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Brief Clinical Report: A Systematic Review and Meta‐analysis of Pain Memory‐reframing Interventions for Children's Needle Procedures
Author(s) -
Noel Melanie,
McMurtry C. Meghan,
Pavlova Maria,
Taddio Anna
Publication year - 2018
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12572
Subject(s) - cognitive reframing , psychological intervention , medicine , distress , randomized controlled trial , intervention (counseling) , meta analysis , grading (engineering) , clinical psychology , psychiatry , psychotherapist , psychology , surgery , civil engineering , engineering
Objective Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and improving subsequent pain experience; however, this evidence has not been synthesized. This brief clinical report includes a systematic review and meta‐analysis of existing memory‐reframing interventions for needle procedures in children and adolescents to stimulate future research. Methods Database searches identified relevant randomized and quasi‐randomized controlled trials. Data were extracted and pooled using Grading of Recommendations, Assessment, Development and Evaluation ( GRADE ) and Cochrane methodologies. Critically important outcomes included fear during a subsequent needle procedure; important outcomes included memory of fear and pain following the needle procedure and pain and distress during a subsequent needle procedure. Results Three studies including 158 children 3 to 18 years of age were identified. The quality of evidence was low to very low. There was no benefit for the critically important outcome of anticipatory fear; however, the test for overall effect trended toward significance ( P = 0.07). Memory‐reframing interventions were efficacious in altering children's memories of needle procedures to be less distressing. No benefit was found for acute fear or anticipatory, acute, or overall distress. Conclusions There are limited data suggesting that interventions that reframe children's memories of needle procedures hold promise for altering pain memories and potentially reducing anticipatory fear. High‐quality intervention development work is needed to determine how these interventions can be adapted to the developing child in order to lead to lasting reductions in pain, fear, and distress at future needle procedures.