Investigating Reassurance and its Effect on Child Pain and Distress

Both healthy and ill children frequently undergo needle procedures. The behaviour of caregivers during these procedures significantly influences the amount of pain and distress the child experiences. Reassurance (e.g. ¿you¿re okay¿) is the most common child-directed verbalization by adults and has been counter-intuitively but consistently associated with child distress. The negative impact of reassurance could arise from the content of the verbalizations or the manner in which they are spoken. The objective of the proposed study is to determine the effect of tone of voice and different types of reassurance on child pain and distress. The participants will be healthy children between the ages of 8 and 10 years. The participants will undergo a commonly used, lab-based manipulation of mild to moderate pain in which the arm is submerged in cold water (10 degrees Celcius). A trained actor will reassure the children in four different ways that manipulate tone and type of reassurance. The Child Adult Medical Procedure Interaction Scale ¿ Revised will be used to code the adult-child interactions and child distress. Pain intensity will be measured via child-self report on the Faces Pain Scale ¿ Revised (FPS-R) which shows faces ranging from ¿no pain¿ to ¿extremely painful¿. Pain tolerance will be defined as the length of time the child keeps his or her arm in the water. Children will also rate the four types of reassurance from most to least helpful. The proposed study will demonstrate how tone of voice and type of reassurance influence child pain and distress and provide insight into why reassurance has been linked with child distress. Results from studies such as these are important to help guide caregiver behaviour during painful medical procedures to improve child coping and reduce child pain and distress.