Correlates of school-age children\u27s pain-related responses to venipunctures

The purpose of this study was to describe the relationship between children\u27s age, gender, exposure to past painful experiences, temperament, fears, and child-rearing practices on their pain responses to a venipuncture. Guided by the Roy Adaptation Model of Nursing, the relationship between the focal stimulus, a venipuncture, the contextual stimuli, and children\u27s subjective, behavioral and physiological responses were explored through multiple regressions and a canonical correlation. The sample consisted of 94 children, aged 8 to 12 years, undergoing venipunctures and their female caregivers. All subjects were recruited from the outpatient clinics of a large American pediatric hospital. Data collection took place during clinic visits. During the venipuncture, children\u27s behavioral and heart rate responses were monitored. Following the procedure, children\u27s subjective responses were obtained. Of the initial variables, only age, distractibility, threshold, medical fears, pain quality, behavioral responses, and magnitude of heart rate change were retained for the main statistical analyses. Multiple regressions revealed that threshold was the single predictor of pain quality. Age alone explained behavioral responses. Distractibility accounted for the variance in heart rate magnitude. A canonical correlation revealed that all four independent variables explained only 5.7 percent of the variance in pain quality and heart rate magnitude. Significant correlations were found between pain intensity, quality, behavioral responses and magnitude in heart rate change. Analyses of variance revealed no significant relationship between age, gender, and the following dependent variables: pain intensity, quality, and heart rate responses. However girls cried significantly more than boys. Past experiences, child-rearing practices, children\u27s health problems, family income, and children\u27s race were not related to children\u27s pain responses. The findings revealed that for 20 percent of the sample, venipunctures were very painful procedures. Age, threshold, and distractibility were found to be important variables in explaining children\u27s pain responses. The relationship between children\u27s subjective, behavioral, and physiological responses confirmed the multidimensionality of pain. Partial support was provided for the use of Roy\u27s Model. Though further research is warranted, current pain management interventions should consider the multidimensionality of pain and children\u27s age and temperament