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Journal of Pediatric Psychology Advance Access first published online on April 2, 2008
This version published online on July 30, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn031
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 Published by Oxford University Press on behalf of the Society of Pediatric Psychology 2008.

A Systematic Review of Randomized Controlled Trials Examining Psychological Interventions for Needle-related Procedural Pain and Distress in Children and Adolescents: An Abbreviated Cochrane Review*

Lindsay S. Uman1,2, Christine T. Chambers1,2,3, Patrick J. McGrath1,2,3,4 and Stephen Kisely4,5,6

1Department of Psychology, Dalhousie University, 2IWK Health Centre, 3Department of Pediatrics, 4Department of Psychiatry, 5Department of Community Health & Epidemiology, Dalhousie University, and 6School of Medicine, Griffith University, Australia

All correspondence concerning this article should be addressed to Lindsay S. Uman, Department of Psychology, Dalhousie University, Life Sciences Centre, Halifax, Nova Scotia, B3H 4J1. E-mail: luman{at}dal.ca


  Abstract

Objective To report the results of a systematic review of randomized controlled trials (RCTs) of psychological interventions for children and adolescents undergoing needle-related procedures. Methods A variety of cognitive-behavioral psychological interventions for managing procedural pain and distress in children and adolescents between 2 and 19 years of age were examined. Outcome measures included pain and distress as assessed by self-report, observer report, behavioral/observational measures, and physiological correlates. Results Twenty-eight trials met the criteria for inclusion in the review and provided the data necessary for pooling the results. Together, the trials included 1,039 participants in treatment conditions and 951 in control conditions. The largest effect sizes for treatment improvement over control conditions were found for distraction, combined cognitive-behavioral interventions, and hypnosis, with promising but limited evidence for several other psychological interventions. Conclusions Recommendations for conducting future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted.

Key words: adolescents; children; procedural pain; psychological interventions; systematic review.


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