25594 Reduction of Immunization-Related Pain and Crying with Use of Distraction Method and Topical Vapocoolant Spray

Tuesday, March 29, 2011
Columbia Hall
Karlen Luthy, DNP, FNP , Assistant Professor, Brigham Young University
Amy Pulsipher, SN , Registered Nurse-Student, Brigham Young University

Background: Because the child’s pain/crying/anxiety is recognized as a common reason why parents hesitate in immunizing their children, it may be helpful to identify ways to reduce a child’s pain/anxiety during immunization. If the use of distraction (using a DVD movie) or a local anesthetic spray successfully reduces the child’s pain, it may also reduce the child’s anxiety and crying during future immunizations, thus encouraging parents to return for the next immunization in a timelier manner

Objectives: To determine the effectiveness of using a distraction method (DVD) or vapocoolant spray to reduce a child’s pain/anxiety associated with immunization administration.

Methods: The researchers obtained IRB approval. A convenience sample of subjects (ages 2-12) participated in the 120 day study at a local pediatrician office. Subjects were randomized into three groups: a control group, a distraction method group, and a vapocoolant group. Following immunization the parent/guardian evaluated the intervention, describing their child’s pain and anxiety during the current immunization using the Wong-Baker FACES Pain Rating Scale and a Likert Scale.

Results: Sixty-seven children participated in the study. Statistically, the reduction of pain was not significantly different between the distraction group (DVD), control group, and vapocoolant group. However, clinically the distraction method (DVD) was more effective with younger children and the vapocoolant spray was more effective with older children.

Conclusions: While distraction with a DVD movie may relieve some immunization-related pain with younger children, and use of a vapocoolant spray may relieve some immunization-related pain with older children, neither of these methods are significantly more effective in reducing a child’s pain during immunization than no intervention at all. Still, attempting to reduce a child’s pain and anxiety during the immunization process is a worthy goal that warrants further research.