儿童和家长正念干预儿童静脉穿刺的随机对照试验研究方案

Rachel L. Moline, C. Chambers, C. McMurtry
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引用次数: 6

摘要

儿童通常会经历痛苦的针刺手术。未经处理的手术疼痛可能有短期和长期的后果,包括手术时间更长,未来手术时更大的痛苦,以及疫苗犹豫。虽然父母行为是儿童对急性疼痛反应的最强预测因素之一,但儿科程序性疼痛管理干预措施几乎完全关注儿童。此外,现有的父母参与的儿童疼痛管理干预措施通常不能改善儿童在疼痛过程中自我报告的疼痛。目前的方案提供了第一个随机对照试验,涉及正念干预儿科急性疼痛,包括儿童和他们的父母。本研究旨在进行一项单点、双组、平行组的随机对照试验,以检验在儿童静脉穿刺前,与对照组相比,正念干预对父母和儿童在初级(儿童自我报告疼痛和恐惧)、二级(父母自我报告和儿童报告父母痛苦)和三级结局(父母报告儿童疼痛和恐惧)方面的影响。将从麦克马斯特儿童医院门诊血液实验室招募父母-子女二人组(n = 150)。二人组将被随机分配到正念组进行正念干预,对照组进行非集中注意力任务。家长将陪同孩子进行静脉穿刺。将收集静脉穿刺后的措施(例如,由家长和儿童报告的儿童疼痛相关结果)。第一次登记发生在2019年10月。我们提供了一种新的干预措施,旨在促进父母和儿童应对儿童静脉穿刺。
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Study protocol for a randomized controlled trial of a child and parent mindfulness intervention for pediatric venipuncture
Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain management interventions focus almost exclusively on the child. Further, existing parent‐involved pediatric pain management interventions typically fail to improve child self‐reported pain during painful procedures. The current protocol offers the first randomized controlled trial involving a mindfulness intervention for pediatric acute pain that includes children and their parents. This study aims to conduct a single‐site, two‐arm, parallel‐group RCT to examine the effects of a mindfulness intervention for parents and children before child venipuncture compared to a control group on primary (child self‐report of pain and fear), secondary (parent self‐report and child report of parent distress), and tertiary outcomes (parent report of child pain and fear). Parent‐child dyads (n = 150) will be recruited from the McMaster Children's Hospital outpatient blood laboratory. Dyads will be randomly assigned to either a mindfulness group guided through a mindfulness intervention or control group guided through an unfocused attention task. Parents will accompany their child for their venipuncture. Postvenipuncture measures will be collected (eg, child pain‐related outcomes as reported by parents and children). The first enrollment occurred in October 2019. We offer a novel intervention that aims to facilitate both parent and child coping during child venipuncture.
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