463 Passive Distraction is the Only Determinant of Pain During Venous Blood Sampling in School Children in An Outpatient Clinic Setting

Abstract

Introduction: Non-pharmacological interventions can be used to minimize discomfort, but data on the impact of non-pharmacological interventions on procedural pain in children are limited. We therefore evaluated the impact of distraction (TV watching) during elective venipuncture in children.

Methods: 58 children (6-12 years) were asked to document pain perception (VASc score, cm) during venipuncture. Parents (VASp) and nurses (VASn) were also asked to quantify procedural pain as perceived by them. In 31 cases, the child was stimulated to watch a movie chosen by the child (passive distraction group). Characteristics and VASc scores between groups were compared (unpaired) and risk factors for increased VASc score (> 4) were entered in a multiple logistic model, interrater agreement (kappa) was used to compare VASc with VASp and VASn.

Results: Median VASc was 2.2 (range 0-7.3), 11/58 children reported VASc >4 (2 in distraction group). Median VASc was lower in the distraction group (1.5 to 3.1, p < 0.001). Gender, age nor earlier blood sampling (last year) determined VASc. In a logistic regression model, passive distraction was the only protective factor (OR 7.25, 95% CI 1.4 to 37.4) to avoid VASc>4. Median VASp and VASn were 2.5 and 2. Although correlations with VASc were 0.74 and 0.53, kappa-scores were fair (0.23 and 0.31).

Conclusions: Although the median difference (1.5 vs 3.1) in VASc during distraction is limited, it does result in a significant decrease in VASc>4 observations. Interrater agreement was fair, confirming that hetero-evaluation of pain remains poor.

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