Systematic Review: Predisposing, Precipitating, Perpetuating, and Present Factors Predicting Anticipatory Distress to Painful Medical Procedures in Children

Abstract Objective Whether parental presence during their children’s painful medical procedures is advantageous with regard to children’s pain-related outcomes is questionable. Research on this topic is equivocal, and additional questions, such as whether levels of parental involvement may play a role as well, remain to be addressed. The purpose of this systematic review is to summarize and critically appraise the literature on the impact of parental presence vs absence during their children’s painful medical procedures on the child’s pain-related outcomes. Methods The review protocol was registered on Prospero (ID CRD42018116614). A systematic search in PubMed, Web of Science, and PsycArticles resulted in 22 eligible studies incorporating 2,157 participants. Studies were considered eligible if they included children (≤18 years old) undergoing a painful medical procedure and compared parental presence and/or involvement with parental absence during the procedure. Results The children’s pain-related outcomes included self-reported pain intensity, self-reported fear, anxiety and distress, observed pain-related behavior, and physiological parameters. Overall, evidence points in the direction of beneficial effects of parental presence vs absence with regard to children’s self-reported pain intensity and physiological parameters, whereas mixed findings were recorded for children’s self-reported fears, anxiety and distress, and observed pain-related behaviors. Conclusions To provide clear recommendations on how to involve the parent during the procedure, as well as for which type of children and parents parental presence has the best effects, further research is needed, as indicated in this review.

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Parental behavior and child distress and pain during pediatric medical procedures: Systematic review and meta-analysis.

Health Psychology ◽

10.1037/hea0000864 ◽

2020 ◽

Vol 39 (7) ◽

pp. 558-572

Author(s):

Małgorzata Sobol-Kwapińska ◽

Marek Sobol ◽

Ewa Woźnica-Niesobska

Keyword(s):

Systematic Review ◽

Parental Behavior ◽

Meta Analysis ◽

Medical Procedures ◽

Child Distress

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Music for pain and anxiety in children undergoing medical procedures: A systematic review of randomized controlled trials

Acute Pain ◽

10.1016/j.acpain.2008.05.038 ◽

2008 ◽

Vol 10 (2) ◽

pp. 106 ◽

Cited By ~ 6

Author(s):

J.A. Klassen ◽

Y. Liang ◽

L. Tjosvold ◽

T.P. Klassen ◽

L. Hartling

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Controlled Trials ◽

Medical Procedures ◽

Randomized Controlled

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A Systematic Review of Interventions to Improve Healthcare Experiences and Access in Autism

Review Journal of Autism and Developmental Disorders ◽

10.1007/s40489-021-00279-2 ◽

2021 ◽

Author(s):

Chloe Walsh ◽

Paul O’Connor ◽

Ellen Walsh ◽

Sinéad Lydon

Keyword(s):

Systematic Review ◽

Morbidity And Mortality ◽

Future Research ◽

Medical Procedures ◽

Autistic Individual ◽

Healthcare Experiences ◽

Complete Detail ◽

Or Organization ◽

What Matters ◽

Research Studies

AbstractAutistic individuals report barriers to accessing and receiving healthcare, and experience increased morbidity and mortality. This systematic review synthesizes 31 research studies evaluating interventions implemented to improve the healthcare experiences and/or access of autistic persons. Interventions were most commonly patient-focused (58.1%), focused on supporting the autistic individual to engage with, tolerate, or anticipate medical procedures, care, or settings. Fewer studies were provider-focused (48.4%) or organization-focused (6.5%). Interventions were typically evaluated using measures of reactions (45.2%) or behavior (48.4%), and outcomes were predominantly positive (80.6%). Further research is imperative and should look to how providers and organizations must change. Future research must be inclusive of the autistic community, must measure what matters, and must offer complete detail on interventions implemented.

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The role of parental presence in the context of children's medical procedures: a systematic review

Child Care Health and Development ◽

10.1111/j.1365-2214.2004.00466.x ◽

2005 ◽

Vol 31 (2) ◽

pp. 233-243 ◽

Cited By ~ 78

Author(s):

T. Piira ◽

T. Sugiura ◽

G. D. Champion ◽

N. Donnelly ◽

A. S. J. Cole

Keyword(s):

Systematic Review ◽

Medical Procedures ◽

Parental Presence

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Analysis of child and parent behavior during painful medical procedures.

Health Psychology ◽

10.1037/0278-6133.9.5.559 ◽

1990 ◽

Vol 9 (5) ◽

pp. 559-576 ◽

Cited By ~ 84

Author(s):

Paul B. Jacobsen ◽

Sharon L. Manne ◽

Kenneth Gorfinkle ◽

Ora Schorr ◽

Bruce Rapkin ◽

...

Keyword(s):

Medical Procedures ◽

Parent Behavior ◽

Painful Medical Procedures

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Non-pharmacological approaches to procedural anxiety reduction for patients undergoing radiotherapy for cancer: systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-035155 ◽

2020 ◽

Vol 10 (10) ◽

pp. e035155

Author(s):

Erin Forbes ◽

Amanda L Baker ◽

Ben Britton ◽

Kerrie Clover ◽

Eliza Skelton ◽

...

Keyword(s):

Systematic Review ◽

Ethical Issues ◽

Affective State ◽

Anxiety Reduction ◽

Pharmacological Intervention ◽

Bibliographic Databases ◽

Cochrane Central Register ◽

Medical Procedure ◽

Medical Procedures ◽

Pharmacological Interventions

IntroductionProcedural anxiety relates to an affective state of anxiety or fear in relation to a medical procedure. Various treatment-related factors may elicit anxiety among oncology patients, including fear of diagnostic imaging (such as MRI scans) and impending treatment and medical procedures (such as chemotherapy and radiotherapy). It is common in oncology settings to manage acute anxiety relating to medical procedures with anxiolytic medication. However, pharmacological approaches are not suitable for many patients. Despite this, non-pharmacological interventions are infrequently used. The aim of this systematic review is to determine whether non-pharmacological interventions delivered prior to, or during, radiotherapy are effective in reducing procedural anxiety.Methods and analysisData sources will include the bibliographic databases CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled trials (CENTRAL) (from inception onward). Eligible studies will include adult patients with cancer undergoing radiotherapy treatment. Included studies will be those which employ a non-pharmacological intervention, delivered within existing radiotherapy appointments, with the aim of reducing procedural anxiety related to radiotherapy. All research designs with a control or other comparison group will be included. The primary outcome will be change in levels of self-reported procedural anxiety. Secondary outcomes will be changes in scores on physiological measures of anxiety and/or changes in treatment completion and/or changes in treatment duration and/or changes in psychological distress. Two investigators will independently complete title and abstract screening, full-text screening, data extraction and assessment of methodological quality. If appropriate, a meta-analyses will be performed. Any important amendments to this protocol will be updated in the PROSPERO registration and documented in the resulting review publication.Ethics and disseminationNo ethical issues are anticipated from this review. The findings will be disseminated through peer-reviewed publication and at conferences by presentation.Systematic review registrationCRD42019112941.

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Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

Paediatrics & Child Health ◽

10.1093/pch/pxz026 ◽

2019 ◽

Vol 24 (8) ◽

pp. 509-521

Author(s):

Evelyne D Trottier ◽

Marie-Joëlle Doré-Bergeron ◽

Laurel Chauvin-Kimoff ◽

Krista Baerg ◽

Samina Ali

Keyword(s):

Health Care ◽

Children And Youth ◽

Medical Procedures ◽

Pharmacological Agents ◽

Therapeutic Procedures ◽

Care Health ◽

Painful Medical Procedures ◽

Provider Experience ◽

Health Administrators ◽

Youth Friendly

Abstract Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies, improve education and access to guidelines, create child- and youth-friendly environments, ensure availability of appropriate staff, equipment and pharmacological agents, and perform quality audits to ensure pain management is optimal.

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