Moline Rachel L, Constantin Kaytlin, Chambers Christine T, Powell Deborah, Lewis Stephen P, Laurignano Laryssa, McMurtry C Meghan
Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada.
Departments of Psychology and Neuroscience & Pediatrics, Dalhousie University, Halifax, NS B3H 1V7, Canada.
Children (Basel). 2022 Nov 30;9(12):1869. doi: 10.3390/children9121869.
Routine needle procedures can be distressing for parents and children. Mindfulness interventions may be helpful for parents and children but have not been examined for pediatric needle procedures despite showing benefits in the context of pediatric chronic pain and in lab-based pain tasks.
This preregistered (NCT03941717) two-arm, parallel-group randomized controlled trial examined the effects of a 5 min mindfulness intervention before pediatric venipuncture for parents and children (aged 7-12) compared to a control group on primary outcomes of child pain and fear, secondary outcomes of parent distress, and tertiary outcomes of parent ratings of child pain and fear. Moderators of parent and children's responses to the intervention were examined: state catastrophizing, trait mindfulness, and experiential avoidance.
Sixty-one parent-child dyads were randomized (31 mindfulness; 30 control). Parents and children completed measures, listened to a 5 min audio recording (mindfulness or control), and parents accompanied their child during routine venipuncture. The mindfulness intervention involved breathing and encouraging nonjudgmental attention to one's experiences, while the control condition involved an unfocused attention task. Three between-subject MANCOVAs assessed for group differences. Child pain and fear rated by children and their parents did not differ between groups. Parents in the mindfulness group were less distressed during the venipuncture than the controls. Parent state catastrophizing may have moderated the intervention effects, such that parents with moderate and high catastrophizing levels had lower distress following the mindfulness intervention versus control.
The intervention did not reduce child pain or fear but reduced parent distress. It appeared most helpful for parents catastrophizing about their child's pain, which is noteworthy as these children are prone to worse outcomes.
常规的针刺操作可能会让家长和孩子感到痛苦。正念干预可能对家长和孩子有帮助,但尽管在小儿慢性疼痛和基于实验室的疼痛任务中显示出益处,却尚未针对小儿针刺操作进行研究。
这项预先注册(NCT03941717)的双臂、平行组随机对照试验,比较了对家长和孩子(7至12岁)在小儿静脉穿刺前进行5分钟正念干预与对照组相比,对孩子疼痛和恐惧的主要结局、家长痛苦的次要结局以及家长对孩子疼痛和恐惧评分的三级结局的影响。研究了家长和孩子对干预反应的调节因素:状态灾难化、特质正念和经验回避。
61对亲子二元组被随机分组(31对接受正念干预;30对为对照组)。家长和孩子完成测量,听取5分钟的音频记录(正念或对照),并且家长在常规静脉穿刺期间陪伴孩子。正念干预包括呼吸练习并鼓励对自身经历不加评判地关注,而对照条件包括一项注意力不集中的任务。进行了三项组间多变量协方差分析以评估组间差异。孩子及其家长评定的孩子疼痛和恐惧在两组之间没有差异。正念组的家长在静脉穿刺期间比对照组的家长痛苦程度更低。家长的状态灾难化可能调节了干预效果,即与对照组相比,处于中度和高度灾难化水平的家长在接受正念干预后痛苦程度更低。
该干预并未减轻孩子的疼痛或恐惧,但减轻了家长的痛苦。它似乎对那些因孩子疼痛而灾难化的家长最有帮助,这一点值得注意,因为这些孩子更容易出现更糟糕的结果。