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Journal of Pediatric Psychology Advance Access published online on March 28, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn030
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The Impact of Adult Behaviors and Vocalizations on Infant Distress during Immunizations

Ronald L. Blount, PhD1, Katie A. Devine, MS1, Patricia S. Cheng, PhD2, Laura E. Simons, PhD3 and Lisa Hayutin, PhD4

1University of Georgia, 2Duke Children's Primary Care, 3Children's Hospital Boston, and 4University of North Carolina Chapel Hill

All correspondence concerning this article should be addressed to Ronald L. Blount, PhD, Department of Psychology, University of Georgia, Athens, GA 30602-3013, USA. E-mail: rlblount{at}uga.edu


  Abstract

Objective The Child–Adult Medical Procedure Interaction Scale-Infant Version (CAMPIS-IV) was used to examine the influence of adult and infant behaviors on infant distress following injections. Methods In this naturalistic observation study, videotaped interactions of 49 infants, parents, and nurses were coded using the CAMPIS-IV. A series of three lag sequential analyses were used to examine the immediate and delayed effects of each of the CAMPIS-IV criterion behaviors, as well as the effects of the onset of each behavior, on infant distress. Results Strong support was found for beneficial effects of the infants playing with an object and sucking, and for adults’ belly-to-belly contact and nonprocedural talk to infant. Some benefit was found for bouncing, patting, and rocking the infant. Apologizing, empathizing, and reassuring the infant received no support, with some indication of detrimental effects. Conclusions The CAMPIS-IV was useful for identifying modifiable risk and protective factors for infants undergoing injections.

Key words: adult–infant interactions; immunizations; infant distress; procedural pain.

Received November 1, 2007; revision received February 29, 2008; accepted March 4, 2008


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