The Association of Parent Behaviors, Chronic Pain, and Psychological Problems With Venipuncture Distress in Infants: The Generation R Study

Objective: To examine the association of parent behavior with infant distress during a potentially painful medical procedure. A second aim was to investigate the association of parent chronic pain and psychological problems with parent behavior and infant distress during the procedure. Design: Population-based cohort study with both cross-sectional and prospective measurements. Main Outcome Measures: Video recordings of 275 parents and their 14-month-old infant undergoing venipuncture were coded with an observational instrument to yield measures of infant distress behaviors and parent behaviors, such as reassuring, showing empathy, praising, and distracting. Parent chronic pain and psychological problems were assessed through questionnaires. Results: Infants cried 58% of procedure duration. Parent reassuring occurred 34% of procedure duration, and parent distracting occurred 37% of procedure duration. Infant distress was positively related to parent reassuring and negatively related to parent praising. Parent chronic pain was related to increased parent distracting but not to parent reassuring. Parent psychological problems were not associated with parent behavior and infant distress. Conclusion: Parent behavior rather than psychological traits is related to increased venipuncture distress in young infants. This finding suggests that the focus should be on interventions based on behavior modification