Evid Based Nurs 13:15-16 doi:10.1136/ebn1014
  • Therapeutics
  • Randomised controlled trial

A multifaceted distraction intervention may reduce pain and discomfort in children 4–6 years of age receiving immunisation

  1. Lindsey L Cohen
  1. Lindsey L Cohen
    Department of Psychology, Georgia State University, Atlanta, GA 30302-5010, USA; llcohen{at}

Commentary on:

Children experience frequent pain with regular healthcare (eg, immunisations), and evidence suggests that there are a host of negative repercussions for untreated pain. Berberich and Landman evaluated an innovative intervention to minimise children’s pain. They combined ethyl chloride, a plastic “multipronged gripper” similar to the ShotBlocker (Bionix, Toledo, Ohio, USA), vibration and a game with the child guessing when the vibrating instrument reached the elbow. The authors refer to this as a “multifaceted distraction” (p. e203) and compared it with routine care for preschoolers’ immunisation injections. Twenty children were randomised to the intervention group and 21 to the control group. Patient self-report, parent report and observational behavioural coding indicated that the intervention resulted in lower paediatric patient distress than in the control group (p < 0.001).

In general, this …

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