Clinical trial NCT06313788: Applying a Small Procedure Prior to Injection/Vaccination Reduces Pain Experiences in Child Patients
Official title: Applying a Small Procedure Prior to Injection/Vaccination Reduces Pain Experiences in Child Patients
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Pediatric Pain
Keywords: mere possession, placebo, analgesia, pain
Lead sponsor: Lingnan University
Sponsor class: OTHER
First posted: 2024-03-15
Enrollment: 100
Sex: ALL
Minimum age (years): 6
Maximum age (years): 11
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Pain is common among children. Given that children are not as mature and independent in assessing or treating their pain as adults, they are a relatively vulnerable group in terms of pain management and are in need of additional attention. However, there is still insufficient recognition and treatment of pain in children. Taken the procedure of injection/vaccination in children as an example, child patients usually wait for their turn to take the injection from the nurse/doctor, during which anxiety and fear of pain develop. As children are less able to manage their pain than adults, the fear they develop during the waiting time, together with the pain they actually felt after the treatment, can bring negative experiences to them. In this proposed project, the investigators aim to apply a minor procedure prior to a treatment that induces pain (e.g., injection / vaccination) to help managing pediatric pain.

Detailed description: In a series of experiments, Yeung and colleagues found that participants who merely possessed an object framed as having a particular function or benefit experienced an elevation of their self-efficacy in a corresponding domain. For example, participants who possessed reading materials regarded themselves as more knowledgeable. This is because people are inclined to associate themselves with the objects they possess, whose attributes are thus incorporated as part of the self. This mere possession effect also extends to the area of placebo analgesia.

Previous placebo analgesic research typically showed pain reduction after using a placebo analgesic. However, a newly emerged line of research demonstrated that sometimes, people who were merely given possession of a placebo analgesic, without using it, already reported better pain outcomes. This is presumably attributable to the mere possession of the object that enables them to believe they have already received the intended benefit of using it. In Yeung, Geers, and Colloca's study, they found that merely possessing a placebo analgesic yielded placebo analgesia similar to a situation where a placebo analgesic was actually used. The researchers claimed that this observed possession effect was due to the positive expectancy derived from owning a placebo analgesic, i.e., participants expected that the owned placebo analgesic could bring benefits to them.

The finding of the above-mentioned possession-based placebo analgesic effect is encouraging as it can inform healthcare practitioners and physicians about the possibility of tailoring, forming, or optimizing their medical intervention strategies to enhance positive pain outcomes and novel pain management. For instance, practitioners, clinicians, and dentists could consider tailoring their therapeutic interaction and treatment by incorporating an appropriate possession procedure to reduce undesired negative pain outcomes. In this proposed project, the investigators attempt to apply a possession procedure to child patients prior to their treatment that would induce pain.

The investigators hypothesize that acquiring the ownership of a first-aid bandage would contribute to pain alleviation by enhancing children's self-efficacy to cope with pain. The investigators expect that children who receive a first-aid bandage prior to injection would report a lower level of estimated pain (before injection) and lower real-time pain intensity and severity (during injection) than children who do not receive the first-aid bandage prior to the injection.

Eligibility criteria: Inclusion Criteria:

* Male or female paediatric patients (aged 6-11 years old) in good general health condition and requiring intramuscular injections
* Submission of signed and dated informed consent form (from paediatric patients and their parents)
* Commitment to comply and cooperate with the implementation of the study procedures

Exclusion Criteria:

* Visual-auditory or neurological deficits
* Allergies to first-aid bandages
* Having existing pain at the injection site

Primary outcomes:
measure: Pain intensity Rating (rating how much pain participants feel)
timeFrame: Before injection (5 minutes before injection), during injection (real time) and after injection (1 minute after injection)
measure: Pain intensity Measurement (measure how much pain participants feel)
timeFrame: Before injection (5 minutes before injection), during injection (real time) and after injection (1 minute after injection)
measure: Pain Threshold (record the first-time participants feel the pain)
timeFrame: During real time injection, participants will report the first pain sensation they feel (the investigators will record it in milliseconds). It will vary across participants.
measure: Pain unpleasantness (rating how unpleasant participants feel about the pain)
timeFrame: Before injection (5 minutes prior to injection) and after injection (1 minute after injection)
Secondary outcomes:
measure: Mood (rating the positive and negative emotions of the participants)
timeFrame: 1 minute after the manipulation of ownership status
measure: State-anxiety (Rating the participants' current anxiety level)
timeFrame: Baseline, after participants signed the consent form (order is randomized by the computer)
measure: Fear of pain Rating
timeFrame: Baseline, after participants signed the consent form (order is randomized by the computer)
measure: Magical thinking Rating
timeFrame: Baseline, after participants signed the consent form (order is randomized by the computer)
measure: Pain Self-Efficacy
timeFrame: 1 minute after participants completed the mood scale
measure: Self-efficacy to tackle pain
timeFrame: 1 minute after participants completed the Pain Self-Efficacy Questionnaire (PSEQ)
measure: Expectation of Pain Severity
timeFrame: 5 minutes prior to injection
Other outcomes:
Locations:
Study officials:
affiliation: Lingnan University
name: WAI LAN VICTORIA YEUNG, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Yeung, V. W. L., Loughnan, S., Kashima, Y., Lun, V. M. C., Yeung, S. S. (2017). When My Object Becomes Me: The Mere Ownership of an Object Elevates Domain Specific Self Efficacy. Applied Psychology, 66(4), 710 741. doi:10.1111/apps.12099
citation: Wai-Lan Yeung V, Geers AL, Colloca L. Merely Possessing a Placebo Analgesic Improves Analgesia Similar to Using the Placebo Analgesic. Ann Behav Med. 2020 Sep 1;54(9):637-652. doi: 10.1093/abm/kaaa007.
citation: Yeung, V. W. L., Chan, C. P., Yau, E. K., Lok, W. K., Lun, V. M. C., Chan, E. (2020). I own therefore I can: Efficacy based mere ownership effect. Journal of Experimental Social Psychology, 90, 104005. doi:10.1016/j.jesp.2020.104005
citation: Yeung VW, Geers AL. Prior Pain Exposure and Mere Possession of a Placebo Analgesic Predict Placebo Analgesia: Findings From a Randomized, Double-Blinded, Controlled Trial. J Pain. 2021 Apr;22(4):415-431. doi: 10.1016/j.jpain.2020.10.004. Epub 2020 Oct 27.
citation: Yeung VW. Temporal expectancy induced by the mere possession of a placebo analgesic affects placebo analgesia: preliminary findings from a randomized controlled trial. Sci Rep. 2022 Jan 26;12(1):1395. doi: 10.1038/s41598-022-05537-9.
citation: Beggan, J. K. (1992). On the social nature of nonsocial perception: The mere ownership effect. Journal of Personality and Social Psychology, 62(2), 229-237. https://doi.org/10.1037/0022-3514.62.2.229
citation: Nesselroade, K. P., Jr., Beggan, J. K., & Allison, S. T. (1999). Possession enhancement in an interpersonal context: An extension of the mere ownership effect. Psychology & Marketing, 16(1), 21-34. https://doi.org/10.1002/(SICI)1520-6793(199901)16:1<21::AID-MAR2>3.0.CO;2-9
citation: Laurent, J., Catanzaro, S. J., Joiner, T. E., Jr., Rudolph, K. D., Potter, K. I., Lambert, S., Osborne, L., & Gathright, T. (1999). A measure of positive and negative affect for children: Scale development and preliminary validation. Psychological Assessment, 11(3), 326-338. https://doi.org/10.1037/1040-3590.11.3.326
citation: Nicholas MK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain. 2007 Feb;11(2):153-63. doi: 10.1016/j.ejpain.2005.12.008. Epub 2006 Jan 30.
citation: Apell, J., Paradi, R., Kokinsky, E., & Nilsson, S. (2011). Measurement of children's anxiety during examination or treatment in hospital--a study evaluating the short-STAI/Matning av barns oro vid undersokning 45 eller behandling pa sjukhus--en studie som utvarderar short STAI. Nursing Science & Research in the Nordic Countries, 31(1), 45+. https://link.gale.com/apps/doc/A273786636/HRCA?u=anon~691011a5&sid=googleScholar&xid=05fcdcaa
citation: Vambheim SM, Lyby PS, Aslaksen PM, Flaten MA, Asli O, Martinussen LM. The Fear of Pain Questionnaire-III and the Fear of Pain Questionnaire-Short Form: a confirmatory factor analysis. J Pain Res. 2017 Aug 8;10:1871-1878. doi: 10.2147/JPR.S133032. eCollection 2017.
citation: Kingdon BL, Egan SJ, Rees CS. The Illusory Beliefs Inventory: a new measure of magical thinking and its relationship with obsessive compulsive disorder. Behav Cogn Psychother. 2012 Jan;40(1):39-53. doi: 10.1017/S1352465811000245. Epub 2011 May 16.
citation: Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011 Oct;152(10):2399-2404. doi: 10.1016/j.pain.2011.07.005.
citation: Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001 Aug;93(2):173-183. doi: 10.1016/S0304-3959(01)00314-1.
citation: Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983 Sep;17(1):45-56. doi: 10.1016/0304-3959(83)90126-4.
citation: Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987 Aug;30(2):191-197. doi: 10.1016/0304-3959(87)91074-8.
citation: Hanssen MM, Peters ML, Vlaeyen JWS, Meevissen YMC, Vancleef LMG. Optimism lowers pain: evidence of the causal status and underlying mechanisms. Pain. 2013 Jan;154(1):53-58. doi: 10.1016/j.pain.2012.08.006. Epub 2012 Oct 18.