Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents

Abstract

Objective: To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy.

Methods: 26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias.

Results: Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy.

Conclusions: Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved.

Keywords: distraction; distress; empirically supported treatments; hypnosis; needles; pain; randomized controlled trials.

© The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Figure 1.

PRISMA flowchart.

Figure 2.

Summary of risk of bias across all included distraction studies.

Figure 3.

Summary of risk of bias across all included hypnosis studies.

Figure 4.

Forest plot of studies examining distraction for self-reported pain.