Distraction for Reduction of Pain Associated With Venipuncture in the Pediatric Post-Transplant Population
Condition: Pain, Procedural; Distress, Procedural; Venipuncture
MeSH terms: Pain, Procedural
Study type: Interventional

Summary: 
      Children with chronic diseases, particularly those who have received transplantation (e.g.
      cardiac, renal, or liver) are a population who undergo frequent painful procedures, such as
      venipuncture multiple times per week. There is currently no standard of care for pain
      reduction during venipuncture for pediatric patients having blood drawn in phlebotomy as an
      outpatient. The study aims to determine the efficacy of distraction in reducing procedural
      pain and distress associated with venipuncture in pediatric post-transplant patients.
    

Detailed description: 
      Children with chronic illnesses experience frequent painful experiences over extended periods
      of time, and may develop long-term physiological, psychological and behavioral sequelae
      including increased sensitivity to pain and higher levels of anxiety before painful
      procedures. There is strong evidence to show that distraction is effective in reducing
      children's pain and distress during painful procedures. However, the evidence to support
      distraction, as well as other methods of pain reduction during venipuncture (i.e. vibration,
      topical anesthetics, sucrose), has primarily focused on children who are previously well, as
      those with chronic disease are an understudied population with regards to pain reduction
      during simple procedures. Children with chronic disease or pathology, particularly those who
      have received transplantation (e.g. cardiac, renal, liver), are a population who undergo
      frequent painful procedures, such as venipuncture multiple times per week. There is currently
      no standard of care for pain reduction during venipuncture for pediatric patients having
      blood drawn in phlebotomy or in the transplant clinics as an outpatient.

      The investigators will conduct a randomized control trial comparing two groups: Distraction
      versus standard of care (i.e. no distraction). The intervention (distraction) will be
      administered using an iPad and allowing the child to self-select a developmentally
      appropriate distraction (e.g. game, movie, music). Participants will be videotaped for
      approximately 1 minute, starting from the time of the venipuncture. This video will be viewed
      at a later date by two trained study investigators to assess the patient's pain and distress
      associated with venipuncture, as measured by the OSBD-r, CHEOPS, and FLACC.
    

Intervention name(s): Distraction
Intervention type(s): Other
Intervention description(s): Distraction will be provided by allowing the patient to will choose an age appropriate application (e.g. movie, game) which will be held for them during the blood draw.
Other intervention name(s): iPad
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Phlebotomy; Pain; Distress