Individual differences in pediatric cancer patients' reactions to invasive medical procedures: a repeated measures analysis.

Previous research on child distress in pediatric cancer has addressed the issue of habituation to invasive procedures using correlational methodology. In addition, most studies have focused on the bone marrow aspiration (BMA); few have examined children's reactions to the lumbar puncture (LP) separately. The present investigation examined 13 pediatric cancer patients over time as they experienced five BMAs or LPs. Direct observation of child behavior during procedures was employed to assess distress responses using a 12-category measure. Individual patients demonstrated a range of distress patterns. Only two children were observed to habituate to these procedures. The importance of individual patient characteristics and differences in the execution of the procedures are discussed, as is the need for greater use of treatments for child distress.