| Summary |
This study examined the impact of parental behaviors and anxiety on children's procedural coping behaviors, pain, and distress during venipuncture in a pediatric sickle cell disease (SCD) population. The first specific aim was to examine the influence of parental behaviors on child coping behaviors. The second specific aim was to examine the influence of parental behaviors and child coping on child distress and pain. Thirty children ages 3-8 years old and their female parents/guardians were recruited from a regional pediatric SCD clinic. The average age of pediatric participants was 5.43 years and the average age of parent/guardian participants was 30.83 years. Parents/guardians reported on demographic and disease-related information as well as their pre-procedural state anxiety. The venipuncture procedure was video-recorded and coded for the following behaviors: child coping, child distress, parent coping-promoting, and parent distress-promoting. Parents, children, and staff also gave a pain rating for the child following the procedure. Results indicated that, overall, frequency of parental behaviors was very low. Parental behaviors and anxiety were not related to child coping behaviors. Parental behaviors were also not significantly related to child distress, child-reported pain, or parent reported-pain. However, parent distress-promoting behaviors significantly predicted staff-reported pain. Notably, more child coping behaviors were predictive of less parent-reported pain and less child distress behaviors. Future research should be conducted to determine the effects of high frequency parental behaviors on child distress, coping, and pain in this population. Additional research is also needed to elucidate the impact of staff, non-maternal caregivers, and other family members on the procedural pain experiences of pediatric SCD patients. Intervention development in this population should do more to include parents and other family members and to establish efficacy of other procedural pain interventions within SCD. Clinical implications include the need to increase children's knowledge and use of pain coping skills in SCD. Additionally, the venipuncture experience may prove to be a platform for practicing pain coping skills in hopes that these skills may also generalize to disease-related pain. This would give clinicians the opportunity to train parents and children on pain coping and give real-time feedback while they are practicing in clinic. Future research is needed to determine the effectiveness of such an intervention. |
