Psychological Interventions for Needle-related Procedural Pain and Distress in Children and Adolescents

This week, as part of the Child Health Emergency Medicine Social Media Campaign, we are highlighting a Cochrane summary on psychological interventions for needle-related procedural pain and distress in children and adolescents. This review was selected for the TREKK Evidence Repository on procedural pain.

Key Messages:


Related TREKK Resources:

Cochrane Summary:

Psychological interventions for needle-related procedural pain and distress in children and adolescents

Psychological interventions (for example, distraction, hypnosis, coping skills training) are treatments used to reduce pain and distress (anxiety and fear, or both) that children and adolescents experience while undergoing medical procedures involving needles. There is strong evidence that distraction and hypnosis are effective in reducing the pain and distress that children and adolescents experience during needle procedures. Distraction techniques can often be quite simple, such as reading the child stories, watching television, listening to music, or talking about something other than the needle. Sometimes parents or nurses are involved in helping to distract the child, although that is not always necessary. Interventions such as hypnosis may require some teaching by a trained professional for a child to learn. Other psychological treatments, such as explaining what is going to happen before or during the procedure (labelled ‘providing information or preparation or both’), using virtual reality (for example, interactive video equipment, goggles, computers showing images, games, stories), or a combination of various strategies have been tested. More research is needed to know whether they are effective for reducing children’s pain and distress during needles.

Authors’ Conclusions:

Overall, there is strong evidence supporting the efficacy of distraction and hypnosis for needle-related pain and distress in children and adolescents, with no evidence currently available for preparation and information or both, combined cognitive behavioural therapy (CBT), parent coaching plus distraction, suggestion, or virtual reality. Additional research is needed to further assess interventions that have only been investigated in one randomized controlled trial (RCT) to date (that is, memory alteration, parent positioning plus distraction, blowing out air, and distraction plus suggestion). There are continuing issues with the quality of trials examining psychological interventions for needle-related pain and distress.

Check Out the Full Cochrane Systematic Review Below:

Uman, L.S., Birnie, K.A., Noel, M., Parker, J.A., Chambers, C.T., McGrath, P.J., Kisely, S.R. (2013). Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev, 10, CD005179. doi: 10.1002/14651858.CD005179.pub3


This post is part of a weekly blog series highlighting pediatric emergency medicine (PEM) focused Cochrane summaries and other key resources selected by TREKK.

Published by arrangement with John Wiley & Sons.