title: A prospective randomised control study: reduction of children's pain expectation using a picture book during blood withdrawal.
abstract: OBJECTIVE
  Blood drawings are very painful and stressful for children. In a prospective control group study we investigated if using a picture book could reduce the children's pain expectation. In addition, the children's pain experience and the observed pain behaviour was monitored.
  
  
  METHODS
  Block-randomization were used and 120 children at the age of 6-12 years who were visiting the general pediatric and coagulation outpatient clinics were included in this study. Pain expectation and experience were assessed with the Face-Pain-Scale-Revised and the pain behavior with the Faces-Legs-Activity-Cry-Consolability Scale. Multivariate covariance analysis was used for data analysis.
  
  
  RESULTS
  The results showed that with statistical controlling the influence of the primary pain expectation (baseline) the pain expectation before blood withdrawal was reduced significantly (p=0.001) and effectively (ES=0.56) using the picture book. Children who received no local anaesthesia reported that they felt less pain during blood drawing after reading the picture book. The few children with local anaesthesia reported no benefit from the picture book. The observed use of local anaesthesia was very heterogeneous.
  
  
  CONCLUSIONS
  The results recommend the usage of this picture book in everyday practice, if the use of local anaesthesia could not be used in an appropriate way.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany. barbara.zieger@uniklinikfreiburg.de
authors.forename: B
authors.initials: B
authors.lastname: Zieger
authors.forename: M
authors.initials: M
authors.lastname: Praskova
authors.forename: E
authors.initials: E
authors.lastname: Busse
authors.forename: M
authors.initials: M
authors.lastname: Barth
mesh_terms: D059787:Acute Pain / Q000517:prevention & control* / Q000523:psychology*; D000772:Anesthesia, Local; D001638:Bibliotherapy / Q000379:methods*; D001800:Blood Specimen Collection / Q000523:psychology*; D002648:Child; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D012718:Set, Psychology