title: Reassurance and distress behavior in preschool children undergoing dental preventive care procedures in a community setting: a multilevel observational study.
abstract: BACKGROUND
  The effect of reassurance in managing distress among children who receive procedures of a less aversive nature has not been fully investigated.
  
  
  OBJECTIVE
  This study aimed to investigate the relationship between reassurance by dental staff and distress behavior of preschool children receiving preventive procedures in a community setting.
  
  
  METHODS
  Nurse-child interactions (n = 270) during fluoride varnish application were video recorded and coded. Multilevel logistic regression modeled the probability of the occurrence of child distress behavior as a function of reassurance provision, controlling for child-level and nurse-level variables.
  
  
  RESULTS
  Child distress behavior was positively related to nurse verbal reassurance but negatively linked to the time that this reassurance occurred. Both child initial anxiety and nurse nonprocedural training increased the probability of observable distress behavior.
  
  
  CONCLUSIONS
  The use of verbal reassurance to promote reception of mild invasive procedures was counterindicated, especially when offered early in the intervention ( ClinicalTrials.gov number: NCT00881790).
authors: School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, Scotland, UK, yz10@st-andrews.ac.uk.
authors: Yuefang
authors: Y
authors: Zhou
authors: Gerry Michael
authors: GM
authors: Humphris
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003729:Dental Care / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D011322:Primary Prevention; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D013997:Time Factors; D014705:Verbal Behavior