Distraction-In-Action
70% of children have a fear of needles…
and for many, they never get over it! 26% of adults have refused immunizations due to their fear of needles. Healthy and normally developing children will undergo over 20 various immunizations before the age of 6 and additional 20 by the time they turn 18.
As part of a multidisciplinary research team from the University of Iowa, we developed the Distraction-in-Action Tool© (DAT) to help parents understand their child’s risk for distress during needle stick procedures and provide education and resources to help them be an effective distraction coach for their child. Young children experience many needle stick procedures (i.e. immunizations) as part of their routine health maintenance. Children with health problems require additional needle sticks related to diagnostic testing and disease treatment. Even non-invasive procedures and routine examinations can turn into distressing episodes after a child has a single bad experience. Children will routinely need to be seen by medical professionals and repeated exposure to stressful healthcare experiences can compound an already prevalent fear. Despite research to support interventions for needle sticks in children, it remains undertreated.
For the past 20 years, our team has conducted research investigating the most effective techniques for reducing children’s distress related to these medical procedures by training parents to coach their children in the use of distraction. The DAT© identifies the risks for distress (DistrEstimate©) of a child undergoing an IV insertion. In DAT© parent answers 16 questions and then hands the device to the child who answers 6 questions. The parent and child responses are used to generate a prediction - the DistrEstimate© - of the child’s level of distress for the upcoming procedure.
Additionally, the DAT© provides an evidence-based training video for parents on distraction coaching and suggests appropriate distraction strategies and instructions tailored to the individual child’s characteristics. Use of DAT© will decrease child pain, anxiety, and distress with painful procedures. Parents who use DAT© will increase their participation and enhance their decision making. Their increase awareness of individual child risk for distress helps to increase procedural success and appropriate allocation of personnel and pharmacological resources. Parents and clinicians use the DAT© to identify children at risk for distress with procedures and engage the parent in a conversation about how to handle the situation.
From left to right:
Ann Marie McCarthy, PhD, RN, FNASN, FAAN — Associate Dean for Research at The University of Iowa College of Nursing
Kirsten Hanrahan, DNP, ARNP, CPNP-PC — Director of Nursing Services at The University of Iowa Hospitals and Clinics
Charmaine Kleiber, PhD, RN, FAAN — Associate Professor Emeritus at The University of Iowa College of Nursing
Ben J. Miller, PhD — Alumnus of The University of Iowa College of Education