title: Needle anxiety in children with type 1 diabetes and their mothers.
abstract: OBJECTIVE
  To report the prevalence of fear, distress, pain, and level of cooperation with insulin injections and blood glucose fingersticks in children with newly diagnosed diabetes and their mothers, and the association with diabetes control.
  
  
  METHODS
  Forty-six subjects (23 children and mother pairs) completed the Perceptions of Insulin Shots and Fingersticks Survey at diagnosis and 6 to 9 months later. Standard descriptive statistics, Fisher's exact tests, and Spearman correlation coefficients were used to analyze the data. Scores were analyzed for associations with age and hemoglobin A1c as a marker of diabetes control.
  
  
  RESULTS
  More young children as compared to older subjects reported fear and pain with injections and fingersticks. A high percentage of mothers reported high fear and distress with needles at diagnosis. Although most improve, 13.6% of mothers continued to report high fear and distress 6 to 9 months later. Mothers' continued report of high distress correlated with the poor cooperation of children, which correlated with poorer diabetes control.
  
  
  CONCLUSIONS
  Nurses should incorporate assessment and intervention for needle anxiety in children and parents at diagnosis of diabetes through informal interview or formal survey. Nurses can effectively incorporate coping strategies into their teaching of parents and children to administer injections and fingersticks.
authors.affiliation: The Diabetes Center for Children, Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. howe@email.chop.edu
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Howe
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Alan
authors.initials: A
authors.lastname: Tuttle
authors.forename: Shayne
authors.initials: S
authors.lastname: Dougherty
authors.forename: Terri H
authors.initials: TH
authors.lastname: Lipman
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D016389:Maternal-Child Nursing / Q000379:methods*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009339:Needles / Q000009:adverse effects*; D024802:Nurse's Role; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011795:Surveys and Questionnaires