A Comparison of Distraction Strategies for Venipuncture Distress in Children
Jill E. MacLaren,1 MA, and Lindsey L. Cohen,2 PHD
1

West Virginia University and 2Georgia State University

Objective To compare the effects of two pediatric venipuncture distress-management distraction strategies that differed in the degree to which they required children's interaction. Methods Eighty-eight 1- to 7-year-old children receiving venipuncture were randomly assigned to one of three treatment conditions: interactive toy distraction, passive movie distraction, or standard care. Distress was examined via parent, nurse, self-report (children over 4 years), and observational coding. Engagement in distraction was assessed via observational coding. Results Children in the passive condition were more distracted and less distressed than children in the interactive condition. Although children in the interactive condition were more distracted than standard care children, there were no differences in distress between these groups. Conclusions Despite literature that suggests that interactive distraction should lower distress more than passive distraction, results indicate that a passive strategy might be most effective for children's venipuncture. It is possible that children's distress interfered with their ability to interact with the distractor.

Key words

distraction; pain; distress; venipuncture; intervention.

Given that children exhibit and report high levels of distress during painful medical procedures, the development and evaluation of interventions in this area is an important endeavor (Jacobsen et al., 2001). This is particularly true for younger children, who tend to display higher distress than older children (Carlson, Broome, & Vessey, 2000). The distress resulting from medical procedures, if untreated, can lead to negative experiences and, in turn, to more anxiety and distress during subsequent procedures (Bijttebier & Vertommen, 1998). Further, early painful procedures