Mitigating procedural XXXX during venipuncture in a pediatric population: A randomized factorial study.

@entity1 @entity158
BACKGROUND: Evidence suggests that a significant number of @entity1 receive less than optimal management of procedure-related @entity158 . OBJECTIVES: To determine if there was a difference in the perceived @entity158 associated with a venipuncture procedure in a group of pediatric @entity1 based on the preparatory intervention used during the procedure and, to determine if age, sex, or ethnic group were associated with the effectiveness of the preparatory interventions used. DESIGN: A quasi-experimental, 3*4 factorial design was used. SETTING: @entity1 were recruited from a non-profit, regional hospital in the southeast United States. @entity1 : @entity1 were recruited from @entity1 between the ages of 18 months and 17 years who were admitted to the facility. Criteria for inclusion was the first needle stick during admission with a parent or guardian present, English as the primary language. Potential @entity1 were excluded if they had previous experience with any of the preparatory interventions, were sedated, unconscious, hemodynamically unstable, developmentally delayed for their age, or had a known chronic condition. Of the 285 @entity1 consented to participate, 173 @entity1 completed the process including 35 (20.2%) toddlers, 34(19.7%) preschool and 65 (37.6%) school age @entity1 , and 39 (22.5%) adolescents. There were 77 (44.5%) females and 96 (55.5%) males; and 101 (58.4%) non-Hispanic white @entity1 and 72 (41.6%) minority @entity1 . METHODS: @entity1 were randomized to one of three treatment interventions. There was a purposeful effort to include representative numbers of each age group, ethnic group, and sex and in each treatment group. Measures of @entity158 before and after the procedure included an observational measure completed by the parent/guardian and a self-report measure completed by the two older age groups. FINDINGS: There were no statistically significant differences among treatment groups based on the observational measures of @entity158 or the self-report measures of @entity158 . There was a statistically significant interaction between ethnic group and treatment group (p=0.006) based on the observational measure of @entity158 which was also found between ethnic group and treatment group (p=.04) based on self-report scores in school age @entity1 and adolescents. CONCLUSION: Findings support the use of both mechanical vibration and topical anesthetic as effective in @entity1 regardless of age group or sex. Further, the interaction between ethnic group and treatment contributes to a growing body of knowledge that suggests ethnic group is an important factor in the @entity158 response and requires further study in an effort to better customize approaches to @entity158 management in @entity1 .
