjali, Simmons Pamela, Cornelissen Tessa, Wong Horace, Pillai Riddell Rebecca, McMurtry C Meghan, Burry Lisa, Stephens Derek, Taddio Anna
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Health and Wellness Centre, University of Toronto, Toronto, Ontario, Canada.
Can J Pain. 2018 Jan 5;2(1):1-8. doi: 10.1080/24740527.2017.1412254. eCollection 2018.
Clinicians commonly advise patients to look away from the needle during vaccinations; however, this recommendation is not evidence based.
The aim of this study was to determine whether looking at the needle versus looking away affects pain and fear during vaccinations in adults.
This was a pilot randomized two-group parallel trial with university students receiving influenza vaccinations. Participants were stratified according to their initial needle-looking preference and randomly assigned to either look at versus away from the needle. Participants self-reported their pain and fear during vaccination.
Of the 184 subjects who agreed to participate, 160 were enrolled; 66% were female. A three-way analysis of variance (ANOVA; Looking allocation assignment × Looking preference × Sex) revealed a significant main effect of looking allocation assignment on fear ( = 0.025); those who were randomized to look had higher fear scores than those who were randomized to look away. There was also a significant main effect of looking preference on fear ( < 0.001); those who preferred to look away had higher fear scores than those who preferred to look. There was no evidence of an effect of looking allocation assignment or looking preference on pain. There was a significant main effect of sex on fear and pain, with females reporting higher pain and fear scores than males ( = 0.017 and = 0.001, respectively). There were no significant interactions.
These preliminary findings suggest that advising individuals to look away from the needle reduces fear. A larger trial including more individuals and a different population is recommended to confirm the results.
临床医生通常建议患者在接种疫苗时不要看针头；然而，这一建议并无证据支持。
本研究旨在确定在成人接种疫苗过程中，看针头与不看针头是否会影响疼痛和恐惧程度。
这是一项针对大学生接种流感疫苗的试点随机两组平行试验。参与者根据其最初看针头的偏好进行分层，并随机分配为看针头组或不看针头组。参与者在接种疫苗过程中自行报告疼痛和恐惧程度。
在184名同意参与的受试者中，160名被纳入研究；其中66%为女性。三因素方差分析（看针头分配×看针头偏好×性别）显示，看针头分配对恐惧有显著的主效应（P = 0.025）；随机分配看针头的人恐惧得分高于随机分配不看针头的人。看针头偏好对恐惧也有显著的主效应（P < 0.001）；偏好不看针头的人恐惧得分高于偏好看针头的人。没有证据表明看针头分配或看针头偏好对疼痛有影响。性别对恐惧和疼痛有显著的主效应，女性报告的疼痛和恐惧得分高于男性（分别为P = 0.017和P = 0.001）。没有显著的交互作用。
这些初步研究结果表明，建议人们不看针头可减轻恐惧。建议开展一项更大规模的试验，纳入更多个体和不同人群以证实结果。
